My post yesterday about the impact of health reform on employment generated an email from NFIB’s Bob Graboyes correcting an error in attribution (thanks Bob). It also got me to dig deeper into the issue of employment and reform – specifically, what’s the net effect – what jobs and how many will be lost to to PPACA, and what jobs and how many will be gained as a result of health reform.
Let’s leave aside the fact that with reform it will be a lot easier for workers to move from a big company and their health plan to individually-insured plan, enabling more would-be entrepreneurs to start their own firms.
According to Monster, there will be a plethora of new jobs for technicians, clinicians, and support workers.
And NFIB’s own analysis estimates the employer mandate [opens pdf, see p 20] – the old one, not the one that exempted employers with fewer than 50 workers – would have created 890,000 jobs. (NFIB hasn’t updated their numbers to reflect the lack of mandate for small employers.)
That said, NFIB indicated the mandate would create a lot of jobs – and good paying ones at that:
“The employer mandate would boost demand for healthcare goods and services, thereby increasing employment in healthcare-related sectors. The number of ambulatory healthcare professionals (physicians, dentists, and other healthcare practitioners) needed will increase by 330,000. An additional 327,000 staff will be required to work in hospitals. Some 157,000 more nurses (net of retirements) will be needed to staff doctors’ offices, outpatient clinics, and other provider locations. And payrolls at insurance companies will expand by 76,000 workers.”
Okay, so we have 330,000 more jobs for docs and dentists, and 157,000 net new openings for nurses. That’s almost half a million new high-paying jobs; these aren’t retail clerks, burger flippers or car wash attendees, these are folks making from $50,000 to $400,000.
True, some jobs will be lost, but we don’t know if there will be a net loss or gain. But lets say there’s a net loss. According to NFIB, the vast majority of the jobs we’ll lose are in retail and food service.
Marketwatch notes that the Sunshine State may well see more jobs added as a result of reform. The article goes on to note some experts’ opinions that while there will be more jobs open, many will go unfilled due to a lack of trained clinicians.
One hopes that the invisible hand will remedy this situation.
Of course, we’d be much better off if we could look into the future. Fortunately, we can. Recall Massachusetts enacted legislation very similar to PPACA back in 2009.
Overall, employment gains in healthcare Massachusetts have outstripped the rest of the country by four points; Mass added 9.5% more health care jobs since passage of reform while the rest of the nation averaged 5.5%.
But the impact wasn’t just on health care job counts. While the rest of the country saw a 2.9% drop in employment since Massachusetts passed reform, Mass’ employment dropped by a mere 0.2%.
What does this mean?
Well, there will likely be fewer overall jobs, but there will be a lot of new, high-paying jobs that may balance out the loss of what look to be lower paying jobs.
Feb
24
While I would not press the point as an argument against the ACA, I would say that the loss of a significant number of lower paying jobs is a matter that should not be glossed over. Economic, technological, and demographic realities are conspiring to make life more difficult for unskilled laborers in a stubbornly intractable way in the “new normal” in which we find ourselves. While Obamacare offers the promise of affordable health coverage to the working poor, it may also make it less likely that they will be working.
Joe you are probably correct on the broad numbers.
However, and I know that one post cannot cover everything, I am nervous about what will happen to the low-paid workers whose jobs disappear.
The dishwasher who dropped out of high school or who is a recovering addict will not get a job as an MRI technician.
Instead he will add to what amounts to virtually a criminal subculture.
The border states like Calif, Texas, and Florida
have very different demographics than Massachusetts. Low wage jobs have a lot about them that is ugly, but they are better than no jobs. The
history of black ghettoes proves this over and over again.
I realize that health care reform in itself cannot cure the massive demographic problem of under-educated, under-motivated Americans. Suffice it to say that health reform will not make things better for that under-class.