The CSA and Symbols: Learning from History

CivilWarSince a crazed, hate-filled and cowardly gunman killed nine black Christians in Charleston, South Carolina, the PC police have been in attack mode on anything associated with the Confederate States of America. The South Carolina General Assembly quickly voted to removed the Battle Flag from a Confederate Soldiers’ Memorial on the State House grounds. Now, critics want to destroy a massive carving on Stone Mountain outside of Atlanta featuring Confederate heroes Jefferson Davis, Robert E. Lee and Thomas “Stonewall” Jackson. Some are even demanding the rethinking of events associated with Thomas Jefferson, Andrew Jackson, and others because they were slave owners.

Ben Hallman at the Huffington Post tells us how we are supposed to think: “The Confederacy was the most vile and harmful political invention in United States history. It was founded on the explicit principle that slavery is the ‘natural and normal condition’ of black people, and that they should be ruthlessly exploited to the benefit of their white masters.” Hallman and others see Confederacy as synonymous with slavery and racism, and tell us to despise all things Confederate. His is a very simplistic view of history.

Slavery was a horrible institution that most of us, thankfully, cannot begin understand. But if we are going to remove symbols and emblems associated with it, we better look at the Stars and Stripes before hunting down anything with the initials CSA. Slavery, of course, existed in the United States from colonial times until ratification of the 13th Amendment. Twelve presidents owned slaves at one time or another, including George Washington and U.S. Grant. Actually, slavery existed longer in the Union than the CSA, since the Emancipation Proclamation did not apply to slaveholding states remaining loyal to the Union. For a good study on the war, causes, and effects, see Robert Higgs, “The Bloody Hinge of American History.” For anyone interested in the growth of the federal government under Lincoln and the Republicans, see Joseph R. Stromberg, “Civil War and the American Political Economy.” For a scholarly argument that war was not necessary to gain emancipation, see Jeffrey Rogers Hummel, Emancipating the Slaves, Enslaving Free Men. A review of the book can be found here.

Of course, the Stars and Stripes has also presided over many horrific acts and policies dealing with removal of American Indians, imprisonment of Japanese Americans in WWII, and the torturing of prisoners at Gitmo. Such examples are abundant.

If we want to hold the USA and CSA to our modern standards and sensibilities, both will be found lacking. But in both the CSA and the USA we can find men and ideas worth studying and considering. Libertarians have long realized this. For example, Professor Randall Holcombe points to many provisions of the Confederate Constitution that limited government power and that would serve us well today. Robert E. Lee rightly remains internationally respected as a brilliant tactician, a gentleman, and man of honor. The Independent Institute has long championed William Lloyd Garrison, his demands for the abolition of slavery, and his contributions to liberty.

Bottom line: We need to pause before we banish all symbols of our past that don’t comport with modern thinking. Our history has rough edges and embarrassments we don’t want to repeat. But there’s plenty to learn from great men of the North and the South, the Blue and the Gray.

Love, Marriage, and Green Cards


For most of human history, love and marriage had positively nothing to do with each other. Marriages were arranged in order to strengthen alliances, end family feuds, and secure political power. You were lucky if you liked your spouse, let alone loved them!

In the United States today, we don’t see marriages for political power (though it’s an interesting thought experiment to think about what would happen if one of President Obama’s daughters married one of Mitt Romney’s sons). But we do see marriages that, more than likely, aren’t for love. The late Anna Nicole Smith, for example, made headlines when she married the 89-year-old oil tycoon J. Howard Marshall. She was 26 at the time. Needless to say, the union of a former Playboy model to a man 63 years her senior raised some questions—until people found out Marshall’s net worth was a cool $1.6 billion.

According to the CDC, approximately 2.1 million marriages occurred in the United States in 2011. My guess is that some of these did not happen for love.

One interesting instance of such a transaction involves a special type of immigration visa—and highlights how government policy induces people to take desperate measures to improve their lives.

A K-1 visa is issued to individuals living outside the United States and allows him or her to immigrate in order to marry a U.S. citizen. I’ve written elsewhere about the complexities of the immigration process and how for many people in developing countries, their chances to obtaining entry for work or asylum are slim to none. Even those who can obtain work visas may spend years waiting in line. This has led people to undertake dangerous journeys and send even their children thousands of miles away alone–all in hopes of a better life.

As such, it should come as no surprise that more than one person has figured out they can get to the States by marrying a U.S. citizen. This issue received some attention recently with the release of the second season of the TLC reality show, “90 Day Fiance.” As the title of the show implies, the K-1 visa allows for a foreign fiancé to enter the country, but requires he or she to marry their betrothed within three months. In nearly every case, the family members of the American were skeptical, some asking point blank if their fiancé was “just in it for the green card.”

This is not to say that everyone who is issued a K-1 visa is solely seeking citizenship, but without a doubt, some people who enter the U.S. on K-1 visas are just in it for the green card. Understandably, there isn’t data on how many marriages take place every year just so a foreigner can obtain citizenship.

This got me thinking, why would someone marry a U.S. citizen if they were just looking to enter the U.S.? Is it easier than the alternatives?

Let’s look at the process for a K-1 visa. Assume the foreign partner is just trying to get a green card.

Timeline (approx) Step Information
Varies 1.
U.S. Petitioner gathers various documents
U.S. Petitioner gathers various documents (birth certificate etc) to send with I-129F
N/A 2.
I-129f Package sent
U.S. Petitioner sends compiled I-129F package to theUSCIS Dallas Lockbox which will forward the package for processing.
2-3 Weeks 3.
1st Notice of Action (NOA)
U.S. Petitioner Receives first Notice of Action (NOA) acknowledging K-1 petition has been opened
See Processing Times 4.
2nd Notice of Action (NOA)
U.S. Petitioner Receives second Notice of Action (NOA) acknowledging K-1 petition has been approved
2 Weeks 5.
Case Forwarded by your Service Center to the National Visa Center (NVC)
Case Forwarded by your Service Center to the National Visa Center
1-4 Weeks 6.
Case Forwarded by NVC to U.S. Embassy in your fiance(e)’s country
Case Forwarded to U.S. Embassy as specified in the I-129F.
1 week 7.
Case received by Embassy from NVC
Embassy receives package and processes it. They will then prepare a letter to be sent to the foreign fiance(e).
1 week 8.
Forms and Checklist sent to Beneficiary
Forms and Checklist sent to foreign Beneficiary (Fiance/e).
Varies 9.
Foreign Beneficiary compiles required forms
Beneficiary fills in Forms and assembles various documents
N/A 10.
Completed Forms sent to Consulate
Beneficiary sends completed Forms to U.S. Embassy
N/A 11.
Fiance(e) must attend medical interview prior to interview
Attend medical appointment.
1 week to issue date 12.
U.S. Embassy issues Beneficiary with Interview date
U.S. Embassy issues Beneficiary with Interview date
1 Month to interview 13.
Beneficiary has Interview at U.S. Embassy
Beneficiary has interview at U.S. Embassy for K-1 visa. All being well case is approved.
N/A 14.
Beneficiary travels to and enters the U.S.
Beneficiary travels from their country to be with the U.S. Petitioner (Fiance(e)) in the US.
5-20 minutes 15.
Point of Entry (POE) in U.S.
Beneficiary arrives at Point of Entry (POE) in U.S. and shows K-1 to the immigration officer.
1 hour (early morning) 16.
Apply for Social Security Number
Apply for Social Security Number (SSN)
1 hour 17.
Apply for marriage certificate
Apply for marriage certificate. Must marry within 90 days of entering the U.S. on a K-1 visa.
Get married
Get married. and give each other a pat on the back. You’ve both earned it!
1 hour (early morning) 19.
Change name on SSN
Go back to the SSA office and bring your SSN Card and marriage certificate. Change your name.
Varies! 20.
Complete I-693
Complete I-693 per the K1/K3 AOS Guide. This is required so that your vaccinations can be documented properly on the I-693 as part of your completed AOS package.
(File as soon as possible once you marry)
Apply for Adjustment of Status (AOS), EAD, AP
Apply for Adjustment of Status (AOS). You should file as soon as possible. If you have not filed for AOS and your K-1 expires, you will be considered out-of-status until you file. Make all attempts to file before you become out-of-status. You may also file for your EAD and AP at this time.
See Processing Times 22.
Receive EAD / AP
Receive your EAD and AP via US Mail. You will have a biometrics appointment prior to being issued the EAD.
See Processing Times 23.
Interview for AOS (I-485 approval)
Interview appointment for AOS. When approved you will receive an I-551 stamp in your passport indicating you have been approved for AOS and will also receive your green card in the mail later.


Add to this process the following. If you are just in it for the green card, you need to find someone to marry you. You can A.) manipulate another person and trick him or her into marrying you. This takes time, effort, and spending copious amounts of time without someone for whom you have no feelings. B.) You can find someone who will agree to marry you if you pay him (The amount of money this takes varies. I’ve seen estimates from less than $10,000 to $25,000+). This requires additional time and effort, though perhaps less time on the back end with someone you don’t really care about (though you have to fake it well enough to fool immigration). C.) You can find someone who is particularly sympathetic to your plight and get him to agree to marry you. You forgo paying them, perhaps, but still incur the costs noted above.

This process should seem insane–because it is! It requires time, money, and fraud. Yet, as economics tells us, individuals would not undertake these transactions if the benefits were not greater than the cost.

This means that the above process, all of it, is more appealing than going through the other U.S. immigration processes. If that doesn’t indicate a need to reform the current immigration system, I don’t know what does!

Let’s Hope Arizona’s New Health Law Is Contagious

a_better_choice_180x270Last April, Arizona governor Doug Ducey signed a law that allows patients to order lab tests directly from a lab, without physician intermediation. The tests will be self-paid: No government nor private health plan has to pay for them.

The legislation was backed by one of the most exciting diagnostic companies in the market: Theranos, founded by an incredibly entrepreneurial young billionaire, Elizabeth Holmes. The firm’s technology allows a battery of tests to be run on a single drop of blood, instead of the long draws we are used to undergoing.

Ms. Holmes’ business strategy necessitates disrupting the very staid world of clinical laboratories, which has been protected from innovation by the government-driven payment model. Instead of lobbying to get inside the model, Ms. Holmes lobbied to be exempt from the model. We need more people like that in health care.

This brings us to an interesting dispute between another billionaire, Mark Cuban, and the journalistic and medical establishment. Mr. Cuban advises everyone who can afford it to have his or her blood tested quarterly. His opponents say that’s overkill. Arizona’s new law makes their opposition obsolete.

(Recall that the Obama Administration has issued a rule allowing anyone direct access to lab results. I was not quite comfortable with it because of a concern for federalism. I have no such concerns with Arizona’s new law.)

Fellow Forbes contributor and health care entrepreneur Dan Munro has taken advantage of the new law. It was a positive experience:

The Theranos process really has removed much of the friction I associate with blood tests I have taken in the past. Access is through a familiar retail facility with pharmacy hours. Billing is a typical retail transaction with credit, debit and HSA cards (or cash/check). The lowest price blood test is $2.70 (Glucose) and Theranos advertises that their pricing is at least 50% below Medicare reimbursement rates for all tests.

The highest price test on the Theranos order form was $59.95 ‒ a comprehensive test for Sexual Health. For comparison purposes, RequestATest (which appears to be an online, front-end for using LabCorp locations around the country), charges $199 for a comprehensive STD test and AnyLabTest Now (with 3 locations in the Phoenix metro) charges $229 for a comprehensive STD test.

The Obama administration is a fan of getting clinical data in the hands of patients. Here is a great opportunity for it to do something I’ve advocated forever: Tell Medicare beneficiaries in Arizona that if they can find a blood test for half the cost of the fee Medicare pays, Medicare will split the savings between the patient and taxpayers, adding some share of the savings to the patient’s Social Security deposit. (Note: Medicare would not recommend or endorse Theranos specifically. Theranos and Walgreens would take care of promoting the option.)

I’d bet that if Medicare adopted such a policy, and beneficiaries in Arizona told their friends on Medicare around the country, other state legislatures would pass laws mimicking Arizona’s pretty quickly.

Government’s Burden on Young Americans

LoveGov2_416x358The Independent Institute’s Love Gov videos offer an amusing look at the raw deal government policies give to America’s youth. In the videos, sometimes government tempts young people into bad deals, such as student loans, and other times it offers them little choice but to take bad deals, as with health insurance. But the videos understate the magnitude of forced transfers from younger Americans to elders.

Social Security, Medicare, and Medicaid make up 60% of the federal budget, and those programs are transfers from the taxpayers who fund them to recipients. Social Security and Medicare are only for older Americans, and a major share of Medicaid also goes to older Americans. Younger Americans pay the taxes; older Americans get the benefits.

Things are getting worse for young Americans. As Jonathan Gruber noted, it is because of “the stupidity of the American voter” that Obamacare charges artificially higher premiums to younger people so that older people can have lower premiums.

So sure, government tempts young people to take out excessive student loans, to take on home mortgages beyond their abilities to afford them, and do other irresponsible things, but government also forces even the most responsible American youth to sacrifice some of their own well-being to support older Americans.

Government does many things. One is: it systematically plunders American youth for the benefit of older Americans. Is this fair? Ironically, programs that support the old at the expense of the young are more politically popular among the young than the old.

None “Heil” Trump

Statue of LibertyAmerica is a country founded on the principle—regardless of how imperfectly carried out in practice—that all men* are created equal. We celebrate and honor the value of the individual, endowed irrevocably with the rights to life, liberty, and the pursuit of happiness.

We cherish the American Dream that, regardless of the circumstances of birth, with grit and determination, anyone can succeed.

And while we may not yet be there, we strive to fulfill Martin Luther King’s dream of a nation in which all are judged solely by the content of our character, not by the color of our skin.

How un-American, therefore, to witness Donald Trump as a candidate for the Presidency of the U.S. practicing identity politics, lumping together and branding an entire population—illegal immigrants from Mexico—as rapists and murderers.

And he goes farther. Trump lays the blame for the moribund American economy at others’ doors: “[The unemployed] can’t get jobs, because there are no jobs, because China has our jobs and Mexico has our jobs.”

Witnessing cheers for such scaremongering should strike fear in the hearts of everyone who loves liberty. We’ve seen before a country weary of economic malaise cheer a charismatic leader rallying his followers against a scapegoat: Hitler laying the blame for Germany’s economic crisis on the Jews.

And just as disastrous German economic and monetary policies exacerbating the punitive Treaty of Versailles—not “the Jews”—produced Germany’s ills, so Trump and the American people need look to our own dysfunctional government—not Mexicans—as the primary producer of our economic stagnation.

A government peddling mediocrity and class warfare in the place of “public” education; a government erecting increasingly insurmountable barriers to economic opportunity and entrepreneurship; a government bankrupting the middle class and inuring dependency.

A land of opportunity has no fear of more people—we recognize them as a source of wealth—human capital, growing our economy.

American Conservatives cheering Trump have forgotten that their patron saints—Milton Friedman and Ronald Reagan—both recognized Mexican immigrants as a benefit to the U.S.

Friedman famously tempered his support for immigration—

Now, that Mexican immigration, over the border, is a good thing. It’s a good thing for the illegal immigrants. It’s a good thing for the United States. It’s a good thing for the citizens of the country. But, it’s only good so long as it’s illegal.

—with warnings on the costs of welfare: advocating illegal immigration, since illegal immigrants are not eligible for welfare. Thus, he rightly called for the abolition of the Welfare State—not the abolition of immigration.

Yet even accounting for the costs of public benefits, numerous studies from Independent Institute and others find that immigration produces a net benefit to the U.S. economy, and a restriction on immigration especially hurts small business.

As more than 500 economists, including 5 Nobel Laureates, agree:

Immigrants do not take American jobs. The American economy can create as many jobs as there are workers willing to work so long as labor markets remain free, flexible and open to all workers on an equal basis.

So this is the cry around which all Americans should be rallying: dismantle the horrific government programs that are producing an ill-educated citizenry, blocking opportunity and entrepreneurship, and replacing our culture of valuing every individual as possessing unique and unlimited potential with one that classifies and brands us by race, creed, national origin, and gender.

Americans should indeed stretch out our right arms—not in “Heil” for Trump’s ridiculous scapegoating—but to raise high the lamp of liberty, a welcoming beacon for all who yearn to breathe free.

*”Man” is our genus: human being, and encompasses male and female.

Ten States Join Interstate Medical Licensure Compact

InterstateMedicalLicensureCompactIowa has become the tenth state to enact the Interstate Medical Licensure Compact. This is a great achievement for the medical profession and state sovereignty. For almost a year now, I have been supporting this effort, and I am glad to see it succeeding.

Licensure itself is problematic, because it confers monopoly power on a profession. A better solution is certification, which prevents unqualified practitioners from using a title claiming certification but does not prevent them from practicing. However, physician licensing is not going away, and as long as it is with us we should applaud developments that facilitate the practice of medicine across state lines.

On June 24, I attended a briefing held after seven states joined the compact. That milestone started the wheels turning to establish a commission that will execute and administer the interstate licensing of physicians. At the meeting I learned a few things, a couple of which surprised me:

First, the impetus for the interstate compact was growing anxiety among physicians that Congress would assert a federal power to license physicians. If state medical boards did not solve the problem of interstate licensing, then they would lose the initiative. This did not surprise me.

Second, they do not need legislation in Congress to authorize the compact. The states that have signed on can move right ahead. This surprised me a little.

Third, the compact is not about telemedicine. This surprised me a lot. I had thought it was all about telemedicine. On the contrary, doctors sometimes visit patients across state lines, and they want easy and responsible licensing in many states. One group at the meeting was from the University of Pittsburgh Medical Center. Its affiliated physicians will sometimes have cause to practice in, for example, West Virginia.

This made me think the compact is not just for physicians in rural areas. There are plenty of physicians who cross state lines between, for example, Virginia, the District of Columbia, and Maryland; or New Jersey and New York; or New York and Connecticut who would benefit from the compact.

Cake Politics

BakeTheCakeFollowing the recent news, I’m not sure under what conditions a baker can decline to provide a cake to potential customers. I’ve seen this story in which an Oregon bakery was fined $135,000 for declining to make a cake for a same-sex wedding, but I’ve also seen this one in which a Wal-Mart refused to make a cake decorated with a Confederate flag for a customer, but did bake a cake with the ISIS battle flag on it, and to add to the confusion, then apologized for providing what the customer wanted.

Is it legal for a baker to refuse to make a Confederate flag cake, but illegal to refuse to make a same-sex wedding cake? Or, did Wal-Mart violate the law when it refused to bake the Confederate flag cake, and then apologize for abiding by the law when it made the ISIS cake? Debbie Wasserman Schultz says “You shouldn’t be able to turn people away based on who they are,” and I presume that would apply to Southerners just as much as to gays.

When is it legal, and when is it politically correct, to refuse to bake a cake to a customer’s specifications? It appears that sometimes it is mandatory to bake a cake to a customer’s specifications, and sometimes it is prohibited, regardless of the preferences of the baker. Cake politics has become quite confusing lately.

Zeke Emanuel Hammers Obamacare Again

a_better_choice_180x270Obamacare’s best frenemy, Dr. Ezekiel Emanuel, and his colleagues at the Center for American Progress, gave up on Obamacare last year. In yesterday’s Wall Street Journal, he and Topher Spiro emphasize that Accountable Care Organizations, which Obamacare established to co-ordinate care and lower costs in Medicare, are failing to achieve either goal:

The Obama administration recently announced a laudable goal: 50% of Medicare payments will be made under new payment models by 2018. But to reach this goal, the administration must change tactics and use the authority given to it under the law to rapidly expand payment reforms.

While many reforms are being tested, the administration’s main focus has been on creating “accountable care organizations.” ACOs are groups of medical providers that are rewarded for achieving savings on their total spending while improving quality.

A cost-control strategy that relies on expanding the number of ACOs won’t be successful. Before it is too late, the Obama administration must focus on a reform that can be scaled. Medicare should lump together physician services, hospital costs, tests, medical devices, drugs and rehabilitation services related to common ailments—such as broken hips, heart stents and cancer treatments—into a bundle. It could then pay a medical provider a discounted amount for the whole array of services.

(Ezekiel Emanuel and Topher Spiro, “The Coming Shock in Health-Care Cost increases,” Wall Street Journal, July 8, 2015)

I am not quite sure what they are getting at, because Medicare did establish bundled payments in 2013. It is not clear what Dr. Emanuel and Dr. Topher believe the current model lacks. Here’s my summary of the difference between government-dictated “accountable care” and “bundled payments”: The former is for healthy patients and the latter is for sick patients.

Anyway, this invites the question: If current bundling and accountability, as determined by the federal administration are failing, then why would we expect the Obama administration to do a better job? Why would we expect a future administration to do a better job?

In which other line of business would we expect an insurer, a third-party, to determine what should be bundled and what should be sold independently? Do auto insurers decide whether radios should be standard in cars? Do homeowners’ insurers decide whether homes should be built with kitchen appliances included?

The only way to ensure that bundled care is bundled right is to let patients control the dollars and let providers experiment with collaborating on different bundles of care. That would mean turning Medicare into “some kind of voucher,” as President Obama has put it.

* * *

For the pivotal alternative to Obamacare, please see the Independent Institute’s new book, A Better Choice: Healthcare Solutions for America, by John C. Goodman.

Pay Attention to History

3204093_SI recently had the chance to participate in an online seminar for high school debate team students. In preparing for their upcoming competition, they were interested in speaking with an economist about U.S. policy in the Middle East.

An online lecture like this was a new experience for me—a very good one. First, I’m used to college students as opposed to high school kids (that change between the ages of 14 and 18 is nothing short of amazing). Students of this age are capable of a lot, but often haven’t been exposed to the economic way of thinking. The second big change was the platform. The students could communicate with each other through a real-time chat room during the lecture. Their comments and questions about the talk were visible to their fellow classmates immediately. What was important for me was that I could also see it...while I was speaking.

Although seeing student feedback like that was a bit jarring, it was fabulous in that I could adapt and, importantly, answer their questions without ever having to hear them ask—a teacher’s dream.

In glancing up at the monitor toward the latter half of my talk, I saw that one of the students had mentioned that many of the things I was discussing weren’t current events. Indeed, I discussed with them U.S. policy going back decades.

Several months ago, I discussed how several states looked to ban or alter their A.P. U.S. History courses for teaching students ideas contrary to “American exceptionalism.” I argued that instead of assuming stupidity and gullibility on the part of our children, we should focus on teaching them critical thinking skills and help them develop the tools necessary to evaluate and critique policies on their own.

Well, here was an opportunity for me to, as they say, “put my money where my mouth is.” Here was a group of high-caliber students interested in current policy and a chance for me to make the case for why they should examine, critique, and care about historical policy.

“So why does this matter?” I asked them. “Why should we care about what U.S. policy looked like in the 1970s or the 1980s?”

I explained to them that the theory we had been discussing is really brought to life by examples. These examples are some of the best tools for making arguments about current policy options. If you want to convince your audience that what you are saying is valid and important, there is nothing quite like history.

I then told them about how during the Soviet occupation of Afghanistan, the U.S. government took to arming the “moderate rebel group” known as the Mujahedeen. The supply of training and weapons to the group was ultimately successful, and the Soviets pulled back. Following the retreat, the U.S. government lost interest in the group and left. Who stepped in to fill the void? Osama Bin Laden.

“And that,” I said, “is how the Taliban got started.” (a-ha! It’s now contemporarily relevant!)

There is a tendency to push history to the side, to ask why it matters. History matters because it provides us a variety of indisputable opportunities to examine how policies, crises, and other events have played out over time. It forces individuals to think in a way that considers both the seen and unseen consequences of an action—to contemplate both the present and future costs of a particular activity.

Moreover, history is a phenomenal way to understand the present. Late Nobel laureate James Buchanan stated that economics “puts limits on people’s utopias.” I think the same can be said for history. History allows us to take fanciful notions and proposals and place them in check. Continuing on with the discussion of the Mujahedeen with the debate students, I then linked this historical episode to the current calls to arm “moderate” Syrian rebels. I could have told them all the reasons why such a policy might be a bad idea, but it was the historical context that made it tangible.

So whether we’re discussing the Middle East, drug prohibition, or the minimum wage, consult simple economics–and crack a history book.

Health Jobs Outpace Soft Employment Report

Health jobs keep growing faster than other civilian, nonfarm jobs. Health care added 40,000 jobs in June, almost one in five of the 223,000 jobs added. At a seasonally adjusted growth rate of 0.27 percent, health jobs continue to grow significantly faster than other jobs, which grew at 0.14 percent (see Table I).

Although hospitals account for one-third of health jobs, they are adding workers at a significantly slower rate than outpatient care centers and home healthcare services. Nursing and residential care facilities added jobs at about the same rate.

Longer term, the story is similar. Health care added jobs at a rate of 2.91 percent in the twelve months to June, while other jobs grew 2.02 percent (see Table II). Outpatient care centers and home healthcare services have experienced sustained jobs growth at a pace greater than other health services.

I continue to believe the relative decline in the rate of growth of hospital jobs is positive, because hospitals are often the least efficient location of care and too politically powerful.

20150702 Health Workforce TI

20150702 Health Workforce TII