Is a trillion dollars’ worth of programming lying on the ground?
It seems to be missing a very big factor: culture.If your goal is to implement some code for, say, healthcare, it is a lot easier to explain the business process to someone who is already familiar with how stuff is done on a higher level. Whenever you hire someone from a different culture / country, you need to start from the basics by explaining the very core of your society.An American programmer might not be too concerned if a body temperature measurement returns 45 degrees Celcius. Similarly, a patient height of 95in probably wouldn't immediately raise alarm bells for a European developer.Your offshore developer team might be perfectly capable of writing the code once they understand what to write, but getting them to understand it is a hell of a lot more difficult.Add to that the possibility that English is the second language for both sides, and things get messy pretty quickly. Not to mention a time zone difference making communication even harder.