Medicare for All’s jobs problem – By Rachana Pradhan and Scott Goldsmith (Politico) / Nov 25 2019
The big Democratic talking point has a big political weakness: It could wipe out thousands of jobs in places like Pittsburgh that have built their new economies on health care.
PITTSBURGH, Pa. — Deanna Mazur, the daughter of a retired steel mill worker who works as a medical billing manager, finds some things to like about the “Medicare for All” policy that she’s been hearing politicians talk about. She likes the notion that all Americans would have health insurance. And it would simplify her own job quite a bit if there were only one place to send medical bills, instead of the web of private companies and government programs that she deals with now. “It would definitely be easier,” Mazur says.
Then again, if it were that easy, her job might not exist at all.
Mazur’s job and those of millions of others have helped turn health care into the largest sector of the nation’s economy, a multitrillion-dollar industry consisting in part of a huge network of payers, processers, and specialists in the complex world of making sure everything in the system gets paid for. If the health care system were actually restructured to eliminate private insurance, the way Medicare for All’s advocates ultimately envision it, a lot of people with steady, good-paying jobs right now might find themselves out of work.
“What if my job doesn’t exist anymore?” she asked in a recent interview.
TOP: Deanna Mazur, a health care billing manager in Pittsburgh, wonders if her job might disappear if the country adopts a Medicare for All-style health care system. BOTTOM: The University of Pittsburgh Medical Center, one of two hospital systems that dominate the local economy. Once the headquarters of the U.S. steel industry, the city’s largest industry is now health care. | Scott Goldsmith for Politico Magazine
This question has particular resonance in this part of Pennsylvania, a must-win swing state in the presidential race, which has already seen massive job dislocation from the decline of manufacturing. As Pittsburgh’s iconic steel industry has been gutted, the city’s economy has been hugely buoyed by health care, which has grown into the region’s largest industry — employing about 140,000 people, or 20 percent of the regional workforce. The city’s former U.S. Steel complex is now, appropriately enough, the headquarters of a mammoth hospital system, one of two health care companies deeply entrenched in the city’s economy.
There are lots of health reform ideas that wrap themselves in the “Medicare for All” label, ranging from a single government-run system to plans that maintain a role for private insurance companies. But under the most ambitious schemes, millions of health care workers would be at least displaced if not laid off, as the insurance industry disappears or is restructured and policymakers work to bring down the costs of the system by reducing high overhead and labor costs. The reform proposals being promoted by Democratic presidential candidates have barely grappled with this problem.
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