On the economic geography of health care

"Health care in America is in crisis" is a serious understatement. It will only get worse!

Consider, for instance, employment.  We tend to assume that health care is a growing industry and, therefore, that is where the income stream is, right?  Yes, jobs are there, but ...

Yet for every higher-paying job held by workers like nurses and doctors, more than six workers such as orderlies, phlebotomists and cooks make less than $15 an hour. Nationwide, 70 percent of hospital service workers make less than $15 an hour, NELP found. In the Midwest, it's 71 percent.

Now, the $15/hr might sound like quite a compensation to a person in Bihar.  But, ahem, a cup of coffee is not 15 rupees either; there is the cost of living:

Most counties in the U.S. have a cost of living across industries that isn't covered by minimum wage incomes, according to a recent blog post from Amy Glasmeier, a professor and co-chair at the Massachusetts Institute of Technology's economic geography and regional planning Ph. D program.
For instance, in Chicago, a single parent of one child needs to earn $24.67 an hour to meet a definition of living wage, while a person living alone there needs at least $12.33, based on a living-wage calculator  developed by Glasmeier in conjunction with MIT.

At least the cities are better, when one looks at health care in rural America; "half of the country's rural counties now don't have hospitals with obstetric services":

Maternity care is disappearing from America's rural counties, and for the 28 million women of reproductive age living in those areas, pregnancy and childbirth are becoming more complicated—and more dangerous.

One important factor is nothing but dollars and cents:

If hospitals want to offer obstetric services, they need to be ready for a baby to be born at any time—they need to have a bed available, the equipment available for mom and for baby, clinicians and staff available that have the necessary skills. That's a substantial expense. If a hospital's revenues are limited because it has a low volume of births—as many rural hospitals do—or if revenues are unpredictable, that creates a really difficult administrative problem.

It is exactly in such situations that we expect the government to step in where the market fails, right?  Especially when you consider this: "Medicaid funds about half of all births in the United States, and an even greater percentage of births in rural hospitals."  So, if these health care services for pregnant women are gone ...?

State and federal programs to support the rural maternity workforce are crucial. There ought to be programs to support training in emergency births in rural communities that lose obstetric care, and to support the costs of providing maternity care in communities where there are willing providers.

trump and his 63 million voters can fix this all with a complete repeal of Obamacare, right?