Healthcare needs immigrants

QUICK READ: More than 3 million immigrants work in the U.S. health care system, accounting for about 1 in 4 people in that field. These range from doctors and nurses to home health care workers to employees at long-term care facilities, researchers said. Attempts to limit immigration will serve to further deplete a system that’s already struggling to find enough workers to care for the aging and infirm

2017 immigrants accounted for 18.2 percent of health care workers and 23.5 percent of formal and nonformal long-term care sector workers. More than one-quarter (27.5 percent) of direct care workers and 30.3 percent of nursing home housekeeping and maintenance workers were immigrants. Although legal noncitizen immigrants accounted for 5.2 percent of the US population, they made up 9.0 percent of direct care workers.

Naturalized citizens, 6.8 percent of the US population, accounted for 13.9 percent of direct care workers. In light of the current and projected shortage of health care and direct care workers, our finding that immigrants fill a disproportionate share of such jobs suggests that policies curtailing immigration will likely compromise the availability of care for elderly and disabled Americans.

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What drives the labor shortage is long-term demographic change. Older people are living longer, most developing chronic diseases and disabilities; the sheer numbers of baby boomers further increases the demand for assistance.

It’s physically demanding work that pays poorly — the median wage for home care workers was $10.49 an hour in 2016, P.H.I. reports — and usually doesn’t include benefits. The aides, mostly women, who serve in this crucial but low-income role frequently qualify for federal programs like food stamps or Medicaid.

Overall employment of in-home aides is projected to grow 41 percent from 2016 to 2026 — translating to 7.8 million job openings. Who is going to fill these positions? It’s a job that has little rewards and that can often lead to depression.

The U.S. spent an estimated $103 billion on home health carelast year, a number predicted to reach at least $173 billion by 2026, according to the Centers for Medicare & Medicaid Services, which put total health expenditures in 2018 at about $3.67 trillion. CMS, veterans programs and private health insurance cover a portion of in-home care, although the estimated value of unpaid care provided by family caregivers added an astounding $470 billion to the mix, according to a 2016 report by AARP — not to mention the drain on family budgets and seniors’ nest eggs.

If we limit immigration it’s our seniors who are going to suffer. Are we willing to let this happen?