The thinning out of the medical middle

From Ben Casselman at the WSJ:

The health-care sector, one of the last redoubts of stable and well-paying jobs for less-educated workers, is beginning to look less secure.

A variety of factors, from technological advances to increased attention on both costs and patient outcomes, are driving hospitals and other health-care providers to demand more from both the most- and least-skilled workers, while gradually eroding opportunities for those in the middle.

The result: the gradual disappearance of semiskilled occupations that don’t require a college degree. Positions such as licensed practical nurses and medical-records clerks are being eliminated or pushed out of hospitals into lower-paying corners of the field such as nursing homes. Meanwhile, positions that were once an accessible first rung on the career ladder, such as registered nursing, increasingly require at least a bachelor’s degree.

The trend is worrisome to economists, because health care had been a relative haven from the erosion of middle-skill jobs elsewhere in the economy. Automation, outsourcing and other forces have eliminated many formerly secure jobs in manufacturing, clerical work and other fields. Now health care is following the same path with unforeseen speed.

Here is more.