American Nurses Apparently Just Don't Cut It

At least that appears to be what the U.S. Senate thinks. The NY Times notes that "a little-noticed provision in their immigration bill would throw open the gate to nurses and, some fear, drain them from the world's developing countries." Note how the Times, as the beacon of American elitism, does not concern itself with how this influx of foreign nurses might impact American nurses, but rather how this might affect the countries these foreign nurses would leave. But the Times is not above reporting some dubious economics:

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 United States would swell to more than 800,000 by 2020.

You see, American women just don't want to be nurses, and why should they? Your typical American woman is either some hotshot corporate lawyer or a pampered housewife instructing her Mexican gardener on where to plant the petunias. It's not like the old days when a middle class woman appreciated a job where she could work part time or weekends and nights to help with the family finances. Oh sure, there's lots of middle class women, but they're all meth addicts or poorly educated, certainly not up to the standards of Philippine health care workers, who'll just so happen to work for a lot less, too.

Now obviously the way to handle a labor shortage - particularly one being projected 18 years in the future - is to raise wages. That way more people would go to nursing school. Yes, that would raise total health care costs. I think it's unlikely that nurses' salaries are a significant chunk of health care costs. There's no reason to suspect that other industrialized countries have critical nursing shortages, and their health care costs are significantly lower than ours. Whatever is driving our high health care costs, it's unlikely to be nurses. (By the way, I googled like mad and couldn't find any stats.) Interestingly, following the 2002 study quoted above, Congress passed the Nurse Reinvestment Act to address this very issue. I guess the Senate would rather not wait around to see if it works.

But the whole shortage claim seems suspect. The Times tries to explain:

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...One of the most important factors limiting the number of students was a lack of faculty to teach them...Professors of nursing earn less than practicing nurses, damping demand for teaching positions.

So it must be really hard to find people to teach finance, law, or engineering - surely professor salaries don't exceed typical earnings in these fields. If our nursing programs are maxed-out, I can't see how this shortage can be real.

Back to the effect on foreign countries:

Removing the immigration cap, they said, would particularly hit the Philippines, which sends more nurses to the United States than any other country, at least several thousand a year. Health care has deteriorated there in recent years as tens of thousands of nurses have moved abroad. Thousands of ill-paid doctors have even abandoned their profession to become migrant-ready nurses themselves, Filipino researchers say. "The Filipino people will suffer because the U.S. will get all our trained nurses," said George Cordero, president of the Philippine Nurse Association. "But what can we do?"

What can we do, indeed.