Bureau of Labor Statistics, March 15, 2019
Total separations includes quits, layoffs and discharges, and other separations. Total separations is referred to as turnover. Quits are generally voluntary separations initiated by the employee. Therefore, the quits rate can serve as a measure of workers’ willingness or ability to leave jobs. Layoffs and discharges are involuntary separations initiated by the employer. Other separations includes separations due to retirement, death, disability, and transfers to other locations of the same firm.
Annual Levels and Rates
In 2018, there were 68.9 million hires, an increase of 3.3 million from 2017. Total separations (the sum of quits, layoffs and discharges, and other separations) rose by 2.6 million in 2018 to 66.1 million. Quits rose for the ninth consecutive year reaching 40.1 million in 2018, up by 2.4 million. Quits comprised 61 percent of total separations. Layoffs and discharges edged up by 307,000 in 2018 to 21.9 million and comprised 33 percent of total separations. Other separations edged down by 44,000 in 2018 to 4.1 million and comprised 6 percent of total separations.
The annual hires for 2018 was 46.3 percent of the annual average CES (Current Employment Statistics) employment level. This rate has been trending upwards since 2009. The annual total separations rate for 2018 was 44.3 percent. The annual rates for the components of total separations were 26.9 percent for quits, 14.7 percent for layoffs and discharges, and 2.8 percent for other separations.
By Don McCanne, M.D.
We are being told repeatedly that we should not enact a single payer Medicare for All program because people like their insurance they get at work, and they should be able to keep it if they want. Yet in 2018, 66 million individuals left their employment – a turnover rate of 44 percent!
For those 66 million separations from work, employer-sponsored plans did not prove to be the stable coverage that most of us want. Sure, many of these individuals were not even offered coverage at work, but that is more evidence that the employer-sponsored plans that the Affordable Care Act was designed to protect often do not provide reliable, stable coverage.
Of course there are other problems with employer-sponsored plans. They frequently have excessive cost sharing requirements, especially high deductibles, that can create financial hardship and impair access to care. Provider networks frequently prevent access to the patients’ choices of health care professionals and facilities, and often even fail to include much choice for highly specialized problems (though some larger employers may have special programs for centers of excellence). With change of employment, provider networks, benefits covered, and cost sharing requirements may change dramatically, potentially creating instability in the individual’s health care.
So who are these individuals who are so pleased with the health insurance that they get at work? Well, the workforce is a relatively healthy population that on average does not require much health care. Many feel secure with the financial protection that they believe their plan is providing even though they may have little experience with the system because of their good health. Some do have more significant medical problems and many of them do find professionals with whom they are pleased, and so the system works fairly well for them. But what about those who can’t go to their established care sources, or who cannot afford the out-of-pocket cost sharing, or who cannot afford the medications on which they have been maintained, or are one of the 44 percent with employment turnover and find that their new employer does not provide coverage, yet they earn too much for ACA subsidies? How can you say that employer-sponsored plans work well for them?
Another thing, employers insure predominantly the healthy workforce and their young healthy families. Those with more significant and costly medical problems tend to receive their care from government programs – Medicaid, Medicare, the VA system, safety-net institutions, and cost shifting by the uninsured (disproportionate share payments, etc.) – financed by us, the taxpayers. Pooling risk is one of the most fundamental functions of health insurance, so why are we granting employers favorable selection in their risk pools while passing adverse selection onto the taxpayers? Obviously it would be much more equitable to have one universal risk pool under single payer Medicare for All. Insurance premiums paid by employees along with forgone wage increases to cover the employer’s contribution are a form of regressive financing of health care – the opposite of the more equitable progressive financing of a tax-funded single payer system.
Next time you are told that we have to reject single payer Medicare for All because it would not allow individuals to have the choice of remaining enrolled in a health plan at work, point out that last year the 66 million people experiencing work separations did not have that choice, even if they previously had been offered insurance at work.
Addendum: About that 66 million job turnover
Quote of the Day, Addendum for April 11, 2019
About that 66 million job turnover each year, Dr. Ed Weisbart makes a very important point:
“I’ve been using numbers like this for a while but to make a different point — that the ~1.3M job displacements from single payer are a single bump in the road, with mitigation strategies, compared to the unending sea that is our current culture. 60M every year, for decades before and decades to come, vs 1M in a single planned way.”
By Don McCanne, M.D.
Thus not only can we use this number of a 66 million job turnover each year as as an argument against “you can keep your insurance,” but also as an indication that the job displacement caused by eliminating private insurance does not create a formidable employment nightmare for the one million or so that might be displaced. We can do it.
Another addendum: About that 66 million job turnover
Quote of the Day, Second addendum for April 11, 2019
About that 66 million job turnover each year, UMass economics professor Gerald Friedman makes another very important point:
“Excellent note! To these 66 million need to be added all those whose employers change their insurance plan. And this is a growing problem because of narrow insurance plans where people need to change their primary care provider.”
By Don McCanne, M.D.
None needed. This thing has a life of its own.
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