Health Care - Who Works Where?

Health care-related articles appeared in the New York Times on March 2 and March 3, 2008. The Times focused on the Presidential candidates' positions (for a useful summary of these positions see: Kaiser's "health08.org" ) and looked at the causes of high cost health care and the tools available for cutting health care costs. The articles quoted an authority as saying that "spending on unneeded procedures, medical errors and hospital infections is a more dire problem than the cost of calling for the uninsured, and that waste accounts for a much larger share of the country's $2.1 trillion health care bill."

In 2006, the U.S. civilian workforce was about 144 million, of which about 14 million were employed in health care. In 2000, the figures were about 137 million and 12 million, respectively. In the last eight years, health care has absorbed and increasing proportion of the workforce. Physicians and dentists have shown an approximately 8% increase in the percentage of employment, hospitals have decreased from 42.6% in 2000 to 39.8% in 2006. Health care is a major U.S. employer and most of the employment occurs in hospitals. Perhaps the first place to look for efficiency in the expensive world of health care is in hospitals, or in the insurers who control the gateway to hospitals and shift costs from their insured, to other payors such as government, the self-insured, employers, and taxpayers. The largest portion of "waste" may not be unneeded procedures, medical errors or hospital infections, but in the enormous administrative overhead of commercial insurers who provide no true health services in exchange for the expensive administrative overhead wrung out of billions in premium dollars.