Eduardo Porter used his NYT column to discuss how Mexico could put pressure on Donald Trump in a renegotiation of NAFTA. After discussing different pressure points he then turns to the ways in which the deal could be modernized. High on the list was fully opening long-distance trucking, which would put truckers in the United States even more directly into competition with much lower paid Mexican truck drivers. (NAFTA already allows Mexican truck drivers to carry many loads into the United States.)

It is interesting that Porter has no interest in removing the protectionist barriers that help our most highly paid professionals. Under current law, even well established Mexican doctors would get arrested if they practiced in the United States. To be eligible to practice they must complete a U.S. residency program.

If we had free traders involved in this negotiation process, surely they would be able to design an evaluation system that would ensure Mexican doctors met U.S. standards, and then could be allowed to practice in the United States. In the same vein, Mexican dentists are also prohibited from practicing in the United States unless they graduate from a U.S. dental school. (Recently, graduates of Canadian schools have also been allowed.)

Doctors in the United States are paid on average more than $250,000 a year, roughly twice the average in other wealthy countries. Dentists are paid on average $200,000 a year, also twice the average in wealthy countries like Germany and Canada. This protectionism costs patients in the United States more $100 billion a year in higher health care costs (more than $700 per family, per year).

It is striking that the debate over NAFTA is so dominated by protectionists that measures that would reduce the barriers that privilege our most highly paid workers are never even discussed. It should not be surprising that truck drivers and manufacturing workers who do have to face competition would not be happy about trade deals.