Your argument rests on there being medical training in other countries that is equivalent to US medical training.
Unless international licensing exams are implemented I don't think the US public is going to be convinved that the Radiologist reading the film in Uzbekistan is as qualified as the US physician.
And I don't see the AMA supporting international licensing exams anytime soon . . .
I'm honestly unsure about how the U.S. medical educational system compares, say to the Australian, Irish, German, Spanish, French, Japanese, South Korean, South African, Mexican, Egyptian, or Russian medical education systems. I'd like to see any reasonably objective studies on this.
Then again, quality without availability isn't quality that matters. It may come down to who has the capacity to treat all these sick people in the future ... the American medical educational system could run into trouble meeting the demand to educate sufficient doctors. Our educational system may be too small and other countries may provide necessary additional capacity to train physicians.
How our education actually measures out in an objective study (if it were possible to do an objective study) is not clear to me. It seems to me that it is possible to get a great education in other countries as well. Most students just seem to study on their own anyway instead of being spoon-fed information by medical school faculty and attendings.
Do we have the best medical educational system by far in the world? I'd be curious if studies have been done on that; this probably becomes subjective very quickly. What I do know is that given enough cash exceptional foreign doctors can come here to study or can be trained by physicians willing to travel. I'm not a radiologist, but my guess is that a gifted soul in India or the Philippines could get quite good at medical diagnosis given their right equipment, work situation, experience, and top educators jetted over there ( alot of ifs).
If global outsourcing of medicine takes off, I would fully expect foreign doctors to come to the U.S. en masse to go through short training programs or residencies and then return to their home countries (some would stay no doubt). This is already happening in engineering. Medicine is much more restricted than the technology field, but, given that the healthcare reimbursement system is straining, some wild ideas might actually see the light of day (who knows, Hilary Clinton might be our next President and she might push for healthcare changes with a Democratic Congress).
As far as the American public is concerned ... many people are totally dissatisfied with our healthcare system, starting with the cost, continuing to the amount of time they must wait for care, and consumating with the lack of quality and/or followup they receive(d). If you're in the top 50% of net worth in this country, maybe you're happy. If you're in the bottom 50% (the other 150 million people), maybe you're not. Also, many people in this country are from other countries and might have preferences for overseas physicians (Mexicans for Mexican doctors, Chinese for Chinese doctors, etc.). I personally am happy with the health care system because I think I get excellent care. If I didn't have health insurance like many millions of Americans, I would probably not be as satisfied.
As far as I can tell, it wouldn't take much for a large number of American seniors to look at new options. Have you heard that seniors are going to Canada or Mexico to pick up large quantities of medications to cut their cost? Maybe they will get other care, such as fixing a hernia there as well. Cost might be the first driving force for globalization of medicine and ultimately it might be quality as other countries are able to take advantage of superior legal liability systems that allow more innovative care and devices. Some of the newest medical devices are already tested overseas before they are brought to the U.S. with its oppressive legal system. A neurosurgeon might prefer to operate out of Monterrey (or another city outside of the U.S.) where her medical liability insurance is maybe $5000/year instead of $100000/year or whatever it is here and pocket the difference, have more control over her hours and live like a queen. For many physicians it's less about the money than the quality of life.
Personally, my dream for American health care would be for medical cost per visit to drop 50% every year, primary/preventative care to become commonplace, enrollment in health insurance coverage for the American public to be near 100%, and for quality metrics to show 100% improvement in heath care every year or two. This isn't possible without significant globalization or technology. Even if my dream doesn't come true, I'm still looking forward to serving in medicine in the U.S. I'm happy to help out either way.
