The healthcare sector’s heavy reliance on immigrants underscores the urgent need for comprehensive immigration reform, argues labor economist Ron Hetrick.
Speaking during a LeadingAge member policy update call on Monday, Hetrick emphasized that while immigration remains a contentious issue, fixing the broken system is imperative to alleviate the growing workforce crisis.
In the past, the country saw immigrants as competition for jobs, he said. Today, Hetrick added, there aren’t enough people to fill jobs in the service industry, making the nation more dependent on immigrants than ever. And that reliance will dramatically increase in the next five to eight years, he said.
Last year, Hetrick said, the nation added 3.3 million immigrants — between 1.8 million and 2.5 million of those immigrants entered the workforce. In healthcare, he said, one in four nurses, one in five healthcare aides, and one in four doctors are foreign born.
Unclogging the pipeline
Although immigration is a subject that “gets a lot of people fired up,” Hetrick said, what people need to understand is how antiquated the system is — the average immigration judge has a backlog of 4,500 cases, and immigrants who applied for a visa five to 10 years ago are just now being processed for visas. Building a wall and funneling immigrants through a single point of entry means there will be 3.4 million people waiting at that door, he said.
In the past year and a half, no sector has become more critically dependent on immigration than the healthcare sector, Hetrick said. The country needs to unclog the immigration pipeline and remove the backlog for those looking to enter the country legally and become part of the workforce, he added.
Pointing to the growing home healthcare workforce, Hetrick said that some states depend more on immigrant labor than others. Failure to address immigration bottlenecks risks exacerbating workforce shortages, with states reliant on immigrant labor facing the prospect of poaching workers form other regions, he said.
“It’s everybody’s problem,” Hetrick said, adding that staffing shortages will likely worsen in the next five to seven years as most baby boomers retire and the birth rate falls off a cliff, leaving fewer working-age individuals available.
No single solution to workforce problems
But the nation’s reliance on immigration also is a concern, Hetrick said, adding that the “faucet won’t run forever” as other countries also are experiencing falling birth rates and will be looking to keep their people to fill their own job openings.
“My concern for the US is we’re starting to see immigration as a path out for a lot of things, which is keeping some industries from doing things to prepare now for the future,” Hetrick said.
Another issue Hetrick sees is a “quit problem” that is plaguing some states more than others. Across the 2 million healthcare job openings, half were created due to people quitting, he said.
“It’s a tremendous concern,” Hetrick said, adding that employers with overworked and stressed employees are constantly creating negative experiences and driving people away from the field. “Take pressure off people so they stop quitting,” he said.
Problems aside, Hetrick said that he is optimistic about the future of the healthcare labor market.
“I believe that pain forces change, and once we get through those things it gets better,” he said. “I believe a lot of healthcare will be pushed to the home over the next five to 10 years — we will see that explode.”
