GBSN Advisor Dr. Kate Tulenko recently published Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad.
Dr. Tulenko’s book is a must read for anyone interested in
international development (as well as those whose interest revolves around
health issues within the United States). Put most simply, the book is about highly toxic "agglomeration effects”. Just as William
Easterly showed that an inordinate share of US wealth is concentrated in a
handful of zip codes, so it is with health workers. Market forces – meaning
salaries and working conditions – draw talent to the highest-income locations
within countries, and, internationally, to the highest-income countries. The
social costs of such private incentives are appalling. With the exception of
the most affluent metropolitan districts, whole countries, where diseases are
rampant, are bereft of the nurses and doctors their inhabitants need. The same
alas is true of rural areas in the United States, although general health
conditions are far better there than in low-income countries.
Dr. Tulenko lists actions which the United
States federal , state and local governments can take in order to stem the
health skills drain: train more healthcare workers, more primary-care workers,
more midlevel providers; train and
employ more behavior-change healthcare workers; align student recruitment and
training with healthcare needs; reduce the cost of healthcare-worker education;
overhaul the way healthcare-worker training is funded; open the federal bonding
system to all funders; increase healthcare workers’ productivity ; and last but
not least, rationalize the US healthcare labor market; mitigate the impact of
the recruitment of foreign healthcare workers.
The list is daunting, but Dr. Tulenko offers practical suggestions for making
progress on each of these fronts.
Click here to find Insourced online.
Guy Pfeffermann is the CEO and founder of the Global Business School Network.