PhoenixRising raises a good point that has to be discussed as health care reform continues forward. There are people who are made worse off as we reform
Um…yay? The fact that home health agencies employ a population of Americans who themselves tend to be poor, brown, low-education-level women…I’m not so sure that overall human happiness or health has improved in McAllen from this metric.
I’m happy that fewer old folks are getting operations they didn’t need, which is the main cost curve effect described in the article. That’s good. Destroying a poorly functioning market in home health care, in which federal dollars were being transferred to some poor folks to make other poor folks less miserable, isn’t the same thing.
People delivering unneccessary services are not seeing that their services are either non-productive or counter-productive as they are working their asses off for their paycheck. They are seeing their paycheck disappear. And given our current political climate, they might be lucky to get twenty weeks of unemployment insurance at best and told good luck. They are not being compensated for their losses even as society as a whole is better off.
In any significant service delivery reform model in the United States, there will be employment shifts. We should expect to see employment shift from specialty care to primary care, we should see employment shift from hospital floor services to “softer” services like care coordination and care education roles, we should see fewer MRI technicians hired but more senior care checkers, we should see fewer back surgeries performed but more phyiscal therapy hours billed. We should see more master level clinicians, we should see more LPNs, we should see significant employment gains but at the same time everyone employed in healthcare today won’t have that same job in the future. There will be significant displacement.