"I wish they would only take me as I am" - Vincent Van Gogh               "How Can I believe in God when just last week I got my tounge caught in the roller of an electric typewriter?" - Woody Allen              "Our truest life is when we are in dreams awake" - Henry David Thoreau              "I took a speed reading course and read 'War and Peace' in twenty minutes. It involves Russia" - Woody Allen            "When promulgating esoteric cogitations, eschew platitudinous ponderosities" - Mark Rowan, my father            "Up, sluggard, and waste not life, for in the grave there will be sleep enough" - Benjamin Franklin             "What really interests me is whether God had any choice in the creation of the world." - Albert Einstein            "Welfare's purpose should be to eliminate, as far as possible, the need for its own existence" - Ronald Reagan            "It's odd that you can get so anesthetized by your own pain or your own problem that you don't quite fully share the hell of someone close to you." - Lady Bird Johnson              "I still want to be the candidate for guys with confederate flags in their pickup truck" - Howard Dean

Monday, February 09, 2009

RE: Sacha

Sacha left some lengthy comments on my previous post, and I felt responses would be more appropriate as a new post. I'm not that interested in addressing all Sacha's points, considering my original post was an off-the-cuff opinionated response. Regardless, I thought some deserved attention.

You're putting in a lot of hard work to get that medical degree. Then you will work very, very hard as an intern and resident. What if graduates of foreign medical schools could be brought in to work at lower wages?

They can. Unfortunately, many residency programs, as well as the USMLE create artificial barriers to their successful employment (medicine is little more than a union). This summer and past fall I worked with an Iranian-born surgeon who attended medical school in the UK. Despite scoring a 99 on his american licensing exams, he is having trouble finding employment. It certainly is a boon for American born students who don't have to meet the same benchmarks, but it hardly seems like its in the best interest of their patients.

Suppose that the medical field operated in a less restricted market, and more foreign-trained physicians could enter the field. You're right that if they worked for less pay, then physician reimbursement would drop, and health care costs would be (slightly) reduced, without a reduction in quality of care...in fact, more likely an improvement in quality of care. It certainly wouldn't help me, as an individual with a clearly invested interest, but it would certainly be of benefit to society as a whole. And if the reimbursement rates dropped, then smart people who otherwise would have been doctors will go into other professions: dentists, lawyers, PhD's, engineers, etc... where they will be more lucratively rewarded.

Besides, since when is competition a bad thing? By your same train of logic, we should prevent the importation of foreign produced products. If Honda weren't allowed to sell cars on US soil, clearly General Motors would be better off. Without needing to worry about producing quality products at an affordable price, they would be virtually guaranteed people to purchase their products. Sounds great.

Also, in your original blog post, you talk about how "An engineer who designs a new products creates jobs: secretaries, product testers, factory workers, people to market the product..." really? I don't think an engineer gets his/her own secretary, and the product testers and factory workers are likely located in Malaysia or Taiwan. It may create marketing jobs, but do we really need more people to go into the "sales" profession?

My father is an electrical engineer (and he has had his own secretary in the past, incidentally). Just to cite a concrete example, several years ago he designed a new, state of the art product. Sales went up. People in the factory (located in the US, fyi) couldn't work enough overtime to meet demand, and the company hired more people to help build the products. Furthermore, the company hired 2 additional engineers to help with R&D. At his current employer (also with factories in the US), things aren't much different.

The same is true for numerous other professions. A surgeon can't exist in isolation. Consider a simple total-joint-arthroplasty. There are multiple nurses and tech's in the OR with the surgeon, not to mention those in pre-op and post-op. An anesthesiologist is required for the procedure. People are employed to clean up the room after the surgery, to manufacture and sell the prosthesis, people paid to bill for the procedure, people involved in the supply chain that got the prosthesis to the hospital...and secretaries to schedule the surgery, schedule the blood donation, coordinate the OR schedule, etc....

Tuesday, February 03, 2009

RE: American Worker

The Coalition for the Future American Worker has a new television ad stating that we are currently bringing in 1.5 million new workers, which is poor policy in a time when millions are being laid off, stating "Ask why we keep bringing in 1.5 million foreign workers a year to take American jobs."

This seems like an incredibly simplified way to approach the issue. What isn't stated in the 1.5 million figure is the number that have advanced degrees in fields such as computer science, engineering, medicine, etc... Such imports fill positions that require immigration to meet domestic needs. Personally, I think its better to have a foreign engineer residing in America--where they will pay taxes and contribute to our economy--than in India or China, promoting outsourcing. Additionally, these highly-skilled workers actually create jobs. An engineer who designs a new products creates jobs: secretaries, product testers, factory workers, people to market the product, etc... Frankly, as I've said in the past, we should be increasing the influx of these workers.

The issue of the unskilled workers is open for more debate. There certainly is overlap with many American workers, particularly those most likely to make minimum wage, but I think this is in large part a function of minimum wage restrictions...and is more than I want to type about now.