America’s Jobs Mirage: Weak Growth, Fewer Workers, and the Wrong Kind of Healthcare Hiring

Originally published on Substack. 

The Bureau of Labor Statistics just dropped a bombshell: the U.S. economy isn’t nearly as strong as Washington claimed. Its annual benchmark revision erased 911,000 jobs from March 2024 to March 2025—a 0.6% drop in employment, one of the steepest downward corrections in decades. That means nearly a million jobs we thought existed never did.

Add to that the August jobs report, which showed payrolls barely budged (+22,000) and the unemployment rate up to 4.3%—its highest since 2021. The household survey showed 7.4 million unemployed, with long-term joblessness up 385,000 over the past year, now making up more than 25% of all unemployed. Labor force participation slipped to 62.3%, and the employment-to-population ratio dropped to 59.6%. This is not a strong labor market. It’s stagnation.

So what did Washington call the “bright spot”? Healthcare jobs. But before we cheer, let’s look closer.

​The Wrong Kind of Growth

In Augus, healthcare added 31,000 jobs, while social assistance added another 16,000. Without those gains, the jobs report would have been net negative. But most of these new roles weren’t doctors or nurses—they were administrators, billing clerks, and compliance staff.

Between 1970 and 2020, the number of practicing physicians . Today, of the 23.5 million people working in healthcare, fewer than one-third provide direct care.

This is what Washington cheers: growth in bureaucracy funded by forced tax dollars, while patients wait longer for care.

Bureaucracy First, Patients Last

Here’s the perverse incentive: government regulations create new administrative requirements, so hospitals hire more staff to handle paperwork. Those salaries are paid first out of taxpayer-funded budgets and insurance dollars. Doctors and nurses are left fighting for what’s left.

The Affordable Care Act was the clearest example. To fund it, Washington diverted $716 billion from Medicare into bureaucracy. That $1.76 trillion law coincided with doctor wait times jumping 25%—from 99 days to 132. More dollars went to administrators, not care. The result was predictable: longer waits and tragic “death by queue”, as patients died waiting for treatments that never came.

Even when Washington warns that Medicaid cuts “pose a threat to health services”, it ignores that bureaucracy is untouchable. Cuts fall on provider reimbursements, not on administrative overhead. The doctor gets squeezed while the paperwork department grows.

The Fed Factor

With job growth flat and unemployment rising, some in Washington are pressuring the Federal Reserve to cut interest rates to “stimulate” the economy. But inflation is still running hot: Core CPI inflation rose 3.1% over the year in August. If the Fed caves, it risks reigniting price surges while doing nothing to create more productive work.

As I’ve been saying for months, we don’t fix a weak labor market by printing more money. We fix it by restraining government spending, ending distortive policies like tariffs, and freeing entrepreneurs and workers to create value.

A Better Prescription for Prosperity

Instead of applauding bureaucratic job growth, Washington should:

1. Cut bureaucracy first. Stop funding administrators ahead of patient care. Taxpayers shouldn’t pay for jobs that add red tape instead of healing.
2. Free up providers. Scrap outdated scope-of-practice and certificate-of-need laws so more medical professionals can serve patients.
3. Empower families. Put healthcare dollars directly in personalized patient accounts. Competition lowers costs and improves quality in every other sector—why not in healthcare?

Closing Thought

The August jobs report isn’t a win for working Americans. It’s a warning: the economy is sputtering, unemployment is the highest since 2021, and nearly a million jobs were just erased from the record books. The only “growth” Washington celebrates is more tax-funded bureaucracy in healthcare, which means higher costs and longer waits for patients.
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Prosperity doesn’t come from Washington’s accounting tricks or the Fed’s printing press. It comes from freedom: lower spending, fewer bureaucrats, more providers, and empowered patients. That’s the kind of growth worth celebrating.