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Greg Siskind on Immigration Law and Policy


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Not an article on foreign physicians, but still helpful in providing context on just how serious the situation is. Forget about foreign doctors for a moment. Even if we did more to encourage American-trained foreign doctors to stay, we've got a HUGE problem that we'll be facing for at least a generation. Congress needs to stop fiddling on this one and start to address the physician shortage in a serious way. Foreign physicians are a small, important part of the solution. But we can only view them as helping to make things less awful and we need to seriously ramp up physician training in the US. More medical school slots and more graduate medical education slots are needed and soon. And that's going to take serious dollars.


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  1. R. Lawson's Avatar
    I wanted to know more about why the ANA opposed the Rural and Urban Health Care Act of 2005. So, I went to their website and they have a page on the issue:

    They make the following claims/assertions regarding nurses on temporary visas:

    1)employed as lower-paid aides, were made to work unreasonable hours in unsafe conditions, and were mislead about the temporary nature of their visas.

    2)ethical questions about recruiting nurses from other countries when there is a world-wide shortage of nurses.

    3)inappropriate to look overseas for temporary workforce relief when the real problem is the fact that the U.S. health care industry has failed to maintain a work environment that retains experienced U.S. nurses in patient care.

    How do you respond to each of these claims/assertions?
  2. Greg Siskind's Avatar
    I'm glad you asked Roy (though this is a post on doctors, not nurses). But I'll address your question anyway regarding what motivates the ANA - it's pure greed. Plain and simple. Nursing salaries have skyrocketed in recent years and it's largely because of the shortage. Solve the shortage and salaries won't go up as fast. The ANA can't tell the truth on this one - obviously - so they push the brain drain argument. Except you know what? Less than 5% of the foreign nurses in the US come from Africa and every brain drain story they've pushed has been about Africa. The vast majority of foreign nurses come from the Philippines.

    As for maintaining a nice environment for nurses, most of the problems with the nurse environment stem precisely from the shortage. That's why the #1 agenda item for the ANA is the imposing of staffing ratios in every state. But then they oppose hiring foreign nurses to help meet the ratio requirements. That leaves one choice - massive salary hikes to get nurses to do more overtime. More overtime means more tired nurses. More tired nurses mean more unhappy nurses. Etc. Etc. See where this is going?

    As for the exploitation of foreign nurses, that's also baloney. As you have so often proclaimed, you like green cards, not temporary visas. Well guess what? There are no temporary visas for nurses. They all come with green cards (except Canadians on the TN). The H-1B is not available to nurses nor is the H-2B. Green cards for 99% of them. So when they get to the US, they're licensed and they don't rely on employer sponsorship to maintain status. It's your dream come true, Roy.

    Remember I said that your argument of only hating H-1Bs and liking green cards was BS and that when push comes to shove, you're really anti-immigrant. This just proves the case. Your first instinct is always the anti-immigrant one. Every time you post. And they you come back and say, "No, I love immigrants. I'm married to one. I just hate the H-1B and all that nasty exploitation."

  3. paskal's Avatar
    don't know enough to answer specific questions.
    i do work in a hospital though and have for a very long time,
    so i will say this:
    i've seen a lot of foreign nurses- have not seen them as low paid aides working unreasonable hours in unsafe conditions. the shortage is severe- when we wanted a nurse in our clinic it took forever to get ONE application. there are plenty of foreign nurses working as RN's.
    maybe bringing in workers stabilizes wages- but the shortage has taken them through the roof first. we find a nurse and make an offer and typically lose to a counter offer that we could never match. now if i remember the whole IT argument- this suggests a shortage. and artificial shortages maintained by not training enough nurses and not allowing an influx of workers can hardly help the "customer". that happens to be you Roy.

    ethical questions? really? i guess it helps anyway that there is a shortage here too. The US system has it's own problems, but experienced nurses are earning more than ever. the same can be said about everyone in healthcare today- overworked, frustrated with the system and battling shortages. So why is it that only the Nurses Union insists on a policy that keeps the shortages going? I do not see a single action from them to solve the problem. And there is no doubt that in absolute numbers Nurses are far too short- by the way they do not even bother to deny it!

  4. R. Lawson's Avatar
    "Remember I said that your argument of only hating H-1Bs and liking green cards was BS and that when push comes to shove, you're really anti-immigrant. This just proves the case. Your first instinct is always the anti-immigrant one."

    What is total BS is how you characterize people who ask critical questions as "anti-immigrant" and continue personal attacks. I didn't state my position regarding the ANA stance on the issue. I am trying to understand the facts and have not formed a complete opinion.

    You just proved my case that you like to toss the "anti-immigrant" word around as much as possible to discredit anyone that doesn't agree with your position. Aren't you the least bit sorry for such childish behavior?
  5. Greg Siskind's Avatar
    Live by the "I really do love immigrants even though I post anti-immigrant comments on every post on Siskind's blog" sword, die by the "I really do love immigrants even though I post anti-immigrant comments on every post on Siskind's blog" sword.

    You make a point of responding to nearly every post I put up and you get incredibly defensive when people point out the flaws in your arguments and usually resort to name-calling. Obviously, you are really, really insecure in your views or you wouldn't be hear everyday reading every single comment and post.

    And you can't stand not getting the last word either. Watch - within ten minutes you'll have a long reply waiting to go.
  6. h1b's Avatar
    Live by the "I really do love immigrants even though I post anti-immigrant comments on every post on Siskind's blog" sword, die by the "I really do love immigrants even though I post anti-immigrant comments on every post on Siskind's blog" sword.

    Greg Siskind you are a drama queen! You are fabulous!
  7. Amused Doctor's Avatar
    It is simply amusing to read the posts of one "R.Lawson"...racism and bigotry could be the only reasons for his opinions. since the immigrants are from India and Phillipines and not from Ireland.

    Americans want cushy jobs...don't like to take care of poor people....don't even want to live in these neighbhourhoods...some of these hospiatla are literally run by Indian, Pakistani doctors and filipino nurses..

    He is completely cluless as to the salaries!! What is he talking about ??/simply moronic. Public hospitals are crumbling under financial pressure. The salaries for nurses (RN) are 60K +!! In some places they offer primary care DOCTORS salary close to 60k!!
  8. R. Lawson's Avatar
    You people who cry racism and bigotry at anyone with different views on immigration are tiny, puny, and soulless individuals who can't form a better argument.

    The fact that Siskind now engages in this behavior is just appalling.

    I asked a very simple question. I stated the views of one organization - the ANA - and asked how you respond to them. I did not claim them as my views. And you mental midgets respond with claims of racism.

    I have nothing more to gain from this blog. I once thought Greg Siskind an intellectual with a different point of view. I now consider you a lobbyist with your own corporate agenda. And an attack dog that launches personal attacks when you are losing an argument. What is interesting is that I didn't engage in an argument - I simply asked how you respond to the views of another organization.
  9. Greg Siskind's Avatar
    And he gets the last word.
  10. USC's Avatar
    "You people who cry racism and bigotry..."

    You are taking this much too seriously. Perhaps, a joke that I have suitably modified will lighten things up.

    Q) How can you tell that an aircraft bearing a bunch of Programmers Guild conventioneers has landed at the Las Vegas McCarran International Airport?

    A) Because you can still hear the whining even after the aircraft engines have been switched off!
  11. TX's Avatar
    R. Lawson.....come on argue like one of the right wing radio talk show hosts. You bring up a statement (in this case the ANA statement) and then say that you do not endorse their views, how does that make any sense? Just recently a national radio talk show host was discussing and even defending an idea of putting land mines on the border, and then says he is just bringing up a listener idea and not endorsing the idea. All you anti-immigrant guys must think we are idiots.

    I was starting to believe you when you said that workers should not be on H1 and instead get green cards and not rely on employer sponsorship. This is true in the nursing field and you find fault even with that. Please don't come back with, "Oh I was just stating the ANA position," that's just bull..... it's your position too and you know it. Boy, you must have really been burnt by an Asian IT worker; don't you think it's about time you got over it? If you can't compete in a certain field, then go find something you are actually good at.

    It's sad that some people can go on with such hate for a group of individuals and then defend themselves by saying that they have an immigrant husband/wife and they don't hate immigrants. It's so easy to sometimes hide behind your spouse, but it's a lame and stupid argument. What I don't get it people like Lou Dobbs wife, how can she, as a Mexican immigrant, tolerate him putting down her heritage on a daily basis?
  12. TX's Avatar
    USC, that was a good one! LOL.
  13. R. Lawson's Avatar
    TX: Can you read? You see what you want to see. You hear what you want to hear. You read what you want to read. You are the worst of the worst. Flinging filthy and baseless comments - and altering the intent of what others say.

    I am personally doing very well. I earn above the curve. I attribute that to hard work and my competitive nature.

    I am pro-immigrant. Anyone supporting the indentured servitude of people are anti-immigrant. Why do you hate other immigrants so much that you would have them on an H-1b indentured servant visa? Thanks Greg for this great technique in debate - just lob a personal attack. Is that what they teach you in law school?

    After looking at the nursing situation, I don't agree with the ANA at this point. They have not proven their case. I looked for examples of fraud and abuse regarding foreign nurses. Most of the cases were in the 1990s. I am unable to find recent problems or much of an outcry from other nurses. That doesn't mean there aren't problems - but they appear to be few and far between. If it is worse than it appears the ANA certainly hasn't proven that.

    My conclusion to disagree with the ANA is no thanks to you folks here. It came about because of critical thinking skills. Which is obviously lacking in this group. You should all be ashamed of your tactics.
  14. TX's Avatar
    Hmmm....I thought you had nothing more to gain from this blog, what are you still doing here then? Stop with your "I am pro-immigrant" bull, you are not convincing anyone. Hey what is this I hear, an airplane engine or is it the Programmers Guild folks whining ;o) I would really love to meet this IT H1 guy/gal that took your job, wow, did they do a number on you.
  15. Greg Siskind's Avatar
    Folks - In case you haven't figured it out, Roy will keep posting responses until we've all moved on to other discussions. He WILL get the last word. So unless you really are a glutton for punishment, I'd leave Roy's comments aside. I think we all know where he stands. If he wants to educate us on new topics, I'm sure he'll get a blog of his own rather than making the comments section of this blog a poor substitute.
  16. R. Lawson's Avatar
    TX: I won't back down to your name calling. The PG has done more to make this issue known than any other group. The ILW pretended there was no issue. The ITAA claimed two million IT jobs would be created since 2000. Strange that we are still at 2000 employment levels.

    Liars drove this debate until good people stepped in. If you want to call them whiners for stepping up to the plate, that just makes you a stupid immigrant hater. I can get use to these ad-hominem attacks.

    Please ILW and bloggers here: Stop hating on immigrants! Stop trying to subject them to indentured servitude! Stop being such bigots!
  17. R. Lawson's Avatar
    Greg, I would have stopped posting had you not pulled the bogus hate card. You had good points on the nursing. Then you devalued your reputation with baseless attacks.

    This is my last comment - assuming nobody makes hateful remarks. The last comment was partially in jest - lampooning some of the debate tactics here.
  18. TX's Avatar
    Ok Roy, have your last word and enjoy your day.

    Greg, Roy does have his own blog, the problem is that no one posts there, so he has to start using yours as a means to get his word out. You are right BTW; he WILL get the last word. All I want is to understand is what motivates people like him, just why are they so afraid of the competition? Personally, if I couldn't compete in a field I would move on to a different career, one that I'm good at, why can't they do the same?

    I would move on to other topics and leave Roy alone, it's just that it's fun to see these Programmers Guild folks vent out their frustration (stemming from not able to compete with us skilled immigrants) in this manner. Please don't drive him away. The way I look at it, I'm doing them a favor...better they vent their frustration here rather somewhere it might actually do some harm. Your blog is entertaining Greg, keep up the lively conversation.
  19. KC's Avatar

    Current salary of US nurses.....60 K
    Salary proposed by Roy ....100K
    Current monthly healthcare premium for Roy ....2000
    Premium proposed by Roy...6000 (to be paid by US employers of course)
    Current salary of US programmers ...80K
    Salary proposed by Roy....160 K
    Current number of US jobs sent to China and India 3 million
    Number of US jobs Roy wants to send to China and India 300 million
    Critical thinking skills of Roy....PRICELESS.
  20. click now's Avatar
    Apparently, there is a new site around , with the purpose of letting candidates and employers rate employment agencies. About time! I was thinking about doing such a thing myself, but now that there is one around, I' d rather see that it gets some support behind it so that data becomes comprehensive.
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