Plan is too broad

First things first: rebutting their rebuttal. Before setting out some further advantages of rich countries actively recruiting medical personnel from poorer ones under the circumstances we have described, we will first point out a number of apparent misapprehensions in the opposition’s attempted rebuttal. Let it be noted again that they have said the following: "The other side may have predicted we would be defending that a country should defend itself from brain drain by closing the borders. If so, they were wrong... We are the real defenders of the right of the individual by defending the status quo" It is this point that drastically reduces our burden of proof. All they are left to contest us on is whether or not enacting our international legislation to create a formal market for medical personnel by requiring richer countries to compensate for the cost of production of a doctor is a good thing. All we need to prove to satisfy them is that this extra measure will improve not exacerbate the problems associated with a brain drain. If doctors are state trained, the state is making an investment in order to see a return, in this case health provision. If this return is reaped by another country, this is what is unfair about the current system. The primary agents are the doctors themselves, so the rich state that benefits has done nothing wrong, and there are no grounds on which they could be made to pay compensation. A formal market reframes the above exchange as a poor state making use of its comparative advantage, and receiving compensation for THOSE DR'S WHO CHOOSE TO LEAVE. Opp's characterization of a state run market for doctors is obviously ludicrous. The government are hardly going to force medical personnel out of the country to ship them off for profit. So, in that mind we reply to their rebuttal: A primary flaw in the opposition’s argument, from which a host of subsequent errors derive, can be discerned in the following analysis: ‘The brain drain is a consequence of a country's bad political situation, rampant criminality, war, impunity (?) and economic crisis, so a resolution to these is necessary to stopping the brain drain.’ Such extraordinary circumstances can, of course, result in large-scale migration but they are not necessary at all for a brain-drain to occur. Brain drains are economic phenomena, and are therefore susceptible to economic solutions. When the Labour Government increased marginal taxation on high earners in the 70’s in Britain, for example, it presaged a brain drain to countries with more favourable tax rates in the absence of war, rampant criminality or even impunity, whatever that may be. This fatal error of analysis on the part of the opposition leads remorselessly to numerous further false conclusions, perhaps exemplified by the assertion that ‘compensation will do nothing to stop this "unacceptable" thing’. Were it true that brain drains were the exclusive product of wars, rampant criminality etc., then this conclusion would be valid. But, as the example given above amply demonstrates, since brain drains are, in truth, economic phenomena, they can readily be stopped by the simple expedient of rebalancing economic incentives. Thus, when the British Government removed punitive rates of taxation, the UK brain drain promptly dried up. Opposition goes on to say our insistence that rich countries compensate poorer ones for recruiting their medical personnel has two ‘fundamental errors’. ‘First, countries need doctors more than they need money. Mere money won't cure a sickness but doctors can.’ We say this is an obvious false dichotomy, again resulting from a failure to engage with economic reality. You can’t have any doctors, or nurses, without money to train them. Money may not cure a sickness but it will pay to train someone who can. On the other hand we have the status quo: no money and no doctors; no health care provision at all. Our second ‘fundamental error’ turns out not to be fundamental, but a matter of degree. Opposition now seem to be arguing that we cannot set our rates of compensation at a level that both makes economic sense to the richer nation and gives adequate compensation to the poorer one. Let’s test this assertion with the example of Kenya. It costs the Kenyan people $66,000 to train a doctor; $43,180 to train a qualified nurse. And yes, contrary to the opposition’s assertion that such matters are beyond calculation, this does take into account primary and secondary education. (For the record in the case of a Kenyan nurse, primary schooling accounts for $10,963; secondary school for $6,865 and tertiary training in nursing, $23,352.) [www.biomedcentral.com/1472-6963/6/89] In contrast it costs the UK tax payer between $300,000 and $375,000 to train a single doctor – between five and six times as much. [Hansard 10/3/06] Differentials in remuneration are proportionately immense. This is why opposition’s objections don’t add up. Even if the UK were to pay Kenya double or triple the entire costs of educating a doctor there, it would still be a bargain for the UK and a massive boost to the Kenyan economy. It’s a straightforward guns and butter exchange. We can see the potential benefits of such an approach by looking at the example of the Philippines, where the government has long determined to train health workers for international export with extraordinarily beneficial results for their economy and the health of the world, according to the World Health Organisation: "The government of the Philippines has encouraged temporary migration by its health professionals in recent years and taken measures to turn remittances into an effective tool for national development by encouraging migrants to send remittances via official channels.” [The World Health Report 2006: Working together for Health. Geneva. 2006 p101.] Even without formal or binding agreements of the kind we advocate, in 2004 in response to these ‘encouragements’ the Central Bank of the Philippines reported total remittances of US$8.5 billion, representing a staggering 10% of the country's entire gross domestic product! (Source: as above) Clearly in this context any measures taken to increase this mutually beneficial exchange are to be desired, and active recruitment on behalf of richer countries in the form of advertising, careers advice, symposia etc. is precisely such a measure and it is on this basis that we advocate it. Finally we come to opposition's claims that our proposals are impractical. They cite the case of the doctor who leaves her country of training but decides to return home, or the Brazilian nurse who migrates to Poland and then to Germany. How could we possibly accomodate all such eventualities without drowning in red tape and legal costs? We don't need to speculate whether or how this apparently intractable problem might be solved because it has been solved already quite routinely by companies and institutions that pay the costs of their employees' training in return for a commitment to remain in their employ for a specified period of time. If the employee changes their mind and wants to change careers they simply buy themselves out of the contract by reimbursing their employer. If they do so after a year or two, they repay a proportion pro rata. Once they have 'worked off' the cost of the investment they become free agents. Not only are such contracts easily framed, they are essential for the provision of educational grants, for without them companies and institutions would lack the security necessary to make the investment in the first place. Imagine the alternative: a company investing all that money in a potential employee only to have them dance off into the sunset as soon as they graduated! As ridiculous as it sounds, this is the reality of the status quo in the labour market for medical personnel, with poorer nations the ones left footing the bill.