Members of Congress petitioned then-Homeland Security Secretary Kristi Noem to exempt the health care industry from the $100,000 fee on H-1B applications for immigrant medical professionals. The motivation for this action is the looming shortage of medical professionals, especially in rural areas. An aging population will worsen this shortage. Immigrant doctors and nurses will help lessen the problem. 

Like much of the developed world, the United States is an aging society.  In 2020, there were 54 million Americans 65 years or older.  This represented 16.3 percent of the population.  By 2040, the Census Bureau projects the number of older Americans will rise by 26 million to 80 million individuals, and represent more than 20 percent of the population.

This increase is driven by higher life expectancy. In 1960, life expectancy for men at age 62 was 15 years. By 2040, life expectancy will reach 22 years. These figures are higher for women. It will rise from 20 years in 1960 to 24 years in 2040.

This is good news. However, it will put more pressure on the health care system.  Older individuals tend to use the health care system more than young and middle-age people. Treatments for heart disease, diabetes and cancer are common. Older individuals are more likely to require knee and hip replacements. Progress in medicine now allows doctors to manage these health problems. However, it does increase the demand for medical services.

An aging society will also limit the supply of health care services. Thirty-one percent of doctors were 65 or older in 2022.  Forty-six percent were between 55 and 64 years old. These healthcare workers will be retiring or working fewer hours over the next 10 years.

The National Center for Health Workforce Analysis provides projections on the supply and demand for doctors. They project large shortages of doctors during the coming decade. In 2028, the demand for full-time doctors will exceed supply by 113,380. The shortage grows to 141,160 full-time doctors in 2038. Only two specialties, Critical Care-Pulmonology and Neurology, will have adequate staffing in 2038. Registered nurses and licensed practical nurses who handle basic care will be in short supply in 2038.  Other nurse specialties are projected to have an adequate supply.

The country needs to expand its capacity to provide health care services. We need to train more doctors and nurses. From 2019 to 2024, total enrollment in medical schools rose 5.7 percent. Enrollment for the 2023-2024 period was 97,903 students. 

If we assume all these medical school students graduate and begin practicing medicine, a strong assumption, we still will have a shortage. Higher salaries generated by the shortage should increase enrollment in medical schools.  However, tight government budgets will limit salary increases.

The other option is to allow more foreign-trained doctors and nurses to practice in the United States. Immigrants already make up more than a quarter of doctors and surgeons. They represent 16 percent of registered nurses. These numbers are even larger in some states.  

Foreign-trained health care professionals usually enter the United States under the H-1B visa program. For the fiscal years 2022 to 2025, foreign healthcare professionals entering the country under the H-1B visa program rose 8 percent, from 18,000 to 19,000. It would make sense to expand this program, especially since these health care professionals often work in underserved rural areas.

The $100,000 fee for hospitals applying for workers under the H-1B visa program reduces the number of doctors and nurses entering the country through this program. Many rural hospitals do not have the funds to bring these needed workers into the country. At a time when the country needs more doctors and nurses, this policy limits the growth of healthcare workers in the United States.

The members of Congress who are urging Noem to exempt the healthcare industry from this fee are correct. The immigration of foreign medical professionals into the United States helps address the country’s shortage. We should act fast because other developed countries face similar problems.  Waiting will only worsen our healthcare shortage.

Robert Krol is an emeritus professor of economics at California State University, Northridge. He is the author of “Effects of Immigration on Entrepreneurship and Innovation,” in the Cato Journal. He wrote this for InsideSources.com.