In a Washington Poststory 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.