KAI RYSSDAL: Remember all the sturm und drang about the health care reform law? How political it all got? You ain't seen nothing yet.
Today the Obama administration asked the Supreme Court to take up the case. It's an appeal of a lower court decision that had struck down a key part of the law: the individual mandate that said everybody has to buy insurance. All of which is to say that if the justices do take the case, chances are the ruling will land right in the middle of the 2012 presidential election.
The basic idea of the whole reform law was to control health costs -- in a part of the economy where costs are growing, but so too are jobs.
Which is where Detroit, Mich., comes in. From the Marketplace Health Desk at WHYY, Gregory Warner reports.
GREGORY WARNER: Sixty-seven students are recovering from their last final of the day at the Oakland University School of Nursing.
Kara Theut, one of the students, tells me that hers is the new face of Detroit.
KARA THEUT: Everybody and their brother are -- they're in school to be a nurse right now. I mean, everybody knows at least five people, I swear.
WARNER: Everyone around here is nodding so it must be everyone's experience.
This is a special accelerated program that attracts students from other careers: lawyers, airline pilots, automotive engineers. Kara Theut herself formerly worked in school administration. So why are so many workers in the city of champions turning to health care?
THEUT: The money, and the demand, you know there's, there's always gonna be a job, somewhere.
This program has a job placement rate of 100 percent. That means every graduate's gotten a job. That would be reason for celebration in any city but in Detroit, with 16 percent unemployment, it sounds like a cry of redemption.
JOHN KING: Health care is going to be one of those key, key areas aiding the city of Detroit to turn around.
John King is a consultant to the Detroit Workforce Development Board. It oversees $60 million in federal funds for job training programs.
KING: And that includes training for lots and lots and lots of health care workers.
That makes health care workers very confident. And when people feel like they're part of a boom, they spend like it.
Jeff Axt owns one of the city's largest women's clothing stores, Biz-R Collection. That's spelled BIZ dash R.
JEFF AXT: Definitely what we're known for here is color. If the department store has it in black and brown, we'll have it in yellow, white, lilac and mint.
He's talking about shoes, by the way. Jeff Axt says health care workers are his best customers. Call it the Biz-R confidence index. He says health care workers are even more confident consumers than people in other jobs -- like autoworkers or schoolteachers.
AXT: But you see it on the ground in the health care industry when you're a neighbor of a health care provider.
WARNER: Or you see it selling them shoes.
AXT: Or you see it selling them shoes. If they're booked to the hill in their clinic for the next six months, you have a lot different psychology than if you're worried about them shutting down your assembly line.
Shutting down your assembly line or firing workers in part to pay for skyrocketing health costs. This irony hasn't been lost on business owners. They have mixed feelings about whether all this federal money to train health care workers is a good thing. When health care expansion drives up the cost of care.
Doug Rothwell is president and CEO of Business Leaders for Michigan.
DOUG ROTHWELL: We are concerned for example about how many medical schools do we need in this state, how many state of the art technology centers do we need? Those all add to cost. On the other hand, we do recognize that it is driving some net wealth creation.
And you find small businesses cropping up to get a piece of that wealth. It's around the expanding hospitals and the university that you find organic food stores. The art gallery and the pet sitter shop, none of this was here five years ago. Because compared to the car industry, health care's workforce is younger, more diverse, more female and maybe more likely to flaunt their success. At least, that could explain the healthy sales of the "El Gringo." The most expensive boot that Jeff Axt sells.
AXT: The leather is distressed and cracked, and it's got Swarovski crystal rhinestones in an eagle pattern on the front and up the shaft. It's a $1,500 western boot. And we sell it 12 months a year.
And that's consumer confidence.
In Detroit, I'm Gregory Warner for Marketplace.