The much-needed growth in healthcare employment may be steadily increasing healthcare spending, according to an article published in JAMA.

The growth of US healthcare expenditures in 2013 slowed to 3.6%, the lowest rate observed in this sector for 50 years. Despite these reductions, healthcare employment increased by 1.4%, — an indicator of a future rise in healthcare costs. Currently, healthcare jobs continue to increase by 2.1% on an annual basis. Increasing employment opportunities also means more wages, which may contribute to the current rise in medical-related expenditures.

Considering that many hospitals are not-for-profit, some centers experience challenges in reducing the rise of healthcare costs without sacrificing the growth and quality of their personnel. Hospital staff are needed now more than ever, particularly in light of the increasing shortage of on-call physicians, nurses, and medical assistants. Advancements in technology also increase job growth and costs. In an era in which technology constantly evolves and becomes smarter by the day, it’s not surprising that healthcare costs continue to climb.

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The Affordable Care Act was 1 initiative used to control cost growth in the healthcare sector; many of the strategies in this act are still in place (eg, accountable care and bundled payments). Despite initiatives to control these costs, they have also paradoxically increased job opportunities and employment.

The study investigators suggest that a delicate balance must be maintained with the current job growth observed in healthcare. For instance, greater employment in healthcare may result in job loss in other sectors, partly due to rising health insurance premiums, the investigators noted.

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According to the researchers, politicians and hospital executives are at the forefront of combating healthcare costs. These individuals often think of healthcare as a jobs program rather than a program meant to improve public health. The researchers suggest that a “focus should be on restraining overall hiring by rightsizing jobs to employees who can best perform them at the lowest cost or by closing inefficient facilities.”


Skinner J, Chandra A. Health care employment growth and the future of US cost containment. JAMA. 2018;319(18):1861-1862.