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Home Publications Blogs Beat the Press Protectionists Continue to Control U.S. Trade Policy: The Case of Foreign Physicians

Protectionists Continue to Control U.S. Trade Policy: The Case of Foreign Physicians

Sunday, 11 August 2013 19:40

The NYT had an excellent piece on how a variety of arcane restrictions make it difficult for even well-trained foreign physicians to practice medicine in the United States. These restrictions are kept in place at the insistence of the doctors' lobbies since they allow them to sustain their high wages. This is a great example of how Washington is dominated by protectionists who are intent on using trade barriers to protect special interests even though it poses enormous costs on patients and the economy.

It is worth noting that one of the issues raised in the piece, the potential drain of educated workers from the developing world, could be easily remedied. Since doctors must be licensed to practice, it would be a simple matter to impose a modest tax on the income of foreign trained physicians (e.g. 10 percent). This tax could then be repatriated to the home country so that it could train two or three physicians for everyone that came to the United States. This one is so simple that even an economist could figure it out. In this way, the sending country would benefit as well from the decision of their doctors to immigrate to the United States.

Comments (7)Add Comment
written by Marcus, August 11, 2013 10:02
The objection to more foreign-trained doctors, that they would leave their home countries with fewer doctors, seems legitimate. However, if these docs are attracted by the outlandish pay here for specialists (a function of our extreme protectionism within the specialist professions), and if more competition undermines this high pay, doesn't the high pay cease to be the main draw at some point?
The pay differences for doctors work just like pay differences for farm workers
written by Dean, August 11, 2013 10:12

sure, if enough doctors from other countries come to the United States to cut the pay here by 75-80 percent then it may stop being an attractive destination for foreign doctors, but that would be very far in the future.
written by urban legend, August 11, 2013 10:22
Isn't the proposal to eliminate non-tariff barriers against foreign doctors biting off our noses to spite our faces? Instead of encouraging across-the-board income free-falls, how about figuring out how to do comparable protections for other workers? If doctors make less, that creates an interest group determined to make sure everyone else suffers just as much.
Denial of Safe American Health Care Unmatched Anywhere in the World
written by Last Mover, August 11, 2013 10:40
The involved testing process and often duplicative training these doctors must go through are intended to make sure they meet this country’s high quality standards, which American medical industry groups say are unmatched elsewhere in the world.

It's humiliating at best to be told high standards are the reason one cannot get an appointment with a doctor for 6 weeks, then wait for an hour in the waiting room only to be brushed off with a perfunctory visit limited to a 15 minute quota set by the corporation that owns the doctor, then sent away for tests that should have been done before the visit, all delivered in a surprise package of price sticker shock.

It would be like trying to shop for groceries or eat out and nothing is available but 4 and 5 star restaurants with long appointment times and prices starting at $500.

You keep saying all you want is a buffet with a good salad bar, and they keep saying you could get food poisoning without the high quality standards and it's them or no service at all.

Millions go without essential health care because they neither want or need the luxury version not affordable anyway, passed off by the economic predators as necessary to be "safe".

If the competition for selling food was restricted as much as the competition is for providing and selling health care for safety reasons, there would be millions of starving Americans dead or roaming the streets looking for food.

At least they would be safe.
why is increased residency not a solution?
written by Lrellok, August 12, 2013 12:23


It seems it could just as easily be argued that we have more then enough people who want to be doctors if residency programs could be expanded to accommodate them.
There are many ways to reduce MDs' profiteering. First, train more ....
written by Rachel, August 12, 2013 8:36

Reduce some of the barriers to practice. Allow people to take their Medicare dollars elsewhere, as Dean has suggested. Do something about market power exerted by many hospital chains... Do NOT force people into Medical Homes.

Yet it is far from clear that importing MDs can do much to reduce silly MD inocmes. Don't we already import some 25%?

One problem is that most people don't even know that MDs are overpaid. Similarly, most people don't know that we're spending too much on financial services. Although I am hearing just a few beginning to catch on to that. So there may be hope.
written by skeptonomist, August 12, 2013 10:20
Dean's supposed "free trade" in physicians (and/or patients) involves disadvantages to the other countries, as I pointed out before; the US would in effect be freeloading on the measures that other countries take to insure a good supply of physicians at reasonable compensation rates. To make it work, it now appears that there would have to be special taxes, assuming that other countries didn't just interdict this kind of parasitism.

The chances of something like this happening, without some large benefits to special interests, is vanishingly small. The obvious, simple solution is for the US to adopt measures similar to those employed in other countries; have some kind of central control of prices and also more direct control of the supply of physicians, or to put it another way, reform the current methods of training physicians.

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About Beat the Press

Dean Baker is co-director of the Center for Economic and Policy Research in Washington, D.C. He is the author of several books, his latest being The End of Loser Liberalism: Making Markets Progressive. Read more about Dean.