Posted on 05/30/2006 6:42:24 PM PDT by neverdem
It's become a stock image in the immigration debates: the flooded emergency room, halls packed with sick illegals seeking subsidized care. But now that image's negative is at the heart of a far smaller battle—not over the immigrants awaiting care in the E.R., but the immigrants providing it.
The immigration bill passed by the Senate last week includes a provision that would allow unlimited entry to foreign-trained nurses until 2014, and as a committee attempts to reconcile that bill with the less permissive House version, an open door policy for foreign nurses has a shot at becoming law. A free flow of RNs may seem like sound policy for a country in the midst of a severe nursing shortage, but opponents claim it's parasitic, emblematic of a ruinous American practice of stealing skilled labor from poor countries that can ill afford to export their most educated workers. The Philippines, in particular, seems to be hemorrhaging nurses, while the U.S. soaks up thousands of Filipino-trained RNs annually. Last week, a New York Times article, headlined "U.S. Plan to Lure Nurses May Hurt Poor Nations," implied that the Philippines' health system risks collapse if the U.S. keeps it up. Talking Points Memo Blogger Nathan Newman excoriated supporters of the Senate provision, complaining that " The U.S. refuses to invest in training and education of our own population, then instead leeches off the tiny investments in education done by developing countries."
The vision of American hospital administrators prowling the streets of Manila poaching nurses from Filipino hospitals presupposes that the number of Filipino RNs is fixed, completely independent of U.S. demand. But that hasn't been true for at least half a century. According to Catherine Ceniza Choy's 2003 book Empire of Care, Americans began training Filipino nurses in 1907, and the first wave of Filipino-trained nurses arrived in the United States between 1956 and 1969 as part of an Exchange Visitor Program. The Philippines has since become the world's largest exporter of trained nurses according to the World Health Organization. Filipino nurses trained in Americanized schools in English have been showing up in the U.S. for decades and in droves, and a nursing education has long been seen as a ticket out.
The government of the Philippines clearly thinks it gains something when America "leeches" off its investment. The government has consistently lobbied for more, not fewer, nursing visas in the United States and United Kingdom, with an eye on the massive remittances nurses send back to families still at home. The Philippines is heavily dependent on money sent from abroad; the government is famous for encouraging its citizens to leave, and eight percent of its population resides abroad as domestic workers in Malaysia, English teachers in China, and nurses all over the developed world. According to the Philippines Central Bank, large scale labor migration brought home remittances totaling $9.7 billion last year, and nurses have historically been among the most stable earners.
If the United States agreed to take in fewer nurses, would Filipino hospitals suddenly be flush with staff? Not likely. According to a 2005 report by the International Council of Nurses, new Filipino graduates "report that they can't find jobs in nursing." It's true that the Philippines suffers from a nursing shortage, but it doesn't suffer from a lack of trained nurses. Its hospitals are simply too poor to employ adequate numbers of them. That's a tragedy, but it won't be solved by slamming the gates at the U.S. border. Underfunded health care programs are a symptom of poverty, not of poaching. If the United States were to turn away nurses seeking placement, they would simply fill vacancies in every other developed country—the current nurse dearth is a global phenomenon affecting every region on Earth. U.S. demand has created supply in the Philippines: The medical professionals leaving now—at least some of whom will eventually return—would have been far less likely to invest years in study and training without the prospect of high pay abroad.
The Philippines won't suffer for the opportunities America offers its citizens. But it's not for well-meaning Westerners to decide where a health care worker would be "better off" anyway. Workers are not the property of countries that train them, and any policy that seeks to limit their options will prove cruelly restrictive. After all, stemming the flow of skilled labor doesn't just mean locking workers out of wealthy nations. It means locking them into poor ones.
Kerry Howley is an assistant editor of Reason.
Only if they are HOT nurses. (did I just type that out loud?)
Most Philipinas are.
Only the senators like Mexicans more than Philipinos who speak english and were actually a colony of the US until WWII.
I would prefer immigrants from Philipines, India, or Jamaica, Bahamas, British West Indies to those who are proximal to our southern border. They can think read and blend into the melting pot easily as they speak english; some better than native US Citizens.
Capitalism works when we let it... that's why everyone else (Dems included) hate us.
Good. My daughter had to ask an assistant to remain in the room with her Pakistani dentist last week. She couldn't understand a word he said.
Nurses eat their own and the hours suck too. If someone can handle the hours, the abuse from fellow coworkers,etc. then great. The profession has great money but the people in it can be very intimidating. Plus don't ever make the mistake of saying, " Yes I want a nursing job because one day I really want to be a doctor!"(((shudder))).
Sure they will have an accent. Why are you going to a Paki dentist? You pay the bills - go to one you can understand.
Jamaicans I met speak the Queens english.
Philipinos have an accent, too, but you can understand them.
The Indians I have been exposed to, I could clearly understand.
In the long run, this guts the domestic nurse workforce. Good candidates who might consider nursing as a career will look elsewhere due to the relatively lower ware. The way to INCREASE the supply of nurses is to raise the wage, not allow others to come in and dampen salary.
He just happens to be part of the dental group and was working emergencies. She had a scheduled appt. for 2 days later, but the tooth abcessed on her.
It occurs to me that we wouldn't need their (poor countries') nurses if they'd only stop sending us their unskilled, uneducated poor.
Just what we need, higher health care costs.
Personally I think many American women and gay men are just too lazy to complete the studies to become nurses. I'm all for importing hard-working legal immigrants.
You dont generally get uneducated relatives from the Phillipines; They abide by the rules. There are Philipinos waiting on the list to immigrate; some since 1983.
The Philipino nurses I know; the majority are involved in long term care and nursing homes.
My wife is Philipina. Met her when I was stationed at Clark.
Philipinos use old US school textbooks. English is the only unifying language for the country, each island has it's own dialect; there are 20K islands and about 2500 dialects.
Yes. We've been doing that for nearly a hundred years. And the reason is simply that the hospitals don't want to (or can't) pay a market wage for these workers because of the high overhead caused by doctors' salaries, and because of the power that the physicians weild.
Lets rephrase this idea from yesteryear's to present. The hospitals can't afford to pay nurses more b/c of all the insurance premiums it pays for possible malpractice claims. While drs still make a decent living it's NOT what it used to be and most would be better going into something else(ie pediatricians and internists). The insurance companies have lowered drs. wages/reimbursements while at the same time continuing to raise premiums on individual policy holders. The individuals blame drs. for rising cost and the insurance companies laugh all the way to the bank. It's a brilliant scam.
Want to know how to say "screw you" in Tagalog?
"Thank you very much doctor".....
I don't think wages are the issue. I have a sister-in-law, and a sister has a step-son who are trained nurses. They both left the profession because of working conditions, not because of wages. Both earn less now than they could as nurses, but working conditions drove them away.
And, BTW, in both cases the problem was gov't legislation, not problems with the hospitals or doctors.
Money in nursing has not gone up much at all in the last ten years, just like in other professions. Don't let those sucker ads with big promises fool you.
The money isn't better, the hours are worse, the responsibility greater and the liability is nutz.
Like every other business, healthcare values cheap labor, not great experienced workers.
There are millions of educated nurses in the US. If they were paid what the job should be paid, they would come and they would stay.
"Hello-o-o-o-o Nurse!"
I knew something was wrong when nurses were telling me don't get into nursing and everything else.
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