Outsourcing SWE work to India and Eastern Europe is already very, very common. I don't know if that has had an impact on the availability of doctors, but in Poland, Ukraine or Belarus you'll find most of the IT workers work in outsourcing. The solution for the tax issue is to either have a subsidiary in the low-cost country or buy the outsourcing as a service from a company that's specialized in this arrangement.

I'm in Europe so this is my point of view for the outsourcing recipient countries. I suppose US companies might outsource to Latin America for better time zone overlap.