America has a socialism problem, and it’s bigger than most citizens realize.
When candidates aligned with the Democratic Socialists of America win Democratic Party primaries, or New York Mayor Zohran Mamdani hails “the warmth of collectivism,” socialism’s advance is obvious.
But it’s making gains in other ways, too, especially in the transformation of America’s workforce — which is coming to be chiefly employed in a sector one step removed from outright government control: health care.
In 1990, manufacturing was the top employment sector in most states, including New York and California.
Today, health care is the nation’s biggest employer, No. 1 in almost every individual state — New York, California, Texas, even Pennsylvania.
When Mary Talley Bowden, the founder of Americans for Health Freedom, posted a chart on X last weekend illustrating this revolution in American labor, it went viral, garnering more than 2.5 million views and eliciting hundreds of follow-up comments.
Yet America hasn’t changed from a nation of makers into a nation of caregivers.
Health-care employment is growing mainly because we’re adding far more administrators.
True, there are rising numbers of in-home caregivers and other medical personnel devoted to the country’s senior population.
But much of the health-care workforce consists of an army of bureaucrats whose jobs are based on keeping up with government regulation.
This is the 21st-century twist on socialism: Instead of government owning industry outright, it forces industries to remodel themselves as Washington directs.
Health care isn’t the only victim of this — compliance bureaucracies and human-resources departments set up to address mountains of federal, state and local regulations have taken root everywhere.
But health care is special: Not only is it more heavily regulated than other fields, it’s tied to the massive entitlement systems of Medicare and Medicaid, and a host of lesser programs as well.
And the socialists who are an increasingly powerful bloc in the Democratic Party aren’t content with the slow conversion of American health care into a quasi-public sector.
They’re eager to expand Medicare into “Medicare for All,” and many still dream of outright nationalization of medicine, on the model of Britain’s National Health Service.
Whether the takeover occurs gradually through regulation or suddenly at a stroke, the consequences of merging health care and government are monumental for social values as well as for the economy.
Progressives see gaining power over medicine as a shortcut to winning battles over abortion, euthanasia, biological sex and gender, and much else.
And the more Americans are made dependent on government — for their health or for their jobs — the less free they are to vote against those running the system.
President Donald Trump’s effort to bring back manufacturing jobs is, among other things, an attempt to restore balance and freedom to our economy.
Tariffs that stop foreign producers from flooding the American market are just a first step, one that must be coupled with creating a competitive environment for domestic firms.
A multiplicity of domestic producers keeps prices down — and gives workers more choices, as companies must compete to offer the best wages and benefits.
Well-paid private-sector workers, whose jobs are helped by protection but not merely a byproduct of government regulation, are secure enough to exercise political choice, too.
Yet too many Republicans and libertarians are so repulsed by tariffs that they fail to see how much worse the alternative is.
“Health care pays more than manufacturing ($39.80 vs $36.70 per hour),” and “is harder to automate/offshore,” wrote Cato Institute scholar Jeremy Horpedahl in response to the news of health care’s workforce dominance and manufacturing’s decline.
That’s like saying it’s better to have people employed by the federal bureaucracy than the private sector, as long as government jobs pay more.
Manufacturing isn’t free from regulation, but even when tariffs are involved, it’s less government-dependent than health care.
Horpedahl himself, like many libertarian economists, is, ironically, a government employee — a professor at the University of Central Arkansas, a public institution.
Although libertarians and old-guard Republicans are sincere in their beliefs, they’re not consistent.
And it often seems that class consciousness is involved in their disdain for manufacturing.
America isn’t facing a choice between perfect, government-free capitalism and anything else.
Instead, our choice is between a new form of socialism — in which government and private-sector bureaucracy blend together and employ increasing numbers of Americans — or a freer market, safeguarded by populist and nationalist politics.
Yes, the new socialism is compatible with free trade and cheap foreign goods for just the reason Horpedahl cites: Those goods don’t compete with domestic bureaucracy.
But friends of freedom should make no mistake, tariffs are a small price to pay for less socialism — and a country is only as free as its workforce.
Manufacturing jobs made America great and free once before, and medical bureaucracy is no substitute.
Daniel McCarthy is the editor of Modern Age: A Conservative Review.
