On Labor Day we tend to think of the American workforce — to the extent we think of it at all — in terms of hard hats and assembly lines, not stethoscopes and nurses’ crocs.
But as a New York Times story revealed in July, the people who staff the nation’s hospitals, medical offices, nursing homes and rehab centers now account for the largest share of the American workforce. At the beginning of the century this sector of the economy accounted for 9 percent of the jobs, third behind manufacturing and retail.
Now health care accounts for 13 percent of the country’s jobs. Its share is rising steadily as the aging of the boomer generation creates ever more demand for medical services. Retail and manufacturing are falling steadily behind. Health care is now the top employer in most of the states, including Georgia.
We ought to keep these statistics front and center when we think about the turmoil at the Centers for Disease Control in particular and the American health care system in general.
However important it may be for our staying alive, public health is never going to be higher than third in the federal government’s priorities, and often it doesn’t rise that high. Military defense can’t be ignored in a world this dangerous, and governments can fall in a sputtering economy.
Even given that grim reality, the country hasn’t come fully to grips with the larger dangers a decline in public health could pose. We haven’t figured out how to put into perspective the impact health care has on the larger economy and our security in the world.
When the top brass of the world’s leading public health agency quits rather than comply with changes they consider unscientific, it’s a bigger foreign policy problem — far bigger, really — than the current tariff war with India. When the Big Beautiful Bill is projected to result in nearly $1 trillion in cuts to Medicaid and Medicare, you’re talking about creating an enormous roadblock for the sector of the economy that is creating jobs faster than any other.
And when CVS announces it’s not offering the updated COVID-19 vaccine in this state, not because of current health conditions but because of the current “regulatory environment,” it’s more than an update. It’s a fundamental change in the way the health care we receive is administered. These are all developments that go far beyond the scope of what we normally think of as health care issues.
On Monday, the Times published a column signed by nine former directors and acting directors of the CDC.
“What Health and Human Services Secretary Robert F. Kennedy Jr. has done to the CDC and to our nation’s public health system over the past several months — culminating in his decision to fire Dr. Susan Monarez as CDC director days ago — is unlike anything we have ever seen at the agency, and unlike anything our country has ever experienced,” they wrote.
Meanwhile, U.S. Rep. Buddy Carter, appearing on CNN’s State of the Union program, called one of the CNN officials who resigned in support of Minarez a “BDSM Satan worshipper” and ridiculed the suggestion that Kennedy has done anything to restrict vaccines. Americans have grown farther apart on a host of issues, but it may be that the gap over these issues is becoming the widest.
Carter said that because of the way the agency handled the COVID-19 vaccine, “the CDC has lost their clout.” That sounds more like the way you might talk about the Atlanta Braves than an organization charged with keeping track of the deadliest viruses and poisons. But that is the way in which issues of life and death, not in the strategic or economic but the very literal sense of life and death, have been routinely politicized.
In their column, the former directors point out that average life expectancy in the United States was 66 when the CDC was created in 1946, and is more than 78 today. That’s not entirely due to the nation’s public system, but it’s one way to consider what’s at stake by monkeying with it.
Great article Tom! Astounding stuff.