Today's Stories

August 4, 2009

Mike Whitney
Bernanke's Shell Game

Dave Lindorff
The Recession Isn't Over, By a Long Shot

Jonathan Cook
Israeli's Campaign to Silence Human Rights Groups

Jeff Sher
Making a Mess of Health Care Reform

Uri Avnery
A Jeremiad

Mark Weisbrot
U.S.-Brokered Mediation in Honduras Has Failed

Alvaro Huerta
Hold That Dustbin! So Much for the "End of Racism"

August 3, 2009

Pam Martens
Millions of Americans Pushed Into No-Law System by Colluding Banks

Anthony DiMaggio
Media Backlash: Obama and the Settlements

Udi Aloni
And Who Shall I Say is Calling? A Plea to Leonard Cohen

Mike Roselle
See the Mountains of WestVirginia ... Before They're Blown Up!

Dr. Susan Block
Beat It! Sex, Death and Michael Jackson

Roy Bourgeois / Margaret Knapke
School of Coups

Joe Bageant
A Yard Sale in Chernobyl

Dina Jadallah
Hiding the State

Dave Lindorff
Of Blue Dogs and Jellyfish

Martha Rosenberg
Grand Closings in Evanston: How the Recession is Hitting Illinois

Website of the Day
Why We Can't "Afford" Health Care

July 31 - August 2, 2009

Alexander Cockburn
The Biden and Clinton Mutinies

Gabriel Kolko
Searching For Enemies

John Prados
The Intelligence Oversight Mess

Joe Bageant
The Bastards Never Die

Tim Wise
Rationalizing Racial Oppression

Carl Ginsburg
Frist First: Follow the Money (and Find the Plump Heart of "Health Care")

Michael Fox
The Honduran Coup as Overture

John Lindsay-Poland
Revamping Plan Colombia

Michael Winship
Pay-to-Play: Washington's Sport of Kings

Rev. William Alberts
White Men Can Jump ... to Conclusions

Andy Worthington
Judge Orders Release of Tortured Gitmo Prisoner

Steve Breyman
Counting the Unemployed

Cyrus Bina
Racism, Class and Profiling

Missy Beattie
Promises Ignored

Ron Jacobs
Into the Vapid: Consuming the Cultural Product

Willie L. Pelote, Sr.
Party of Concessions: Democrats Never Learn

Lucia Alvarez
Fall of the House of Kirchner? Return of the Right in Argentina

Dave Lindorff
David Brooks' White Guy Nightmare

Lawrence R. Velvel
Madoff: What Should be Done Now?

Omar Barghouti /
Sid Shniad
United for Freedom and Universal Justice

James L. Secor
The Name of the Game is Wipe-Out

Belén Fernández
Zelaya in Nicaragua: Has Another Constitution Been Violated?

Jeffrey St. Clair
Frank Lloyd Wright in Hollywood: the Ennis House as Imperial Ruin

David Yearsley
Beauty in Dark Places: Berlin's Olympic Stadium

Brian J. Foley
Pre-Eating: a Threat to Restaurants Everywhere

Alan Cabal
Onward, Into the Fog: Thomas Pynchon's
"Inherent Vice"

Kim Nicolini
The Way War Feels

Lorenzo Wolff
The Way It Felt the First Time: the Jump Rope Magic of the Shangri-Las

Poets' Basement
Four Poems From the Chinese

Website of the Weekend
Obama's Ex-Doc Knocks ObamaCare

July 30, 2009

Patrick Cockburn
Victims of a Covert Tit-for-Tat War

Gareth Porter
Afghanistan's US-Backed Child-Raping Police

Saul Landau
Summer of Denial

Greg Grandin
Honduran Coup Over?

Diane Farsetta
Pentagon Pundits Get a Pass

Stephen Soldz
The King Case, the APA and the Missing Ethics Investigation

Alan Farago
Learning How to Survive in a Depression From "Weeds"

David Macaray
Cops and Labor Unions

Mike Howells /
Jay Arena
Volunteerism Will Not Rebuild the Gulf Coast

Christopher Brauchli
Oatmeal Envy

Website of the Day
Changing the SOFA

July 29, 2009

Carl Ginsburg
Our Crisis, Their Gain

Clifton Ross
From Tegucigalpa to El Paraiso: a Voyage From Curfew to State of Siege

Paul Craig Roberts
How Fake is the "Recovery"?

Franklin C. Spinney
Winning Hearts and Minds, Pentagon Style

James Bovard Lackawanna Six: Bogus Charges and Martial Law

Anthony DiMaggio
Health Care, the Media and Public Opinion

Bouthaina Shaaban
How Will Arabs Wake Up?

Greg Moses
A Catch and Trade Policy for Labor Costs

Wajahat Ali
No Racism in Obama's Post-Race America?

Gary Leupp
Beer Will Not Solve This

Ayesha Ijaz Khan
Musharraf, Imran Khan and Overseas Pakistanis

Website of the Day
Why Single-Payer Gets No Respect

July 28, 2009

Jean Bricmont
Bombing for a Juster World?

Uri Avnery
Obama, Netanyahu and the Settlements

Dean Baker
Right to Rent: a Remedy for the Foreclosure Crisis

Heather Gray
Stupid Cop Tricks: Driving Too Close to a White Female and Other Episodes in Racist Policing

Jonathan Cook
Can an "Arab Soul" Yearn for Israel's Anthem?

Winslow T. Wheeler
Beyond the F-22: the Future of Pentagon Reform

Belén Fernández
Thomas Friedman Does Afghanistan

Carl Finamore
The Hotel Workers' Kickass Local 2

Eli Jelly-Schapiro
Striking the World Cup

Harvey Wasserman
We All Stand Before Peltier's Parole Board

Website of the Day
Behind the Wheel

July 27, 2009

Ishmael Reed
Gates: Post-Race Scholar Yells Racism

Patrick Cockburn
Elections Shake Kurdistan

Roger Burbach
Hillary and Obama Nix Change in Honduras

Steve Breyman
Bomber Joe and Russia: Why is Biden Channeling Cheney?

Ramzy Kysia
Gaza: On the Right of Resistance

Stephen Soldz
Will the American Psychological Association Renounce the Nuremberg Defense?

Raymond J. Lawrence
Sexual Hocus Pocus in the Episcopal Church

Greg Moses
The Color Line is Black

Binoy Kampmark
Swine Flu Panic

Kim Ives
Lavalas and Haiti's Student Union Unite

Website of the Day
Meet the Paid Assassins of Health Care

July 24-26, 2009

Alexander Cockburn
"A Damned Murder, Inc."

Clifton Ross
Surreal Honduras

Patrick Cockburn
Party of "Change" Challenges Old Guard in Kurdistan

William Polk
Report Card on Obama From a New Frontiersman

David Sterritt
Screening the Politics Out of the Iraq War

Ray McGovern
Hooded in Bush's Hood

David Lindorff
Cops Gone Wild

Hannah Mermelstein
"The War is With the Arabs"

Carl Ginsburg
The Actually Existing Health Care System

Helen Redmond
The Selling of Single-Payer Features

John Ross
The Song of the Guerrilla

Bill Simpich
Fair Play for Cuba and the Cuban Revolution

Mark Weisbrot
Learning From China on How to Beat the Recession

Lee Sustar
U.S. Labor in Crisis

David Macaray
Union Workers Forced to Accept Massive Cuts

Felipe Matsunaga
Obama's Slow (and Familiar) Dance With Cuba

Sara Mann
Why Health Care Will Kill My TV

Martha Rosenberg
Which is Worse? Germs in Our Food or the Antibiotics That Kill Them?

Missy Beattie
Cha-ching Culture

David Ker Thomson
Empty Nest: a Natural History of Now

Ron Jacobs
United4Iran, a Footnote

Stephen Martin
The Crying of Lots 1 Thru 50

David Yearsley
Psst, I Show You a Feelthy Gluck

Gilad Atzmon
Bruno: a Glimpse Into Zionism?

Kim Nicolini
Guilty Laughter in the Dark: Seeing Brüno Twice

Poets' Basement
Kakak and McLellan

Website of the Weekend
Dead Prez: Summertime

July 23, 2009

Jeffrey St. Clair
The Masters of Perfidy: AIG and the System

Saul Landau /
Nelson Valdés
Hypocrisy and the Honduran Coup: Term Limits Only Apply When Governments Help People

Jonathan Cook
The Reality of Israel's "Open" Jerusalem

Nadia Hijab
Israeli Warships in the Red Sea

Dave Lindorff
Living in a Police State: the Gates Incident

Laura Carlsen
21st Century Coups d'Etat

Steve Breyman
Bankers Beware?

Ellen Brown
How California Could Turn Its IOUs Into Dollars

Norman Solomon
Spinning Health Care

Jorge Mariscal
Youth Activists Demand Military-Free Schools

Website of the Day
Copy-Editing Sarah Palin

July 22, 2009

Bernard Chazelle
How to Argue Against Torture

Nikolas Kozloff
The Coup and the U.S. Airbase in Honduras

Carl Ginsburg
The Recovery, Phase Two

Clifton Ross
Back to the Future? Return to El Salvador

Anthony DiMaggio
Health Care, Media and the Case for Socialized Medicine

Michael Donnelly
The Whoppers Behind WOPR

Nadia Hijab
Memoirs of a Lost Arab World

Dedrick Muhammad
Structural Inequality: News Not Fit to Print?

Charles Thomson
Cronyism at the Tate

Alan Farago
Ted Williams and the Florida Keys

Website of the Day
Himmelstein: Howard Dean is a Liar

July 21, 2009

Sasan Fayazmanesh
The Iranian Election and Its Aftermath

Uri Avnery
Breaking the Silence on Israeli War Crimes

Dean Baker
Séance on Wall Street

Jonathan Cook
Team Twitter: Israel's Internet War

Dave Lindorff
Saving Private Bergdahl

Andy Worthington
Interrogating the Uighurs

David Macaray
Heat, Dust and OSHA

Carl Finamore
The Deferential Party

Harvey Wasserman
Cronkite and Three Mile Island

Walter Brasch
The Marie Antoinettes of Health Care

Website of the Day
Linebaugh: Magna Carta and the Commons

July 20, 2009

Pam Martens
Judicial Apartheid

Nikolas Kozloff
Honduras and the Big Stick: Obama's Bullish Behavoir in Latin America

Paul Craig Roberts
Threatening Iran

Deepak Tripathi
Obama's Policy on China and Iran

Ira Glunts
Netanyahu's Time Bomb: Building in the Vineyard of the Mufti

P. Sainath
Put Your Money Down, Boys

Binoy Kampmark
The Moon Landing and the Cold War

Stephen Fleischman
The First Anchorman

Norman Solomon
Cronkite and Vietnam: Beyond the Hype

Andy Worthington
Predictable Chaos as Gitmo Trials Resume

Ron Jacobs
Out of the Haze, Into the Darkness: Recalling 1979

Website of the Day
Why Publishing Can't be Saved (as it is)

July 17-19, 2009

Alexander Cockburn
"Watch What We Do, Not What We Say"

Nikolas Kozloff
Chiquita in Latin America: From Arbenz to Zelaya

Joanne Mariner
CIA Apples: Bad at the Top of the Tree

Joe Bageant
America's White Underclass

Jonathan Cook
Israeli Road Signs: Wiping Arabic Names Off the Map

Saul Landau
Why So Much Sympathy for Madoff's Dupes and So Little for the Poor?

John Ross
Jurassic Fallout in Mexico

Sue Sturgis
Senator Sessions, Race and Impartiality

Anita Sinha /
Daniel Farbman
The Ricci Case and the Myth of Special Treatment

Peter Morici
Obama's Donut Economics

Pervez Hoodbhoy
Whither Pakistan? A Five-Year Forecast

Ramzy Baroud
Gaza and the Language of Power

Greg Moses
The Real Demand Crisis

Kia Mistilis
The Niger Delta Crisis

Missy Beattie
The Placebo President

David Ker Thomson
How Not to See: Things to Tell Your Eyeballs

James G. Abourezk
Evil Spirits: the Booze Strip in Indian Country

Paul Richards
Why Does Jon Tester Want to Log Wild Montana?

Dave Lindorff
Dark Days for Working People (With Three Small Rays of Light)

Marc Levy
Just Like Hanoi Jane

Matt Siegfried
The Good War Goes Hot

Stephen Martin
Panopticon Blues

Ben Sonnenberg
Sembène's Faat Kiné

David Macaray
Casablanca: When Melodrama Trumped History

Charles R. Larson
A Pakistani, Victorian Novel Celebrating Women

David Yearsley
That's Women for You: Abbas Kiarostami's Così

Lorenzo Wolff
Death Rattle and Roll: the Sound From England's Gutters

Poets' Basement
Payne, Anderson and Williams

Website of the Weekend
Hitler Learns of Sarah Palin's Resignation

July 16, 2009

Paul Craig Roberts
What Economy?

Afshin Rattansi Iranian Planes and the Hidden Toll of Economic Sanctions

Gregory V. Button
The Search for Environmental Justice in Perry County, Alabama

Evan Knappenberger
Profile of a Deserter

Michelle Bollinger
Why is Leonard Peltier Still in Prison?

Russell Mokhiber
White House to ABC News: No Obama Single-Payer Doc

Belén Fernández
Iranian Penetration, Oh My!

Alice Walker
What is Torture Like? A Letter to Obama

Nicholas Dearden
Paying the Climate Debt: the G-8's Troubling Model

Albert Osueke
Sotomayor and the Identity Mountain

Website of the Day
Sotomayor for the Prosecution

July 15, 2009

Manuel Garcia, Jr.
The Assassination Bureau

Vijay Prashad
A Political Recession

Dean Baker
Stimulus Arithmetic

Ray McGovern
Cheney Sweating Bullets

Jonathan Cook
Jenin's Model of "Economic Peace"

David Rosen
Shouts From the Gallery: the Sotomayor Hearings and the Culture Wars

Eric Walberg
Uighurs vs. Afghans: a Study in Contrast

Greg Moses
Three Dimensions of a Complete Stimulus Plan

Sousan Hammad
Decolonizing Israel

Binoy Kampmark
The Trial of Charles Taylor

Tracy McLellan
The Story of My Arrest

Website of the Day
11 Days in Saudi Gitmo

July 14, 2009

Eamonn McCann
The Emperors of Bombast: Bono, U2 and the Crisis of World Capitalism

Joanne Mariner
Obama's New Euphemism

Franklin Spinney
The Taliban Rope-a-Dope

Steve Heilig
Walking Mount Tam: an Interview with Gary Snyder

Ali Abunimah
Hamas' Choice

Dave Lindorff
The End of "Nice" Health Care Reform

Nikolas Kozloff
The Politics of Destabilization: McCain and Honduras

Ellen Brown
From Golden State to Subprime State

Alice Slater
How US Missile Defense Plans Sabotaged Nuclear Disarmament Talks With Russia

Ron Jacobs
Protest U.S. Aggression

Joe Allen
The Fight to Save James Hickman in Jim Crow-Style Chicago

Website of the Day
Mel Brooks Does the French Revolution

July 13, 2009

Uri Avnery
The Essence of the Regime

Mike Whitney
The Deflating Economy

P. Sainath
How the World Depression Hits Orissa

Gareth Porter
A US / Iraq Conflict on Iran

Paul Moore
Rap in the Streets, Rap in the Suites

Tim Wise
Off the Deep End: Private Clubs, Public Prejudice

Andy Worthington Former Insider Shatters Credibility of Military Commissions

David Macaray
Cartoon Voices: Serf's Up in Hollywood

Cal Winslow
The Healthcare Worker War

Niranjan Ramakrishnan
Spring in the Time of Obama

Website of the Day
Washington's Deep Game with China

July 10-12, 2009

Alexander Cockburn
Obama's Biden Problem

José Pertierra
The Cuban Five: a Cold War Case in a Post-Cold War World

John Ross
After the Honduran Coup

Conn Hallinan
The Settlements and the Quartet

Nikolas Kozloff
C Street Band: Sex Scandals, Moral Hypocrisy and the Far Right Agenda in Latin America

Clifton Ross /
Marcy Rein
U.S. and Honduras: Dr. Jekyll and Mr. Good Neighbor

Carl Ginsburg
Summers' Clouded Crystal Ball

Michael Neumann
Say It Loud, Say It Proud: There is No God!

Gilad Atzmon
The Left and Islam: Thinking Outside of the Secular Box

Jeffrey St. Clair
The Parable of the Golden Parachute

Ellen Hodgson Brown
California Dreamin': How the State Can Beat Its Budget Woes

Jim Goodman
Rural America Needs More Than Listening Sessions

Christopher Bickerton
Europe's New Politics of Hard Times

Wendell Potter
Health Care Industry Adopts Tobacco Lobby's Tactics

Dave Lindorff
CIA Lies: Why Isn't Congress in Open Revolt?

David Ker Thomson
Switchbacking Toward Bastille Day

Anthony DiMaggio
The Michael Jackson Feeding Frenzy

Raymond Lawrence
Michael Jackson as Sexual Pervert: the Calumnies of Peter King

Walid El Houri
Neda and Marwa: a Tale of Two Murdered Women

Stephanie Westbrook
Yes, We Camp

Roger Gaess
The Shades of Highgate Cemetery

David Yearsley
Tara, America's Dream House

Kim Nicolini
Caution: Men at Work, Robbing Banks

Poets' Basement
Five Poems From the Japanese

Website of the Weekend
Free Tiga and Hugh!

August 4, 2009

The Doctor is In ... Bangkok

Why Don't We Globalize Health Care?

By DEAN BAKER

With the rising cost of healthcare now atop the national agenda, one theme rings like a frustrating refrain: healthcare is special, so the tools we use to fix normal economic problems don’t apply. What good is mass production in confronting the complexities of the body? How can cost-benefit analysis grasp the unfixable value of a human life?

There is at least one tenet of modern economic policy, however, that we are excluding from the healthcare debate at our peril: globalization.

It may seem bizarre to suggest that globalization could somehow improve healthcare. After all, the practice of medicine is not only deeply individual, but tightly tied to time and place. Apart from possibly buying drugs from Canada, most people have probably never given any thought to the idea that globalization could have a meaningful impact on healthcare in the United States. But globalization, carefully applied, could reduce costs in the short term and create pressure for the bigger changes our system desperately needs.

There are clear ways to take advantage of lower costs in other countries, making our own system more affordable without diminishing the quality. We could allow more foreign-born doctors to work in the United States, for instance. We could encourage the “medical tourism” that allows Americans to have major procedures performed in other countries, and we could permit Medicare beneficiaries to buy into the lower-cost healthcare systems of other wealthy countries.

Each of these offers enormous opportunities for savings in the healthcare sector and benefits for the economy. They don’t need to be exploitive - we can structure any new arrangements to ensure that our trading partners benefit as well. This is especially important in the case of developing countries: we cannot let healthcare savings for the United States come at the expense of reduced access to care for people in the developing world.

It will not be easy to globalize healthcare. The interest groups that oppose government cost-containment measures will be just as vigorous in their objections to increased international competition, if the result is to reduce their income. There are also real problems in ensuring quality control. But if we get it right, a globalized healthcare system would not only lower costs, but could even bring health benefits. Canada, Germany, France, and the United Kingdom all pay roughly half as much per person for their healthcare as the United States, yet all these countries enjoy longer life expectancies than ours. This implies that there are enormous potential gains to the US economy, and to American patients, in opening up this sector to the world.

The economic idea driving globalization is simple: that the United States - and the world - gain when goods and services are produced in the country that can provide the best quality at the lowest price. Just as we benefit from allowing goods and services to flow freely over the border between Pennsylvania and New York, we also benefit from allowing them to flow across international borders.

The reality of globalization is often less beneficent than the textbook picture. It has reduced wages for a large segment of the US workforce; it has often meant dreadful working conditions and environmental degradation in the developing world. Nonetheless, there are real gains: we pay far less for our clothes, our cars, our computer service calls than if the United States was a closed economy. Costs go down, and our standard of living, on balance, goes up.

Globalization has been conspicuously missing in healthcare policy debates, however. Even the economists who normally push a free-trade agenda have been silent, largely because there has been a tendency to conceive of healthcare narrowly as a domestic issue. There is some logic to this narrow view: in a healthcare emergency, we need immediate treatment, not assistance from someone halfway around the world. Nonetheless, there are some obvious and important ways in which the healthcare sector can benefit from increased globalization.

The first route is through opening the door wider to medical professionals from other countries. Doctors in the United States, especially highly trained specialists, earn far more than their counterparts in Western Europe or Canada, at least in part because it is very difficult for doctors - even those who meet our high standards - to train in other countries and then work in the United States. There has been little effort to coordinate medical licensing standards so that well-trained doctors elsewhere can practice here. In economic terms, this is a form of protectionism, just as arbitrary as restrictions on imported shoes or clothes. Trade policy over the last three decades has worked to dismantle the barriers to imported goods, but largely ignored the barriers that obstruct the entry of qualified doctors.

What if, however, the government sought to remove the licensing barriers for foreign physicians? Compensation in the most highly paid medical specialties averages far above $250,000 a year (even after paying malpractice fees). Many doctors trained outside the United States would find these positions attractive even if they only paid $100,000 a year. Opening medical practice to foreign competition would allow for the same sorts of gains from trade that we have seen with opening trade in apparel and textiles - except that we spend far more on doctors each year than we do on clothes.

To allow hospitals to hire well-trained doctors from Mexico, India, and other developing countries, the government would need to eliminate certain protectionist barriers, such as the requirement that an employer first try to hire a US citizen or green card holder at the current market rate. The next step would be drafting international training and licensing standards; doctors could be tested in their home countries, by US-certified testers. Those who do would have the same access to a healthcare job in the United States as a US citizen. A kid growing up in Mexico City or Beijing would have as much opportunity to work as a neurosurgeon in the United States as a kid growing up in Long Island.

To compensate for the inevitable brain drain from developing countries, we could impose a modest tax on the gross income of foreign-trained doctors in the United States for their home countries to spend on training doctors who stay. A 10 percent tax on one US-based doctor’s salary would almost certainly support the training of two doctors in most developing countries, and ensure that countries sending doctors to the US would also see an improvement in the quality of care at home.

The next important way to gain from globalization is to move some procedures overseas. Today this practice goes by the slightly pejorative term “medical tourism,” but behind that nickname is an important and growing trend that can offer real benefits.

Facilities in developing countries such as Thailand and India can perform many major medical procedures for a fraction of the cost in the United States. These facilities are set up to meet Western standards of care; in many cases they are equipped with the most modern medical equipment. For some medical procedures, the savings over an American procedure can easily cover the cost of airfare and hotel bills for the patient and several family members. Today, between 60,000 and 85,000 people cross international borders each year for medical procedures, according to consulting firm McKinsey & Co., and the number is growing. But its growth, and the potential gains, are limited by the lack of adequate government oversight.

If US policymakers embraced rather than ignored medical tourism, the government could create a process for certifying facilities in other countries to ensure the quality of care. It could also establish guidelines for malpractice liability; insurance companies could contract with facilities in the developing world and offer large discounts to patients who opt to travel for major procedures. (Some insurance companies have already begun offering such options.) To ensure that the host countries also benefit, the US government can insist that developing countries impose taxes on medical tourism, and use the proceeds to improve their own healthcare systems.

The third way that globalization can help healthcare is by allowing Medicare beneficiaries to buy into national health systems overseas. Currently, tens of millions of current or future Medicare beneficiaries have close family or emotional ties to countries with more efficient healthcare systems, and in many cases may want to retire to these countries. However, at present their Medicare benefits are of no use outside of the United States. Medicare beneficiaries moving to a foreign country are left to make healthcare arrangements for themselves, or return to America for any expensive procedure.

What if Medicare benefits could cross borders instead? With portable healthcare, Americans might feel more liberated to retire abroad, enjoying comfortable lives in lower-cost countries and generating enormous savings for the US government. The cost of healthcare abroad is so much lower that the U.S. government could even offer a premium to participating countries - say, 10 percent above that nation’s per-person healthcare costs. Medicare beneficiaries and the US government could split the remaining savings, which would still be substantial. For example, a beneficiary moving to the Netherlands or the United Kingdom in 2010 could expect to pocket close to $2,000 a year just from their share of the savings, a nice supplement to retirement benefits. That amount will only grow over time.

Having a large segment of our retired population living overseas may not be desirable in the long term, but it is almost certainly better than letting their runaway healthcare costs wreck our economy.

There will be many objections to increased globalization of healthcare. Some people may object to being treated by immigrant doctors, no matter how highly qualified they may be. And the thought of people flying around the world for major surgery is somewhat offensive on its face - if you need healthcare, you’d like to think that you could get it near where you live. The AMA and the other interest groups will object just as strongly to potential income losses due to globalization as they do to potential income losses due to President Obama’s healthcare plan.

To counter this opposition, we need stronger voices among the experts. It would be helpful if my fellow economists would act like economists on this issue and start singing the praises of globalization. If economists denounced the doctors and others demanding special protections in the same way they denounced autoworkers seeking such protections, it would go a long way toward moving the debate forward.

The goal of globalizing healthcare, of course, is not to send Americans around the world in search of healthcare. Our real goal should be to fix the US system to provide quality at a reasonable price. Globalization is best seen as a stopgap measure: a way to save money by taking advantage of more efficient foreign healthcare systems, while providing incentives for retooling our own.

If it works, it could increase the pressure for reform by making the inefficiencies of the US system more apparent. It could also put much-needed downward pressure on prices in the United States. If the gap between the cost of major medical procedures performed in America and other countries continues to grow, fewer people might have those procedures performed here. Highly paid medical specialists will either accept lower fees or go with much less work. The same logic will apply to other high-cost areas of the system.

Globalization offers enormous opportunities: it allows Americans to escape a broken healthcare system and generates new pressures to fix it. If done right, our trading partners will benefit as well. This may be a circuitous route to a system that provides high quality care for everyone, but it may also be the only route.

Dean Baker is the co-director of the Center for Economic and Policy Research (CEPR). He is the author of Plunder and Blunder: The Rise and Fall of the Bubble Economy.

This article was originally published by the Boston Globe.

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