Medical Gridlock and Health Reform

By Eli Ginzberg | Go to book overview

8
The Health Sector: Employment Frontier

Eli Ginzberg

In 1965 the total expenditures for U.S. health care amounted to $41.6 billion, about 6 percent of the GNP. For 1992 the level of expenditures is estimated to be over $830 billion, about 14 percent of GNP. With corrections for the declining value of the dollar and the increase in the population, health care expenditures per capita rose more than fourfold in these twenty-seven years.

The explanations for such a large and rapid rise in health care outlays are many and diverse. Among the most important are the much enlarged therapeutic and diagnostic capabilities of modern medicine; the rapid growth of the U.S. economy, which made it easier for both the private and public sectors to spend more on health care; the radical changes that occurred in the financing of health care with primary reliance on private health insurance and governmental entitlement programs (Medicare and Medicaid); and the strong efforts of the hospital leadership--trustees, administrators, and physician staffs--to provide quality in-patient care as close to home as possible for most, if not all, Americans.

The aim of this chapter is to focus specifically on the human resource and labor market dimensions of the sustained expansion that occurred between 1966 and 1992. Although money and technology played critical roles in the delivery of more and better health care, the successful exploitation of these resources depends on more and better-trained health care personnel, from medical and surgical specialists to the different supporting groups required for the effective functioning of a complex hospital center with a wide array of sophisticated high-tech services for a diversified patient population.

Table 8.1 summarizes the number and principal occupational categories of persons employed in the health care sector in 1966 and 1991.

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Medical Gridlock and Health Reform
Table of contents

Table of contents

  • The Eisenhower Center for the Conservation of Human Resources ·Studies in the New Economy· ii
  • Title Page iii
  • Contents v
  • Preface vii
  • 1: The Changing World of Work 1
  • Notes 14
  • 2: Demographic Trends in the Labor Force 15
  • Notes 32
  • 3: Central Cities and Their Suburbs 33
  • Appendix: The Data 62
  • Appendix: The Data 63
  • 4: Services and Globalization: New York City 65
  • Notes 86
  • 5: Literacy and Work 87
  • References 114
  • 6: The New Immigrants 119
  • Notes 141
  • 7: School to Work: The Integration Principle 145
  • Notes 169
  • Notes 171
  • 8: The Health Sector: Employment Frontier 175
  • Notes 188
  • 9: The Future of Employment Policy 189
  • About the Contributors 203
  • Index 205
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