It is pretty simple really.
Outside of capital investment such as a CT Scanner or a huge lab, the item which in almost all cases the LARGEST cost of ANY business is always wages/labor.
America has offshored almost all of its manufacturing capability since the end of World War Two.
Manufacturing was the holy grail of working class wages, driven by "organized" labor and rising standards of living brought on by these decent (if mundane and boring), jobs. Factory labor was often the PRIMARY source of tax revenue, and municipal income.
Then the sharp pencil kids figured out that Japanese, Koreans, Indonesians and others would do the same job for three or four CENTS on the dollar that American labor was charging. A 'new day' in profiteering was begun.
As people began to complain about losing family incomes... another voice was heard from.
Enter stage left those that while reaping the benefits of the increase of dividends on the bottom line made public pronouncements of how WE somehow 'owed' it to these people to raise THEIR standard of living. These same people that were crying in other countries milk neglected to mention that vast numbers of Americans would lose the only decent paying job that their families had EVER had.
Time passes. People adjust. Some retire or are RETIRED forcibly. Some die from Lung Cancer, Silicosis, other things brought on either by the job or by the lifestyle made possible by these jobs and simple human cussedness.
A new generation arrives. Jobs are FOUND for them, specially those with the wherewithal or gumption to morph thru the government training systems and come out degree or certificate in hand.
The new holy grail of American labor? Wait for it..... HEALTHCARE.
NOW in order for the stage left folks to consolodate POWER wich is the ONLY goal of politics a huge RUSHED push is made to get 'universal healthcare' IMPOSED, even though a quick read of all the plans SHOWS that it won't be "universal".
So... back to point 'a'... the LARGEST cost of ANY business, and make NO MISTAKE about it 'heath care' IS a BUSINESS is always wages/labor.
All those kids that went into the medical arena are about to be factory workers, EXCEPT instead of the jobs going AWAY they will be DRAFTED at some lower form of compensation, whether it is simply fewer of the 'gravy' billings that everyone has gotten used to OR some form of government IMPOSED fee structure.
The fat cats will never lose a dime but the nurses, the radiologists, the clerks and the maintenance people will see a drop in the standard of living BEYOND that their parents did.
And this time???? where will THEIR kids go for work.