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Opinions of Tuesday, 18 April 2006

Columnist: Amegashie, J. Atsu

Brain Drain: Response and Further Thoughts

My two articles on the brain drain have generated some debate. Kwabena-Osei Dadzie and Louis Anane have written very good rejoinders to these articles.

Let me first respond to those who attack diasporans for writing about Ghana from afar. I respectfully suggest that you attack the message instead of the messenger. Should it be an all or nothing choice? Drink deep or taste not? I understand your frustration but you should not ignore ideas because you do not like the messenger, even if you think they are good ideas.

Think about this. Most diasporan professors in North America do not teach in the summer. At least, those at research universities do not. Our universities can create a database of such professors and create a network of Ghanaian diasporan professors who will teach in Ghana periodically. I am aware that the World Bank is working on a similar idea. Indeed, this is exactly what Israeli/Jewish professors in the USA do. The leading Jewish/Israeli economics professors in the elite USA universities are partially affiliated with Tel Aviv and Hebrew Universities in Israel. This has made these two universities one of the best in the world. A recent ranking of economics departments in Europe placed Tel Aviv University at # 1 ahead of the London school of economics. Note that there are only 5 universities in Israel. These Israeli universities achieved this remarkable feat, in part, by tapping the fine brains of their citizens and other Jews in the diaspora. Robert Mensah-Biney proposed a similar idea in a 2004 feature article titled ?Brain Refill: Using Expatriate Ghanaian Professionals ....:?:

I understand the frustration of those who want diasporans to permanently return home. But really, it does not have to be ?drink deep or taste not.?

My "attack" on the salaries, fringe benefits, official perks, etc of ministers was to draw attention to the misallocation of resources in the public sector. And if we are not spending too much on ministers, should that not be public information? Exactly how much do ministers, MPs, etc get? Ghanaians should demand accountability.

It appears that in Ghana, once someone becomes a minister s/he thinks any position other than minister or above will be a demotion. If you were teaching at the University of Ghana, Legon prior to your ministerial appointment, I see no reason why you should not go back to Legon after your term in office, if you cannot find any other job (e.g., be on the board of a company). But in Ghana going back to Legon after being in government may not be seen in a favorable light. If ministers are chosen from the pool of those who were good in the private sector, I see no reason why they cannot go back and compete in that sector after their term expires. We can minimize the risks associated with ministerial appointments that some are worried about, if we do a thorough job of selecting highly able people. These people should be able to return to the private sector.

In our society, we care too much about social class and status. So our politicians care about being above everybody. In the western world, the richest people are in the private sector and the politicians do not dream of competing with them nor do they see it as a sign of lower status. They cannot afford the cars and houses that these people in the private sector can afford. In Ghana and other parts of Africa, the politician wants to earn more than or be in the same class as the businessmen, CEOs, and other professionals in the private sector. That also explains why the rule of law is so weak in our part of the world because there are those who believe that they are above it and must be above everybody else. There are just too many people competing for status based on material wealth in Africa. Here in Canada, I sometimes take the bus to work when I feel like it. It is no big deal because I know that my status as professor is judged based on how good I am as an academic. My material wealth is irrelevant. I do not think that a professor in Ghana can take the bus without public ridicule, even if the public transport system was very good. Therefore, the return on material wealth stemming from social status is very high in Ghana. This very high return is likely to induce professors and other high-ability individuals to invest more in directly unproductive rent-seeking activities like lobbying, networking with the political elites, as part of wealth redistribution (i.e., get their piece of the national pie). It will then appear that a society that puts an excessively high premium on direct material wealth, no matter how it is acquired, will paradoxically generate less aggregate wealth. In the western world, the direct investment in academic work of professors indirectly leads to wealth accumulation. My point is not that social status based solely on material wealth does not exist in the western world. My point is that there is a much higher return to social status based on material wealth in Ghana, regardless of how this wealth was acquired.

As indicated in part 1 of my article, there is an explicit comparison of the salaries of ministers and other professionals in Singapore. So in Singapore, this comparison is not unthinkable. Why can we not do that in Ghana? As argued above, this has something to do with the pedestal on which ministers expect to be put and indeed where we also put them. You see, it is in our psyche. Somehow, we do not really see ministers as servants of the nation. But in reality, that is exactly what they are.

I want to make it clear that I was not suggesting in my articles that we should pay our doctors western-type salaries. We cannot so and this is not required to retain them. Our doctors value things other than money (e.g., social ties, Ghana's warm weather, our culture, etc). Besides, they also know that they have to be retrained, at the risk of failure, for some years before they can become qualified medical practitioners in western countries. Therefore, for these reasons, they will be willing to accept less than what they will be paid in western countries. However, below a certain threshold (i.e., when their salary in Ghana is just too low), the non-pecuniary benefits indicated above are not enough to keep them in Ghana.

My outside option argument carries some force and indeed has some merit. For example, all universities in Canada are public universities. However, different professors are paid differently within the same department and across different departments depending, in part, on their outside option. Therefore, my salary is different from the salary of my colleagues who were hired in the same year with identical qualifications. Some of the difference may be due to discrimination but it is not the entire story. For example, if I get an offer from say McMaster University which is better than my current salary, my current employer, the University of Guelph will try to match my salary, if I threaten to leave Guelph based on McMaster's offer. Hence my superior outside option will put me in a higher salary bracket than my colleagues at a similar stage in their career. Note that my threat is credible to the University of Guelph because I have an actual offer. If Guelph does not match McMaster's offer, I would leave for McMaster just as our doctors will continue to leave if we do not pay them well enough.

The issue is not that someone should be in charge of checking what the exact outside options are. The point is that if a worker can credibly signal that s/he will leave if s/he is not paid well, then the employer should try to increase his salary (not necessarily match his outside option), If his services have a sufficiently high value. Our doctors fall in this category.

Some have argued that doctors are not the only people in the public sector. In the same vein, ministers are not the only people in the public sector. It appears that the thought of a doctor earning more than a minister does not sit well with some people. Is that a taboo, EVEN IF that could halt the exodus? If we do not have the resources to do so, let us explicitly lay out the revenue and resources of the country and how they are being currently allocated. Clearly, issues of pay equity in the public sector exist but if you are losing health professionals at such an alarming rate, you ought to take drastic measures.

On pay equity and inequality, different societies have devised different schemes depending on their values. In Norway, there are small differences in salary and their top professionals are willing to tolerate such small differences. However, one?s sense of patriotism to a country depends on how well the resources of the country (including taxes) are allocated to public goods and quasi-public goods like roads, health care, education, etc and also on the degree of income inequality. People love their country when they see that there is justice and fair play. Arguably, this is what holds countries like Norway and Finland together. If the average Ghanaian knows that each minister or government official is tightening his/her belt for the common good, s/he will also tighten his/her belt accordingly till we all get to the promised land. In a world where some are asked to tighten their belts while others loosen theirs - using the resources (taxes and foreign aid) of the land that everyone is entitled to - there can be no patriotism, justice, or progress.

Some people have argued that countries like Canada also experience a brain drain and that some ministers earn more than doctors in these countries. The relative salaries of ministers and doctors and other professionals may not require re-examination if economic performance (including the performance of the public health sector) is sufficiently good. The Canadian health care system is no where as bad as the Ghanaian health care system. You can get very good health care in Canada in spite of the USA?s poaching efforts. Canadian universities lose some of their best professors to US universities. However, you can still get a very good undergraduate and post graduate education in any Canadian university. Canada is not in our predicament. It is we who find ourselves in a very dire situation. Therefore, the issue is not whether Canada is experiencing a brain drain or not. The issue is the magnitude of the adverse effect of this brain drain on the Canadian economy.

In Ghana, we are way below the threshold for urgent and desperate action to halt the exodus of doctors because the situation is alarming. If paying doctors more than ministers, eliminating the obvious waste in public expenditure, equipping our hospitals, and accordingly reallocating other resources will solve the problem, then we should do it.

In his well-written rejoinder, Louis Anane wrote "Anyone who knows malaria knows that you do not need such highly skilled health professionals--doctors--to deal with them."

This makes sense but we really have to be careful here. You see, once malaria has been diagnosed, it is easy to treat it. But who will perform the diagnosis? A patient may have malaria and other ailments simultaneously or false malaria-like symptoms. Do we want less qualified people to be in the business of diagnosing diseases? In any case, I am no expert here. I have to leave this to the medical doctors and professors.

I fully understand that doctors are not the only professionals in the public sector and that a more holistic solution is required. But at the end of the day, it is all about what we value as a nation. The question before us is ?Do we really value health care and doctors??

Let me end by thanking Kwabena Osei-Dadzie and Louis Anane one more time for their good rejoinders.

*The author, J. Atsu Amegashie, teaches economics at the University of Guelph, Canada.

Views expressed by the author(s) do not necessarily reflect those of GhanaHomePage.