Janice Staheli earns more than $20 an hour. She works from home. And her employer, UW Medical Center, offers health insurance, vacation, a pension, even incentive pay.

There’s only one hitch. As a medical transcriptionist who turns doctors’ dictation into patient records, her work is highly mobile.

So it’s hardly surprising that Staheli, 58, and dozens of her colleagues fear losing their jobs to cheaper workers around the country and overseas.

Factory jobs have moved overseas for decades. The process is so well documented it even has a wonky name — deindustrialization. Economists say this transfer cuts costs and enlarges the economic pie for everyone. In this virtuous circle, new workers elsewhere earn money, get better educations and join the global economy, eventually buying U.S. products.

Theories questioned The downside to globalization for U.S. economy

But as such “offshoring” spreads across the white-collar world of hospital workers, engineers, architects, lawyers — even economists — those old theories are being questioned anew in ways that are sometimes tough to answer.

• How valid is the comforting clich้ that globalization must be good for the U.S. economy because a rising tide lifts all boats?

• How many jobs are really being outsourced overseas?

• Does focusing on the simple tally of jobs lost and gained obscure important elements of the bigger economic picture?

Paul Samuelson, the 89-year-old winner of the Nobel Memorial Prize in Economic Sciences and architect of much of modern trade theory, recently raised eyebrows by arguing that the U.S. can lose in trade, especially where offshoring is involved. In Samuelson’s analysis, the U.S. loses when research and inventions it developed move overseas, taking jobs with them. While this is no excuse for protectionist measures that stifle trade, it is something trade advocates must address.

The growth of such foreign-based manufacturers as Toyota and Honda “certainly adds to world output and certainly adds to real income in Japan,” he said in an interview. “But it reduces our [U.S.] share of real output.”

In other words, moving industries offshore, while often good for the owners of companies, shrinks the U.S. slice of the total world economy.

Moreover, Samuelson says that a shift in U.S. tax and social policies in the past 20 years has worsened the effect by steering less of the economy’s trade gains to the people losing jobs than was the case under New Deal policies of the 1930s and ’40s.

“I don’t think that the gains of the gainers pour off in the market system to assuage the losses of the losers,” Samuelson said.

Others have a more droll critique of this “rising tide” theory. “Globalization creates a more buoyant economy and floats all yachts,” said Marcus Courtney, president of Washtech, a national labor association of high-tech workers based in Seattle. “It’s about floating the richest and most powerful boats.”

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