Immigration II: Global Healthcare

A few facts from 2011

Largest groups by source country amongst Canadian permanent residents: Philippine, Chinese, Indian.

Another fact (2011)

Of 44000 permanent residents from Africa and the Middle East, 34000 had 10 years of schooling or more, 18000 had a university degree.

Similarly for immigrants from Asia and the Pacific and from South and Central America.

“Canada needs skilled workers”

20-25% of physicians in the U.S. and Canada are immigrants.

40% of nurses in the U.S. are foreign-trained.

Doctors per 1000 population (2011):Canada: 2.0EU: 3.41Cuba: 6.7Switzerland: 4

What about ‘donor’ countries?

Whom or what do immigrants in the healthcare sector leave behind in their home countries?

Global healthcare

Physicians per 1000 of population (2004):

Malawi: 0.02South Africa: 0.77Niger: 0.02Philippines: 1.15India: 0.6Pakistan: 0.8

Global healthcare

37% of health workers work in the American continent (mainly US and Canada).

1.3% of health workers work in sub-Saharan Africa where 14% of the world’s population lives and the health burden is extreme.

Global healthcare

Flows of healthcare workersTraining costs

Arguments in favour of migration

Welfare of the health workers (why do they leave their home countries?):

- poor salaries- few promotion prospects- poor working conditions- Instability/insecurity in home

country.

Remittances

- About 3% of the world’s population live outside their country of origin.

- Remittances to less developed countries ≈ $400 billion.- Highest recipient countries: India, China,

Philippines, Mexico, Nigeria. - Tajikistan receives remittances equal to

nearly 50% of its GDP.

(World Bank statistics, 2012)

Human capital and taxi drivers

What about those trained in healthcare who are not permitted to practice their profession in rich countries?

34% of skilled immigrants to Canada were unemployed in the mid-2000s.

Rights vs. utility

Do utilitarian considerations dictate that health workers should not be allowed to emigrate?

Do health workers have a right to emigrate?

Moral responsibility

Positive and negative duties (again)

Are we, as individuals, morally responsible for the poverty, disease and deaths of others?

Policy implications

What should we and/or governments of rich countries do to help? Example of UK.

What can the governments of donor countries do to help? Examples of Hungary and Lithuania.