Re: Re: Re: Nurse-to-patient staffing minimums are a reform victory

[Rakesh Bhandari <rakeshb@xxxxxxxxxxxx>]

Michael wrote:

> The brain drain, such as the nurses from Philippines, might provide
> remittances to needy people back home, but the country would do better to
> find productive domestic employment for their trained personnel.

Yes but when the average doctor in third world probably does not make
more than $500/mo--which is about 1/20th what could be made in the
US?--it's going to be difficult to encourage professionals to stay at
home when high income societies can in fact afford (and have
effective demand for) more professionals than they are themselves
producing--it's not clear to me that immigrants have taken away jobs
from native born Americans. Kenya for example is being routed of its
doctors I believe. But then Spain is sending nurses to the UK;
Hungary doctors to Norway, I believe.

There is also the possibility that if there wasn't the prospect of
emigrating to a high income country, there would be many fewer people
who would train themselves to be doctors, engineers and nurses.  That
is, the requirement that professionals stay at home may decrease
their supply? I don't know. I am just guessing? But I wouldn't rule
it out. My doctor uncle in India works six day weeks, 10 hour days
for what I would imagine is not more than 1/10th what he could have
made in the US.

I do remember reading an analysis about five years ago about the
Korean and Philippine states may have allowed for there to be an
oversupply of nurses, hoping that those who emigrated would send back
hard currency which after all is needed to buy things like good
medical equipment.

So if we take this option away, how else is hard currency to be earned?

And as long as there is emigration of professionals to high income
countries, shouldn't there be some payment for the so called human
capital they embody? It would also help if IPR regimes were lax, and
the IMF did not require medical services to be cut! On that I am sure
we are all agreed.




>  In my
> hometown, the good number of the doctors are from India and the
> Philippines.  I cannot believe that they have a surplus of good medical
> care.

No but they are low income countries. And it's not clear that there
is a shortage of professionals vis a vis the demand that is generated
in a low income country. So if there is going to be an overflow, I
think there should be talk of some compensation mechanism. I
seriously doubt that the remittances that flow back are sufficient to
cover the costs that went into the education of emigrant professionals



>  Cuba can afford to export doctors, given its surplus, but it is
> unique.

yes.

rakesh