2009 January 25 Sunday
The Flight To More Secure Job Occupations
An article in the New York Times discusses the flight of workers toward safer and more stable jobs. But the most interesting observation has to do with teaching salaries at some community colleges. People who earn Ph.D.s and teach at community colleges do not get paid much.
At 41,000 students, Macomb’s enrollment is up 10 percent from last year, Mr. Jacobs said. With the recession driving enrollment, he is adding to his staff of 220 full-time teachers and 750 adjuncts. Most of the new hires are adjuncts, though the courses they teach there and at another community college often add up to full-time work.
Since enrollment is rising, they are assured of work semester after semester, Mr. Jacobs said. The annual pay is $40,000 or less — usually less — and no benefits. Still, they are coming back.
“If you spent six or seven years and hundreds of thousands of dollars getting a graduate degree and you end up doing this, that is not a happy thought,” Mr. Jacobs said. “But it is steady work.”
A lot more people are getting Ph.D.s than ought to. Do they appreciate just how little some of their degrees are worth? Does getting a doctorate assure them that they are smart and wise? Or do they hold out hope they'll get one of those highly paid full professorships at the big name universities?
I see these doctorates as economic waste. Why take smarter people and convince them to spend lots of money in their 20s, go into debt, and spend years getting a credential that isn't going to provide a way to make a high salary? We shouldn't even have anywhere near as many college professors as we have anyway. The lectures of a fairly small number of professors can be video recorded and made available for viewing by anyone with an interest in a topic.
Health care is the field that most reliably grows even in recessions, mostly due to an aging population. But the economy will reach a point within 10 years where health care costs will become too large to allow continued growth at a rate faster than the economy overall. So I do not see health care as a good long term bet for job security. Though doctors will probably stay employed - albeit eventually at lower income levels.
Does anyone see an occupation which will provide job security in the long term?
Randall, as I read this post, I sense you do not fully understand what and why health care is so expensive in the US. First of all, aging has been shown to play at most a 2% role in the rise of health care costs in this country. Aging itself is not the problem.
You will never understand health care spending unless you think in non-linear terms (and FYI, health care spending is most definitely fractal). For in the same way that it is a few billionaires who own most of the wealth on this planet, it is a few people, and a few regions of the country, and a few people in these hyper spending regions, who are spending most of our health care dollars.
A link to my own blog to help see what is going on a little better.
Or if you would prefer to look at the raw data from congress and medicare yourself
The US vs other countries
The geographic variation in health care spending in the US.
The biggest issue of all is that our health care system just spends to improve things 'a little more' for an individual without regard to whether the money spent to make things 'a little better' for that one individual might be better used (for many other people) spending it differently. Someone (usually in a tertiary care Ivory Tower like Hopkins or Harvard) does a study showing that their outcomes are 'a little better' than everyone elses and therefore everybody else is required to change the way they are doing things to this new approach, and no one asks whether it is still not worth spending the money the new way vs. spending it in a myriad of other way. And because it does benefit a single individua at the time care is delivered, we all feel we are doing the right thing, even if we are making things worse for everyone else.
The other big issue is Americans are a lot less healthy than they used to be. We are fatter, more sedentary, etc... and therefore require more and more care to make up for our poor health. But this is not the same thing as aging per say, it is poor lifestyle choices, and were we to prevent a lot of these illnesses, we could easily save $1.5 Trillion/year (current estimates) from our current national health care consumption. Again, this is money we are currently spending and if we were not spending it, we could use it any other way we wanted.
Again, the problem really is not per say that we are getting older. It is
1. We are hooked on a consumption where every additional dollar spent actually reduces median national longevity
2. We refuse to have a national rationing discussion (or "prioritizing discussion if you prefer the word... although there are people out there who keep trying to tell us we need to ration intelligently and according to our collective morality)
3. We are becoming fatter and less healthy (but this is a different issue than age per say)
4. We have too much faith in the ability of sub specialists to improve our health when we get into serious trouble
5. Certain regions of the country are so economically dependent upon sucking health care dollar from the rest of the country (notably All of New England but especially Boston, New York and Long Island, Philadelphia, Miami, West Los Angeles, etc...) they are blocking any changes to our system with their very last breath (as it would cause a MAJOR depression in their economies)
6. Certain super spending people simply need to be told 'enough is enough' (remember, 1% of people spend 25% of the money, 5% spend 50%, etc... )
5. The current Med Mal system makes rationing (or if you prefer 'prioritizing) care absolutely impossible, even if you might get more care when you could really use it, an individual physician is not permitted to say "no" without losing their license as rationoing for the collective good is in a conflict with their hippocratic oath to look out for the best interest of the patient.
Again, think non-linear (80/20 rule stuff) and it is very easy to see what is going on in health care.
"Does anyone see an occupation which will provide job security in the long term?"
Anything involving security. It'll be a growth industry the way this nation is headed...
I understand that there are multiple causes for rising health care costs. I would include:
1) More treatments available and so more delivered. It was cheap to die of cancer or heart disease when they were totally untreatable.
2) Government funding for old age care. Can't spend money you don't have. But with taxpayer support the amount spendable goes way way up. What's the incentive for turning down a treatment that'll add 2 months to your life when turning it down won't increase what you get to leave to your inheritors?
3) Insurance. Similar to government funding. The receiver of care has little incentive to be cheap when someone else is paying.
4) Aging population. I do not understand why you dismiss this. Old people get far more spent on them per person per year and they are becoming a much larger fraction of the total.
5) Agreed on lawyers and medical malpractice.
6) Hospitals. When my father was dying the hospice people warned us that if we called for an ambulance and they took him to a hospital he'd never get out of the hospital. He'd spend extra days alive in an ICU. Do hospitals do this for money, malpractice fear, or just stupidity?
"Do hospitals do this for money, malpractice fear, or just stupidity?"
I have NEVER seen money play a role in this (other than no one thinks about money so bills can sometimes get out of control before anyone ever thinks to ask what it is all going to cost), I guess it could be the case in some ICUs in the US but I have never seen it. I have seen fear of med mal play a role and I have definitely seen it happen out of sheer stupidity as well, but more often than not the families themselves cannot come to grips with the issue of letting go, and because physicians cannot override the wishes of families and patients (the downside of not making physicians all powerful), it will happen according to the family's wishes whether the doctors want it to happen or not.
There are also cultural and educational factors that play a big role. As I said, some areas are 'super spending areas' (I personally think the need to be cut back to the median). For example, Miami spends more than twice as much at the end of life as anywhere else in the country.
But age is only 2% of the issue, look it up yourself if you don't believe me. The reason the elderly show up so heavily in the numbers is the elderly are so much closer to death than everyone else and it will always be true that 30% of all health care dollars will be spent in the last year of life, just like 5% of physicians will always be responsible for 50% of med mal cases and 5% of all patients will always spend 50% of all the money- it is one of those scale invariant curve things.
Age is not the main issue per say. I see a fair number of elderly Mennonites and most of them have hardly ever seen a doctor.
You can't beat Nursing. What other profession lets you come in with a two year associates degree and a passing score (on the RN exam)?
I think that's great, however the nursing lobby has been pushing states to require 4 year bachelors nursing degrees... with current nurses grandfathered in, naturally. If they pull that off, next thing you know they'll be like pharmacists and shift the requirements from a bachelors degree to a Doctorate. Again, grandfathering in current members. As a rule, anytime a profession tightens standards (always for reasons of "public safety") but exempts current members, its a scam to limit supply and jack up wages.
I should imagine that police work either with local or national agencies will have a growing future for quite some time to come. It may take considerable expansion of law enforcement to protect the elites from the consequences of a declining economic system. High-end private security staff may do quite well for the same reason.
People who sustain the reliable operation of power and water systems may be left mostly undisturbed by the contemporary turmoil. This probably won't be a growing field, but it may be quite secure for the present holders of such jobs.
Direct employment in health care is probably going to flatten out as we hit the part of the "S-curve" where exponentially increasing costs hit the wall of patients (or their insurance companies) ability to pay. By some accounts that I have read, we are already spending more than 50% of health care dollars on persons in their last six months of life - which indeed is about 5% of the patient population. This isn't a good "investment" by any standard.
A huge portion of health care costs are administrative expenses imposed by insurance billing, legal protection systems and government regulations, and this shows no sign of being controllable under the pending regime of socialized medicine. There might be slightly more openings for billing clerks, auditors, medical coders, and arbiters who are in charge of delaying or denying medical care to those without political connections.
This would certainly displace actual health care providers, such as doctors, nurses, and therapists, so the overall numbers of people in health care may not change much in the future. The quality and availibility of care would decline.
The perception of job security is likely to be very different from the reality and most of the "flight to more secure job occupations" will consist of jumping out of the frying pan and into the fire. There simply isn't reliable information available at any level for most people to make rational decisions. Throwing darts at a list might be the best method for selecting your next job direction.
My best guess is that versatility and situational awareness are the only means to attain some approximation of job security.
Healthcare is not secure. Foreign nationals can get a piece of paper and domestic traitors in high places are letting them in.
The best way to have financial security in your life is to live well under your means early on so that you can weather inevitable future downturns when you're unemployed or underemployed. In the long run you'll make far more money in riskier professions and endeavors than if you always play it safe. I think a good mix is to assume 70% employment and 30% no income and adjust your lifestyle accordingly. Ambitious and smart people deliberately choosing recession proof career paths so they have less of a chance of ending up without a job for a year is a stupid thing to do for both themselves and the rest of the world's well being.
No job is secure.
It doesn't take too much thought to realize this considering the rapid rate of technoloical change we are likely to see in just the next decade to say nothing of the 2020s. Kurzweil and others who think the exponential rate will keep going into the 2030s , 2040s, etc may be wrong, but they do not have to be correct for major changes to occur in the workplace within just 5 to 10 years.
At the same time, the idea of almost no work being secure will change society's attitudes as well. My guess is that in the 2020s we'll look back and think how lucky we are that we are no longer stuck in one job, that all jobs will involve more creativity, and that material standards will be higher than in the early 2010s.
Want a job with long term security and great benefits?
Relocate to a liberal stronghold and run for political office. Vote for every wealth transfer mechanism that comes up and blame Republicans, big business and rich people for your constituent's failures and you have a sure fire formula for success. Hang out on the Hill for 20 years and retire with a great pension guaranteed by the federal govt.