A popular phrase over the past year has been, “Let’s stop getting bogged down by health care and turn our attention to the nation’s top problem, which is ‘jobs, jobs, jobs.’” This statement at least implicitly assumes that health policy and jobs have nothing to do with each other. In fact, they are quite intertwined.

First, health care has become “the great American jobs machine.” Health employment goes up almost every month, and this was even true during the depths of the recession (Winter 2009) when the US economy was shedding some 750,000 jobs a month. In July 2010 there was a net gain of 27,000 jobs in the health care sector, and over the last year, health care employment has increased by 231,000. This has occurred over a period of only slight improvement in the overall jobs picture and no real progress in lowering the unemployment rate.

Of course, as we reform health care, we are likely to find inefficiencies and wasteful spending, and successfully addressing this problem may eliminate some health care jobs. But with an aging population and an increase in the demand for care associated with covering many of the uninsured, health care employment is still likely to continue to grow.

Another link between health care and jobs involves the federal economic stimulus package. First, the stimulus package included much higher federal matching rates to the states under Medicaid, and Congress just recently extended the higher match into the first half of 2011. This provision has been important to saving and creating jobs. States used this money to help pay for the rising number of people enrolling in Medicaid, which meant they were able to preserve funding in other areas such as education that would have otherwise been cut to pay for the Medicaid expenditures. Stimulus grants to states also saved the jobs of many police, firemen, and teachers. Further, many states are using stimulus funding to advance their adoption and use of health information technology, which will also create good-paying health care jobs.

The stimulus program included a provision that subsidizes employers who hire lower-income workers, with a special focus on people making the transition from welfare to work. States use this money to pay most of the cost of the workers’ wages over a period of several months. Some states have also used a portion of the funding to provide for emergency needs such as shelters for the homeless, or temporary help for victims of abuse.  

Sadly, this program is expiring this month, despite its widespread success and popularity across political party lines.

Another program supported by ARRA is M.O.S.T. This program provides an intensive two-week training for unemployed workers resulting in very high placement rates into jobs generally paying at least $30,000 a year and including health benefits. This program, too, may not be kept by some of the states after this month.

While these are jobs programs, they are carrying people from being uninsured into private, employer-based health coverage. This is another link in the jobs/health care chain.

In other words, health care can create new jobs, and new jobs can create health care!

Maybe it is time to start thinking about health care and jobs together, instead of viewing them as competing concerns.

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