Agreed that we should consider the broader set of costs/benefits you list! The top talent loss cost could be an especially a big deal in Nigeria, where I’d expect a weaker “bench” of substitute human capital than the Philippines (both for new potential nurses and for those who would train the new nurses/found new private colleges).
My (unquantified) view is that the CBA still looks pretty one-sided in the Philippines context, but I’d love to see what a formal modeling exercise produces (and if the conclusions are different for Nigeria or other Sub Saharan African countries).
Not sure if we disagree here. Of course I’d expect the average nurse quality to go down as the workforce increases by 9x. Rather, the claim about weaker substitutes in Nigeria was about explaining why Philippines nursing supply might be more price elastic than Nigerian supply. Specifically, since literacy, numeracy and high school graduation rates are likely significantly higher in Philippines than Nigeria, there’s a larger share of the population that could plausibly respond to the migration demand shock by acquiring the relevant training.[1]
Agreed if we conducted the CBA today. However, as stated in the original comment, we want to be careful about lags here. Even in the Philippines, the migration increase started in 2000 when the US policy changed (Figure 3) and peaked in ~2006. While the enrollment rate in nursing programs did start increasing in 2000 itself (Figure 4, Panel A), the increase in the nurse graduation rate (i.e., the trained workforce) only started in 2004 (Figure 4, Panel B), and only hit it’s peak in 2010, 10 years after the migration began. If we were looking at the change in Philippines’ nurse workforce from 2000-2004, I think we might’ve concluded that they’d lost nurses and that the migration was a net-loss for them. Now, as we’ve discussed, there are reasons to believe that Nigerian nursing supply may not be as elastic as Philippines nursing supply, but I just wanted to emphasize that the current net-loss of nurses in Nigeria doesn’t yet give us strong evidence that the CBAs will be wildly different.
Implicit here is that basic numeracy, literacy and high school graduation are pre-requisites for acquiring nurse training.