The Real Jobs Machine - Newsweek

If you’re interested in job creation—and who isn’t these days?—you should talk to someone like Morris Panner. In 1999, Panner and some others started a Boston software company called OpenAir. By 2008 they sold it for $31 million. The firm had then grown to about 50 workers. It turns out that entrepreneurship (essentially, the founding of new companies) is crucial to job creation. But as Panner’s experience suggests, success is often a slog.

What’s frustrating and perplexing about the present job dearth is that the U.S. economy has long been a phenomenal employment machine. Here’s the record: 83 million jobs added from 1960 to 2007, with only six years of declines (1961, 1975, 1982, 1991, 2002, 2003). Conventional analysis blames today’s poor performance (jobs are 7.6 million below their pre-recession peak) on weak demand. Because people aren’t buying, businesses aren’t hiring. Though true, this omits the vital role of entrepreneurship.

In any given year, employment may reflect the ups and downs of the business cycle. But over longer periods, almost all job growth comes from new businesses. The reason: high death rates among existing firms. Even successful firms succumb to threats: new competition or technologies; mature markets; the death of founders; shifting consumer tastes; poor management and unprofitability. A company founded today has an 80 percent chance of disappearing over the next quarter century, reports a study by Dane Stangler and Paul Kedrosky of the Kauffman Foundation.

True, some blue-chip firms—the Exxons and Procter & Gambles—endure. Four fifths of the Fortune 500 were founded before 1970. But they are exceptions, and many blue chips have died: Pan Am (once the premier international airline), Digital Equipment (once the second-largest computer maker), and Circuit City (once a leading consumer-electronics chain).

The debate over whether small or big firms create more jobs is misleading. The real distinction is between new and old. American workers are roughly split between firms with fewer or more than 500 employees. In healthy times, older companies of all sizes do create lots of jobs. But they also lose jobs, as some businesses shrink or vanish. On balance, job creation and destruction cancel. All the net job increases occur among startups, finds a study of the 1992–2005 period by economists John Haltiwanger of the University of Maryland and Ron Jarmin and Javier Miranda of the Census Bureau.

To be sure, entrepreneurship has a downside: booms and busts. Remember the dotcom “bubble.” But more damaging, says Panner, are widespread popular misconceptions about what it is and isn’t.

Start with the Blockbuster Myth: successful entrepreneurship creates huge enterprises à la Google that transform how we live. In reality, “most ventures don’t change the world,” says Panner. They’re unknown companies providing highly specialized goods and services, plus restaurants, auto-repair shops, and many other unromantic businesses. There are more than 500,000 startups annually. The number must be large to make an impact on the 155 million–person labor force.

Second is the Inspiration Myth: most startups spring from some epiphany suggesting a new product or technology. Wrong. Gee-whiz moments are few. Companies constantly change plans. OpenAir ditched its original idea, which didn’t draw customers. “You can’t do anything until you meet someone’s needs,” says Panner. Failure rates are high; half of new firms die within five years.

And finally, the Incentive Myth: it’s necessary to keep tax rates low, so entrepreneurs can reap huge rewards for their time, sweat, and money. Well, this may be true, but it misses a parallel truth: government disincentives to entrepreneurship. Panner, a registered Democrat, criticizes complex accounting, employment and health-care regulations imposed by federal and state agencies that consume scarce investment funds and time. There’s a bureaucratic bias, unintended perhaps, against startups.

It’s all about risk taking. The good news is that the entrepreneurial instinct seems powerful. Americans like to create; they’re ambitious; many want to be their “own bosses”; many crave fame and fortune. (Panner is already involved with a new startup; it has five employees.) The bad news is that venture capital for startups is scarce and that political leaders seem largely oblivious to burdensome government policies. This needs to be addressed. Entrepreneurship won’t instantly cure America’s job deficit, but without it, there will be no strong recovery.

Robert Samuelson is also the author of The Great Inflation and Its Aftermath: The Past and Future of American Affluence and Untruth: Why the Conventional Wisdom Is (Almost Always) Wrong.

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What UPMC affiliation has meant for two Pittsburgh-area hospitals - GoErie.com

Published: October 03. 2010 12:01AMPITTSBURGH -- Phil Pollice, M.D., understands what Hamot Health Foundation's soon-to-be-former neurosurgeons are going through.
The five physicians with Tri State Neurological Surgeons are leaving Hamot later this year to work at Saint Vincent Health Center.
They are switching hospitals for several reasons, Tri State President Brian Dalton, M.D., said. One of their concerns is the effect of Hamot's ongoing affiliation talks with the University of Pittsburgh Medical Center.
Pollice, an ear, nose and throat specialist, had just started treating patients at Passavant Hospital in suburban Pittsburgh when it affiliated with UPMC in 1997.
He had no idea what to expect. Some of his fellow Passavant physicians left the hospital before the affiliation took effect.
"There was a lot of fear among the physicians," Pollice said. "The fear was that we were going to be phased out and replaced with UPMC-employed physicians."
Thirteen years later, Pollice is still treating patients as a private physician at UPMC Passavant and UPMC Mercy. He estimated that about half of UPMC Passavant's doctors remain in private practice.
He recently visited Erie to talk with Hamot doctors about what they could expect if Hamot affiliates with UPMC.
"Like I tell people, some doctors did better when UPMC came in," Pollice said. "Others did worse and moved on."
Doctors aren't the only people concerned about Hamot's possible affiliation with UPMC.
Patients are worried they will be sent to Pittsburgh for procedures and surgeries they now undergo at Hamot.
Erie County Executive Barry Grossman has said he fears that Hamot -- Erie County's second-largest employer -- will slash jobs after affiliating with UPMC.
Neither of those scenarios are going to happen, said Liz Concordia, UPMC executive vice president and president of the health system's hospital and community-services division.
"We're looking to invest $300 million in Erie," Concordia said, referring to the amount of money UPMC will give Hamot over the next 10 years if the two health systems affiliate. "So we want Hamot to be successful. We want to bring patients to Erie."
Sending large numbers of patients to Pittsburgh isn't an option simply because there isn't room for them, Concordia said. Most of the UPMC hospitals in Pittsburgh have occupancy rates of more than 90 percent, she said.
"Our hospitals in Pittsburgh are full," Concordia said. "It's to our advantage to have patients stay in Erie, instead of coming down here where there aren't enough beds already."
UPMC plans to do that by sending physician specialists to Erie who will treat patients and perform surgeries currently not done at Hamot.
For example, Hamot cardiologists told Concordia during her visit to Erie that they would like to see a heart surgeon at Hamot who could perform minimally invasive heart-valve surgeries.
"Those surgeries are currently sent to the Cleveland Clinic," Concordia said. "Our goal would be to help Hamot recruit someone to do that surgery in Erie."
As for jobs, UPMC officials are adamant that an affiliation will not result in significant job losses at Hamot, either immediately after an agreement is reached or several years afterward.
"Overall, our history has been net growth in full-time jobs for the hospitals who have affiliated with us," Concordia said. "We tend to see less growth in low-paid back-office jobs and more growth in high-paid clinical jobs."


Concordia pointed to UPMC Passavant and UPMC Shadyside as affiliation success stories.
Both hospitals joined UPMC in 1997. Passavant, located just north of Pittsburgh in McCandless Township, was a 240-bed community hospital that had just begun performing heart surgeries when it joined UPMC.
Shadyside, located in eastern Pittsburgh and one of the city's oldest hospitals, was a 300-bed facility that opened in 1866.
Since affiliating with UPMC, both hospitals have increased by more than 100 beds and hired additional staff, Concordia said. The number of full-time workers has risen by 38 percent at Shadyside and by 79 percent at Passavant.
"Being affiliated with UPMC has really helped us recruit new physicians," said Joel Weinberg, M.D., a UPMC Shadyside pulmonary critical-care physician. "For whatever reason, being part of UPMC is the biggest aphrodisiac to physicians."
One reason could be UPMC's willingness to pump money into each hospital.
The health system has spent $359 million at Shadyside since 2001 and an additional $283 million at Passavant to build cancer centers, expand emergency departments and purchase state-of-the-art diagnostic and surgical equipment.
"Before we affiliated with UPMC, we were a nice, strong community hospital," UPMC Passavant President Terri Petrick said. "Now, we draw patients from a much larger area. We see patients from West Virginia and all along the Interstate 79 corridor."


Not all UPMC hospitals have shared Passavant's and Shadyside's success.
UPMC Braddock closed Jan. 31, almost 14 years after the eastern suburban Pittsburgh hospital merged with UPMC. The hospital had lost more than $27 million over the previous six years.
"There was too much redundancy in terms of service with other hospitals close by," Pollice said. "It's always hard to see a regional community hospital close, but it was the right decision."
UPMC decided in 2008 to convert its financially struggling South Side Hospital into an outpatient center. The urban hospital, which opened in the 1890s, had lost $4 million in operating and total income in fiscal 2008.
In 2005, UPMC sold its Lee Regional Hospital in Johnstown to the rival Conemaugh Health System.
UPMC merged with Lee Memorial in 1998, but couldn't help the 249-bed hospital make money. It sold Lee Memorial to Conemaugh in 2005 for $58 million.
Hamot Chief Executive John Malone said he is aware of how those hospitals have performed but isn't worried that Hamot will suffer their fate.
"Those hospitals had significant problems and issues that Hamot simply doesn't have," Malone said. "Keep in mind that there have also been examples like UPMC Mercy, which was on the verge of bankruptcy and UPMC turned its finances around dramatically."
Mercy Hospital, which opened in 1847 and is Pittsburgh's oldest hospital, merged with UPMC in 2006. It is losing money but has seen its revenue from treating patients increase by 3.2 percent since the merger; operating costs have risen by just 1.17 percent.

Highmark questions affiliation
One of the affiliation's loudest critics has been Highmark Blue Cross Blue Shield, western Pennsylvania's largest commercial health insurer.
Highmark recently placed advertisements in the Erie Times-News and sent letters to local insurance agents questioning the need for the affiliation and what effect it could have on the cost of health care in Erie.
"Our concern is that this affiliation will cause the cost of health care in northwestern Pennsylvania to increase because more people will be sent out of town for treatment," said Dan O'Malley, Highmark's market president of the western region. "We've had a lot of experience with UPMC throughout western Pennsylvania, and the result of these affiliations is often higher costs. Not all the time, but it has happened."
Malone called Highmark's comments "disingenuous."
"One of their claims is that we didn't spend enough time looking at alternatives," Malone said. "One of the alternatives we did look at was partnering with Highmark. We had a meeting and asked them to put some meat on the bones of their proposal, and they came back to us and said they couldn't go through with it for several reasons."
The truth, Malone said, is that Highmark fears an affiliation between Hamot and UPMC will strengthen UPMC Health Plan. Highmark currently has about 63 percent of the commercial health insurance market in Erie County, compared with 4 percent for UPMC Health Plan.
Hamot employees and their families could switch their health insurance from Highmark to UPMC Health Plan if the affiliation is approved. That's about 9,000 covered lives, Malone said.
"That would give UPMC Health Plan a foot in the door," said Martin Gaynor, a professor of economics and public policy at Carnegie Mellon University. "It could enable them to compete with Highmark for folks who are not Hamot employees."


Hamot and UPMC have reached a tentative affiliation agreement and are currently examining each other's finances.
A formal agreement should be finished by December, Malone said. It will then need to be approved by the boards of trustees at both UPMC and Hamot before an affiliation could take effect.
"I believe this affiliation will strengthen Hamot as the area's premier tertiary health-care provider," Concordia said. "For us, it gives UPMC an anchor at the other end of the state, so that patients in your area will go to Hamot instead of going across state lines to hospitals in Ohio and New York state."
DAVID BRUCE can be reached at 870-1736 or by e-mail.

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Stein says she knows how to help 'ordinary people' - Boston Herald

LEXINGTON - As a physician, Jill Stein says she grew tired of prescribing pills for people who could not afford them, so she left her clinical practice and decided to go into medical research and policy work to help improve the nation’s health care system.

Now, the 60-year-old says she is sick of politicians who promote solutions, such as business tax incentive programs, that only benefit the wealthy.

She says the focus of state government on corporate elites — instead of the working class — is what has motivated her to mount her second run for governor of Massachusetts as a Green-Rainbow candidate.

"Business as usual has not been delivering for ordinary people," she told The Associated Press during a recent interview at her home in suburban Lexington. "We are starving small businesses so that we can give to the big gorillas."

Stein paints her opponents — Democrat Gov. Deval Patrick, Republican Charles Baker, and independent Timothy Cahill — as three political insiders who care more about "arcane policy details" than the real needs of people across the state.

"They tend to spend a lot of time finger-pointing and calling each other liars," she said. "Who could care less?"

Stein is a graduate of Harvard and Harvard Medical School. She has been an internist, medical teacher, author and guitarist. Her husband is a surgeon, and the couple has two sons — 27-year-old Ben and 24-year-old Noah.

In 2003, she helped found the Massachusetts Coalition for Healthy Communities, a nonprofit focused on health care and the green economy. She has not practiced medicine since 2006, instead becoming something of a perennial candidate.

In 2002, she ran for governor; she ended up receiving 3.5 percent of the vote. She then ran unsuccessfully for state representative in 2004 and secretary of state in 2006, but explained losing did not mean the campaigns were not successful.

"Change does not happen easily," she said.

If she were to be elected, Stein would have the state place more emphasis on creating green jobs. She would support public schools rather than pitting them against charter schools. When she gets to talking about subjects that she feels the most passionate about, like creating more home weatherization programs to reduce energy costs, she moves her hands emphatically and leans in to her audience.

Stein hopes her message connects with voters who are upset with the status quo, including tea party supporters. She says she sometimes refers to her coalition of supporters as the "Green Tea Party."

"We share the same feeling that we have been betrayed," Stein said.

Some political observers believer her campaign can siphon liberal voters from Patrick, since Stein espouses support for the legalization of marijuana and single-payer health care while opposing casino gambling.

So far, Stein has attacked Patrick for what she calls his failure to deliver results for the middle class.

"The governor pretends he is a friend of the ordinary working person," she said. "He is powered by big corporate America."

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USF a partner in gene research lab taking shape near Naples - Tbo.com

By LINDSAY PETERSON

lpeterson@tampatrib.com

Published: October 3, 2010

TAMPA - To the medical school dean at the University of South Florida, the future of health care lies in a big field about 165 miles south of Tampa, along the road from Naples to Immokalee.

It's a vision that started in Collier County, spread to a research lab in Maine, then attracted USF with an ambitious proposition: high-paying biomedical jobs, research breakthroughs and a foothold in the emerging practice of personalized medicine.

"It's about creating a national model for health care for the 21st century," medical dean Stephen Klasko said.

A vice president with the Maine institution, Mike Hyde, let his rhetoric fly higher: "We propose a kind of Manhattan Project for health care," he said, referring to the World War II enterprise that led to the atom bomb.

USF and the private, not-for-profit The Jackson Laboratory have agreed to work together in what they're calling a bioscience village near Naples. Jackson would build it, then devote itself to finding personalized, gene-based treatments for today's most threatening diseases: cancer, Alzheimer's and diabetes.

"This is completely different from the way we deliver health care today," Hyde said. "It's a game-changer."

Manhattan Project

But game-changers, particularly Manhattan Project-style game-changers, are expensive. And the returns are uncertain.

To build and set up its Florida lab and treatment facility, Jackson says it needs at least $260 million, which it expects to get from state and Collier County taxpayers. It plans to raise $120 million for the first few years of operation.

The Legislature has approved $50 million for Jackson, with a promise of $80 million more in the next two years. It hasn't been so easy in Collier County, home to both wealthy retirees in Marco Island and farmworkers in Immokalee.

Jackson is promising high-tech jobs - about 7,000 in 20 years - and a chance for Collier to become nationally known for its bioscience innovation. But some residents question whether that chance is worth the $130 million they're expected to produce.

Who's right is hard to say, said Daniel Vorhaus, a lawyer specializing in genomics research for Robinson Bradshaw in Charlotte, N.C.

"All over the country, all over the world," health care institutes are rushing into genomics and personalized medicine, he said. "Everyone is competing for the same opportunity, for the same investment dollars, for the same business, for the same knowledge."

Some will succeed. Some won't.

"It's not always better to put $130 million into something as long term as personalized medicine," Vorhaus said. "But you don't want to lose sight of what you can do if you take a longer outlook."

What angers Naples lawyer Anthony Pires, a critic of the project, is that the Jackson effort was well down the road before the Collier County Commission began talking about it this summer.

"There's been a lot more going on than was reflected in the public record," Pires said.

Early work was secret

Tammie Nemecek, president of the Economic Development Council of Collier County, conceded that plans have been in the works for a while, but said there was no skullduggery involved.

She has been at the center of the effort from the start, about two years ago, when she attended a meeting organized by a prominent couple in Naples, Leslie and Rainey Norins.

Leslie Norins had worked with Jackson earlier in his career and, in retirement, he and his wife decided to raise money for the lab.

Nemecek said the fundraising presentation she attended "blew me away."

Jackson isn't one of the powerhouse biotech institutes such as Scripps, a California research institute that opened a much-sought-after branch in Palm Beach County last year. But it's well-respected for its efforts to unravel the genetic underpinnings of disease.

Established more than 80 years ago to study the role of heredity in cancer, it has created more than 5,000 strains of mice used around the world to test gene-based treatments.

After the presentation in 2008, Nemecek said, she approached Jackson representatives and told them, "You need to move here."

For years, Collier's economic developers have been working to bring biotech businesses to the county. It became a priority when the Florida real estate market collapsed.

But when she suggested it to the Jackson officials, they "looked at me like I had four heads."

They were trying to raise money for the Maine operation, she said. But as time passed, they talked more with local and state economic development officials, who assured them taxpayers would help them build in Florida.

The money would come from the state's Innovation Incentive Fund, created in 2006 to lure Scripps and other research companies to Florida.

The centerpiece of the Jackson incentives included a donation of 50 acres from Barron Collier Cos., which manages the vast Collier family land holdings. The company has donated hundreds of thousands of acres for parks and schools, so giving land to Jackson is consistent with its practices, spokeswoman Dolly Roberts said.

But the donation isn't all philanthropy.

"We want Jackson Labs," Roberts said.

What Collier Cos. gets

Collier Cos. plans to develop the land around the proposed research and clinic complex, which it envisions will include homes, schools, a hospital and several private biotech spin-off companies.

Also nearby is the town and campus of Ave Maria, developed and controlled by Collier and Domino's Pizza founder Tom Monaghan.

With decades of experience in genetics, Jackson is perfectly placed to help lead the revolution in health care known today as personalized medicine, said Hyde, the vice president in Maine.

Personalized medicine is the practice of tailoring drug treatments to an individual, based on family history and genetics.

"It answers the question of why some people respond to treatment and some people don't," said Klasko, the USF dean.

"This isn't just a fad. It's real," lawyer Vorhaus said. "And it's extremely necessary. With the cost and limits of our health care system today, we really need to deliver medicine in a more efficient, less costly way."

Genetic tests are available for some diseases, such as breast cancer.

"We believe that in the next few years, it will be possible to develop very, very definitive tests based on your particular individual genomic profile," Hyde said. "Our ability to diagnose a disease when symptoms occur and treat it will all be transformed by this."

About the time Naples-area lawmakers were pushing through the bill to fund the Jackson project, word reached Klasko, USF's energetic medical school dean, who encourages entrepreneurial approaches to health care.

"We invited them down for a day," Klasko said. "They had no idea what we had."

USF throws hat in ring

They liked what they saw at USF Health's Byrd Alzheimer's Institute, where professors do basic research in neuroscience in the same building where clinicians work with patients.

"We're looking at a scenario (at Jackson) where USF and Jackson researchers would work side by side," Klasko said. "We could take basic research, translate that into drugs and translate that into clinical trials with humans."

He also envisions partnering with southwest Florida's Edison Community College and Florida Gulf Coast University to offer courses in gene-based health care, from genetic counseling to treatment.

Collier's Roberts said the company is considering additional land donations, possibly for a hospital.

But these ideas remain just that - ideas.

"We're very much at the conceptual stage" of working together, said USF's vice president for research, Karen Holbrook.

"We know we're going to have people on the ground in Collier, but at this point we don't know who or exactly what they'll do," she said.

USF and Jackson have signed a three-page collaboration agreement, but it doesn't include details of the relationship.

That kind of vagueness concerns Janet Vasey, a member of the Collier County Productivity Committee, which sized up the Washington Economic Group's report on Jackson's economic impact.

"They say they'll bring all these jobs, but they don't say exactly how," Vasey said. They say dozens of private biotech companies will relocate to be near Jackson, she said.

"We asked who? And we got no answer."

One company has announced plans to move to the biomedical village. That's California-based Athleticode, which uses genetic testing to identify whether someone is at risk for certain athletic injuries.

"We just have a problem with the rosy projections," Vasey said.

A big price tag

She and others have proposed that the county commission put the $130 million county allocation to a public vote. She also noted that the plan to raise the money with a bond issue means it will ultimately cost taxpayers about twice that much.

The commission voted down the proposal.

Jackson has submitted its proposal to Enterprise Florida, the state's economic development arm that has to sign off on the project, along with the state Office of Tourism and Economic Development, before Jackson can get money from the state.

After that, Collier County has 120 days to approve its $130 million share.

Hyde isn't worried.

"There's little doubt that this is going to happen," he said. "This is a smart investment."

People who question the project might not be happy over the next few years. They won't see much, except for some construction.

"We're not going to cure cancer or transform the economy tomorrow. That's not how this works," Hyde said.

"But my guess is that 10 to 15 years from now, people in Florida will be delighted that this investment was made."

Reporter Lindsay Peterson can be reached at (813) 259-7834.

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The best resources for home health aide jobs - Helium

The best resources for home health aide jobs

Home health aides work in the home of patients who are still recuperating from an illness, or for chronically ill people who needs assistant with activities of daily living. It is easier to narrow your search by determining which area of home health you would like to work. In most cases home health aides are responsible for the care of one patient.

The best place to find a home health aide job is to apply with a home health aide agency. There are several different type of agencies with each one addressing different patient needs.

Patient Sitter

A person who wants to work as a patient sitter should apply with an agency that offer sitting services for patients in the hospital. This job is scheduled in twelve hour shifts, and a patient sitter spends most of the time sitting in the patients room. Your job might include, helping nursing staff to turn, and feed patient. This type of work is typically carried out in a hospital or a nursing home.

Provider Care

There are agencies which provide home health aide services to low income individuals which are paid for by Medicaid. These agencies  offer up to twenty eight hours per week. The department of aging and disability will have a list of these agencies for your area.

Referral Agencies

These are agencies that refer home health aides to people needing home health services. These can be live in work or by shifts or week ends only. You will be paid by the patient, and you can find these agencies through your local news paper. They might be listed under the domestic section or they might advertise in any type of senior news paper.

Private Home Health Agencies

Home health agencies that hire and assign care givers to specific patients. These agencies typically pay more, and work with more affluent clients. They are easier to find because they advertise constantly and often have web sites. There are several different franchises in this area of home health.

Group Homes

Group homes hire home health aides to provide care for elderly and mentally challenged individuals. You will be required to care for more than one individual.

Hospice Care

Agencies that specialize in hospice care hire home health aides to assist patients who are in their final stage of life. These can be private agencies who require the patient to pay for the service or other agencies that is paid for by Medicare or Medicaid. Patients can live in their home or in a nursing home. Additionally there are also agencies who hire home health aides to visit patients to assist with baths and meals.

Experienced Home Health Aide

An experienced home health aide can advertise their services in the classifieds. Craigslist is an Internet classifieds where you can place advertisement for free.

Home health aide work is easier to find for people who have Home Health Aide Certification or for a Certified Nursing Assistant. 

Learn more about this author, Jennifer Mcdonald.

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