Very interesting analysis here, but I would add one potential drawback of moving to a high-income country: brain drain. In some countries, there is a lot of lost economic value that happens when highly skilled workers leave developing countries, and it appears that it sometimes (though not always) can harm economic growth. Harming economic growth in a developing country is a bad thing, and can potentially outweigh the benefits of earning to give. The second study I have linked focuses specifically on the negative effects of healthcare worker emigration in Kenya, and though it is a bit old, I think it’s an interesting read.
I was also wondering if you can explain what you mean by “The effect size interval of ‘physician density’ crosses zero (P value ~ 0.4(!)). So with more sceptical priors/practices you might take this as a negative result.” I haven’t encountered some of these terms before so if you could explain them to me I would really appreciate it!
Just off hand-having spent a couple of months in a rural part of Kenya with a severe doctor shortage, the estimate of 1 ‘life saved’ per year of Kenyan medical practice seems off to me, especially in rural areas, but I’m basing this purely off of discussions with people and anecdotal stories so I could be completely wrong. I’ve just heard a lot of stories of patients dying bc there wasn’t enough available healthcare staff in the area. I do think you’re right that investing in less intensive medical training like nursing is probably more cost-effective than investing in doctors.
Brian drain is an interesting topic. The brief research and thinking I’ve done on brain drain leaves me without clear answers as to what an individual facing a decision to emigrate should actually do.
Even if it is in aggregate bad that so many people move from poorer to richer countries (which is not obvious to me), it could still be the rational thing to do on an individual basis.
I would love to see a sort of guide based on EA-principles written for people in low-middle income countries considering moving to higher-income countries.
what are the benefits you might provide to the world working in a (potentially higher-leverage) higher-income country?
what about if you stayed in your home country?
for which careers is emigrating likely to make more sense vs. staying, and vice versa?
If earning to give if a key motivator in emigrating, how much would you have to believe you can earn in order to offset any downsides
what about moving to a high-income country for a few years, gaining experience, then moving back and?
Side note: the methods used in the second paper you shared don’t make sense to me. They say that “for every doctor that emigrated, a country lost about: (i) US$ 517,931”, but they arrive at this 517k figure by saying that education costs ~$65k, and then applying compound interest over 32 years. Seems to me it would be more accurate to say that the country lost $65k, plus the medical services that person would have provided.
Hi Gregory,
Very interesting analysis here, but I would add one potential drawback of moving to a high-income country: brain drain. In some countries, there is a lot of lost economic value that happens when highly skilled workers leave developing countries, and it appears that it sometimes (though not always) can harm economic growth. Harming economic growth in a developing country is a bad thing, and can potentially outweigh the benefits of earning to give. The second study I have linked focuses specifically on the negative effects of healthcare worker emigration in Kenya, and though it is a bit old, I think it’s an interesting read.
I was also wondering if you can explain what you mean by “The effect size interval of ‘physician density’ crosses zero (P value ~ 0.4(!)). So with more sceptical priors/practices you might take this as a negative result.” I haven’t encountered some of these terms before so if you could explain them to me I would really appreciate it!
Just off hand-having spent a couple of months in a rural part of Kenya with a severe doctor shortage, the estimate of 1 ‘life saved’ per year of Kenyan medical practice seems off to me, especially in rural areas, but I’m basing this purely off of discussions with people and anecdotal stories so I could be completely wrong. I’ve just heard a lot of stories of patients dying bc there wasn’t enough available healthcare staff in the area. I do think you’re right that investing in less intensive medical training like nursing is probably more cost-effective than investing in doctors.
Sources:
https://wol.iza.org/articles/brain-drain-from-developing-countries/long
https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-6-89
Brian drain is an interesting topic. The brief research and thinking I’ve done on brain drain leaves me without clear answers as to what an individual facing a decision to emigrate should actually do.
Even if it is in aggregate bad that so many people move from poorer to richer countries (which is not obvious to me), it could still be the rational thing to do on an individual basis.
I would love to see a sort of guide based on EA-principles written for people in low-middle income countries considering moving to higher-income countries.
what are the benefits you might provide to the world working in a (potentially higher-leverage) higher-income country?
what about if you stayed in your home country?
for which careers is emigrating likely to make more sense vs. staying, and vice versa?
If earning to give if a key motivator in emigrating, how much would you have to believe you can earn in order to offset any downsides
what about moving to a high-income country for a few years, gaining experience, then moving back and?
Side note: the methods used in the second paper you shared don’t make sense to me. They say that “for every doctor that emigrated, a country lost about: (i) US$ 517,931”, but they arrive at this 517k figure by saying that education costs ~$65k, and then applying compound interest over 32 years. Seems to me it would be more accurate to say that the country lost $65k, plus the medical services that person would have provided.