| The opening of American floodgates for
Filipino nurses will put under further strain the health
system in the Philippines, according to health experts
alarmed by the immigration bill of the U.S. Senate that
carries a little-noticed provision that will lure more
nurses from poor nations.
If passed, the Senate provision will remove the limit on
the number of nurses who can immigrate to the U.S.
Sen. Sam Brownback (R-KS), who sponsored the proposal,
said it was needed to help the U.S. cope with a growing
nursing shortage, according to a New York Times report.
Brownback said he acknowledged that it could have an
impact on the Philippines and India, which are already
sending thousands of nurses to the United States a year, but
said he doubted the measure would greatly increase the small
number of African nurses coming to the U.S.
The Senate provision, which would remain in force until
2014, has not stirred serious opposition in Congress.
But since the provision is not part of the House
immigration bill, a committee from both houses would have to
decide whether to include the provision on nurses if the
full Congress approves the legislation.
The exodus of nurses from the Philippines, India and
Africa has strained health systems in the developing world,
which are already facing severe shortages of their own.
In fact, many African countries have begun to demand
compensation for the training and loss of nurses and doctors
who move away.
The New York Times said public health experts,
particularly in the Philippines — which sends more nurses to
the U.S. than any other country in the world — reacted with
dismay and outrage at the proposed removal of the
immigration cap for nurses.
They said health care has deteriorated there in recent
years as tens of thousands of Filipino RNs have moved abroad
for greener pastures.
Thousands of ill-paid doctors also have abandoned their
profession to become migrant-ready nurses themselves,
Filipino researchers told The New York Times.
“The Filipino people will suffer because the U.S. will
get all our trained nurses,” lamented George Cordero,
president of the Philippine Nurses Association. “But what
can we do?”
The nurse proposal has strong backing from the American
Hospital Association, which reported in April that American
hospitals had 118,000 vacancies for registered nurses.
The federal government predicted in 2002 that the
accelerating shortfall of nurses in the U.S. would swell to
more than 800,000 by 2020.
“There is no reason to cap the number of nurses coming in
when there’s a nationwide shortage, because you need people
immediately,” said Bruce Morrison, a lobbyist for the
hospital association and a former Democratic congressman.
The American Nurses Association, a professional trade
association that represents 155,000 registered nurses,
opposes the measure.
The group said it was concerned the provision would lead
to a flood of nurse immigrants and would damage both the
domestic work force and the home countries of the
immigrants.
“We’re disappointed that Congress, instead of providing
appropriations for domestic nursing programs, is outsourcing
the education of nurses,” said Erin McKeon, the group’s
associate director of government affairs.
Holly Burkhalter of Physicians for Human Rights, an
advocacy group, said the proposal could undermine America’s’
multi-billion-dollar effort to combat AIDS and malaria by
potentially worsening the shortage of health workers in poor
countries. “We’re pouring water in a bucket with a hole in
it, and we drilled the hole,” she said.
There are now many more Americans seeking to be nurses
than places to educate them.
In 2005, American nursing schools rejected almost 150,000
applications from qualified people, according to the
National League for Nursing, a nonprofit group that counts
more than 1,100 nursing schools among its members.
One of the most important factors limiting the number of
students was a lack of faculty to teach them, nursing
organizations say. Professors of nursing earn less than
practicing nurses, damping demand for teaching positions.
Under the current immigration system, experts estimate
that 12,000 to 14,000 nurses have immigrated to the U.S.
annually on employment visas that entitle them to bring
their immediate family members and obtain green cards. They
must pass English and U.S. nursing exams to qualify for
visas.
In recent years, there had been enough visas for foreign
nurses from most countries, but a bottleneck developed in
2005, after immigration authorities made a big push to clear
a backlog of employment visa applications.
That year, Congress set aside 50,000 additional visas for
nurses and their families. But those visas will likely have
all been used up by early next year, State Department
officials said.
It is difficult to forecast exactly how removing the
limit on nurse immigration would affect the number of nurses
who moved to the U.S.
Based on past trends, Morrison, the lobbyist who
represents the hospital association, said he thought the
numbers would grow 5 to 10 percent a year over recent
levels.
Recruiters would focus on countries with large numbers of
well-trained nurses, mainly the Philippines, India and
China.
“But it’s certainly true that the longer the United
States puts off investing in training nurses, the more
pressure there will be to find nurses abroad,” he said.
Brownback said that while the Philippines could see an
increase in nurse immigration, such flows could also bring
benefits not just in the money they sent home but in the
nurses’ voluntary efforts to improve health care in their
home countries.
The flight of nurses from the Philippines, a former
American colony, has provided a huge boost to a weak
economy, through remittances.
Some government agencies there have encouraged the export
of nurses, who send home billions of dollars each year to
their families.
A nurse in the Philippines would earn a starting salary
of less than $2,000 a year compared with at least $36,000 a
year in the United States, said Dr. Jaime Galvez Tan, a
medical professor at the University of the Philippines who
led the country’s National Institutes of Health.
Galvez Tan, a former secretary of the Health Department,
said the exodus of nurses had a corrosive effect on health
care.
Most Filipinos died without medical attention in 2003,
just as they had three decades earlier. And the percentage
of women who gave birth with a doctor, nurse or midwife
attending has declined in recent years, he said.
Based on surveys, Galvez Tan estimates that 80 percent of
the country’s government doctors have become nurses or are
enrolled in nursing programs, hoping for an American green
card.
“I plead for justice,” he told The New York Times in a
telephone interview. “There has to be give and take, not
just take, take, take by the United States.” |