Greetings from late September. I’m writing this from several different airplanes and airports, traveling back from the University of Alaska’s second AI Symposium. Aircraft wifi has been uneven, dropping in and out, and once tried to double charge me. Another time United actually apologized for not having Starlink yet.
Today’s post takes one of my future of higher education scenarios, Health Care Nation, and adds some more to it. If you haven’t seen it before the idea is that allied health – the full range of health care from emergency services to surgery, psychotherapy, and hospital administration – keeps growing on the American landscape. Over time allied health employs more people, uses more technology, constitutes a large part of the national economy, and achieves a higher cultural prominence. (You can find more details in my previous writing: in 2014 (EDUCUASE Review; blog post), 2017 (blog post; another one), 2018 (blog post; another one), 2020 (in Academia Next), 2024 (video; blog post), and 2025 (blog post).)
Ryan Craig recently published a newsletter issue backing the scenario’s drivers and implications. I’d like to draw your attention to it and apply it to the scenario.
To start, he notes the sector’s enormous size and steady growth:
Last year, healthcare spending increased an astonishing 7.3% to $5.7 trillion. While the average developed country spends less than 10% of GDP on healthcare, in the U.S. it’s approaching 20% of the economy – up from 5% in 1960 and 13% in 2000. Eight of America’s 20 largest companies by revenue are healthcare businesses. Our healthcare sector is now bigger than every other country’s GDP save China. Government spending on Medicare and Medicaid has grown nearly 50% since 2020…
Last year, healthcare accounted for 121% of net job growth in the U.S; of 360K net jobs added in 2025, healthcare generated 436K (meaning a loss of 76K jobs across all other sectors). As America ages, healthcare has added jobs every month since January 2022 and is responsible for nearly half of net job growth since the pandemic. The Department of Labor projects millions more new healthcare jobs in the next few years. Plus, healthcare jobs aren’t just in Silicon Valley and big cities; healthcare providers are dominant employers in every market.
Craig finds that some of higher ed is responding by increasing health-related offerings, and can do even more because so doing involves:
(1) responding to market signals; (2) adding capacity in programs with clear pathways to good jobs; and (3) increasing enrollment in programs that balance classroom instruction with work and thereby do a credible job of equipping students with valuable practical skills.
And so: “Healthcare programs have lines out the door because they lead directly to good entry-level jobs with well-trodden career paths. ”
Craig also, and accurately, points out challenges to campuses seeking to do this work. It can be difficult to attract medical professionals to teach when academic compensation can be relatively low. There are also limits from state governments and medical bodies. Craig intriguingly points to the possibility that Americans will eventually reach an upper limit to how much we will pay for medical services.
I would add a few more details to this account. Campus allied health programs can backfire for internal reasons, like any academic program: hiring the wrong people, bad administration, poor marketing, oversaturating a given region. Automation (both AI and robotics) may play a major role in medical services, requiring more educational support in terms of research and development, preparing students to use new tech, and studying the changing world of medical work. I’d also give more emphasis to the demographics on this score, namely that as we age up (which America is doing, especially as we’re turning away and violently evicting immigrants) we tend to consume more health care. Elder care fields are apparently lacking in staff.
Overall, it seems that 2026 sees American higher ed moving ever more deeply into the Health Care Nation scenario. I hope academia can do well in it as it comes to pass. Thanks to Ryan Craig for helping us think it through.
(hospital ICU room photo by Quinn Daedal; my thanks to the fine team at Reclaim Hosting for their support!)
Great info, thank you, Bryan. I’m actually giving a presentation on this exact same topic next week to our Nursing degree program at the university where I teach. AI, as well as robotics and AI-infused robotics, is growing more and more because of our aging population. The only thing missing from your overall topic of “Health Care Nation” is the often-overlooked hidden gem of medical tourism. Price differences are just completely crazy. I just had an abdominal surgery done here in Armenia. The cost here was exactly $875, which includes all taxes, an overnight stay for observation, and all aftercare drugs. By the way, most surgerns here have been trained in the USA. This same surgery done in Kansas, USA (where I’m from), would have cost me $10,000. Imagine that. For that price, you could buy a ticket, come to Armenia for a week, and have a nice visit beforehand. Then have the surgery and stay for another week to recuperate before flying back. You would still have saved thousands of dollars.
I’m grateful that Ryan pointed out the shortage of clinical placements, which acts as a brake on the number of students in many key programs. At my college, we could easily double the number of students in some programs if we had enough clinical placements (and yes, we could find faculty for them!).
But we are also experiencing other problems. Our local health care industry is an oligopoly that pays its nurses and some of its allied health workers the lowest wages in the market; all our graduates have to do is drive 35 to 50 miles in a different direction and they can earn 15-20% more. And when our faculty explain to the hospital administrators that our graduates routinely cite higher pay as the driving factor, the administrators refuse to acknowledge the validity of the complaint.
Which goes to the larger caveat that I would want to put on this. Yes, there are shortages of healthcare workers, and demand should continue to grow. But there are other factors that affect the workforce pipeline, and not all of them are within the control of higher education. Could hospitals decide to replace, say, expensive and scarce radiologists with less expensive and scarce sonographers or radiology technicians, or nurses with nurses’ aides? Will Medicare offer fewer reimbursements for certain types of medical care, leading to less workforce demand? Will anything reverse the decline of hospitals in rural communities? I’m not saying that colleges and universities should refuse to add programs and spaces in allied-health fields. I’m saying they need to move carefully and in partnership with local providers in order to be sure they aren’t leaving themselves exposed to possible changes in the industry.