Administrative job growth in healthcare isn't good for America
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A recent headline shouted the great news that, “500,000 jobs [were] added to health-care sector under ObamaCare.” This conclusion was based on a confidential Goldman-Sachs financial report. There is a widely held consensus that job growth is good: we want any new jobs we can get. But, do we? Might there be job growth that we don’t want?

There is no published data that breaks down new healthcare jobs into doctors versus administrative positions. Therefore, we must fall back on inference. The U.S. added 120,526 new physicians to the healthcare workforce between 2010 and 2016. We also lost physicians with an attrition rate of 62 percent. Thus, the net gain was 45,800 doctors.

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If 500,000 jobs were added to healthcare and only an estimated 46,000 are physicians, then more than 90 percent of the ObamaCare-created jobs weren’t for doctors. So where does this job growth come from?  The vast majority must be administrators, actuaries, advisers, agents, billers and coders, compliance officers, consultants, IT developers, lawyers, managers, navigators, project managers, salespersons, and writers of rules and regulations needed to tackle increased bureaucracy. You pay for all these administrators’ salaries and pensions through taxes as well as through insurance premiums, co-pays, and deductibles. What do you get for all that money?

 

A recently released Merritt Hawkins survey confirms what we get for supporting all those new ObamaCare-created bureaucratic jobs: reduced access to healthcare!

According to official CMS statistics, 16.9 million Americans gained insurance through ObamaCare. Somewhere between 72 percent and more than 90 percent acquired their insurance for free, through Medicaid expansion.

To pay for all those new administrative jobs, Medicaid payments to doctors had to be cut even further below their already low levels. Increasing numbers of doctors cannot afford to see Medicaid patients. In 2012, 69 percent of U.S. doctors accepted new patients with Medicaid coverage. Now, only 53-60 percent will. So, as millions more people have Medicaid coverage, fewer and fewer doctors can care for them.

That is the evidence for more jobs equals reduced access to care. But wait! There’s more (and it’s worse).

Care when you need it has become a thing of the past. As another result of ObamaCare, waiting time to see a family physician in Albany went from 109 days to 122 days. That means a patient with chest pain must wait four months to find out if he has gas, a hiatal hernia, or a heart condition. The patient’s only alternative is the ER.  

What happens when newspapers start regaling us with stories of average Americans dying while standing in line waiting for health care, or what is calleddeath by queueing? This has already happened to 792 Illinoisans and more than 300,000 U.S. veterans.

ObamaCare has driven up healthcare costs so that average annual expenditures for a family of four have reached $25,826 a year, which is close to half of all of their income. As a nation, the U.S. is now expending more than $3 trillion per year on its healthcare system, an amount greater than the entire GDP of the United Kingdom.

Despite spending more both as individuals and as a nation, there isn’t enough money to pay care providers. Who or what is siphoning off trillions of healthcare dollars that we need to get medical care when and where we need it?

The culprit is ObamaCare-created jobs that expanded healthcare bureaucracy at the expense of health care service. ObamaCare made the healthcare system so complex and confusing that the law created a whole new class of healthcare bureaucrats called navigators. The Patient Navigator Program is Section 3510 of the Affordable Care Act. Navigators are hired to help us find our way through the maze they laughingly call a healthcare system. That system is an unworkable administrative and regulatory nightmare supposedly designed to facilitate the simplest of all transactions: doctor cares for patient; patient pays doctor, period.

In 1991, research showed that 31 percent of all U.S. healthcare spending went to federal bureaucracy, administration, rules, regulations, and compliance (BARRC.) A subsequent report suggested that BARRC consumed a higher number, 40 percent. Both of these estimates were made before ObamaCare bent the spending curve upward, spending more than $2 trillion (with a “t”) simply to extend and enlarge healthcare BARRC.

Where do all those healthcare dollars go—money that is desperately needed to pay providers? It is being consumed by those shiny new administrative jobs, hundreds of thousands of them. When someone crows about all the jobs that former President Obama’s namesake law created, calmly explain how those jobs hurt all Americans.

Deane Waldman (@SystemMd), MD MBA, is Emeritus Professor of Pediatrics, Pathology and Decision Science, and director of the Center for Health Care Policy at the Texas Public Policy Foundation. He is the author of The Cancer in the American Healthcare System.


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