The U.S. Government’s decision to raise the fee to $100,000 for H-1B visas will impact healthcare for American citizens in several ways.
H-1B visas are a type of visa that many foreign born physicians-in-training use to practice in the U.S. Previously, these visas cost $5000 and were generally covered by the hospital in which the physician would work. This was a known expense that was usually paid for in the operating budget of the facility or university that managed the residency programs.
Residency training programs are partially funded by the federal government to cover physician salaries (which are SIGNIFICANTLY lower than that of a fully trained physician, physician assistant or nurse practitioner) as well as their malpractice and health insurances. While these physicians-in-training do generate income for the facilities, this revenue along with the subsidies are approximately a break-even. Most hospital systems cannot afford to the raised cost of $100,000 in expenses to each of these positions which have traditionally been staffed by H-1B visa holders.
While it may be possible to find U.S. graduate physicians-in-training to fill these positions, these spots that the H-1B visa holders occupy are often “leftover positions” that those U.S. graduates do not take. These available, often primary care, spots are often found in physician shortage areas – both rural and urban. The alternative may then be to staff the position with a non-physician or leave the position vacant. Put simply, the immediate impact is that there will be fewer doctors working in primary care in places that need it the most. Also, Emergency Rooms may have longer waits.
The secondary impact with come in 3-5 years when those H-1B visa holders who would have previously completed training and stayed in the US to work, won’t be here because they opted to train in a country with a lower H-1B visa cost – such as Canada or the United Kingdom. After residency training, H-1B visa holders generally have a requirement to practice in shortage area for a specific duration (usually 3 years) Many of these highly qualified doctors end up staying and working in the U.S. for their entire careers.
Many of my current colleagues in our community have obtained U.S. medical licenses through the H-1B visa programs. It is highly likely that you have received care at some point from someone who used an H-1B visa. The next time you may need a qualified doctor, they may not be there and your health may suffer. In short, the government’s decision to raise the cost of obtaining a H-1B will be detrimental to America’s healthcare system.
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DR JOSHUA USEN 