In the 1800s, a "managerial hierarchy" developed in corporations in which professional managers (i.e., "white collar" workers) added value by being transmitters of information. This was at a time when large numbers of workers were either illiterate or uneducated, and needed to have critical information about the production processes digested, then parceled out to them depending on their task.
MANAGERS WERE CONDUITS OF INFORMATION. That was their primary job in "management."
But with the advent of computers, and with a super-highly educated workforce (i.e., virtually everyone with a high school degree and 25% of the workforce college educated), these managers no longer added value when a "line" employee could obtain critical information by going on his company's computer and getting it himself, usually hours or days before he got a response from his boss.
Most companies could not explain this phenomenon. They knew it was occuring, and they knew managers were no longer "profitable," but could not specifically say why. In the 1990s, we saw the first big wave of these managerial layoffs. There will be more, because managers (not all, but many) HAVE BECOME BOTTLENECKS TO INFORMATION TRANSMISSION WITHIN A CORPORATION.
Now, as for the Indian x-ray readers, there is likely some of that going on, but I can tell you that the trend is the other direction---hiring lower cost DOMESTIC workers (i.e., "nurse practitioners" and "lab techs") to do in-house work in doctors' offices instead of adding expensive doctors. These are good paying jobs that don't carry the risk of malpractice nor the burden of years' of medical college debt.
When did they ever add expensive doctors to do lab work?
This is a very interesting perspective.
I would add that the US college and university system is geared to turning out graduates that fit into the previous managerial role. This was done through a liberal arts and business adminstration type of education.
By contrast, the Indian and especially Chinese systems turn out a very high percentage of science and engineering degrees, and thus have a workforce with educations that address the new skills required today.