What causes mass layoffs? The recession and unemployment has reduced demand for elective procedures and reduced reimbursement from government programs (Medicaid and Medicare). Charity care has also increased and hospitals are adjusting to a lower bottom line by eliminating their most costly item...employees.
Physicians, too, have noticed a decrease in patients in the office. Doctors who previously had a long wait for appointments are now more available. That is a good outcome. But bad debt is soaring. Insurance companies have shifted more first dollar coverage to employees in the form of high deductibles and co-pays. Neither the patient nor the doctor knows how much the patient's responsibility will be at the time of the visit. When the bill is finally adjudicated...sometimes months later...it is increasingly more difficult to collect from the patient. (As an example, I just got an insurance check from an office visit in June.)
Despite these gloomy facts, health care remained among the few sectors adding jobs. The health sector grew by 0.2%.