Health Care Reform: Good for Patients, Good for Workers


In
my last column of 2008,

I built on Linda
Hirshman’s idea

that an economic stimulus package offered under the Obama administration
should focus on making sure that job creation equally benefits
men and women.  We should applaud the Presidential transition team
for embracing the idea of green
jobs
, but, as Hirshman
points out, the jobs that have been proposed are mostly blue collar jobs in industries dominated
by men.  Hirshman suggests that the Obama administration additionally prioritize building our educational system, which would employ
more women.  I suggest that the country should view health care
reform as an economic investment that can create jobs women are likely to take. 

Forty-six million Americans currently go without health insurance, and most of them have patchy access
to health care, avoiding preventive services and only seeing a doctor
when lack of prevention lands them in an emergency room — perversely, this
creates the very long lines we’re told to fear if said people instead receive
basic health care.  Under most universal health care proposals, these 46 million would be able to purchase health insurance, dramatically elevating the labor demand for doctors, nurses,
pharmacists, and other health care providers.  With doctors alone,
this improves women’s employment prospects, since female medical school
applicants outnumber male applicants.
 
But with the increasing emphasis on prevention, the demand for nurses
and other medical staff will rise even faster.  These are professions in which women are predominant.

Obviously, the incoming administration
has an opportunity to kill two birds with one health care reform stone. 
Applying the green job reform model to health care — creating a demand
for labor and creating a means to fill it — will work nicely for health
care.  We have a nursing shortage in America, but it’s not for
a real lack of actual human beings who need the jobs.  Most of
the women who might find nursing a good job can’t quite seem to get
into it, because cobbling together the time and money for the training
falls just outside of their means.   

Making the leap from a minimum
wage service industry job into a higher income nursing job means, for
many women who would like to make that transition, finding money
to pay for it, and dealing with increased child care costs to cover their hours working
their normal job and the hours at school.  For many women, these
are costs they simply cannot afford. But our federal government can
easily provide both the tuition money and the child care.  It’s
been demonstrated in this country’s past, that if need be, the federal government
can create child care programs to free up women’s time
so they can take jobs that must be done. During
World War II, the federal government set up 24 hour day care centers
for female shipyard workers taking jobs that men couldn’t fill.
This would have the added benefit
of employing more women, since child care workers are largely female.  

Should the demand rise high
enough, the government might even invest in on-the-job training programs
for female health care workers, so they can start drawing a salary immediately,
reducing their need to hold down an outside job while receiving the
training to be a nurse.  Right now, one of the biggest barriers
between the many women (and men, too) who would like nursing jobs is
the long
waiting lists at nursing school.
 
Again, the federal government can attack this problem,
funding an expansion of the educational apparatus to increase the number
of graduates coming out of school and meeting the growing demand for
this kind of health care.

Just a couple of years ago,
the idea of widespread federal investment in infrastructure for the
purpose of investment and job creation seemed a
marginal idea that had been abandoned once we recovered from the
Great Depression.  That changed in pretty short order, and if things
go as planned, historians will mark this as a time of a great paradigm
shift.  And thank goodness. If this is a country that really is
committed to the equality of all, the federal government should consider
the needs of the working class to obtain and maintain decent work to be
at least as important as the desires of the wealthy to keep their stock
holdings from plummeting precariously when the latest economic scheme
collapses.   

Federal job creation is a good unto itself, so long as the work is real and dignified, but we
have a unique opportunity to create jobs that really do pay us back
tenfold.  Green jobs that set the standard for a modern environmentalist
society are one way to get our investment back beyond just the standard
good of full employment, and health care job creation does the same
thing.  Everything in our society will improve when our citizens are as healthy as possible. 

And we can do all this without
compromising feminist principles that advocate for an economy where
women don’t depend on men, and aren’t forced, as I argue in this
week’s podcast, to make compromises like staying in abusive marriages
because they can’t afford to escape.  In opposition to the New
Deal of the 1930s, which glorified the nuclear family and female dependence,
we really can create a new New-er Deal that supports female independence
and truly healthy families formed out of full consent, economic and
otherwise.

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  • http://www.justmeans.com/index.php?action=profilehome invalid-0

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  • invalid-0

    Would you want someone doing “on-th-job-training” on your mother. There is a legitimate reason why registered nurses spend at least two years in school and preferably four years in college. There is a lot more to it than emptying bedpans.

  • amanda-marcotte

    Paying people to be in school might be our only hope.  How it shakes out depends on the demands of the job, of course, but I fail to see why it’s a bad idea to incentivize the job even more, so we get devoted and talented people in there.

  • invalid-0

    Federal Jobs Good?

    Um, not so sure there. If it is anything like teaching where it is hard to fire incompetent and even abusive staff, and there is no way to earn better pay within the system. Many teachers leave the profession in the first five years for better pay, hours and conditions. It would be a shame if our health care were to go that way.

  • amanda-marcotte

    All plans offered by Democrats would embed universal health care into the current system.  There wouldn’t be "federal" jobs in the sense you seem to think.  It’s just that the current system—a patchwork of private and public sources of health care—would be expanded.  No one would take your local hospital and force it to be government-owned.

     

    Thus, even if we believe (and there’s no reason to believe this) that federal employees are incompetent, your argument makes no sense, because the people involved would not be federal employees.

  • invalid-0

    What I like most about the new health care ideas is the focus on saving money by promoting healthy living. Unfortunately in the US, a huge amount of people are not too interested in changing lifestyle. Those whose change in lifestyle would make the most impact are also the least likely to change; older people. I think it would take much education and proding to get even modest lifestyle changes from many people.

    My concern about gov’t in health care is more about situations such as in Arizona, where a ballot initiative to permanently guarantee people’s right to pay for their own medical treatment was fiercely opposed and barely failed. If no one wants to keep people from going outside the system why would anyone spend even $1 in ad money to oppose a measure that would guarantee that people could go outside the system to buy their own medical care?

    My friend just move to Canada where doctors are not allowed to work privately and patients have to leave the country to get treatment sooner or different from the what the system provides.

    While I don’t think that is what is currently being proposed at the federal level, the Arizona situation is not too reassuring.
    As for incompetent workers in the public sector, they are no more prevalent than in the private sector. I just think they are harder to fire. When I was teaching, staff who abused students were just moved to the district admin. office because it was cheaper than trying to fire them.

  • http://www.insuresaver.com invalid-0

    It is good to know that the government is making health care a priority. There seems a lot of issues and problems at hand when it come to health care costs, health insurance, quality health care and a lot more. We are all after seeing improvements in our health care system.