Why Doesn't Job Retention Work

Health care reform or no health care reform, we don't have enough doctors in this country. A Harvard economist, writing in the New York Times Magazine, has declared: "Today, the shortage of doctors in the United States is worse than at any time in the last fifty years. This is not to say that the total number of doctors has decreased; actually, the total is now higher than ever. I speak of the increased gap between our doctors and our total population."

It's an odd finding to contemplate-that at a time of massive unemployment, a critical, well-paying field like medicine should go wanting for workers. Perhaps odder still: The words cited above were written when the country was coming out of a recession and the economy was actually growing. I'm not, however, referring to 2010, but to 1950.

The shortage of doctors-and nurses, engineers, and other high-paying career slots-is a persistent perennial of the American economy, which seems incongruous with high unemployment numbers. If we've had a shortage of doctors since 1950, or 1900, or whenever, then why don't more unemployed people take up the stethoscope? Granted, becoming a doctor is no easy task, but with American doctors swimming in cash, and so many Americans out of work, shouldn't we be witnessing a massive migration of workers to medical and other high-paying careers?

These issues were hinted at in a recent retraining and an earlier story in USA Today . (Goodman's story is part of a Times series called "The New Poor ," which has been gripping, if gloomy, reading.) Both papers, though, overlooked some broader points that make the inadequacy of the American workforce more urgent-and more confounding.

The basic problem: Some of the stubbornly high unemployment America faces today-14.6 million officially unemployed, with millions more jobless who don't meet the technical definition-is cyclical, meaning that hard times wiped out jobs that will presumably be restored when conditions improve. But much of it is also structural, so there is a dramatic mismatch between the kinds of jobs that millions of Americans have historically held, and the kinds of jobs that we generate now and will generate in the future.

Liberals (and others) have traditionally addressed this problem by advocating worker retraining: Teach the factory worker to write software, and he or she will prosper in a new career. Not surprisingly, worker retraining is a cornerstone of the Obama administration's jobs policy. In 2009, the Department of Labor spent a little more than $4 billion on adult workplace training; about one-fifth of that comes from the stimulus bill. Spending for 2010 and 2011 should be roughly the same. While it's hard to know how much overlap there is between different retraining programs, millions of Americans are undergoing such training every year; those numbers are supplemented by state-run programs like Michigan's "No Worker Left Behind ."

And what are workers being retrained to do? A complete answer is not easy to come by, but it seems like a significant portion of the money is aligned with Obama's political goals, including "green jobs" and health care industry jobs. Since those are high-growth employment sectors, such efforts ought to move a large chunk of unemployed people into jobs. But the Times story makes clear that current job retraining is inadequate, and hints that it may never really work. Says the Times: "Most money has been directed at the same sorts of programs that in past years have largely failed to steer laid-off workers toward new careers, say experts, and now the number of job openings is vastly outnumbered by people out of work."

So why doesn't worker training produce its intended results? The Times grabbed the easy answer: "Because there are no jobs." That might, indeed, be the major reason, but before endorsing it, consider that it contradicts many things that we think we know about the American economy. According to the Bureau of Labor Statistics, the job category that will grow the most over the next decade is nursing; specifically, that nearly 600,000 new registered nurse positions will be created by 2018 , increasing the size of the nursing workforce by 22 percent.

Yet it is hard to see how America will be able to fill those jobs, since apparently we can't fill the nursing jobs we have now. Various health care associations estimate that there are 135,000 nursing vacancies in the health care system today (116,000 in hospitals and 19,000 in long-term health care facilities). That shortage is projected to grow to 260,000 by 2025.

Experts place the blame for this shortage on the burdens created by the aging Baby Boom generation, but that is only part of the story. As indicated in the 1950 article cited above, America has had a shortage of nurses for a half-century or more-and a doctor shortage, and an engineer shortage. At the same time, USA Today last month cited a "rare glut of nurses " as a reason that recent nursing grads can't find work. Is it possible to have a shortage and a glut at the same time?

I'm unable to locate a single explanation for why worker training isn't more effective, but here are some theories:

The shortages aren't real. When medical organizations speak of shortages of doctors and nurses, it's not because, say, there used to be 20 doctors working in clinic X and now there are only 10. Typically, they are measuring current workforce levels against a theoretical number of health care workers per capita. The shortages are "real" in the sense that the United States is notoriously on all sorts of health indicators. But just because health professionals say they need more employees doesn't mean that the market-hospitals, nursing homes-has the capacity to support them. This would explain why we appear to have both decades-long shortages and occasional gluts.

Unemployed people aren't capable enough to be retrained. With approximately 17 million people out of work (official unemployed plus those "marginally attached" to the workforce), this is undoubtedly true for a fraction of the unemployed. Some conservative observers, notably Ben Stein in the American Spectator, have argued that nearly all unemployment can be blamed on the personal shortcomings of the unemployed : Either they don't save, they overspend, they are lazy, or they "create either little utility or negative utility on the job." This misanthropic theory may provide emotional satisfaction for some, but it's clearly too sweeping and unverifiable to have real analytical value.

There's a geography gap. Economists have long noted that while capital and physical goods are easily moved from economically stagnant places to economically productive ones, people are much less so. Americans relocate from town to town more readily than most nationalities, and over time, Rust Belt communities have lost millions of residents to more job-dynamic locales in the South and West. But in the short term, it's not easy for unemployed people-trained or not-to pick up stakes and move to where jobs might be. A continually depressed housing market makes that task harder still.

There's a gender gap. Rationally, any good-paying job should be attractive to any needy worker. But reality is usually messier than that. As noted above, the nation has for decades suffered from a shortage of nurses. Maybe today, plenty of young men are willing to enter into nursing as a career. But do men in their ‘40s and ‘50s really want to put in the years of training to switch to what is, after all, a historically female job? My Slate colleague Hanna Rosin recently touched on this in a provocative Atlantic essay called "The End of Men ." "Many professions that started out as the province of men are now filled mostly with women-secretary and teacher come to mind," Rosin wrote. "Yet I'm not aware of any that have gone the opposite way. Nursing schools have tried hard to recruit men in the past few years, with minimal success. Teaching schools, eager to recruit male role models, are having a similarly hard time."

If gender friction keeps otherwise qualified people from taking good-paying jobs, it may well be a two-way street: engineering, IT, and software development are notoriously and stubbornly male-dominated fields. The relative lack of female engineers may have a different rationale than the relative lack of male nurses, but any gender inflexibility will stand in the way of effective retraining.

Our training is really lousy. This seems like an obvious culprit, except that all the way down the line the incentives to create effective worker training appear intact. Governments and business leaders want unemployment to go down; places like community colleges want federal grants to provide workplace training; companies want skilled employees; and unemployed workers want good-paying jobs. And since as a country we know how to train our existing workforce to perform nursing jobs, clean energy jobs, etc., the problem shouldn't be an inability to teach skills.

But maybe it is, and if so, that means that our decades-long reliance on worker retraining is misplaced. And yet it seems irresponsible to simply give up on the idea of teaching adults new workplace skills. Perhaps we need a thorough revamping of what we are teaching and how we are teaching it. But who will retrain the retrainers?

By: James Ledbetter, editor of The Big Money, and of The Great Depression: A Diary , published recently by Public Affairs