We will get immigration reform — the kind that allows far more immigrants into our country — whether it is politically popular or not. Politicians are no match for the kind of raw, pro-immigration economic forces that lie ahead.
For the past two decades, immigrants flooded into this country to do jobs that Americans no longer wanted. They installed shingles, harvested food and cleaned motel rooms. We needed them, but liked to pretend that we did not. Their work didn’t seem important, even though it was.
As baby boomers age and retire, the work of immigrants will become increasingly important. Nothing illustrates this more clearly than the shortage of primary care physicians.
American medical schools cannot produce the number of physicians needed to care for retiring boomers, let alone the 32 million additional Americans who will be entitled to consume medical care when Obamacare takes hold in 2014. Additionally, a large percentage of physicians plan to retire soon.
The United States already depends on immigration for one quarter of its entry-level residency physicians, and the only answer to resolving the looming shortage involves more immigrant physicians.
“All the old people will need access to medical care,” said Rajkrishna Iyer, a Los Angeles-based attorney who specializes in helping physicians immigrate to the United States.
Iyer said a lot of well-trained foreign physicians — men and women who meet or exceed medical licensing standards in most states — are eager to practice in the United States. Just like agricultural workers and software engineers, they are held back by a lack of visas and an abundance of immigration bureaucracy. The first step toward immigration, which is labor certification by the federal government, can take up to two years. By declaring a physician shortage, the federal government could do away with the need for labor certification. Iyer said immigrant physicians, particularly those from India and China, can spend eight to 10 years waiting on immigration bureaucracy and visa availability in order to enter our country to work.
Meanwhile, more Americans are finding themselves on waiting lists to see primary care physicians.
“As foreign physicians wait to come here, other opportunities arise for them,” Iyer said. “Physicians would like to come here. It is a great country. It is just that the uncertainty of whether one can stay here or not causes all sorts of anxiety.”
The United States isn’t alone in this dilemma. Throughout the industrialized West, countries with aging populations and inadequate fertility rates are facing physician shortages. The United Kingdom cracked down on immigration in 2006 and began reversing course in 2010 when it became clear that exclusionary immigration policies were aggravating the physician shortage.
The United States has, since its founding, prospered and progressed by welcoming the best and brightest from all over the globe. If we need more physicians quickly, the solution is simple. Import them. End of problem.