At its apex, the Simpsons did a remarkable job of satirizing the reality of America. But one fundamental fallacy of the show was the (nuclear)-factory-as-the-economic-engine of a community. In reality, as the USA prospered through the second half of the 20th century, industrial jobs were outsourced to developing countries and the US began specializing in the service sectors. These included the financial sector, the software sector and, crucially, the health sector.
Nowadays, a large percentage of jobs in any community belongs in the health field. On an aggregate level, it's been well publicized that US health-care related costs comprise about 15% of the national income. But on a more specific level, we can see from this Forbes.com list how influential these jobs are in large communities:
Atlanta, Ga.
1. Home Depot: 1,180 job openings
2. WellStar Health System: 1,013 job openings
3. Northside Hospital: 759 job openings
4. Pizza Hut: 753 job openings
5. Emory University: 648 job openings
Boston, Mass.
1. Staples: 1,250 job openings
2. Massachusetts General Hospital: 1,048 job openings
3. Liberty Mutual: 829 job openings
4. Harvard University: 753 job openings
5. Kindred Healthcare: 700 job openings
Chicago, Ill.
1. Accenture: 918 job openings
2. Pizza Hut: 815 job openings
3. Sears: 696 job openings
4. HCR Manor Care: 680 job openings
5. Taco Bell: 613 job openings
Dallas – Fort. Worth, Texas
1. Texas Health Resources: 1,623 job openings
2. HCA: 1,219 job openings
3. Baylor Health Care: 979 job openings
4. Pizza Hut: 921 job openings
5. Methodist Health Systems: 704 job openings
In these randomly selected large markets, at least one of the top five employers is a health facility, while in the Dallas/Ft. Worth area, four of the top five are. These examples go on across the country: Johns Hopkins in Baltimore, UCSF in San Francisco, the Texas Medical Center in Houston and in New Orleans, Tulane Hospital and Ochsner Health Systems.
But it's not just the US where health related employers are a focal point of growth. As money is spent on development in Africa, a large percentage goes to health expenditures. And in India, scores of not-for-profit and for-profit companies are racing to build hospitals, both for domestic consumption and for medical tourism (they even have a conference just on how-to-build-hospitals in India).
As technology accelerates and the complexity of health structures grows the construction/consulting industry that envelops it also grows. The quaint notion of a hospital with a certain number of medical beds + more surgical beds + some examining rooms has given way to highly complex mini-cities. These self-contained locals now have their own energy sources, sanitation systems, HVAC (heating/ventilation/AC) complexes, information systems, high-volume laundromats, restaurant/grocery-store/catering businesses and, of course, the focal medical parts which include the clinics/ORs/ERs/radiology/lab/pharmacy/patient beds/etc.
As an end-punctuation, here are some links you can use to find more information on hospital construction:
- A conference in India
- A primer on how to think about building your own hospital
- A much more indepth site on how to build a hospital, with lots of technical manuals
- More technical manuals
- An expensive book summarizing 5 different symposia presentations

