Mr. Sam Jonah’s proposal is a 1980-era inter-national economic model for healthcare staffing in the rich countries. It is outdated and it is not original. The new model has middle-income and other “smart” developing countries setting up high quality medical facilities in their urban areas. These centers are good enough and affordable enough to attract patients from the advanced industrialized countries to go to those countries for healthcare. One does not need to go to Thailand or India to find out that this is the trend and that it constitutes truly a win-win for the receiving nation and individuals who need medical care. The elementary problem is, living in America and other western developed economies, including Japan, is very expensive, increasingly. Many people cannot afford their doctors, but they can afford Thailand/Indian/Ghanaian? doctors. Ghanaians ought to be smarter, and are! Mr. Sam Jonah ought to be asking for the government and private industry to fund more upgrades to healthcare facilities in Ghana. And so, a la Prof Tagoe, University of Ghana, and Ronald Reagan, Prof Lungu says, “Mr. President ‘complete (the) Teaching Hospital this year…’” (Prof Lungu, 19 Apr 08)

The call by Mr. Sam Jonah for Ghana to “Adopt strategies to gain from brain drain,” (Ghanaweb, 19 Apr 08) with additional taxes was as confusing as they come. Maybe some of the confusion is the responsibility of the GNA when they reported that “In all, 647 ‘grandaunts’ were presented with certificates for PhD, MSc, MPH, MPhil,..(BS)…degree and diploma in health and the applied sciences…” Reads a bit like the story from the NPP a few shot weeks when NPP “POCs” proclaimed, “Huge increase in hospital beds under NPP,” which was as hollow as they come. But we digress!

So Mr. Sam Jonah is asking the Government of Ghana to use public policy to facilitate the migration of all the “647 grandaunts,” to greener pastures to make it a “win-win” for all? But isn’t it Mr. Sam Jonah who concedes that Ghanaians in the Diaspora, regardless of their qualification, do contribute hugely through remittances of foreign exchange.

Which way, then, Mr. Sam Jonah? Which way, with the other side of his mouth expressing “…regret that Africa possesses 25 per cent of the global disease burden, yet has only 1.3 per cent of the world's health professional working in the continent…” Is Mr. Sam Jonah telling us that when the Ghanaians leave for greener pastures overseas, that healthcare professional in “advanced” economies will migrate to Ghana to work as healthcare professionals, even if they’ve not been trained at Ghanaian public expense?

And so, attention was diverted from the more useful comment/appeal from Professor Clifford N. B Tagoe, the Vice Chancellor of the University of Ghana, in his request for immediate assistance for the “government to make funds available to enable the University to complete its Teaching Hospital this year….(and for the)…the ‘grandaunts’ to use their skills to ensure quality health care..” for the people. Befuddling and nonsense, Prof Lungu will tell you, this Sam Jonah “Brain Drain” tax!

Problem is, Mr. Jonah wants the new healthcare professionals to go, yet he wants them to stay. And how will Mr. Jonah make them come back after they have been sponsored to go? Or will Mr. Jonah propose that they pay their own tickets and the Government of Ghana can expect them to come back when it is time, on Ghana’s time or on their own time? The other question is what is the history of the return of students and professional who were on the government's tab? And more fundamentally, how long will it take to train enough healthcare professionals (and doctors) in order to have a surplus to “export”? Or was Mr. Sam Jonah arguing that the interest of the public is of no consequence, perhaps because public officials and others who can afford can go overseas for healthcare for themselves and their family members? (Does this remind you of Prof Mills going to South Africa for sinusitis and the Asantehene sending his wife to the US to deliver a baby, a baby who then automatically becomes a US citizen?). Now, that is “royalty” and “elitism” for you, won’t you agree?

Fortunately, the piece generated a lot of interest among Ghanaweb commentators, some from people who said they are doctors. Some of those comments were frankly comprehensive and Ghana-centered enough as “Feature” essays. Pieces from Opia on the dynamics involved given the global context, TruePatriot on the current institutional inadequacies that allow healthcare professionals to leave Ghana after public funding and the fallacy of the “Filipino” example, and Dan Opoku, ex NPP, on “a multi-millionaire who is entering a reflective phase in his life (and who now) wants to give back to the country” stood out. Then there was mclexus- Copenhagen for his opposition to additional taxes on auto imports and on the Ghana construction industry, and why a president who does not pay income tax enjoys so much “per diems.” I will provide a summary of the more interesting comment, but first, here is an item to chew on:

ITEM: Mr. Sam Jonah’s proposal will allow a few well-placed “labor runners” to make money off the labor that will not necessarily be repatriated to Ghana. Prof Lungu lived in Houston many years and knew a Filipino labor contractor who made a lot of money running that medical staffing game. The Filipino nurses, as “contractors,” lived in virtual labor camps. But the important thins is, little of all that money went to the Philippines or even as taxes. So what problem does Mr. Sam Jonahs have saying the government currently does not “tap economic benefits from the current brain drain in the health sector,” even when the other side of his mouth is saying “…remittances from…the Diaspora (is) a major source of foreign exchange...”?

Selected Comments on Sam Jonah’s Re-cycled Brain-Drain-Gain Tax Proposal:

Opia - “…International mobility of skilled workers can generate global benefits by improving knowledge flows and satisfying the demand for skills. The contribution of foreign skilled workers to economic growth and achievement in host countries, in particular to research, innovation and entrepreneurship, is increasingly recognised. But almost all the benefits go to the affluent countries that host these talented migrants!... Poor countries like Ghana can never win this brain drain burden. If economic conditions in third world countries fail to improve, migration of talented individuals to affluent countries in search of 'greener pastures' is never going to cease…”

Black Hero – “…Most professionals I know living outside Ghana do build houses and are involved in other financial activities…in Ghana…. I have not met a single one who say they would still have travelled outside if Ghana offered a level playing field… But as it stands the politicians and military are the only ones benefiting. Politicians in Ghana live better than their western counter parts but they want others to sacrifice…”

Biologic – “Black Hero…You've hit the nail right on the head…If the infrastructure is improved to upgraded standard, those who visit home on holidays would be impressed enough to seriously think of coming back again and perhaps for good…I want to be able to travel 200 to 300 miles up country and find a internet café…A decent KPV toilet and shower facilities and decent eating cafe would be appreciated…. what will the money be spent on? Two presidential cruise ships? Or they will find another project to ease the hardships of the president…Ghana does not have a problem with money coming to the government….problem is how the money is spent…”

mclexus- copenhagan - “…I will not goddamn pay any additional levy or whatsoever on the car that I have bought nor the building I have put up with my hard-earned money! What you should have suggested instead is this: your boss Kuffour should cut down his unnecessary foreign trips and willingly refund part of the per diem he had accumulated from these futile trips for all this nearly eight years…”

TruePatriot – “…I know many clueless Ghanaians have come out with plans to benefit from the brain drain of health care Professionals especially the medical doctors, however, most of these so called intellectuals know nothing about the system here…(A)ll medical students should sign a bond of serving the country for at least 4 yrs before they are allowed to leave. This is where the problems begin, because the Agya Ba(s) are the one left behind and the sons and daughters of the government officials and well-to-do are the ones who have money to take the Exams and ticket to leave the country. Therefore, the likes of Sam Jonah refuses to commit to these ideas...”

Tolitala – (Prof Lung, Sam Jonah’s proposal)… is called "escalation of obfuscation"!... Either the reporter goofed or Sir Sam was boozed-bonkers!

So tell us, are we there yet? Tell us, are we yet in the belly of the whale, Mr. Jonah? Can we move to 2008 and plan rationally for the people, and not for a few “indigenous capitalists”? And what about public officials who go overseas routinely for healthcare for themselves and their family members? How are we doing in the quest to provide excellent healthcare for Ghanaians? How about those outside Ghana who can benefit from Ghana’s comparative economic advantage in labor, real estate, location in a tropical paradise-to-be, and thriving medical/healthcare fields?

So tell us, Mr. Sam Jonah, is Ghana there yet?

Prof Lungu
Email: professor.lungu@yahoo.com