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5 Cities Vulnerable to the Next Bursting Bubble

Pittsburgh, Pa.
Unemployment rate: 7.4%
Largest employer: The University of Pittsburgh Medical Center
It's almost a shame a town so hard hit by the industrial decline of the late 1970s and early 1980s has become a perfect storm of bubbles. The University of Pittsburgh is still one of the town's largest employers, the empty manufacturing facilities are being populated by tech startups and arguably the biggest employer in town is the University of Pittsburgh Medical Center -- which is, yes, separate from the university from which it takes its name.

The last may be the most volatile of Pittsburgh's three rivers of revenue, as Pittsburgh and other health care heavy towns such as Augusta, Ga., and Boston may not have to wait for the baby boomers to blow through to see their bubble burst. According to health care consulting firm Millman, American families insured through their jobs are racking up an average of $19,393 in health care costs, up 7.3% from last year. The roughly $8,008 they're paying out of pocket is 9.3% higher than it was last year and only slightly more expensive than the $9,235 they averaged in total costs in 2002, when their out-of-pocket costs were $3,634.

In fewer than nine years, the cost of health care has more than doubled. Hospital spending, which is only 48% of total health care spending, accounts for 60% of the increase. If you consider this kind of growth unsustainable, join the club. The nation's still sharply divided over President Barack Obama's health care plan and GOP candidate Mitt Romney is among those with a plan of his own, which means 2012 could be another take on the of the midterm elections many considered a de facto referendum on the issue.

None of this posturing has cut so much as a cent from costs, and communities that lean heavily on their hospitals will bear the brunt of it. Pittsburgh knows this too well already; a University of Pittsburgh Medical Center hospital in its Braddock neighborhood was closed just last year.
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