RxPG - Health Worker Shortages And The Potential Of Immigration Policy

Offivcial report by Rob Paral for the Immigration Policy Center

Foreign-born and foreign-trained professionals play an important role in the delivery of health care in the United States. This report examines the important role of immigrant doctors and nurses – many of whom have received their training abroad – in the U.S. health industry, using new Census Bureau data as well as information from numerous interviews with health industry experts. The findings of the report include:

1.1 million immigrants account for 13 percent of health care providers in the United States.

The foreign born account for 25.2 percent of all physicians; 17 percent of nursing, psychiatric and home health aides, 15.8 percent of clinical laboratory technicians; 14.8 percent of pharmacists; and 11.5 percent of registered nurses.

During the 1990s, immigrant employment grew by 114 percent in home health care, 72 percent in nursing care facilities, and 32 percent in hospitals.
35 million Americans live in areas with too few doctors to adequately serve their medical needs.

Overall, the lack of doctors affects more than 1,600 geographic areas in the United States.

Nearly 16,000 doctors would be needed to alleviate this shortage.

Foreign-born professionals play a crucial role in filling severe shortages within the two largest health care occupations: physicians and nurses.

The most significant federal program sponsoring foreign-trained doctors to work in underserved areas – managed by the U.S. Department of Agriculture – was abandoned in February 2002.

The program established in its place - managed by the U.S. Department of Health and Human Services - has sponsored few doctors and has become increasingly restrictive.

In 2001, about 1,050 immigrant doctors with temporary J-1 exchange visitor visas were permitted to stay in the United States in exchange for their commitment to treat patients exclusively in underserved areas.

Despite a national shortage of 126,000 nurses, federal policies designed to permit entry of foreign-trained nurses have become increasingly restrictionist since the mid 1990s.

In 1990, most nurses were made ineligible for H-1B temporary worker visas, even while an exemption was made for fashion models. In 1995, the federal government ended the H-1A program under which employers had sponsored 6,512 foreign-trained nurses as temporary workers since 1989.

Credential evaluation, tests of English and nursing skills, and other requirements result in waits of up to one year for nurses who have a U.S. employer willing to sponsor them for legal residence. The long wait makes it difficult for hospitals and other health providers to efficiently fill staffing shortages.
Largely as a result of more stringent requirements, the average number of nurses granted legal residence in the United States each year fell to about 4,800 in the late 1990s, compared to nearly 8,600 at the beginning of the decade.