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Booming Employment in Health Care

February 27, 2026

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Good morning,

Today, we’re looking at the rising number of health-care jobs, Carter-case spending in New York, and President Trump’s presence and influence.

Write to us at editors@city-journal.org with questions or comments.

A nurse at a computer inside an exam room

For more than a century, health care has seen steadily growing employment. Over the past year, in fact, the U.S. health and social-assistance sector added about 760,000 jobs while the rest of the economy lost about 400,000. And health-care jobs made up almost all of the jobs added in January. What’s driving this continuous expansion?

“The growth of health-care jobs reflects the expansion of insurance and entitlement programs. Underlying these trends is the steady improvement of medical capabilities,” Chris Pope explains. “The more that medical services can do for the sick, the more people want these services. The more health care extends life into old age and despite disease, the more people will spend on it.”

In Burlington School Comm. v. Mass. Dept. of Ed. (1985) and Florence County v. Carter (1993), the Supreme Court ruled that when a school district fails to provide students with disabilities with a Free Appropriate Public Education, parents can place their children in private school and seek reimbursement through “due process.”

These Carter cases, as they came to be known, were intended as a backstop for the public school system in a limited number of instances. But they have come to cost New York City $1.3 billion. What happened?

Jennifer Weber sums it up: “service-delivery lapses, routine settlements that locked in private placements long past need, and a private, contractor-based evaluation process that doesn’t take account of available public programs.”

Read her analysis of where things went wrong and what it will take to fix the system.

President Trump seems to be everywhere. Not only is he battling institutions at home like universities and legacy media, but he’s also making waves around the world, from bunker-bombing Iran to forcing NATO countries to boost defense spending. And it’s all personalized. Democratic governors aren’t fighting the federal government; they’re fighting Trump. It’s not a general plan to end the war in Gaza; it’s the Trump plan.

“Both Trump and his antagonists, for different reasons, like it personal, and there’s some justification for this approach,” Martin Gurri writes. “Trump is an attention vortex and probably a world-historical personality.”

So what would the world look like if Trump were absent from the picture? Even without his outsize presence, Gurri writes, “the world remains a place turned upside-down. The old rules and categories have vanished, even if we still mutter the same familiar words in our civic rituals. Democracy now means perpetual conflict. Information now means a war over the truth.”

Read his analysis.

“Once people join an extremist organization, they tend to adopt views that are more and more extreme. Joining gives them a little thrill, but that fades. Another thrill can only be had by professing a more extreme position. Members who are already more extreme egg them on.

I’ve always suspected that, for the hard core of the Democratic Socialists, the constant pointing at Nordic-style social democracy was always a bait-and-switch tactic. If they ever got enough power, they would push for real ownership-of-the-means-of-production socialism. Their response to objections would be, ‘We told you we are socialists and you voted for us!’”