An Ignored Impact Of US Health Care Reforms

An aspect of 'optimizing' political decisions is playing off internal interests against external interests - what is good for your voters/citizens against what is good for people outside of your precint as and when their interests are in conflict. Obviously, you have to satisfy your own voters, but at the same time, pissing off foreign allies and trade partners makes for very difficult situations. How much will, can and should you screw over everyone else for 'your people' !?!

Consider, for example, Obama's healthcare reforms. No doubt, for Americans it's a pretty good deal - at least for the average people on the street, if not necessarily for insurance companies and other corporate types. Of course, a hit to financial corporations has repurcussions that hit all areas of society down the road - so over time whether or not the decision is good for Americans is something that, well, time will decide. At least, in the short run, it's good for regular Americans.

But to follow through with the reform promises which will suddenly make healthcare available to tens of millions of Americans who hitherto were denied it either partially or completely, Obama will have to hire shiploads of new doctors. Given the timeframe, he will have to do so quickly. This means getting more homegrown doctors is not a practical option. He will have to import most of them. Now, most of these doctors are going to be taken from poor countries like the Phillipines, India, China, Bulgaria, etc...

This means that a lot of poor countries, which are already starved for good doctors, will be deprived of even more of them. And remember, the US is not going to take the run of the mill, average physicians, it's going to take the cream of the crop. Furthermore, as you go on adding doctors to a population each new doctor added helps fewer and fewer people. However, the number of people deprived of doctors increases exponentially with every doctors who leaves. This means that every doctor who comes to the US from, India or China, will be helping far fewer Americans than he or she will be hurting Indians or Chinese.

In summary, Obama's decision is likely help many Americans (at least in the short-medium term) while screwing over many more in the third world. As the US president, of course, his duty is to his people, so of course you can't really blame him for his decision. But it is an awkward decision to have to take. More than anything else, this highlights the 'damned if you do, damned if you don't' nature of politics.

It's probably a stretch connecting this medical piracy with invading people for oil. After all, the US isn't exactly invading the countries it's going to be taking doctors from. However, taking thousands of doctors from a country is obviously going to cause all manner of medical crises among the society left behind. The case could be made that this decision could really hurt a lot of poor people in the third world. In a world where India, China and other poor countries - despite their poverty - are becoming too powerful for the US to treat lightly, this may make things very hot for the President.

I should point out as a sort of disclaimer, that this very pessimistic post is based on an assumption that the US will need many more doctors, and that this is how the US will go about getting them. This may not necessarily be the case.