The Great Healthcare Robbery

Overreaching medical journal denounces 'poaching' of medical professionals

Kerry Howley | March 6, 2008

Is Ephraim Dagadu stolen goods? The Ghana-born and trained physician, who runs a successful family practice in Maryland, does not speak like a man who has been ripped from his rightful home and forced to toil in the Baltimore suburbs. His visage appears on no milk cartons; no cross-continental Amber Alert calls for his return. But according to a recent piece [registration required] in a prominent British medical journal, a caring U.S. would have done more to keep Dagadu from encountering opportunity abroad. He, goes the argument, belongs to Ghana.

Read the entire article at the Los Angeles Times.

Comments

|3.6.08 @ 12:07PM|#

This is sometimes called "poaching," which suggests educated African men and women are some kind of exotic prey.

It's another excellent article by Reason's most lauded staff member. I agree with it's thesis completely. However, there is nothing sinister in this use of the word 'poaching'. Poaching is routinely used in this sense when discussing labor recruitment.

Eric Cartman|3.6.08 @ 12:12PM|#

My mom says there's a lot of black people in Africa.

Christopher Monnier|3.6.08 @ 12:13PM|#

Yeah, I think that bashing the use of the word "poaching" is a little reaching...you'd think MSNBC might be a little more [over] sensitive, but I don't think it's worth calling out in an article. My favorite part was this:

His answer to the problems of Malawi, a country with a per capita GDP of $596, an AIDS crisis and endemic corruption at every level of government: Ban those text messages. That way, valuable health workers won't think to seek opportunities outside of the colonial boundaries in which they happen to be born.

|3.6.08 @ 12:40PM|#

Maybe some sort of bounty could be paid out for capturing these doctors and getting them back to Africa. Probably the best way would be by boat. But these are poor countries, so we'd want to pack the boat as efficiently as possible. Maybe using this as a diagram...

Or, you know, they could be allowed to make their own fucking choices about how and where to live their lives.

|3.6.08 @ 12:41PM|#

"Active recruitment of health workers from African countries is a systematic and widespread problem throughout Africa and a cause of social alarm: The practice should, therefore, be viewed as an international crime,"

If you believe that people are the property of the state that they were born/reared/educated/trained in, this makes sense. If, OTOH, you believe that people are free agents, not property, this argument falls flat on its face.

BTW, we take Africa's best in other occupations as well.

BTW #2, Africa recruits some of America's best in the areas of mineral extraction.

stuartl|3.6.08 @ 12:51PM|#

I wonder if these well paid professionals ever send any money back back home to help their friends, family, and communities. Is it conceivable that they might even find a way to provide useful medical supplies and equipment?

LarryA|3.6.08 @ 1:34PM|#

Active recruitment of health workers from African countries is a systematic and widespread problem throughout Africa and a cause of social alarm: The practice should, therefore, be viewed as an international crime

As opposed to "endemic corruption at every level of government?" As long as we're talking about medical professionals, let's mention the principle of curing the disease instead of treating the symptoms.

Now there's a project for the United Nations; and one that might actually do some long-term good. If the UN had any reputation for actually accomplishing anything.

|3.6.08 @ 1:39PM|#

I´ve seen this argument before - notably in the case of the old Soviet Union - that someone who is educated in a country is somehow beholden to that country.

This, of course, would mean that all those foreign students in US universities are now indentured to the US.

So, I gather the Lancet is in favor of repealing the 14th Amendment in the US and Britain´s 1831 Statute abolishing slavery within the British Dominions.

|3.6.08 @ 3:00PM|#

Wow.. So, the Lancet advocates slavery. Pretty fucking evil of them.

-jcr

|3.6.08 @ 3:32PM|#

So, I gather the Lancet is in favor of repealing the 14th Amendment in the US and Britain´s 1831 Statute abolishing slavery within the British Dominions.

Most likely, yes. The problem most people have with slavery nowadays was that traditionally it was racist (i.e. it was white people enslaving black people). They don't actually have a problem with involuntary servitude in and of itself, as long as it is race and culture neutral.

The real question, is given the Lancet's continued posturing on political and social issues, is it really a medical journal anymore? I thought the Lancet was a place that scientists and medical professionals publish for peer review, but apparently it is a place for self-rightious doctors to make random proclamations about this and that and expect us to take it more seriously because they are doctors.

"Well, a doctor, a *DOCTOR* says that boxing should be banned! Obviously, anyone who disagrees with that is ignorant about boxing and public health!"

|3.6.08 @ 5:12PM|#

"Some have chosen to immigrate themselves, but many have been lured to their new homes with offers of an enormous increase in pay, moving expenses and help to navigate the visa and citizenship processes."

I'm still waiting for someone to use this type of evil coercion to force me to move to Australia.

|3.6.08 @ 7:49PM|#

"I'm still waiting for someone to use this type of evil coercion to force me to move to Australia."

That's two of us. I'm not even that picky regarding destination, either...

|3.6.08 @ 9:35PM|#

Although Ghana is presently an exception, there is so little social and economic stability in Africa overall, you can't blame people for leaving, particularly if they are worried about the safety of family members.

If 'poaching' is a crime, who is the criminal, the organization offering the jobs or the person who accepts them?

These "poachees" are much better off than Yao Ming. He's gotta play for China even if his foot isn't healed.

|3.12.08 @ 12:24PM|#

Hey people, wake up and open your eyes. Your myopia on this foreign-doctors issue is amazing. Why in the world do you think there's a shortage of doctors in the U.S. in the first place that needs to be addressed with foreign imports?

If you are libertarians who believes in free markets and fair competition, you should be slamming the American medical industry that uses these foreign doctors to prop up their monopoly on the sale of medical services. By focusing on only half of the equation you are serving as a cute little lapdogs for the anti-free-market AMA.

When you support the importing of foreign doctors, you are supporting the monopoly of American doctors and the rent-collecting incomes they collect by virtue of their severely restricting competition within their industry. American doctors use foreign doctors to fine-tune the supply and fill the lower-paying doctor jobs in this country, all in an effort to maintain the system of barriers to entry into their business.

Suppose that Archer Daniels Midland was a cooperative of a small number of greedy farmers and that they paid Congress to give them a monopoly on the growing and selling of all grain in the U.S. (ie. corn, wheat, rice, etc.). Of course ADM would try to maximize their income and the price of such staples would rise to at least several times their fair market price.

Then suppose that ADM occasionally found it profitable to buy supplies of such staples from less developed countries, which incidentally caused a few extra citizens of those countries to die prematurely from malnutrition. Would your primary sense of outrage in this situation really be directed towards people who tried to reduce this outflow of staples from the poor countries? Or mightn't you more properly focus your attention on the unfree market that gives rise to the problem in the first place?

And how would you feel if some super-rich Saudi prince decided to buy up half the doctors produced in American medical schools every year to provide lots of doctors to his tribe. Would you really just say that it's the market in action and if Americans have to go without medical attention on that account, well, c'est la vie.

And if you say that the U.S. could just train more doctors, then why not allow those doctors to be trained anyway. It's not like there's a shortage of people who want to be doctors. In a free market such an increase in supply would lower the high prices that are Americans are charged now and would lead to more affordable medical care for everybody. And if "too many" doctors were trained, maybe a few would end up going to the poor countries who are bleeding doctors today.

If you really believe in free markets, the elephant in the room is the rich and powerful medical monopoly in the U.S. The problem is not the forlorn voices trying to staunch the flow of human capital from desperately poor third-world countries. Countries in which, no doubt, the citizens have been exploited to pay for the medical education of the doctors who flee.

You really need to reorganize your priorities if you are believers in free and fair markets.