Today's healthcare hiring could be gone tomorrow


One thing that the healthcare industry has steadily supplied during these dolorous economic times are jobs. It is easily the fastest-growing sector in the United States during the worst economic contraction since the Great Depression. The signing bonuses of five or six years ago are mostly gone, but a pharmacist, nurse, or physician's assistant can find a position with little effort. And any medical school graduate who is not recklessly incompetent is set for life.

On paper at least, this job production should last for a couple of decades. America is a graying country whose need for care is only going to grow. But amid the din of the healthcare jobs juggernaut are cries that are, for the moment, too easily ignored.

They were most recently voiced through a Commonwealth Fund scorecard on U.S. health system performance that again put into high relief healthcare's key problem: The quality of care delivered continues to decline while costs rise.

The Commonwealth Fund gave the U.S. healthcare system an overall score of 64 out of 100. That's down from previous years. Meanwhile, the United States still far outspends any other advanced nation to heal its citizens.

According to the report, were the American insurance system to cut its administrative costs down to the level of better-performing countries, it would save more than $1 trillion over a decade. If the mortality rates approached that of those other nations, at least 84,000 Americans each year would live longer.

"The U.S. is not achieving the health outcomes or quality that should be possible with the resources the nation invests," the report said.
It's the same kind of waste and disengagement from consumers that dropped the U.S. auto industry to its knees during the Arab oil embargo of 1973 and gave a huge opening to overseas competitors.

That was a sentinel year in this nation's history--the start of a swift decline in our manufacturing base and the end of middle-class wage growth. It took nearly a decade for Detroit to figure out something was amiss, and by then it was too late.

Healthcare isn't likely to experience quite the same fate, as being hospitalized is not a consumer choice parallel to picking a Camry over a Buick. But that's not a good enough reason to not be proactive.

Technology changes things rapidly. The way we communicate and make purchasing decisions has been radically transformed in just 15 years--about the same amount of time it took for the manufacturing jobs to evaporate. By 2025, it's entirely possible our primary care will be delivered via our tablets or television sets with a physician's assistant in India or a nurse in the Philippines--particularly if it can be done for a tenth of the cost of the typical office visit. For elective procedures, we may get ferried to a floating foreign-owned hospital anchored just beyond the 12-mile limit.

Anyone who argues these aren't possible scenarios is in denial, particularly since it's even money the U.S. Supreme Court could invalidate all of the Affordable Care Act. Without any sort of reform, market pressures will continue to mount. That will invariably lead to what economists refer to as "creative destruction."

What would get destroyed here? Many of those nascent healthcare jobs. That would leave a lot of healthcare executives doing what they do every day: trying to preserve margins in a competitive environment. But they would be making do with a hell of a lot less revenues and resources. And they would be left to wonder if the rudder will respond before it's too late. - Ron (@FierceHealth)

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