ABSTRACT
This chapter aims to focus on the human resource and labor market dimensions of the sustained expansion that occurred between 1966 and 1992. In the American health care system, the states, rather than the federal government, play the leading role. Since the cadre of baby boomers entering the labor market was relatively small at the time that the needs of the health and hospital sector for trained workers spurted, the fact that the community colleges were able to expand their nursing programs without great difficulty was a fortuitous coincidence. Many economists favored a substantial increase in the physician supply on the ground that only such a trend would brake physicians' rising fees and earnings; in fact, they argued, with an expanding supply, incomes would actually decline. There have been ongoing tensions between physicians who dominate the health care sector and nurses who have been seeking to broaden the scope of nursing practice and enhance the status of their profession.
