eds and meds
As we drove back from last night's unsuccessful aurora hunting attempt, the conversation turned to cities and suburbs, and the effects of the decline of American manufacturing on America's population centers. Even Philadelphia - a "real" city, a top-six city, an iconic American city with an actual rail-based transit network - even Philadelphia in this century is primarily supported by "eds and meds". Penn. Drexel. Main Line Health. CHOP. Jefferson. Merck. (Lockheed Martin, Vanguard, Acme, and Aramark are the other four.) The line between institutions of higher education and medical institutions blurs with all the medical schools and teaching hospitals, but in this post-industrial city, Penn's 30,000 employees certainly make it the largest employer.
Go back to my hometown of Rochester, New York, and it's the same thing. With Kodak dying, the University of Rochester dominates with 20,000 employees. Also on the top 10 are Rochester General Health, Unity Health System, Lifetime Healthcare Companies, and RIT. (Wegmans is #2.) msarcher's hometown of Pittsburgh is much the same. UPMC. Pitt. West Penn Allegheny Health System. Highmark. You can probably find similar listings for whatever declining industrial city you check. Buffalo (UB, Kaleida Health). Binghamton (SUNY Binghamton, United Health Services). There is an argument that Detroit's real problem is that it never had a state university to hold it up.
Eds and meds. A familiar pairing. But then I remembered the other place I'd seen it - that morning, when I'd idly thrown some money at Rolling Jubilee, in the hopes of helping them randomly eliminate some people's debt. Because the conversation about debt focuses on the same two things - student loans and medical debt. The tens of thousands of dollars we borrow for our educations, and the huge expense of basic medical procedures, especially for the uninsured. A cursory glance at how medical expenses work seems to reveal that the whole system is broken; the ballooning of college tuition over the past few decades is sort of astounding. There are reasons for everything - technology and staffing are both expensive - and there is some leveling of tuition costs due to financial aid (and theoretically due to health insurance?), but the bottom line seems to be that we are supporting these critical institutions with huge amounts of money that we don't actually have. And in turn, these institutions are holding up our cities.
What does this mean for the cities? How do these things interplay? If the cities are actually being supported through gigantic debt from the rest of the country, what does this mean for their futures? And how would the kind of tinkering that probably ought to happen with financing these things - attempts to somehow get the costs of healthcare and education to drop so they were actually affordable - affect our cities? It seems like one more complication in an impossible situation, one more reason we won't be able to get out of this mess without breaking something else precious.
But maybe I am missing something?
This entry has
comments. Leave a comment? (Click "Log in with OpenID?", top right corner.)
Go back to my hometown of Rochester, New York, and it's the same thing. With Kodak dying, the University of Rochester dominates with 20,000 employees. Also on the top 10 are Rochester General Health, Unity Health System, Lifetime Healthcare Companies, and RIT. (Wegmans is #2.) msarcher's hometown of Pittsburgh is much the same. UPMC. Pitt. West Penn Allegheny Health System. Highmark. You can probably find similar listings for whatever declining industrial city you check. Buffalo (UB, Kaleida Health). Binghamton (SUNY Binghamton, United Health Services). There is an argument that Detroit's real problem is that it never had a state university to hold it up.
Eds and meds. A familiar pairing. But then I remembered the other place I'd seen it - that morning, when I'd idly thrown some money at Rolling Jubilee, in the hopes of helping them randomly eliminate some people's debt. Because the conversation about debt focuses on the same two things - student loans and medical debt. The tens of thousands of dollars we borrow for our educations, and the huge expense of basic medical procedures, especially for the uninsured. A cursory glance at how medical expenses work seems to reveal that the whole system is broken; the ballooning of college tuition over the past few decades is sort of astounding. There are reasons for everything - technology and staffing are both expensive - and there is some leveling of tuition costs due to financial aid (and theoretically due to health insurance?), but the bottom line seems to be that we are supporting these critical institutions with huge amounts of money that we don't actually have. And in turn, these institutions are holding up our cities.
What does this mean for the cities? How do these things interplay? If the cities are actually being supported through gigantic debt from the rest of the country, what does this mean for their futures? And how would the kind of tinkering that probably ought to happen with financing these things - attempts to somehow get the costs of healthcare and education to drop so they were actually affordable - affect our cities? It seems like one more complication in an impossible situation, one more reason we won't be able to get out of this mess without breaking something else precious.
But maybe I am missing something?
This entry has
comments. Leave a comment? (Click "Log in with OpenID?", top right corner.)