Insourced: How Importing Jobs Impacts the Healthcare Crisis Here and Abroad

by Laurie Garrett

For years, opponents of outsourcing have argued that offshoring American jobs destroys our local industries, lays waste to American job creation, and gives foreigners the good jobs and income that would otherwise remain on our shores. Yet few Americans realize that a parallel dynamic is occurring in the healthcare sector—previously one of the most consistent sources of stable, dependable living-wage jobs in the entire nation. Instead of outsourcing high-paying jobs overseas—as the manufacturing and service sectors do—hospitals and other healthcare companies insource healthcare labor from developing countries, giving the jobs to people who are willing to accept lower pay and worse working conditions than U.S. healthcare workers. As Dr. Tulenko shows, insourcing has caused tens of thousands of high-paying local jobs in the healthcare sector to effectively vanish from the reach of U.S. citizens, weakened the healthcare systems of developing nations, and constricted the U.S. health professional education system. She warns Americans about what she’s seeing—a stunning story they’re scarcely aware of, which impacts all of us directly and measurably—and describes how to create better American health professional education, more high-paying healthcare jobs, and improved health for the poor in the developing world.

192 pages, Kindle Edition

First published April 24, 2012

About the author

Laurie Garrett was awarded the Pulitzer Prize for Explanatory Journalism in 1996 for a series of works published in Newsday that chronicled the Ebola virus outbreak in Zaire.

If Laurie Garrett hadn't interrupted her science career to pursue journalism, she probably would have been a professor at a top-rate university doing AIDS research in her lab, says Lee Herzenberg, geneticist at Stanford University and a longtime mentor for Garrett.

Garrett (born 1951) had advanced to a doctoral candidacy in immunology at University of California at Berkeley before deciding that "journalism would be more fun and interesting." She learned the craft at a California radio station, eventually joining National Public Radio as a science correspondent. After eight years at NPR, she joined Newsday in 1986. It was an unusual hiring for Newsday; Garrett had no newspaper experience.

But Garrett, whose flamboyant personality matches her spirit of adventure, already was experienced at traveling the world reporting on new diseases, especially the emergence of AIDS in East Africa. For Newsday, she returned to Africa for further reporting on AIDS and to India where she wrote about a plague outbreak. During the Persian Gulf war, when Jordan's borders were closed, Garrett managed to get in from Israel with a Paris-based doctors' group to report on refugees. She also toted back a bag of Saddam Hussein souvenir watches and SCUD missile earrings for her colleagues. In 10 years, her accordion-like passport has 45 visa stamps from different nations.

Her book, The Coming Plague: Newly Emerging Diseases in a World Out of Balance was a paperback best-seller in 1995. The Brooklyn resident is currently president of the National Association of Science Writers.