The recent discussions about immigration, deportation, and travel bans bring forth many questions. Some people are concerned about themselves or their family members being deported or family members not being allowed to come to the United States. Others are worried that immigrants are taking jobs away from them. However, an area that most don’t think about in relation to immigration is healthcare. What impact does immigration have on healthcare? What would happen if we changed our current laws?
Immigration affects all of us, whether we realize it or not. Most of us would not be in the United States if our ancestors didn’t immigrate. Our country is founded on immigration.
When you look at the plaque on the pedestal of the Statue of Liberty, you can see the role immigration plays as a core value of America. The words, which come from the poem “The New Colossus” by Emma Lazarus, are as follows: “Give me your tired, your poor, your huddled masses yearning to breathe free. The wretched refuse of you teeming shore. Send these, the homeless, tempest-tossed to me, I lift my lamp beside the golden door!”
So, the idea of deporting people who have immigrated here or banning others from coming is absurd. Besides these policies being against everything that America stands for, the impact these will have is far-reaching and will cause significant issues in the economy and the ability of many industries to function.
To understand the influence immigration has in the United States, we must look at it more in-depth. As of 2016, our population was 323.1 million people, with 43.7 million people being immigrants, which comes out to about 13% of the population. Of the number of immigrants, about 11 million are undocumented, and 80% of these are in the workforce.
It’s thought that about 7.2 million immigrant adults have college degrees, and about 23% of these people are either un- or under-employed in low-wage jobs. There are several reasons for this. The most common are the standards of practice from these individuals’ home countries vary from those here in the United States. So, unless these individuals redo all of their training in US-based schools or find some way to meet the difference in standards, they are unable to use their college degrees, forcing them to find some other kind of work.
Most jobs that immigrants pursue require minimal education/training because they’re trying to find a way to support themselves or their families and don’t have the financial means to get the training they need, even if they have a college degree from their home country.
Why are these jobs available? Americans don’t want them because they offer low wages and usually no health insurance coverage.
What influence does this have on healthcare?
One example is home health caregivers. In 2010, there were about 3.4 million home healthcare workers in the United States, and the number is expected to rise to 4.3 million. The increase is because of the aging Baby Boomer population. In May 2014, the US Census Bureau estimated that the population of people 65 and older was around 55 million and is projected to increase by 27% to 76 million by 2050.
Also, in 2014, the American Association of Retired Persons stated that an American turns 65 every 8 seconds, meaning our need for home healthcare workers is only going to increase. Immigrants make up 28% of the home healthcare workforce, and it’s estimated up to 20% of these, mainly women, are undocumented. It’s hard to get an accurate number since some people set up arrangements with individuals rather than using a home health company.
Home health isn’t the only area of healthcare that will be affected. The American Medical Association approximates that the United States will be short 90,000 physicians by 2025. The number will only increase if foreign-born and trained physicians are prohibited from entering our country. International Medical Graduates (IMGs) comprise about 27% of our physician workforce.
Special visas are currently in place to allow a physician trained in another country to come here and complete their residencies. Once they are finished with their residencies, a different visa enables them to remain in our country for some time as long as they are willing to serve in areas where there are shortages of physicians, such as rural or inner-city areas. These shortages directly result from US-born and trained physicians not wanting to practice in those areas.
Another component is that US-born and trained physicians don’t pursue certain types of residencies, like internal medicine, pediatrics, or family medicine, leaving many vacancies with no doctors to fill them. Foreign-born and trained physicians are much more likely to undertake residencies in these disciplines, which helps decrease the shortages considerably.
The same holds for the nursing profession. It was estimated that the United States needed 1 million new and replacement nurses by 2022. About 15% of registered nurses are foreign-born and trained and often work in hospital settings.
Immigrants fill much-needed healthcare jobs, which will only increase as the American population ages. Instead of turning people away, we need to do a better job convincing people to come and fulfill our ever-growing need for individuals in the healthcare setting.
In addition to the healthcare field, immigration notably affects healthcare use in the United States.
American citizens are not the only ones who are aging. It’s estimated that 10% of undocumented immigrants are over 55. Since they don’t have health insurance and are ineligible for Medicaid or Medicare, this presents a unique challenge that needs to be addressed. Due to their lack of insurance and the expense of healthcare, they forgo preventive care and only seek treatment when a chronic condition becomes out of control. This results in them receiving treatment from the hospital, where it’s much more expensive to fix a problem than prevent/maintain a condition.
These individuals can’t pay their medical bills because they don’t have insurance and low wages, resulting in their bills going unpaid. Since hospitals need to recoup their losses, this expense gets passed on to those of us who have insurance by hospitals raising their prices for services, which in turn causes insurance companies to raise the prices we pay.
Immigrants are a vital part of our workforce. Not having them here would cause huge economic impacts in various sectors. So, we should find a way to help them become American citizens, increase their wages (so they can afford to pay for preventive medical care), and provide health benefits to defray the cost evenly among everyone.
For individuals with college degrees, we need to help them work in their selected professional capacity by standardizing practice throughout our country and across the globe, with a special focus on the areas where the majority of these individuals come from. The federal government needs to create a way for legally residing immigrants who are internationally trained health professionals but are currently not working in healthcare a way to transition back into healthcare so we can meet the growing demand for healthcare professionals.
We need to legalize undocumented immigrants who are home healthcare workers that are currently residing in the United States and meet the criteria for citizenship. To increase the number of home healthcare workers, we should create a special temporary visa for individuals coming here to fulfill this growing need. It should also consider allowing the temporary visa to become permanent after a specified time period and specific criteria are met. These same measures should be in place to encourage individuals who are currently, or interested in becoming, physicians or nurses to help with shortages in these areas.
By helping immigrants, legal and undocumented, become citizens, we can have a better future as a country. Having more health professionals is vital to treating our aging population. Increasing the number of immigrants who become citizens and, therefore, have access to better-paying jobs and health insurance will help to lead to this.
Rather than blocking people from entering or deporting people who already are in our country, we should be looking towards the future and finding the best way to address immigration through better policies that will lead to more people already contributing to the country being accepted as citizens.