As congressional Republicans embark on
their promise to repeal and replace President Obama’s signature Affordable Care
Act, they are being overwhelmed by claims that imply it’s a jobs program.
Scholars affiliated with the Milken Institute School of Public Health at
George Washington University estimate Obamacare
repeal would
kill 2.6 million jobs by 2019. Almost a million jobs would be lost from
health services, while the balance would be lost in construction, real estate,
retail, finance, and insurance.
Unfortunately, such research relies on the
so-called “multiplier effect,” a politically seductive but misleading type of
voodoo economics. It goes like this: Obamacare throws money at hospitals,
doctors’ offices, and other health services. Those recipients build new
facilities and hire more workers, who spend their paychecks in their
communities. It is the same kind of research that developers seeking
taxpayer-subsidized stadiums commission – and it is meaningless.
If Congress just sent a fleet of
helicopters to scatter banknotes from the sky, the same “multiplier effect”
would take place: people would pick the money up and spend it. Businesses
located near the drop zones would profit, hire, and expand. However, jobs
and the economy would not grow, because the effect would be a mix of inflation
and reduced spending in areas away from the drop zones.
Worse, because this type of spending is
politically motivated, it is usually demanded by industries which resist
productivity improvements. Last July, Dr. Bob Kocher, a venture
capitalist who served as a special assistant to Obama when Obamacare was
crafted, lamented that just over
half of health service workers are administrators, up from just over one third
before Obamacare.
Further, health services do not need
Obamacare to add jobs. The sector is recession-proof. Nonfarm
civilian employment peaked in January 2008 (at 138.4 million jobs) and bottomed
out in February 2010 (at 129.7 million jobs). Jobs were lost in 24 of
those 25 months. Nonfarm civilian employment did not cross the January
2008 threshold until May 2014. And that recovery was not smooth: from
June through September 2010, 289,000 jobs were lost in a jobs mini-bust.
However, there was no recession in health
services. Indeed, over half a million such jobs were added between January
2008 and February 2010. In other words, health services added jobs while
the Great Recession destroyed 9.25 million other nonfarm civilian jobs before
the Affordable Care Act was passed in March 2010.
But Obamacare has skewed the American
workforce toward health services. This persists now that the economy
has recovered. By December 2016, the United States had added 6.87 million
jobs to the previous peak in January 2008. However, 2.59 million jobs are
in health services, which grew by 20 percent. All other nonfarm jobs grew
only 3.42 percent, adding 4.29 million jobs. Health services accounted
for 38 percent of all jobs added from the January 2008 peak through the end of
last year. And this counts only private health services, not insurers and
other middlemen or government employees added by Obamacare.
Republican politicians need to accept the
fact that some industries can have too many workers and that health services is
surely one of them.
Workers and businesses outside health care
are paying the price for Obamacare with sluggish job and wage growth.
Health reform that focuses on patients’ needs, not preserving health
service jobs fattened by Obamacare, will also help the rest of the economy.
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