ROBERT SIEGEL, HOST:
This is ALL THINGS CONSIDERED from NPR News. I'm Robert Siegel. It is time to talk about health care once again. Next week, the Supreme Court takes up the Affordable Care Act. And the questions that consumed us two and three years ago will resume their place at center stage of our national political life. Of course, health care is never far from center stage in our personal lives.
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SIEGEL: Nearly all of us are born into the hands of a health care provider. We go to the doctor for childhood illnesses...
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SIEGEL: ...to get checkups...
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SIEGEL: ...to get medicine...
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SIEGEL: ...to treat our allergies...
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SIEGEL: ...and to treat much worse.
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SIEGEL: When you add up the doctors and hospitals we visit, the technicians and nurses who care for us, the receptionists who check us in, the people who file our claims, mop our hospital rooms, we are talking about a huge chunk of society. And since we're going to be hearing lots of talk about that chunk in the coming days and how we pay for all this, we thought we'd spend some time today describing it. We can't be comprehensive, but here are some features of the U.S. health care sector. First, it is huge.
TONY CARNEVALE: The American health care system is the big guy on the block.
SIEGEL: That is Tony Carnevale, a labor economist at Georgetown University.
CARNEVALE: It is 16 million jobs. It is superseded in size by retail, but that makes sense. There are a lot more malls and stores than there are hospitals and dentist offices, but only by retail and wholesale. And it is a sector of very good jobs, really. It's what's replaced manufacturing.
SIEGEL: It's more than one-sixth of our gross domestic product. And Tony Carnevale says it employs one American worker in eight.
CARNEVALE: What is outstanding about the health care workforce is the extent to which it's female and the extent to which it's female at higher wage levels and higher education levels. This is in much the same way the manufacturing workforce - the old industrial economy - was a boy's economy. The health care economy - the post-industrial economy - is a woman's economy.
SIEGEL: And it's an educated person's economy.
CARNEVALE: And an educated person's economy.
SIEGEL: People, obviously, who are doctors, have M.D.s, but there are also a lot of people with certificates and associate degrees from community colleges in there.
CARNEVALE: Health care is the most credentialed industry, apart from education itself, in the American economy.
SIEGEL: Our health care sector, it's always said, accounts for a bigger share of the U.S. economy than just about any other country's health care sector accounts for it. Still true?
CARNEVALE: Still true. The Europeans are pushing 10 percent. They're at about nine in terms of the overall size of health care as a share of their GDP in general. We're at 17, and projections 10 years out say we're going to be at 20, maybe more than that.
SIEGEL: That health care could exceed one-fifth of the economy in terms of GDP.
CARNEVALE: That is correct. That either means that we get an awful lot more health care, or we get a lot of health care that's awfully expensive. And generally, it's about 50-50. We get a lot more health care, and the health care we get a lot more of is more expensive.
SIEGEL: Tony Carnevale told me that when the Labor Department counts jobs in the health care sector, surprisingly they don't count people who work for pharmaceutical companies or health insurance companies. Even so, health care's share of our workforce and our economy keeps on growing.
CARNEVALE: It's growing like crazy. In some ways, it's out of control.
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