How do you eliminate wasteful jobs without backlash? Stop hiring and let attrition take care of the problem?
In 2009, they'd have to look to increase employment elsewhere.
In 2009, they'd have to look to increase employment elsewhere.
A goverment-mandated major healthcare streamlining would reduce health administration and support (financing, management, IT, billing, coding, legal support, etc., etc., etc.) in the long term, but in the short term it would create lots of jobs—and mostly in the same general space—in a a surge that (with the most likely kind of implementation timeline) would ramp up over a couple years of implementation planning, stay steady for a few years of main implementation, and then taper off to the new, lower equilibrium as new systems and processes moved from implementation to routine operation.
Probably no better time for that than an economic downturn where employment was soft, if the government is deficit funding to subsidize the implementation costs. It's basically a short-term jobs program with long term dividends for the whole economy.
I work in automation, and what's happened when a location introduces our tech is not an immediate loss of jobs, but rather the existing employees move to higher productivity roles. Any job losses eventually come via attrition and non-replacement.
Let me be clear: I don't support keep useless jobs around simply because it would be painful to the employee to lose their job.
Right now, if you are employed and have insurance, you are really just subsidizing these jobs - middle-class welfare.
This allows the party cutting costs the flexibility to reallocate now-redundant people directly to problem areas, without having to procure additional funding. The rebates cover the cost of retraining (maybe mandate this for for-profit parties).
The jobs that can be cut without reducing quality are the administrative nonsense like dickering back and forth with the insurance company, but those jobs also can't be cut without reducing revenue. It would take a change to the way we pay for healthcare to significantly reduce costs, and/or getting the cost of pharmaceuticals under control. There's a lot of fat in pharma too but that's another conversation.
Aside from that, there's a huge amount of undocumented knowledge in the field. Given its stability, people can still work 20-30 years for the same company.
Given there are always areas who need more people, I can't believe you'd rather have someone who knows nothing than the person with 20-30 years of experience (salary aside, admittedly).
If a company can capture a greater share of the market by offering the same service with a lower premium, isn't that what they'll do?
I don't know why that effect is not present now, but it could have much to do with the way most people get insurance through a group policy provided by their employer (and therefore get no chance to shop around).
Inelastic demand. Whether you have a debilitating/life-threatening illness, or are worried whether the lump in your throat is heartburn or the cancer that'll end your life, your incentive to engage with competing market presences is massively diminished for several reasons (urgency, many people have a desire for their life-or-death decisions not to be commoditized, etc.).
Sure, it's a problem when industries and job classes disappear - but keeping them around doesn't solve the problem, it only defers it. In many (most? all?) cases it even makes it worse.