Wednesday, November 14, 2012


On the heels of Congressional leaders announcing that they are considering Comprehensive Immigration Reform that could increase the number of employment-based visas, the National Foundation for American Policy (NFAP) has just released a 27 page detailed Report, "U.S. Government , Heal Thyself : Immigration Restrictions and America’s Growing Healthcare Needs".  The NFAP Report's recommendations include:

1)   Expand the number of employment-based green cards so the wait times for skilled immigrants, including nurses, physicians, and physical/occupational therapists, can be measured in weeks or  months,  rather than in years or decades.

2)   Establish a temporary visa that facilitates the entry of foreign nurses. Current temporary visas do not work for the vast majority of foreign nurses and their potential employers.

3)   To aid patients in under-served areas and enable more U.S.-trained doctors to pursue specialized medical fields expand the Conrad 30 program to include many more physicians per state and in the country as a whole. Also, we should consider policies to overcome the limitations on medical residency slots in the U.S. by developing guidelines to allow foreign-trained doctors to practice in the United States if they can demonstrate  a  high  level  of  expertise.  Congress  logically  should  include  physicians  and  medical researchers  in  biology  and  chemistry  in  the  definition  of  Science  Technology   Engineering   and Mathematics (STEM) for exemption from employment-based green card quotas in future legislation.

4)   Streamline  state  licensing  and  other  procedures  for  foreign  medical  personnel,  including  physical therapists and occupational therapists, to help with the nation’s long-term health needs.

The report makes a compelling argument.  It explains how staffing shortages lead to dire consequences for US patients and how these staffing shortages are not being served by US workers.  These staffing shortages will remain for the foreseeable future, given greater demand for smaller nurse-patient ratios, a paucity of instructors, the graying of the existing workforce, and other institutional factors.

The Report details the present visa options and the failure of these options to satisfy healthcare staffing needs.  The failures of the H-1B, TN, and current green card programs to adequately address these staffing shortages are fully explained in the NFAP Report. (One quibble: the Report lists the H-1C visa as "reauthorized", which it was; it subsequently expired in 2009, thus taking yet another option off of the table.)

The Report is chock full of data and should be required reading for anyone in the industry and ought to be on the desk of any Congressional staff who are looking to establish policy initiatives aimed at a significant gap in the current US immigration policy. 


  1. Great News!

    I am delighted with this blog and I have been contemplating on how the Comprehensive Immigration Reform really works now that Obama has been re-elected. It has come to my realization that illegal immigration has been pinching hopeful legal immigrants like me who are indirectly punished with a decade-long wait.


    Sounds fair, but is it really fair for us who did nothing but obeyed the authorized proceedings on immigration?

    When I graduated nursing and passed the NCLEX, I had this dream that someday I will be able to work, live and serve this great country: an American Dream.Two years after, an employer sponsored me and then BANG!- visa retrogression.


    Ouch! The wait is tormenting me. It feels like paying for a meal that I will be eating probably 10 years after and no food available till then. "I shall return ...", said General McArthur- and he did. Probably I am still holding on to those words. Then here I am.. I could imagine Uncle Sam, sitting next to me and says, "Kid, you wait... and till then.. you wait..." How reassuring :)

  2. Thanks for your thoughts and the kind words on the blog.

  3. Although I hope and pray for an immigration reform, I am glad that the STEM bill is not making much progress in the current form. I feel that the current bill is so narrowly tailored which satisfy only certain interest groups. I am a physical therapist on H1B. I went to school in the US for my MS and I am currently working on my clinical doctorate while working as a fulltime therapist. I am humbled by the opportunity to work with elderly individuals to get them function better. There is a growing need for therapists and the current supply does not meet demand. I get calls from different rehab settings asking me to help them for a few hours to conduct evaluations or treatments. Sadly I need to let them know that it is ‘Illegal’ for me to help their patients as I can work only for one employer. The STEM bill needs to be revised/expanded to accommodate professionals outside STEM fields who are in equal demand. However our voice seems to disappear in thin air as we don’t have multi-billion corporate giants to back us up.

  4. Top Private Hospitals in Pune, potential consumers prohibited themselves in Healthcare Maintenance Organizations (HMOs). The HMO negotiates with providers (hospitals, clinics, pharmacies) to gain dimensions discounts and the greatest charge from beginning to end negotiations.


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