The Bureau of Labor Statistics has a clean-sounding explanation for the downsizing that’s hit hospital in dozens of states over the last four years, calling it “a result of efforts to control hospital costs and of the increasing utilization of outpatient clinics and other alternative care sites.” Hospital workers and their unions call it something else — the result of mismanagement, greed, and federal neglect. Facing growing pressures to turn big profits and shrinking Medicare and Medicaid payments, hospitals are lurching into crisis, workers insist.
Whatever the cause, the effects are clear: From Long Island to Miami, Philadelphia to Oakland, hospitals have eliminated hundreds of thousands of jobs. Even with the nation in the midst of a nursing shortage, with hospitals in California, Ohio and elsewhere adding nursing jobs, job security remains bleak. That’s especially true in Florida. In the summer of 2000, there were 149,060 registered nurses working in Florida hospitals. By the summer of 2003, that number had plummeted to 131,260, a drop of more than 10 percent. Nurses in Illinois have been hit with an economic double-whammy. Not only are there fewer hospital jobs for registered nurses, but real income has dropped. Adjusted for inflation, registered nurses’ wages in Illinois actually fell by about .3 percent between 2000 and 2003.
Support workers, among the lowest-paid hospital employees, have been hit particularly hard. In Pennsylvania, for instance, more than 4,000 housekeeping jobs have disappeared since 2000. And there has been little if any growth in wages. While housekeeping workers across the nation saw incomes increase by about 1.6 percent between 2000 and 2003, workers in many states, like Florida and Michigan, saw only meager gains of about .3 to .5 percent.
Among all hospital workers, there is one group that has gained in just about every way — managers. True, job growth has been modest — just 1 percent nationwide. But wages have accelerated at an industry-best rate. Adjusted for inflation, medical managers are earning nearly 10 percent more today than they were in 2000.