Tuesday, Sep 20, 2011, 06:55AM CST
By Mark Lisheron
As if the health care industry wasn’t worried enough about the impact of a federal debt reduction agreement that would include Medicare and Medicaid cuts, President Obama threw in a $447 billion jobs stimulus plan for good measure.
The American Jobs Act promises something for teachers, construction workers, firefighters and police officers in Texas and the other states. Conspicuously absent are health care workers, one of the rare lines of employment that has weathered the protracted recession.
Not only does the jobs act offer them nothing extra, health care workers are worried their jobs will be sacrificed to support jobs in the other areas -- a kind of jobs shell game -- if the savings to pay for the program come out of the nation’s twin behemoth health care plans.
“It gets hard to follow which shell has the peanut under it,” Robert Collinge, a professor of economics at the University of Texas San Antonio, said. “They can confuse us all they want, but there is an appropriate cost for the creation of those jobs that has to come from somewhere.”
COLLINGE
Texas health care organizations say because so many things are in play with the debt reduction and jobs act discussions it is difficult to say how many layoffs there might be. The American Hospital Association last week estimated the number at 194,000 jobs nationally by 2021, citing a study by Tripp Umbach, a health care consultant.
“While we do not have specific figures on number of jobs that may be lost through cuts, it is clear that Medicare and Medicaid cuts to home health and hospice, and Medicaid cuts to personal care services will have a huge impact on jobs since this is a very labor intensive business,” Anita Bradberry, executive director for the Texas Association for Home Care & Hospice, said. “Further cuts to home health payments will have a significant and alarming impact on the financial viability of Texas home health providers.”
The national association produced its own study done by the consultant The Moran Company, contending that the federal government’s proposal to find savings in cuts in payments to health care providers would cause nearly 60 percent of home health agencies in Texas funded by Medicare to operate in the red.
BRADBERRY
For those home care providers not driven out of business altogether, Bradberry said, the alternative would have to be cutting staff.
Nearly 1.2 million people work in the broad field of health care in Texas, from doctors to hospice care assistants, according to the latest figures provided by the Texas Workforce Commission. Nearly 1.1 million or about 90 percent of those jobs are in the private sector and 125,401 of them are public, local, county and state.
Private and public health care services employ roughly 600,000 of those workers, hospitals employ another 400,000 and about 175,000 people work in nursing and residential care, according to the Workforce Commission figures.
In the thrall of chronic 9 percent unemployment nationwide, the health care industry created 306,000 jobs in the previous 12 months ending in August, 30,000 of those in August alone, according to the latest survey by the federal Bureau of Labor Statistics.
Until this past session of the Legislature, health care employment by the state of Texas was also robust. Over the past five fiscal years ending in 2010, the Department of Health and Human Services grew by 21 percent or more than 9,500 employees, outstripping the 18.2 percent increase in public education employees and more than twice the increase in higher education employment, according to the state Auditor’s annual employment report.
In the past session, the Legislature cut more than $11 billion out of the budgets of the five agencies that make up Health and Human Services over the next two years, and yet nearly all of the 55,619 state health care jobs are safe, at least for now, spokesman Stephanie Goodman said.
At the Texas Department of Aging and Disability Services, where their work processing Medicaid for those eligible in the Rio Grande Valley is being taken over by five managed care organizations, the budget called for the loss of 372 full-time positions.
Many of those positions were filled by temporary employees or were already vacant, spokeswoman Allison Lowery said. So far, during the transition to managed care just eight people were laid off, she said.
“It’s difficult at this point to predict how many people would be affected by layoffs as STAR+PLUS (the managed care plan) expands,” Lowery said.
The agency also lost 60 inspection and investigation positions and another 40 in information technology, all 100 of them vacant, she said.
It isn’t clear whether taxpayers will stop paying for jobs eliminated or if positions within the department are shuffled like those at the Texas Department of State Health Services. The department this year eliminated the equivalent of 172 positions, 116 of them full-time, but 104 of those positions were already vacant, department spokesman Chris Van Deusen said. The other 68 people were offered other jobs in the department at their current salaries, he said.
How the private and public health care employment outlook might change depends upon where the co-called Supercommittee chooses to identify budget cuts that will not only reduce the debt but fund the jobs plan.
In advance of these debates, the Administration estimated for each of the states their share of the jobs act largesse. By spending nearly $2.6 billion on highway, transit and rail infrastructure in Texas, the plan hopes to create at least 33,800 jobs in Texas.
Another $2.6 billion would be used to keep 39,500 police officers, firefighters and teachers on the job. And another 30,300 jobs would be created with $2.3 billion to upgrade Texas schools.
The whole plan is predicated on funds that exist entirely in theory on a premise that contradicts the reason for the existence of the Supercommittee, Collinge said.
“If we were to accept the President's jobs package, that panel would be denied the opportunity to use those tax increases to cut the deficit,” he said. “If the panel were to propose tax increases as part of their plan to reduce the deficit, those tax increases would have to be in addition to these other tax increases proposed by the President now.”
Employment, Collinge said, stands a better chance if “we get government out of the way of the private sector. That's where jobs in the United States come from.”
Aside from opposition on principle, opponents find it curious that a president who fought so hard for the expansion of health coverage in the Patient Protection and Affordable Care Act would craft a jobs bill that might undermine it.
“As Congress looks for ways to cut the deficit, we urge lawmakers to first, do no harm,” Rich Umbdenstock, president of the American Hospital Association, said in a statement issued on Sept. 12. “Reject cuts to hospital services that could create devastating job losses to communities.”
Bradberry said those sentiments are shared throughout the health care industry.
“Further cuts to Medicare home health will drive home care providers out of business,” she said, “and threaten Medicare beneficiary access to the most cost effective and preferred method of care.”
Not only does the jobs act offer them nothing extra, health care workers are worried their jobs will be sacrificed to support jobs in the other areas -- a kind of jobs shell game -- if the savings to pay for the program come out of the nation’s twin behemoth health care plans.
“It gets hard to follow which shell has the peanut under it,” Robert Collinge, a professor of economics at the University of Texas San Antonio, said. “They can confuse us all they want, but there is an appropriate cost for the creation of those jobs that has to come from somewhere.”
COLLINGETexas health care organizations say because so many things are in play with the debt reduction and jobs act discussions it is difficult to say how many layoffs there might be. The American Hospital Association last week estimated the number at 194,000 jobs nationally by 2021, citing a study by Tripp Umbach, a health care consultant.
“While we do not have specific figures on number of jobs that may be lost through cuts, it is clear that Medicare and Medicaid cuts to home health and hospice, and Medicaid cuts to personal care services will have a huge impact on jobs since this is a very labor intensive business,” Anita Bradberry, executive director for the Texas Association for Home Care & Hospice, said. “Further cuts to home health payments will have a significant and alarming impact on the financial viability of Texas home health providers.”
The national association produced its own study done by the consultant The Moran Company, contending that the federal government’s proposal to find savings in cuts in payments to health care providers would cause nearly 60 percent of home health agencies in Texas funded by Medicare to operate in the red.
BRADBERRYNearly 1.2 million people work in the broad field of health care in Texas, from doctors to hospice care assistants, according to the latest figures provided by the Texas Workforce Commission. Nearly 1.1 million or about 90 percent of those jobs are in the private sector and 125,401 of them are public, local, county and state.
Private and public health care services employ roughly 600,000 of those workers, hospitals employ another 400,000 and about 175,000 people work in nursing and residential care, according to the Workforce Commission figures.
In the thrall of chronic 9 percent unemployment nationwide, the health care industry created 306,000 jobs in the previous 12 months ending in August, 30,000 of those in August alone, according to the latest survey by the federal Bureau of Labor Statistics.
Until this past session of the Legislature, health care employment by the state of Texas was also robust. Over the past five fiscal years ending in 2010, the Department of Health and Human Services grew by 21 percent or more than 9,500 employees, outstripping the 18.2 percent increase in public education employees and more than twice the increase in higher education employment, according to the state Auditor’s annual employment report.
In the past session, the Legislature cut more than $11 billion out of the budgets of the five agencies that make up Health and Human Services over the next two years, and yet nearly all of the 55,619 state health care jobs are safe, at least for now, spokesman Stephanie Goodman said.
At the Texas Department of Aging and Disability Services, where their work processing Medicaid for those eligible in the Rio Grande Valley is being taken over by five managed care organizations, the budget called for the loss of 372 full-time positions.
Many of those positions were filled by temporary employees or were already vacant, spokeswoman Allison Lowery said. So far, during the transition to managed care just eight people were laid off, she said.
“It’s difficult at this point to predict how many people would be affected by layoffs as STAR+PLUS (the managed care plan) expands,” Lowery said.
The agency also lost 60 inspection and investigation positions and another 40 in information technology, all 100 of them vacant, she said.
It isn’t clear whether taxpayers will stop paying for jobs eliminated or if positions within the department are shuffled like those at the Texas Department of State Health Services. The department this year eliminated the equivalent of 172 positions, 116 of them full-time, but 104 of those positions were already vacant, department spokesman Chris Van Deusen said. The other 68 people were offered other jobs in the department at their current salaries, he said.
How the private and public health care employment outlook might change depends upon where the co-called Supercommittee chooses to identify budget cuts that will not only reduce the debt but fund the jobs plan.
In advance of these debates, the Administration estimated for each of the states their share of the jobs act largesse. By spending nearly $2.6 billion on highway, transit and rail infrastructure in Texas, the plan hopes to create at least 33,800 jobs in Texas.
Another $2.6 billion would be used to keep 39,500 police officers, firefighters and teachers on the job. And another 30,300 jobs would be created with $2.3 billion to upgrade Texas schools.
The whole plan is predicated on funds that exist entirely in theory on a premise that contradicts the reason for the existence of the Supercommittee, Collinge said.
“If we were to accept the President's jobs package, that panel would be denied the opportunity to use those tax increases to cut the deficit,” he said. “If the panel were to propose tax increases as part of their plan to reduce the deficit, those tax increases would have to be in addition to these other tax increases proposed by the President now.”
Employment, Collinge said, stands a better chance if “we get government out of the way of the private sector. That's where jobs in the United States come from.”
Aside from opposition on principle, opponents find it curious that a president who fought so hard for the expansion of health coverage in the Patient Protection and Affordable Care Act would craft a jobs bill that might undermine it.
“As Congress looks for ways to cut the deficit, we urge lawmakers to first, do no harm,” Rich Umbdenstock, president of the American Hospital Association, said in a statement issued on Sept. 12. “Reject cuts to hospital services that could create devastating job losses to communities.”
Bradberry said those sentiments are shared throughout the health care industry.
“Further cuts to Medicare home health will drive home care providers out of business,” she said, “and threaten Medicare beneficiary access to the most cost effective and preferred method of care.”
***
Contact Mark Lisheron at 512-299-2318 or mark@texaswatchdog.org or on Twitter at @marktxwatchdog.
Keep up with all the latest news from Texas Watchdog. Fan our page on Facebook, follow us on Twitter and Scribd, and fan us on YouTube. Join our network on de.licio.us, and put our RSS feeds in your newsreader. We're also on MySpace, Digg, FriendFeed, and tumblr.
Follow Texas Health Care Report on Twitter, and fan us on Facebook. Texas Health Care Report is a project of Texas Watchdog.
Photo of 'Adenocarcinoma X-ray' by flickr user Pulmonary Pathology, used via a Creative Commons license.
Contact Mark Lisheron at 512-299-2318 or mark@texaswatchdog.org or on Twitter at @marktxwatchdog.
Keep up with all the latest news from Texas Watchdog. Fan our page on Facebook, follow us on Twitter and Scribd, and fan us on YouTube. Join our network on de.licio.us, and put our RSS feeds in your newsreader. We're also on MySpace, Digg, FriendFeed, and tumblr.
Follow Texas Health Care Report on Twitter, and fan us on Facebook. Texas Health Care Report is a project of Texas Watchdog.
Photo of 'Adenocarcinoma X-ray' by flickr user Pulmonary Pathology, used via a Creative Commons license.
Like this story? Then steal it. This report by Texas Watchdog is licensed under a Creative Commons Attribution 3.0 United States License. That means bloggers, citizen-journalists, and journalists may republish the story on their sites with attribution and a link to Texas Watchdog. If you do re-use the story, we'd love to hear about it. E-mail news@texaswatchdog.org.
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Comments
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Robert Collinge
Tuesday, 09/20/2011 - 11:47AM
This administration is busy destroying jobs on the one hand and creating different jobs of its choosing overseen by its cronies on the other. That kind of central planning is anathema to a dynamic, entrepreneurial economy. Not only do you lose some jobs in this shuffle, you also get the wrong people doing the wrong jobs because they are not responding to the weeding out process of market competition. This inefficiency shrinks the economic pie and lowers the standard of living for the average American. Well done article on an important topic! |
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R. Lennon
Wednesday, 10/19/2011 - 09:52PM
Government can't create jobs; only the illusion of jobs that go away when the funds--that have been drained from the private sector--do.
The government is a vampire that sucks the blood of taxpayers and businesses and has taught people that their anemic wallets should make them feel good about themselves. |
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