I've been asked my opinion of Dean Baker’s ebook The Conservative Nanny State, which has some provocative theses on free trade and immigration. I'm interested in your thoughts. My take, after reading the first third of the book, is that he tends to oversimplify complicated issues. He also contradicts himself by offering opposing motivations of the "rich". For instance, if allowing more foreign-trained physicians would lower health costs, as Baker surmises, then why aren't the greedy capitalist business owners who pay the healthcare costs of their employees clamoring for more lax immigration policies for internationally trained doctors?
In fact, over 25% of the physicians currently practicing in the
Baker would have a stronger argument if he supported opening more US medical schools or training more specialist surgeons to increase the competition, which economic law of supply and demand would seem to dictate lower salaries and lower costs. Unfortunately, studies show that if more surgeons practice in a given community, then more surgery overall is performed, even if the per capita number of cases declines. More doctors often leads to more healthcare expense. Just as having both a Wal-Mart and a Meijer store in town doesn’t mean that people will buy less televisions and toasters, having more doctors does not mean that people will access medical care any less.
It may seem I'm merely reacting to Baker's assault on the
Another point I'll add: Baker keeps confusing immigration with free-trade. Restricting immigration is much different than restricting free trade. While US citizens may not be able to "enjoy the benefits” of having a horde of low-priced foreign-trained doctors rooting around their bellies at their local hospitals, these same citizens are more than free to travel to Mexico or Guatemala for their hysterectomy. Interestingly, that is happening to some degree with hospitals operating in Costa Rica and parts of SE Asia that cater to wealthy Americans and Australians, respectively. These hospitals are often staffed with well-trained nurses and doctors, but operate very cheaply because of the lack of expensive regulation and malpractice insurance. Caveat emptor.
In sum, the provision of healthcare is an extremely complicated economic model that even the venerable economist Peter Drucker couldn't solve. To think that simply opening our borders to every foreign doctor with a diploma would solve the problem is laughably glib. Would flooding the US market with foreign-trained physicians lower doctors' salaries? Certainly. But would it lead to lower healthcare costs? Never. And better quality? Ha! Is
Looking forward to finishing the ebook and engaging a more thorough discussion.