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Although President Trump may not like America’s current healthcare system much, lately it’s been keeping his own economic record in solid shape – not to mention and bolstering his reelection chances. The evidence? Robust employment creation in the nation’s enormous healthcare services sector this year has been almost singlehandedly responsible for keeping job growth in the respectable range, and for strengthening the case that he’s steered the economy ably.

Unfortunately, the big 2019 relative rebound in payrolls in healthcare services and the rest of what I’ve long called the subsidized private sector is less good news for the economy itself. For the huge scale of these positions says much more about the government largesse on which their existence depends than about the state of the nation’s economic fundamentals – the market forces that drive employment in what can be called the economy’s real private sector, and that are supposed to be the keys to long-term national prosperity.

In fact, the figures for 2019 – which now cover its first eleven months – show that whereas the subsidized private sector’s profile in the U.S. labor market had been receding during the first two years of the Trump administration, this year it returned to levels not seen since the early days of the current (record-length) economic recovery. And consequently, the real private sector’s performance has revealed new weakness.

Specifically, from January-through-November 2011 (when the economy settled into normal expansion mode after the typically strong short-term bounceback from an unusually deep recession) through the comparable 2016 period, the subsidized private sector’s share of total gains in “nonfarm employment” (the U.S. Labor Department’s definition of the American jobs universe) grew from 19.35 percent to 25.87 percent. And its share of employment increases in the total, conventionally defined private sector itself, increased from 16.71 percent in 2011 to 36.88 percent in 2016.

By Mr. Trump’s second year in office, healthcare services and other subsidized private sector employment had sunk to 18.96 percent of total nonfarm job creation and 24.55 percent of total private sector job creation.

But what a difference a year has made! For the first eleven months of 2019, fully 30.96 percent of all U.S. jobs created have come in the subsidized private sector, and these industries accounted for more than half (50.75 percent) of private sector job creation. The former figure was the economy’s highest since 2010 (when it hit 32.78 percent), and the latter’s the highest since 2016 (when it hit 58.43 percent).

The Trump record isn’t entirely discouraging if you’re a fan of real private sector job creation – and you should be if you believe (as you should) that the predominance of market forces represents the economy’s best hope for sustainable prosperity. For the pace of public sector hiring has definitely waned over the last three years – and not only in relative terms. During the final three January-through-November periods of the Obama administration, government was adding an annual average of 140,000 jobs. During the first three such periods under Mr. Trump, the annual average is down to 110,000 (though it’s been on the upswing since 2017).

Yet if levels of government spending are the driving forces in both cases, is the relationship between the public sector and the subsidized private sector a distinction without a difference?