The CEOs, to be sure, will have to get real jobs. There are quite a few options for ordinary employees.

If the financing of health care is a public good, then public oversight can insure that the claims processing jobs that remain will never be sent out of the country. This is true whether we hire existing insurance companies to do this work or build a separate institutional structure from scratch.

Once the burden of being robbed by expensive middlemen is removed from private and public employers, they will be able to afford to hire many more employees. The CA Nurses Study estimates that single payer could provide 2.6 million new jobs this way.

There is a growing shortage of nurses, and we should be funding more training in this field.

Private insurance will not disappear. All countries with universal health care have regulated private insurers who provide plans to fund extras not provided by the basic system.

With health care not tied to a job, people will be free to start their own businesses, or to retire early and take on second careers or community work. This will free up spaces on their former employer’s career ladder.