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Much like education, we spend increasing amounts on health care with worse results. Life expectancy continues to grow, but that has more to do with the development of specialized medications and procedures rather than where much of the money goes.
In trying to make the case against the big congressional spending bill and Medicaid reductions, the New York Times unintentionally touches on the problem.
“For years, the United States labor market has been undergoing a structural transformation. As jobs in manufacturing have receded, slowly but steadily, the health care industry has more than replaced them.”
The change has been particularly visible over the past year, during which health care has been responsible for about a third of all employment growth, while other categories, like retail and manufacturing, have stayed essentially flat.
But where manufacturing actually produced things of use, many of those ‘health care’ jobs are bloat. Where manufacturing added value to the private sector, much of this is funded by the public sector. And the bloat is eating our economy alive “going from 9 percent of the total workforce in 2000 to 13 percent today.”
“As much as politicians may focus on factory jobs, long idealized as the kind of work that could support a comfortable life for people without advanced degrees, health care is now playing that role for more people. The field has seen much faster wage growth than non-health care occupations. Unlike in the broader economy, average pay increases have moved particularly quickly for middle-skilled roles such as nurses and physician’s assistants, while salaries for doctors have increased only moderately in percentage terms.”
In short, we’ve replaced factory jobs with SEIU jobs for all sorts of people who scamper around hospitals and offices while contributing next to nothing to health care outcomes. There are multiple tiers of nurses (all in Democrat unions and donating to their candidates), assistants and (which the New York Times) doesn’t mention, administrators, who account for something like a third of all health care spending.
Doctors are now struggling to make the economics work.
Is this good for patient health care outcomes? You tell me. It’s certainly good for ensuring that you fill in the same paperwork three times, for ensuring that before you see a doctor, you have to be condescended to or insulted by three SEIU members who can barely read and write, but have grandiose titles and salaries.
Factory workers are being replaced by immigrants who got through a program and now have a title and are a drain on the system.
The plan is to continue shifting patient care away from doctors and to union members who will shortly just ask the medical version of ChatGPT what to do. Which really means that they’re at best are getting paid $82,000 a year to follow AI directions. And if AI gets it wrong, bad things happen. With AI, we have coders who don’t know how to code, writers who don’t know how to write and soon ‘medical professionals’ who won’t be able to find your pulse without following the guidelines on the screen.
But they’ll also make 15% and then 20% of the economy unless we have an actual recovery.
I certainly agree there is plenty of administrative bloat in healthcare, but worse, there is plenty of outright fraud. For example the gimmick where some states tax doctors and hospitals, then reimburse them with Medicaid payments paid for mostly by the federal government, and pocket the net for state spending on other things. Hopefully the BBB will address this technically-legal financial fraud by blue states.
BUT – I strongly disagree with your take on medical assistants. Lately I’m getting most of my primary care from a physician’s assistant who is extremely knowledgeable, always available, and energetically engaged. He knows when to consult the doctor and when to expeditiously adjust prescriptions or set up appointments with specialists. He’s saving our health system tons of money because a high-paid doctor is not required to waste his time handling my basic questions and issues. And I don’t have to wait weeks for an appointment to open up with my doctor, I’m getting seen within a day or two of contact, sometimes on the same day I call.
Unless you have an illness his 4 semesters ( as opposed to 4-8 or even
More YEARS for the actual physician ) cannot accurately diagnose. Then, it can be curtains for you. Assistants are fine in some roles. But I always opt for the MD.
I am Glad you are happy, BTW. Good luck to you.
I’ve known a few good lawyers.
That doesn’t mean they’re all good. Most are scum.
See what I’m getting at?
Someone once said: “If you think healthcare is expensive now, wait until it’s free.” And of course we all know that dems (and RINOs) want free healthcare.
The insurance and healthcare industry pigs have an insatiable appetite for tax payers dollars and politicians love feeding the pigs because they get financial kickbacks for steering tax payers dollars into those industries.
Heads they win, tails we the tax payers lose. That’s just the way it was, is and will always be and there’s nothing we the people can do about it.
I was a x-ray tech and to make myself more valuable I became a medical assistant. Now I am a self made millionaire a couple times over and still growing exponentially – I think the Great Big Beautiful Bill that was signed by Speaker Mike Johnson and headed to the Resolute Desk in the Oval Office for President Trump to sign has some changes in how we get our treatment from medical professionals and insurance.
Medical assistant, huh? The ones at my GP’s office are nice.
I remember the ones at the big hospitals I used to work in were usually as bad as the nurses in those places. I guess it just depends where you’re at. I can’t imagine you being incompetent or a bad guy. I’ve met a lot of bad people in my life, though.
The solution is simple. This is not sustainable and the system will collapse.
The system collapsing is what the dems hope and pray for. Why? Because they think socialism is the answer. It isn’t. Socialized healthcare works as long as you don’t get sick and need it.
A perplexing conundrum of great practical significance. Worries me daily.
I figure I’ll just die and future generations will have to worry about it.
I read your articles daily and value your insights. You are spot on. With respect to physician assistants, I would like to clarify their role in medicine. I’m a physician assistant not a physician’s assistant. I went to school with doctors, took many of the same classes, and did most of the clinical rotations they did. PA’s get about 85% of the didactic education and at least 70% of the clinical hours. We are highly skilled and trained in medicine. My first job was doing cardiothoracic surgery where I made 85K/year and worked 110 hours/wk. I looked at it as a residency where learning was far more important than money. Since then, I have never made less than 180K/yr and up to 220K/yr. I mention the pay because it reflects both my skills and value to the medical practice. I spent many nights sleeping (but not much) in hospitals for days at a time taking surgical call for the entire hospital and ER when the doctors needed an opinion on whether or not a patient needed surgical intervention while during the day running the surgical intensive care unit. Medical assistants assist doctors and, for that matter, PAs. I agree that a significant percentage of nursing is simply administrative and could be done by non-nursing and paid significantly less. There is too much redundancy in paperwork, etc. Electronic Medical Records are, for the most part, far too labor intensive. There is a lot of fluff where people do little and get paid too much. In hospitals, especially in the VA system and state systems like UCLA where I worked for a while. Moreover, I have worked in multiple specialties. I have done general and vascular surgery, interventional radiology, critical care/pulmonology, dermatology, and urgent care. I’m routinely asked my opinions by doctors on ECG tracings, surgical options and to interpret, chest X-rays, MRI’s, CT scans, and PET-CTs as well as serious skin conditions that are indicative of serious underlying diseases. I have a much broader understanding of diseases because I view them from multiple perspectives. Many PA’s have training in several specialties which makes them able to integrate and understand the patient’s condition and implement a sound treatment plan.
Thank you for sharing your experience
Healthcare is much worse than it was before Obama care. It’s worse for
Patients and doctors and other professionals. Reimbursement is regulated by lawyers in Congress who do not regulate themselves or law practice, of course. Most doctors have had to join big corporations Patients get corporate type treatment (try getting an appointment or even calling your doctor on the phone!).
Those too young to remember better days accommodate to this. Someone is making a lot of money but it is not the doctors. There is a huge layer of administrators now. And less trained assistants provide much of the care.
Yes, like so called education. The administrators there make 80% of the lucre, teachers make about 8 and the students have a measly 2 wasted on them, not that money educates students. CA ranks 48th in education nationally despite spending FAR more money on “education” than any other state.