David R. Henderson  

Dean Baker Nails It on Immigration

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In a Washington Post story today, reporter Philip Rucker bemoans the fact that the expansion of demand for medical care that would follow from the passage of Congress's health care bill would butt up against a restricted supply of doctors. He's right, but he takes the number of doctors as given. He breathes not a word about how the immigration laws restrict the supply of doctors. My favorite line:

there's no sign that anyone would head to such an area, or that the country is training enough family practitioners

Anyone? Well, not quite, as Dean Baker points out. Baker writes:

In fact, it would take much less time to remedy the situation if the United States would adopt free trade policies with respect to physicians' services. If the U.S. had a more open door policy for qualified doctors, we could fill any gap in the supply very quickly.

I'm not sure if Dean realizes this, but in writing that, he's echoing Milton Friedman's thoughts from his 1962 classic Capitalism and Freedom. Friedman wrote:

After 1933, when Hitler came to power in Germany, there was a tremendous outflow of professional people from Germany, Austria, and so on, including, of course, physicians who wanted to practice in the United States. The number of physicians trained abroad who were admitted to the United States in the five years after 1933 was the same as in the five years before. This was clearly not the result of the natural course of events. The threats of these additional physicians led to a stringent tightening of requirements for foreign physicians that imposed extreme costs upon them.

Dean Baker goes beyond Friedman, though, with his next sentence, writing:

It is also a very simple matter to construct a tax system on the earnings of foreign trained physicians, with the money used to reimburse the home country. This could allow foreign countries to train two or three physicians for everyone that works in the United States, ensuring that they benefit as well.

I understand his goal, but the means Baker advocates are pretty coercive. Would he apply that policy to China, making doctors who leave China pay a huge tax? Would he have applied it to Germany in the mid-1930s? He doesn't say.

H/T to Adam Ozimek.


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COMMENTS (2 to date)
RL writes:

This would also be a good time to push for creation of medical licenses that work like drivers licenses; that is, that are automatically and costlessly recognized as valid in all states when obtained in one state.

I'm NOT an advocate of medical licensure, but given its existence, and that it is administered independently by all 50 states, it creates significant dislocations of physician labor (which explains in part the significant geographic variance in physician incomes). While this might not increase physician supply over all, to the extent that there is geographic variation in those currently without health insurance, such licensure modification would be helpful in meeting shifts in demand.

superdestroyer writes:

Do you really think that a physician from Korea, Pakistan, or Nigeria would ever want to live in Post, Texas. They would stay there long enough to get their permanent status and then they would be gone to the large metropolitan areas that have large ethnic communities.

You should also realize that women physicians just will not take those kinds of jobs. Small town physician is the domain of the white male with stay at home wife or Hispanic physicians. Immigrants, blacks, and women just do not want to live in such towns.

Open borders and unlimited immigration will do will do nothing to help Post Texas but will harm most areas of the U.S.

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