Volume 4 (2007)

Abandoning the Destitute to Heal the Wealthy: The Medical “Brain Drain” Phenomenon in the Context of Globalization

Deena Guzder

A quarter of all doctors practicing in the United States are foreign medical school graduates, a large majority of which come from developing countries that are being decimated by AIDS, malaria, tuberculosis and other infectious diseases. Why are countries in critical need of medical professionals unable to retain their locally trained staff? What are the consequences of the medical “brain drain” phenomenon and is it caused by natural attrition or proactive recruitment by developed nations? I suggest globalization—integration of economic activities via free markets—is creating huge incentives for medical migration and, although recipient nations as well as relocating doctors economically benefit from this trend, impoverished countries already in dire need of culturally-aware, competent medical professionals are forced to absorb the resulting loss in health capacities to their severe detriment. For the short-term, I suggest several policies that may provide incentives to doctors to remain where they are most needed—policies such as making medical school scholarships contingent on returning to one’s country of origin, opening more medical institutions in developing countries, increasing medical school enrollment numbers in the US to saturate the domestic market, and using humanitarian aid to increase the salaries of foreign doctors that forgo the economic temptation of medical migration. For the long term, I advocate broader policies concerned with ending the endemic poverty plaguing an unevenly developed world.

Poverty Alleviation for Internally Displaced Persons: Case Study of Georgia

Maggie Koziol

The frozen conflicts in Abkhazia and South Ossetia have created anywhere from 200,000 to 350,000 internally displaced persons (IDPs) in Georgia. The number of IDPs worldwide has steadily risen and has now surpassed the number of refugees globally. Problems of poverty permeate the IDP issue. On one hand, displaced Abkhazian and South Ossetian people suffer from extensive poverty due to insufficient infrastructure, lack of job opportunities and the ambiguity surrounding which agency or government is responsible for the IDPs’ needs. On the other side of the issue, the stagnation of the frozen conflict precludes efforts at positive long-term poverty alleviation. To better understand the conflicts in these regions and their implications for IDP poverty in Georgia, this note explores the history of these tensions and how Russian interests may have worked against their resolution.

Book Review of Carol Lancaster’s Foreign Aid: Diplomacy, Development, Domestic Politics

Daniel M. Rothschild

Book review.

Regulating Egg Donation: A Comparative Analysis of Reproductive Technologies in the United States and United Kingdom

Michelle Sargent

While rapid scientific development of egg donation technology has made it possible to elude infertility and to expand options for means of procreation, it has also thrust policy makers advanced societies in the midst of a raging debate that involves several ethical concerns. This paper describes and contrasts the respective regulatory approaches of the United States and the United Kingdom towards egg donation, and explores their potential implications for policy making in both countries.

Asylum States and Urban Refugees: The Benefits of an Integrative Approach

Holly Sienkiewicz

While refugees have traditionally been viewed as a burden, an alternative view of refugees as resourceful and beneficial to the host state has emerged. This paper focuses on the benefits of urban refugees to host states. Specifically, urban refugees bring to host states much-needed human and financial capital. Current state policies, however, constrain the activities of refugees and limit them from fully integrating into host societies. They also discourage urban refugees from registering with aid agencies, which undermines efforts to provide funding and assistance to refugees. This paper argues that it is in the best interests of host states to allow urban refugees to work and live freely within their cities.

Workplace Wellness Programs: Proven Strategy or False Positive?

Rachel Silberman

The cost of health care and the rate of uninsurance in the United States continue to rise as American firms struggle to contain the cost of health coverage. Workplace Wellness programs may be a way to mitigate the rising cost of insurance by improving employee health, reducing demand for medical services, lowering the cost of insurance for firms, and by decreasing the cash firms lose to unhealthy employees by increasing productivity and reducing absenteeism. This paper assesses the potential benefits of Workplace Wellness Programs by presenting the shortcomings as well as the potential impact of current evaluation literature given programs such as Healthy Workforce 2010, and gives recommendations for producing statistically rigorous research to make HHS advice more applicable to a broader range of firms.

Real Estate Capitalization by Policy Input in the Cleveland Empowerment Zone: An Application of Adjusted Interrupted Time Series Analysis (AITS)

Richard J. Smith

This paper reviews select research and metareviews of Enterprise Zones and Empowerment Zones to assess the methods used to measure the impact of these areas on real estate capitalization. The review pays close attention to the policy implications of the empirical findings regarding the impact of EZ policy on housing prices, business location decisions, job growth, industrial output, employee income, and other effects. It closes with a brief application of the adjusted interrupted time series (AITS) method in the Cleveland Empowerment Zone. Controlling for land use type, the study finds a larger one-time increase in real estate values after the EZ designation compared to the year after the introduction of the tax incentives. However, results are not significant when controlling for fixed tract and year effects. The paper closes with recommendations for policy and future research.