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Column: The Ozempic revolution in weight-loss drugs exposes the weakest links in our healthcare system — drug pricing and insurance

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Column: The Ozempic revolution in weight-loss drugs exposes the weakest links in our healthcare system — drug pricing and insurance

It’s rare — miraculously rare — that a drug can have such a pronounced effect that its immediate benefits translate into healthcare savings for years, even decades. To the wonder drugs Harvoni and Sovaldi, which wipe out hepatitis C, we can now add the weight-loss medicine Ozempic and its cousins Wegovy, Mounjaro and Zepbound.

These drugs have shown remarkable effectiveness in reducing obesity. That points to long-term reductions in users’ vulnerability to the whole spectrum of obesity-related medical conditions, including diabetes, cardiovascular disease, bad knees and sleep apnea.

They appear to work on other unhealthful dependencies such as narcotic and alcohol addiction, and possibly even on Alzheimer’s.

‘Insurers routinely don’t see people for more than a few years at a time …. This limits the length of time that health gains can be internalized as reduced claims.’

— David Anderson, University of South Carolina health policy expert

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Yet millions of Americans are unable to access these drugs, thanks to the two big, interrelated flaws in our healthcare system: unrestrained pricing by drug companies and the economics of health insurance.

We’ll explore how these factors work to deny access to drugs that address America’s No. 1 health malady. But first, a look at the seriousness of the obesity epidemic.

Weight is typically measured by the body mass index, or BMI, which correlates weight with height. Roughly speaking (and not accounting for differences between males and females), a “healthy” weight for a 5-foot-10-inch person is reckoned by the Centers for Disease Control and Prevention to be 128 to 173 pounds, which translates to a BMI of between 18.4 and 24.9.

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Between 173 and 208 pounds places that person in the “overweight” category and heavier than that is judged to be “obese,” defined as a BMI of 30 or higher. Those with a BMI of 40 or higher, or 278 pounds for a 5-foot-10 adult, are “severely obese.”

America has been getting more obese over time, according to the CDC. In 1960, about 31.5% of U.S. adults were overweight; in 2017, the latest period tracked by the agency, the figure was 30.3%. In 1960, however, 13.4% of adults were obese and 0.9% severely obese; by 2017, about 42.8% of adults were obese and 9.6% severely obese.

The rate of obesity among children — about 20% — is especially worrisome. Obese children are more likely than those with healthy weights to have high blood pressure and diabetes, and more likely to be obese in adulthood.

The toll this epidemic takes on the economy is horrific. Obesity and its consequences cost the U.S. healthcare system nearly $173 billion a year, the CDC estimates.

Experience with the weight-loss medicines thus far shows that they can cut the rates of obesity-related conditions materially. A five-year study of more than 24,000 nondiabetic but obese subjects published earlier this month by a team of Taiwanese researchers found significant reductions not only in heart disease, hypertension, stroke and kidney failure but in mortality from all causes as well. Those in the control group (not receiving the drug) had a 3.5% annual mortality rate; for those given the drug, it was only 0.75%.

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So why would stakeholders in our healthcare system not be beating down the doors to make these drugs more widely available?

The answer, of course, boils down to money.

The estimated cost of Wegovy and similar drugs for insurers, net of bulk discounts provided by manufacturers (Denmark-based Novo Nordisk for Wegovy and Ozempic and Indianapolis-based Eli Lilly for Mounjaro and Zepbound) runs from about $8,600 to $9,100 a year. That’s a big lift for insurers contemplating coverage of drugs for which the public demand can be in the millions.

That might work if insurers could be sure that the long-term savings from their enrollees’ health improvements would save them as much or more. In our fragmented healthcare system, however, they can’t be sure that they’ll still be covering those enrollees in the cost-avoidance period. Customers can move to other insurers or leave the employers who were providing the insurance.

“Insurers routinely don’t see people for more than a few years at a time,” observes David Anderson, an expert in health policy at the University of South Carolina. “This limits the length of time that health gains can be internalized as reduced claims.”

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As a result, insurers have been placing obstacles in the way of customers seeking coverage. Some require advance authorization before they’ll pay or limit coverage only to patients with a high BMI. Some insurance plans will cover them only for employees already diagnosed with diabetes, the condition for which these medicines were first developed, but not for weight loss alone.

Insurers administering plans for self-insured employers — large companies and institutions — are probably responding to their clients’ directives.

Some big employers that originally covered the weight-loss drugs have pulled back. The Mayo Clinic has imposed a $20,000 lifetime limit on the coverage for its employees. Purdue University will cover the drugs for employees with BMIs over 30, but requires employees to have lost at least 5% of their body weight after three months to continue coverage.

Others have simply dropped the option altogether. That leaves employees or the uninsured on the hook for the cost of $1,000 or more a month.

The insurer best positioned to pay for the weight-loss drugs and to reap the long-term benefits is Medicare, in which enrollees typically remain for life. Moreover, insurers are generally required to cover drugs considered the standard of care for known conditions.

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Unfortunately, Medicare is prohibited by law to cover drugs prescribed specifically for weight loss. It can pay for them only if they’re prescribed for a related condition, such as heart disease or diabetes. For example, Wegovy was added to the standard formulary for Medicare’s Part D prescription benefit after it received approval from the Food and Drug Administration in March for the treatment of heart attack risk.

The popularity and efficacy of the drugs prompted legislators in June to update a measure unsuccessfully introduced in 2014 legalizing Medicare coverage for weight loss alone. The new version would cover mostly those who had been taking a drug for at least a year before joining Medicare, however.

Some experts estimate that expanding coverage of the weight-loss drugs would cost Medicare up to $6.1 billion a year, assuming that 10% of patients eligible for the coverage actually receive prescriptions. That would increase the $120-billion annual cost of Medicare prescriptions (net of enrollee premiums and contributions from state programs) by a little over 5%.

Whether that cost would be fully offset by subsequent healthcare savings for Medicare is unclear. Not every patient prescribed the weight-loss drugs tolerates them well enough to stay on them for even a year, and not all will escape a major health crisis that could have been averted by weight loss alone.

But it seems now that our healthcare system will have to deal with the new class of weight-loss drugs in one way or another. Wegovy and Ozempic are expected to be selected for the next round of Medicare price negotiations, due to take place next year with price reductions effective starting in 2027. Drug industry analysts don’t expect the drugs’ popularity to wane. The market for them reached $6 billion last year, according to Goldman Sachs, which projected that it would grow to $100 billion by 2030.

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The weight-loss drugs are by no means the most expensive on the market — that trophy belongs to certain cancer drugs and gene therapies, some of which clock in at several million dollars per treatment. But none of those serve a market anywhere near the potential size of weight-loss treatments.

Unless the U.S. moves toward a single-payer healthcare system and starts to place limits on drug prices, it’s the manufacturers of the weight-loss drugs that will reap most of the benefits. Sales of Wegovy and Ozempic made Novo Nordisk the most valuable European company last year and helped drive an increase in profit at Lilly for the second quarter that ended June 30 by nearly 69% over the year-earlier period.

To put it another way, America’s 20th century healthcare system is coming face to face with a spate of 21st century drugs. Something will have to give.

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Column: The rise of Kamala Harris shows that our political 'polarization' was always a myth

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Column: The rise of Kamala Harris shows that our political 'polarization' was always a myth

A funny thing happened after July 21, when President Biden ended his campaign for reelection. It’s not merely that Kamala Harris emerged to take his place; it’s that her campaign had overcome the polarization of American politics.

At least, that’s the reading provided by not a few political pundits. But it’s not quite true. The reality is that Harris’ rise as a leading political figure demonstrates that America was never as polarized as our commentators claimed.

I made this point nearly three years ago, in the wake of the failed recall effort against Gov. Gavin Newsom. The recall failed by a 2-to-1 vote. As i observed at the time, the commentariat persisted in viewing the result through the prism of the “polarization” theme, even though it demonstrated conclusively that in California, at least, there was broad agreement, not disagreement, about Newsom’s policies on fighting COVID, abortion and gun control.

Another four years of Donald Trump’s chaotic leadership, this time focused on advancing the dangerous goals of Project 2025, will hurt real, everyday people and weaken our sacred institutions.

— Letter from 200 former Republican aides endorsing Kamala Harris for president

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Harris has (so far) finessed the polarization meme by making an explicit appeal to voters based on issues likely to find widespread conformity across the partisan spectrum. These include abortion rights (despite the issue’s appearance as a wedge driving Americans apart) and economic policies aimed at the middle class.

The harvest appears to be a surge in cross-party support for the Harris campaign. On Monday, more than 200 former Republican aides to presidents George W. and George H.W. Bush and Sens. Mitt Romney and John McCain endorsed Harris in an open letter, stating that “another four years of Donald Trump’s chaotic leadership, this time focused on advancing the dangerous goals of Project 2025, will hurt real, everyday people and weaken our sacred institutions.”

A dozen lawyers who served Ronald Reagan and both Bushes in the White House issued their own joint endorsement, stating, “We believe that returning former President Trump to office would threaten American democracy and undermine the rule of law in our country.”

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The Harris campaign, emboldened by positive polls, is seeking to expand its presence into Sun Belt states that were either judged out of reach or leaning Republican, such as Georgia, Arizona and North Carolina.

Yet it may be more accurate to view these developments not as Harris overcoming polarization, but as her exposing the shallowness of the polarization impression. Political scientists have increasingly come to the conclusion that the apparent polarization of debate in the U.S. is an artifact of where that debate has been conducted — chiefly on social media.

“At first blush, the American political landscape can seem quite bleak, in part because of heightened political polarization,” observed researchers from UC Berkeley and Columbia University in March. But they found that “the landscape of debate is distorted by social media and the salience of negativity present in high-profile spats.”

The misimpression among Americans, they wrote, fosters “a false reality about the landscape of debate which can unnecessarily undermine their hope about the future.”

The methods used by social media platforms to grab and hold users’ attention deserves much of the blame for this distortion, they asserted. “There is evidence that negative information spreads more quickly on social media and is often amplified by social media algorithms that promote or push content to the forefront of users’ pages,” they wrote.

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“This negativity is exacerbated by non-human actors or ‘bots’ that often inflame online conflicts …. These factors combined suggest that negative, conflict-laden debates will flow to the top of people’s timelines.”

A similar conclusion was reached by political scientists James Druckman of the University of Rochester, Matthew Levendusky of the University of Pennsylvania and their colleagues, who found in a 2020 paper that the “hyper-partisan polarization” that defined current American politics in the 21st century was “affective polarization” — meaning that when people were asked in surveys about the party whose policies they opposed, was based on “stereotypes and media exemplars of ideologically extreme and politically engaged partisans.”

What was happening, they wrote, was that people incorrectly assumed that those extremists “comprise the majority of the other party.”

Another factor is Trump, who “is also a polarizer: he takes existing trends and pours gasoline on them,” Levendusky told me.

Still, the image of a hopelessly polarized America is belied by opinion polls and ballot results on individual issues. Nearly two-thirds of Americans feel that abortion should be legal in all or most cases, according to a survey issued in May by the Pew Research Center. That’s higher than it was in 1995.

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More evidence comes from abortion-related ballot initiatives in seven states in 2022 and 2023, following the Supreme Court’s overturning of Roe vs. Wade: The pro-abortion rights position prevailed in every one, including in the red states Ohio, Kansas and Kentucky. Abortion rights measures will be on the ballot in 10 states this November, including Florida, Missouri, Nebraska and South Dakota.

Sizable majorities also are seen in opinion polls in favor of stricter gun laws and antipandemic measures such as masking and social distancing. COVID vaccines may be the target of obstreperous antivaccination fanatics, but most Americans have voted with their feet by walking into vaccine clinics: 81% of Americans have received at least one shot and 70% are considered fully vaccinated with multiple doses.

That includes states in which antivaccination politics reign, such as Florida, where the Republican-appointed surgeon general, Joseph Ladapo, has issued antivax recommendations so misleading that he was publicly rebuked by the Centers for Disease Control and Prevention and the Food and Drug Administration. Despite Ladapo’s antivax propaganda, 81.4% of Floridians have received at least one shot and 68.6% are considered fully vaccinated.

As for the homogenizing of the major parties’ opposing positions on matters of public concern — liberals becoming Democrats and conservatives becoming Republicans — that’s not polarization so much as what Levendusky described as “the partisan sort” in his 2009 book of the same name. Voters take their cues from the leaders of their favored party, he noted, “looking to elites who share their values to figure out where they stand on the issues.”

“People have gotten a bit more divided over time, but much less than people think,” Levendusky says. “People have sorted themselves so that Democrats are now mostly one side of the issue, and Republicans on the other. A generation ago, you had lots of pro-environment Republicans, pro-choice Republicans (and pro-life Democrats!), Democrats who were strong gun rights supporters, and so on. Now, that’s much less true.”

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What is true is that the platforms of the two major parties have moved further apart; more precisely, while the Democratic Party stayed where it had been, slightly left of center, the Republican Party moved distinctly toward the extreme right.

The reason, Levendusky argued in his book, was the flow of evangelicals and other fundamentalist Christians into the Republican Party starting in the 1970s. Party leaders — the “elite,” in Levendusky’s term — moved rightward to accommodate this new, outspoken bloc; some nonfundamentalist party members followed along, but most remained centrist on economic issues and abortion rights.

This process is relatively new in American politics. During the New Deal, the most obdurate critics of Franklin Roosevelt’s policies were Democrats — Southern Democrats, to be sure, but his party members nonetheless — while among his most loyal supporters were liberal Republicans. One of the two aides who served in FDR’s Cabinet for all 12 of his years in office, Harold Ickes, was a Republican. (The other was Frances Perkins, a Democrat.) Lyndon Johnson had to trample over opposition by the Southerners in his party to get the Civil Rights and Voting Rights acts passed in the 1960s.

Just as the Republicans had a progressive wing, the Democrats had a conservative wing comprising Wall Street bankers and corporate executives such as Alfred P. Sloan, the chairman and chief executive of General Motors. Sloan and his fellow rich reactionaries established a rump anti-New Deal bloc, the American Liberty League, to lobby against FDR’s policies from inside the Democratic Party.

FDR rhetorically drummed them out of the party — their “two particular tenets,” he said, are that “you should love God and then forget your neighbor” — but they remained part of the party until the league disbanded in 1940.

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In recent years, Levendusky observed, there has been a shift in both parties toward the extremes. But it’s not as pronounced as social media posters and political commentators would have it. “The majority of the electorate remain closer to the center than to the poles.”

That’s where Harris is right now, which may be the key to her placing the “polarization” ogre in its grave for good.

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The Geography of Unequal Recovery

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The Geography of Unequal Recovery
Change in jobs +10% –10% +50% –50%

The U.S. economy has added some 19 million jobs in the past four years — all the jobs lost in the pandemic plus millions more. The comeback has been faster and more complete than any in recent decades, or maybe ever.

But it has also been uneven.

In some parts of the country, jobs came back quickly once vaccines were available, if not earlier. In many of those places, more people are working, and earning more money, than ever before.

In other places, the rebound has been much slower. As of 2023, more than two in five U.S. counties — 43 percent — still hadn’t regained all the jobs they lost in the early months of the pandemic, according to annual data from the Bureau of Labor Statistics. Some of those places were struggling long before 2020. Others had been thriving economically and were knocked off course by an airborne shock few saw coming.

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The geography of that unequal recovery helps reveal how the pandemic — and the policies adopted in response to it — reshaped the U.S. economy, changing the kind of work Americans do and where they do it.

The patterns could have electoral implications: The battleground states that will help decide November’s presidential election include some of the biggest winners in the recovery — but also several of the losers.

The winners have some things in common. They are concentrated in the South and the Mountain West, particularly in suburban counties, which have done well in an era of remote and hybrid work.

They tend to be places where job losses were comparatively mild in the first place, often because their major employers were in industries that were less affected by — or that even benefited from — the disruptions of the pandemic. They are, on average, richer and better educated than counties that have been slower to rebound. They voted disproportionately for Donald J. Trump in the 2020 presidential election.

The losers, by contrast, tend to be concentrated both in big cities, which were hit particularly hard by the pandemic, and in rural areas, which were struggling long before the virus struck. They are relatively poor, on average, but with notable exceptions: San Francisco and several of its wealthy neighbors, for example, have yet to regain all the jobs they lost in the pandemic.

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Leisure and hospitality jobs did not return in many places

Percentage change in leisure and hospitality jobs from 2019 to 2023. Battleground states are in bold.

Utah

Idaho

Mont.

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Texas

Ariz.

Ark.

Tenn.

S.D.

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Okla.

Neb.

Wyo.

N.C.

S.C.

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Fla.

Colo.

Kan.

Ga.

Ky.

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N.J.

N.H.

N.M.

Va.

Mo.

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Ind.

Ohio

N.D.

Del.

Wash.

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Wis.

Miss.

R.I.

Ala.

Alaska

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Calif.

Maine

Iowa

Conn.

Pa.

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Minn.

Mich.

Nev.

Ore.

W.Va.

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Ill.

Mass.

N.Y.

Vt.

Md.

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La.

D.C.

Hawaii

–8

–4

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0

+4

+8

+12%

The pandemic also changed the types of jobs that Americans hold. Restaurants, hotels, movie theaters and other in-person businesses laid off millions of workers, while warehouses and trucking companies went on a hiring spree to meet the surge in demand.

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Those shifts have reversed, but gradually and incompletely: The United States has more truck drivers and fewer waiters, as a share of the work force, than it did in 2019.

The economic changes that started in the early days of the pandemic have played out differently in different parts of the country — including the states most likely to decide the election. Nevada, which depends more heavily on tourism jobs than any other state, was hit especially hard in the pandemic, and while Las Vegas is booming again, not all the jobs have returned. That may help explain why both major presidential candidates have sought to woo casino workers there by promising to eliminate taxes on their tips.

Hospitality jobs have also been slower to return in the Northern swing states like Michigan and Pennsylvania than in Sun Belt states like Georgia and Arizona, where pandemic restrictions were lifted earlier.

There’s been a construction boom

Percentage change in construction jobs from 2019 to 2023. Battleground states are in bold.

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Idaho

Ariz.

Mont.

Utah

Ark.

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Tenn.

S.D.

Nev.

Neb.

Mo.

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Maine

N.C.

N.H.

Ky.

Fla.

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Ind.

Wis.

Mich.

Miss.

Ala.

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R.I.

Ore.

Ga.

Minn.

Iowa

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Kan.

Wash.

Texas

Mass.

N.M.

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Va.

Ohio

S.C.

Del.

Colo.

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Alaska

Vt.

Ill.

Conn.

N.J.

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Calif.

D.C.

Hawaii

Okla.

Pa.

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Wyo.

N.D.

Md.

N.Y.

W.Va.

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La.

–5

0

+5

+10

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+15

+20

+25

+30%

Government policies have also helped shape the rebound in the job market. Big federal investments in infrastructure, green energy and high-tech manufacturing under President Biden helped fuel rapid hiring in manufacturing and heavy construction.

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In Nevada, new factory jobs — and jobs building those factories — helped offset the slow rebound in tourism. Arizona has enjoyed one of the biggest construction booms of any state thanks partly to giant new chip manufacturing plants whose funding includes federal grants.

Sun Belt states thrived

Percentage change in jobs from 2019 to 2023, by county

Suburban and urban counties

X indicates no available data. Change in jobs +5% –5% 0% +20% –20% 0%
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Nevada

Partly because of these patterns, battleground states in the Sun Belt have thrived in recent years, at least in job growth. Maricopa County, Ariz., which includes Phoenix and is the site of the chip plants, is one of the fastest-growing big counties (those with at least one million residents) in terms of employment. Jackson County, Ga., is one of the fastest growing of any size — up more than 60 percent since 2019, partly because of a major new plant that manufactures batteries for electric vehicles.

That rapid growth has brought opportunities, but also challenges, particularly a critical shortage of affordable housing. It is no coincidence that the presidential campaigns of Mr. Trump and Vice President Kamala Harris have put housing at the center of their economic messages.

“Blue Wall” states fared relatively poorly

Percentage change in jobs from 2019 to 2023, by county

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Suburban and urban counties

Change in jobs +5% –5% 0% +20% –20% 0%

Wisconsin

The Northern “Blue Wall” states face a different set of challenges. They struggled economically before the pandemic and have been laggards in the recovery.

Pennsylvania, for example, largely missed out on the construction and manufacturing booms. Allegheny County, which includes Pittsburgh, is the only big county in the country where total employment has fallen more than 5 percent since 2019. But the losses have been widespread: Of the state’s 67 counties, 51 lost jobs from 2019 to 2023.

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How, exactly, these trends will play out on Election Day is unclear. Polls show that voters are worried about the economy across the country, not just in the places where the recovery has been weakest. That may be because, at least until recently, many Americans have been worried less about finding a job than about the rising cost of living.

That could be changing now, as rising unemployment and slowing job growth have begun to expose cracks in the labor market’s foundation. That is especially true in states like Pennsylvania, where hiring has lagged, but even fast-growing states have areas where the labor market is struggling.

While the election will probably be decided by voters in a handful of battleground states, nearly every place looks different than it did four years ago.

In Lee County, Fla., a wave of construction helped offset a big decline in hotel and restaurant jobs. Portsmouth, Va., bucked the national trend and added hospitality jobs due mostly to the opening of the state’s first permanent casino. McLean County, Ill., has gained thousands of manufacturing jobs in recent years, many of them at the electric vehicle maker Rivian.

See what has changed in your county:

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In

, there is not enough data available.

Cumulative percentage change in jobs from 2019

All industries

Insufficient data

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2019

2023

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Construction

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Manufacturing

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Trade, transportation and utilities

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Information

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Finance

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2019

2023

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Business services

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Education and health

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Leisure and hospitality

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Other services

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Methodology

Jobs data are average annual employment levels from the Quarterly Census of Employment and Wages, published by the Bureau of Labor Statistics. Totals are for all covered employment, public and private. Industry breakdowns are private sector only.

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Population, demographic and socioeconomic data is from the American Community Survey five-year sample for the years 2016 to 2020. Election results are from Dave Leip’s Atlas of U.S. Presidential Elections.

The Bureau of Labor Statistics withholds some data to protect the confidentiality of individual businesses. Data for a small number of counties is not shown because of changes in county definitions from 2019 to 2023. Maps do not show change in employment for counties with populations under 500.

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Michael Crichton's estate sues Warner Bros., Noah Wyle, others over 'ER' reboot

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Michael Crichton's estate sues Warner Bros., Noah Wyle, others over 'ER' reboot

The estate of mega-selling author Michael Crichton filed suit against Warner Bros. Television, actor Noah Wyle and producer John Wells for breach of contract over the reboot of the blockbuster series “ER.”

According to the complaint filed Tuesday in Los Angeles Superior Court, the Crichton estate spent nearly a year unsuccessfully negotiating with Warner Bros. for the right to reboot the celebrated medical drama that ran on NBC.

When the parties did not reach an agreement, the studio “simply moved the show from Chicago to Pittsburgh, rebranded it ‘The Pitt,’ and has plowed ahead without any attribution or compensation for Crichton and his heirs,” the lawsuit alleges.

The move is a “callous disregard for Crichton’s inception of ‘ER,’” a “personal betrayal” of a 30-year friendship between the author and John Wells, the original series’ showrunner, and “an effort to rob his heirs of the fruits of one of his greatest creations,” the complaint states.

Wells has been announced as executive producer of “The Pitt” and Wyle is set to both star and serve as an executive producer.

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“The lawsuit filed by the Crichton Estate is baseless, as ‘The Pitt’ is a new and original show. Any suggestion otherwise is false, and Warner Bros. Television intends to vigorously defend against these meritless claims,” said in a spokesperson for the studio in a statement.

Spokespersons for Wells and Wyle were not immediately available for comment.

Before he died in 2008, Crichton was a prolific, bestselling author who wrote 25 novels that sold more than 250 million copies worldwide, 13 of which were made into films including “Jurassic Park.” His novels, films and television series have collectively grossed over $10 billion to date, according to the suit.

In 1974, he wrote the screenplay for what became “ER’s” two-hour pilot, inspired by his own experiences as a medical intern in the emergency room of an urban hospital.

Fifteen years later, Crichton and Steven Spielberg developed his script into the groundbreaking series that ran on NBC for 15 seasons between 1994 and 2009, earning 124 Emmy nominations, winning 23. The show delivered “billions of dollars” to Warner Bros., states the complaint.

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Before entering into an agreement with Warner Bros., Crichton extracted a series of contractual promises, including a “frozen rights” provision that prohibited the studio from making any sequels, remakes, spinoffs, or other productions derived from “ER” without his “express consent,” according to the suit. Further, the author would receive the appropriate credit, while his heirs would “receive compensation commensurate with the ultimate success of ‘ER,’ in connection with any future productions.”

After Crichton died, the lawsuit says that Warner Bros. made a series of moves that “betray[ed] his trust and diminish[ed] — and ultimately erase[d] him from his work, including the HBO remake of “Westworld,” based on the 1973 film that Crichton wrote and directed. Instead of giving Crichton a “created by” credit, he received a ‘’’based upon’ credit buried deep in the end credits.”

Then, in 2020, the suit alleges that Warner Bros. began developing an “ER” reboot to air on its struggling HBO Max service, “without ever shopping the project to ascertain its true value” and without informing the author’s widow, Sherri Crichton, the guardian of the estate that controls her late husband’s “ER” assets for the benefit of his children and in violation of the “frozen rights” provision.

After nearly two years of development, the studio informed Sherri Crichton and the estate of the planned reboot, “pressur[ing] them to consent, without regard for how Crichton would be credited or his heirs would financially benefit from the project,” according to the complaint.

After rocky discussions, the estate was prepared to approve the project in exchange for a “created by” credit give to Crichton and a $5-million nonperformance guarantee.

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However, the suit alleges, the studio and Wells then rescinded those terms and demanded that the estate “waive the guarantee,” and proceeded to work on the reboot without its consent, initially in secret.

In a statement to The Times, a spokesperson for Sherri Crichton called Warner Bros.’ actions a “shameful betrayal.”

“Sixteen years after his death, Warner Bros. is effectively rebooting ‘ER,’ and seeking to boost the more than $3 billion profit it has already earned from his creation, without crediting Crichton and without obtaining consent as they are obligated to do under Crichton’s contract. Changing the show’s name does not change the fact that ‘The Pitt’ — which has exactly the same premise, structure, themes, pace, producers, and star — is ER’ through and through.”

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