How Domestic Healthcare Reform Effects U.S. Efforts To Reform Healthcare Abroad
Heard some startling statistics at a SIPA* event last Thursday:
- When women in developing countries are educated up to the primary education level (grades 1-6), we almost never see their kids achieve a lower level of education than their mothers. The same is true of secondary education.
- The incidence of natural disasters is increasing worldwide, and this is not because of the surveillance effect (i.e. not because pervasive news media just happens to document more disasters than in the past and not because modern voracious news consumers happen to learn of more disasters).
- Healthcare reform in the U.S. has a direct and negative impact on sustainable healthcare initiatives in the developing world.
For instance, after passage of the recent U.S. healthcare reform bill, the demand for medical professionals such as doctors, nurses and pharmacists in the U.S. is bound to grow. As in the past, the U.S. is unable to produce enough homegrown medical professionals to fulfill demand, so we recruit heavily from developing nations abroad. This “brain drain” and loss of talent from nations with weak educational systems stunts the growth of their health care infrastructure.
Consequently, U.S. initiatives aimed at strengthening the healthcare infrastructure in the developing world (such as those championed by USAID and others) are continually and inadvertently hampered by loss of native talent to developed nations, such as the U.S., thus mitigating sustainable health care reform efforts. This two steps backward, one step forward approach is hardly sustainable. Increasingly, U.S. domestic policy makers must take into consideration the unintended impact their actions have on the developing world.
As we take, we must give back in order to be able to accomplish lasting democratic and educational reform and development abroad. Domestic laws and regulations designed to strengthen the often inadequate foreign educational institutions which train the majority of U.S. doctors are necessary. As we siphon off professionals from the developing world, it is increasingly important to mitigate the loss of talent by financing educational institutions, promulgating training programs for teachers and assisting in the development of meaningful job opportunities for medical professionals in the developing world. This practice is cost-effective, pragmatic as well as sustainable and ensures the U.S. a continuous supply of educated elite.
*SIPA stands for the School of International and Public Affairs at Columbia University in New York.
