Having grown up in (and returned to, like a bizarro-world Prodigal Son) the Midwest I am all too well acquainted with dying cities. All of the signs of torpor, the economic drain-circling, and the post-industrial malaise of the Daytons and Fort Waynes of the world are well known to me by this point. Or at least I thought I could spot them all; in the past year I've discovered a new Big Red Flag: boasts about the growing "health care sector" of the economy. It turns out that a booming health care sector is a way of saying "All the young people have left and someone has to care for our elderly, dying population."
Visit the website of any derelict Rust Belt city and search for references to the number of hospitals or the strength of the health care sector. It won't take long to find them. It turns out that along with local government and, of course, prisons, hospitals are one of the few things that remain open when everything else closes. They may not have jobs anymore, but someone still needs to lock 'em up and occasionally stitch 'em up. The hundreds of Fast Company-style articles in the business media over the past few years proclaiming nursing as THE NEXT BIG THING in the job market always puzzled me…is it really a sign of the strength of our economy when the best job (supposedly) is to take care of the rapidly increasing number of dying old people? There's reason to be alarmed when reading things like this:
Americans spent $2.6 trillion on health care in 2010 — ten times more than in 1980. That revenue boost has, in turn, driven job growth; the health care industry last year created more than 540,000 jobs in Michigan alone, making it the largest private employer in the state, according to the Detroit News. The trend holds true at the national level too, with the health care industry remaining one of the few reliant drivers of job growth in the aftermath of the financial crisis, according to The New York Times.
Hear that, Michigan? The auto industry may be gone but there's a good buck to be made sticking tubes and needles into the people too old, too poor, or both to flee the state. What is a quote like this other than an admission that our population is aging and, given our level of material wealth as a society, staggeringly unhealthy? We're number one! …in elderly diabetics.
No one seems to know what we'll do with all of these nurses and "home health care professionals" when the Elder Care Bubble bursts; thinking that far ahead has never been our strong suit. If the best thing that can be said about the economic condition of a city is that it has a lot of hospitals – you know, because a lot of its residents are on the verge of dying – then that city might not have a lot going for it. On the national level, if the best thing we can tell college students and adult job-seekers is that America is going gangbusters at generating sick people, we might want to step back for a moment and ask if that's the kind of growth industry that defines a strong economy.