America has a problem with socialism, and it’s bigger than most citizens realise.
When candidates allied with the Democratic Socialists of America win the Democratic Party primaries, or New York Mayor Zahran Mamdani praises the “warmth of collectivism,” the advance of socialism is clear.
But it’s also benefiting in other ways, particularly in the transformation of America’s workforce – which is going to work primarily in a sector that has been removed from full government control: health care.
In 1990, manufacturing was the largest employment sector in most states, including New York and California.
Today, healthcare is the nation’s largest employer and No. 1 in nearly every individual state — New York, California, Texas, and even Pennsylvania.
When Mary Talley Bowden, founder of Americans for Health Freedom, posted a chart on X last weekend depicting this revolution in American labour, it went viral, garnering over 2.5 million views and hundreds of follow-up comments.
Many famous Americans still consider the nation a nation of makers rather than a nation of carers.
Health care employment is growing less because we are adding more doctors and nurses than we are adding more administrators.
The health workforce consists of an army of bureaucrats whose jobs depend on maintaining government regulations.
This is a 21st-century twist on socialism:
Instead of the government keeping industry outright, it forces industries to reshape themselves in the shape of Washington’s bureaucracy.
Health care isn’t its only victim—compliance bureaucracies and human resources departments set up to manage mountains of federal, state, and local regulations have taken root everywhere.
But healthcare is special:
Not only is it heavily regulated compared to other sectors, it’s also tied to the massive entitlement systems of Medicare and Medicaid and many lesser programs.
Socialists, an increasingly powerful bloc in the Democratic Party, however, are not content with turning American health care into a quasi-public sector.
They are keen to expand Medicare into “Medicare for all” and many still dream of nationalising medicine on the model of Britain’s National Health Service.
Whether the takeover is gradual through regulation or a sudden shock, the consequences of the integration of 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 wars over abortion, euthanasia, biological sex and gender, and more.
And the more Americans depend on government — for their health or their jobs — the less free they will be to vote against those who run the system.
The Trump administration’s efforts to bring back manufacturing jobs are, among other things, an effort to restore balance and freedom to our economy.
Tariffs that prevent foreign producers from flooding the U.S. market are only a first step, which must be combined with creating a competitive environment for domestic firms.
A large number of domestic producers keep prices down – and give workers a choice of employers, as companies must compete to offer the best wages and benefits.
Well-paid workers in the private sector, whose jobs are supported by protections but are not simply a byproduct of government regulation – like the growing health care bureaucracy – are also sufficiently protected to exercise political choice.
Yet many old-guard Republicans and libertarians are so repulsed by tariffs that they fail to see how damaging the alternative is.
“Healthcare pays more than manufacturing ($39.80 vs. $36.70 per hour), and … is more difficult to automate/offshore,” Jeremy Horpedahl, an adjunct scholar at the Cato Institute, notes at X in response to a chart showing the dominance of the healthcare workforce and the decline of manufacturing.
But it’s like a liberal would prefer to hire people through the federal bureaucracy over the private sector if the government jobs pay more and are locally based.
Manufacturing is not free from regulation, but even when tariffs are involved, it is a less government-dependent sector than health care.
Harpedahl himself, like many libertarian economists, is, ironically, a public servant – a professor at the University of Central Arkansas, a public institution.
Although libertarians and old-guard Republicans are sincere in their beliefs, they are inconsistent, and often class consciousness seems to be involved in their hatred of manufacturing.
America does not face a choice between perfect, government-free capitalism and something else.
Instead, our choice is between a new form of socialism—in which public- and private-sector bureaucracies merge and employ a growing number of Americans—or a free market immune to populist and nationalist politics.
Yes, the new socialism is compatible with free trade and cheap foreign goods just for the reason Horpedahl cites: those goods do not compete with the domestic bureaucracy.
But friends of liberty should make no mistake: tariffs are a small price to pay for low socialism.
A country is only as free as its workforce. Manufacturing jobs made America great and free once, and the medical bureaucracy is no substitute.
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