Don Marti

Mon 08 Sep 2008 01:29:18 PM PDT

Closing a loophole in globalization?

David Frum, from the American Enterprise Institute, writes in the New York Times, "Between 2001 and 2008, the amount that employers paid for labor rose impressively, at least 25 percent. Yet almost all of that money was absorbed by the costs of health insurance, which doubled over the Bush years."

Globalization arrives unevenly. If you make backhoes or web sites in the USA, you're already competing with workers in China and India. If you provide medical services, you aren't.

Yet. The Economist predicts a "dramatic boom" in medical tourism. And there's a thriving US/Mexico border dental industry: Get Your Teeth Fixed in Mexico. If we ever end the embargo on Cuba, the place will fill up with hospitals and nursing homes serving the US market, since it's teeming with trained MDs and nurses and a short hop from Florida.

When I mention the idea of a "medical free trade zone" to US workers, nobody says, "That's crazy! I refuse to put myself in the hands of a medical professional without the protection of the FDA and the malpractice bar!" A more typical reaction is, "So I could get cheaper health insurance if I agreed to have non-emergency work done in the free trade zone? Hmmm...." The free trade zone looks a lot more politically possible once it becomes a case of a US city getting a piece of the action from medical globalization that is happening anyway.