Care Worker Migration and Transnational Justice

Abstract:

Here I consider the migration of health workers and propose a conception of transnational justice that can best address the concerns it raises, including the perpetuation of global health inequities. My focus will be on nurses and direct care workers (DCWs), also called paraprofessionals—the vast majority of whom are women—coming from the global South to the United States. In the first part of the paper I will identify the factors behind this flow of what I will hereafter call ‘care workers’. From there, I will describe a conception of transnational justice that seems especially promising and explore selected policy options. Finally, I will conclude by offering specific prescriptions for action on the part of a wide range of agents, including institutions as well as individuals.

“Care Worker Migration and Transnational Justice,” Journal of Public Health Ethics,  vol. 2, no. 2 (July 2009): 171-183 Click this link to view the full article.

“Health System Reform: How Are We Doing So Far?” - Multiple Locations

“Health System Reform: How Are We Doing So Far?”, this presentation took place at the following locations and dates:

Colorado Health Symposium, Keystone, CO, July 29, 2009

San Diegans for Health Access, San Diego, CA, July 18, 2009

The Permanente Medicare Group Leaders Meeting, San Francisco, CA June 26, 2009

Grantmakers in Health, New Orleans, LA March 18, 2009

Competition in the Healthcare Marketplace - U.S. Senate Committee on Commerce, Science and Transportation

Introduction:

Chairman Pryor, Ranking member Wicker and other distinguished members of this committee and subcommittee, thank you for inviting me to offer my thoughts today about how to improve the performance of health service markets. My name is Len M. Nichols. I am a health economist and I direct the Health Policy Program at the New America Foundation, a non-profit, non-partisan public policy research institute based in Washington, D.C., with offices in Sacramento, California. Our program seeks to nurture, advance, and protect an evidence-based conversation about comprehensive health care reform. We remain open minded about the means, but not the goals: all Americans should have access to high quality, affordable health insurance and health care that is delivered within a politically and economically sustainable system. The best way, though not the only way, to accomplish these goals is to ensure reform legislation earns bipartisan support. I am happy to share ideas for your consideration today and hereafter with you, other members of the Committee, and staff.

“Competition in the Healthcare Marketplace” — U.S. Senate Committee on Commerce, Science and Transportation — July 16, 2009.

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“Financing Health Reform” - Alliance for Health Reform

This presentation took place on July 13, 2009 at the Alliance for Health Reform, in Washington, DC.

“Financing Health Reform,” Alliance for Health Reform¸ July 13, 2009

Stewardship: What Kind of Society Do We Want? - Len M. Nichols

Introduction:

To exercise stewardship, or not—that is the question. Why put the point that way? Because one path leads to an abundant life, and the other is a dishonest, if elaborate, form of suicide. Stewards distinguish themselves first by accepting responsibility, and then by acting on that responsibility to preserve, protect, and nurture something precious, through recurrent threats, for the purpose of delivering that precious thing to future generations. Who may confer and who must accept responsibility for stewardship of our health resources and the health of our population?

Some libertarians today argue that society is a myth, that no one has responsibility for the outcome of hundreds of millions of health-related decisions, and that anyone who asserts such responsibility and tries to act upon it is both an arrogant tyrant and an existential threat to the essential freedoms upon which our nation was founded. Nothing (and no tiny group of argumentative people) has ever been more profoundly wrong.

“Stewardship: What Kind of Society Do We Want?”, in Connecting American Values with Health Reform, Hastings Center, July 2009.

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