Health Care Reform: Good for Patients, Good for Workers, Good for Women

By Amanda Marcotte, RH Reality Check. Posted January 5, 2009.

In my last column of 2008, I built on Linda Hirshman's idea that an economic stimulus package offered under the Obama administration should focus on making sure that job creation equally benefits men and women.  We should applaud the Presidential transition team for embracing the idea of green jobs, but, as Hirshman points out, the jobs that have been proposed are mostly blue collar jobs in industries dominated by men.  Hirshman suggests that the Obama administration additionally prioritize building our educational system, which would employ more women.  I suggest that the country should view health care reform as an economic investment that can create jobs women are likely to take. 

Forty-six million Americans currently go without health insurance, and most of them have patchy access to health care, avoiding preventive services and only seeing a doctor when lack of prevention lands them in an emergency room -- perversely, this creates the very long lines we're told to fear if said people instead receive basic health care.  Under most universal health care proposals, these 46 million would be able to purchase health insurance, dramatically elevating the labor demand for doctors, nurses, pharmacists, and other health care providers.  With doctors alone, this improves women's employment prospects, since female medical school applicants outnumber male applicants.  But with the increasing emphasis on prevention, the demand for nurses and other medical staff will rise even faster.  These are professions in which women are predominant.

Obviously, the incoming administration has an opportunity to kill two birds with one health care reform stone.  Applying the green job reform model to health care -- creating a demand for labor and creating a means to fill it -- will work nicely for health care.  We have a nursing shortage in America, but it's not for a real lack of actual human beings who need the jobs.  Most of the women who might find nursing a good job can't quite seem to get into it, because cobbling together the time and money for the training falls just outside of their means.   

Making the leap from a minimum wage service industry job into a higher income nursing job means, for many women who would like to make that transition, finding money to pay for it, and dealing with increased child care costs to cover their hours working their normal job and the hours at school.  For many women, these are costs they simply cannot afford. But our federal government can easily provide both the tuition money and the child care.  It's been demonstrated in this country's past, that if need be, the federal government can create child care programs to free up women's time so they can take jobs that must be done. During World War II, the federal government set up 24 hour day care centers for female shipyard workers taking jobs that men couldn't fill. This would have the added benefit of employing more women, since child care workers are largely female.  

Should the demand rise high enough, the government might even invest in on-the-job training programs for female health care workers, so they can start drawing a salary immediately, reducing their need to hold down an outside job while receiving the training to be a nurse.  Right now, one of the biggest barriers between the many women (and men, too) who would like nursing jobs is the long waiting lists at nursing school.  Again, the federal government can attack this problem, funding an expansion of the educational apparatus to increase the number of graduates coming out of school and meeting the growing demand for this kind of health care.

Just a couple of years ago, the idea of widespread federal investment in infrastructure for the purpose of investment and job creation seemed a marginal idea that had been abandoned once we recovered from the Great Depression.  That changed in pretty short order, and if things go as planned, historians will mark this as a time of a great paradigm shift.  And thank goodness. If this is a country that really is committed to the equality of all, the federal government should consider the needs of the working class to obtain and maintain decent work to be at least as important as the desires of the wealthy to keep their stock holdings from plummeting precariously when the latest economic scheme collapses.   

Federal job creation is a good unto itself, so long as the work is real and dignified, but we have a unique opportunity to create jobs that really do pay us back tenfold.  Green jobs that set the standard for a modern environmentalist society are one way to get our investment back beyond just the standard good of full employment, and health care job creation does the same thing.  Everything in our society will improve when our citizens are as healthy as possible. 

And we can do all this without compromising feminist principles that advocate for an economy where women don't depend on men, and aren't forced, as I argue in this week's podcast, to make compromises like staying in abusive marriages because they can't afford to escape.  In opposition to the New Deal of the 1930s, which glorified the nuclear family and female dependence, we really can create a new New-er Deal that supports female independence and truly healthy families formed out of full consent, economic and otherwise.

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Amanda Marcotte co-writes the popular blog Pandagon. She is the author of It's a Jungle Out There: The Feminist Survival Guide to Politically Inhospitable Environments.

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