Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad

Overview

For years, opponents of outsourcing have argued that offshoring American jobs destroys our local industries, lays waste to American job creation, and gives foreigners the good jobs and income that would otherwise remain on our shores. Yet few Americans realize that a parallel dynamic is occurring in the healthcare sector--previously one of the most consistent sources of stable, dependable living-wage jobs in the entire nation.

Instead of outsourcing high-paying jobs overseas--as...

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Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad

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Overview

For years, opponents of outsourcing have argued that offshoring American jobs destroys our local industries, lays waste to American job creation, and gives foreigners the good jobs and income that would otherwise remain on our shores. Yet few Americans realize that a parallel dynamic is occurring in the healthcare sector--previously one of the most consistent sources of stable, dependable living-wage jobs in the entire nation.

Instead of outsourcing high-paying jobs overseas--as the manufacturing and service sectors do--hospitals and other healthcare companies insource healthcare labor from developing countries, giving the jobs to people who are willing to accept lower pay and worse working conditions than U.S. healthcare workers. As Dr. Tulenko shows, insourcing has caused tens of thousands of high-paying local jobs in the healthcare sector to effectively vanish from the reach of U.S. citizens, weakened the healthcare systems of developing nations, and constricted the U.S. health professional education system. She warns Americans about what she's seeing--a stunning story they're scarcely aware of, which impacts all of us directly and measurably--and describes how to create better American health professional education, more high-paying healthcare jobs, and improved health for the poor in the developing world.

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Editorial Reviews

Publishers Weekly
Tulenko, a physician and director of clinical services for a global health nonprofit, pursues a new angle in the ongoing healthcare debates in this intriguing and lucid study. She argues that the insourcing of health care workers—i.e. bringing them to the U.S. after they complete training in their own countries—is a destructive trend. Currently, 25% of physicians are "imported" from "countries that can least afford to lose them," a practice that has resulted in a "multibillion-dollar international healthcare-worker recruitment" industry operating in at least 74 countries. In the U.S., she says, this results in lower salaries and employees who are less likely to unionize, as well as medical errors due to cultural differences or language barriers. Despite insourcing, there is nevertheless a scarcity of trained medical staff, and that shortage of workers will grow as baby boomers age. To address this deficit and provide jobs for Americans, Tulenko suggests reducing the cost of education needed to attain necessary credentials, training more workers at every level, better aligning students with healthcare needs (such as those of rural communities), and increasing efficiency in hospitals and doctors' offices (e.g., via the use of electronic records, which technology has been available since the 1960s, but largely unutilized). Those interested in healthcare management or public policy will find plenty of cogent information in this well-researched treatise. (May)
From the Publisher
"Tulenko, a physician and director of clinical services for a global health nonprofit, pursues a new angle in the ongoing healthcare debates in this intriguing and lucid study. . . . Those interested in healthcare management or public policy will find plenty of cogent information in this well-researched treatise."--Publishers Weekly

"Tulenko proposes some strategies the U.S should consider as it revamps its healthcare system. Strengthening training facilities for health workers, especially in rural areas would not only produce more workers but also support development of minority groups. One doctor from India accounts for only 0.0001 percent of its physicians but recruiting a physician from Liberia denies it one percent of its physicians. So becoming more cognizant of where the health workers are being imported from could go a long way in enabling poor countries to serve its people better."--Smisha Agarwal, Huffington Post

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Product Details

  • ISBN-13: 9781611682274
  • Publisher: Dartmouth College Press
  • Publication date: 5/8/2012
  • Pages: 192
  • Sales rank: 1,369,140
  • Product dimensions: 5.80 (w) x 8.60 (h) x 1.00 (d)

Meet the Author

DR. KATE TULENKO is a physician with degrees from Harvard University, Cambridge University, and the Johns Hopkins School of Medicine. The former coordinator of the World Bank's Africa Health Workforce Program, she currently serves as director of clinical services for a global health nonprofit and resides in Washington, D.C.
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Table of Contents

Foreword - Laurie Garrett Preface Acknowledgments Introduction Shortage in the Land of Abundance How the United States Created Its Healthcare-Workforce Problem The Path to America The Damage Done The Fox and the Hydra: Failed Attempts to Address Insourcing Successful Efforts to Curb Insourcing The Way Forward Notes
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