Labor Mobility for Health Care Workers
Economic freedom should include freedom to work where one chooses. Doctors, nurses, and other medical professionals should be able to work in any state they wish, regardless of where they received their training. Labor mobility for healthcare workers can help address shortages today and in the future. (Allowing more medical schools would help as well.)
In Telemedicine Across State Lines, the Cicero Institute notes:
During COVID, most states waived the requirement that a doctor be licensed in state to provide a telemedicine visit, but these waivers are rapidly expiring. Physicians should be allowed to register as telehealth providers with other states’ medical boards and see patients in the state so long as they are licensed and in good standing in their home state…
The Cicero Institute further offers a Telemedicine White Paper and Model Bill.
International Physician Licenses could also be offered, again with White Paper and Model Bill:
• Allow internationally licensed doctors to practice without having to repeat a residency program.
• Ensure internationally licensed doctors meet or exceed U.S. standards.
• Let hospitals, physician practices, and other healthcare providers sponsor and mentor international doctors as they transition to U.S. practice.
• Automatically convert provisional licenses for sponsored, internationally-licensed, doctors to full licenses after three years of successful practice.
Debaters with the NCFCA topic on listed Central American countries could propose legislation opening the door to trained health care workers from listed countries. This could be part of a larger labor mobility and work visa program, or limited to healthcare workers.
Resources on Improving Labor Mobility for Health Care Workers
Below are links to articles and videos from the Migration Policy Institute, Cato Institute (video), Cicero Institute and Center for American Progress.
Also, the case against these reforms includes concerns from US doctor and nurse associations who say immigrants will lower incomes for US-born health care workers. One response to this is that most rural health care workers now are immigrants, working where US born doctors and nurses are less interested in, and where pay is lower.
A second objection: drawing health care workers from other countries leaves fewer in those countries. But there is more to the story, and the second MPI article looks at data from various countries. Much higher pay in developed countries leads to more remittances sent home. Also Germany and I think other countries are providing assistance to countries migrant healthcare workers are from.
Some years ago Kenya proposed a limit on Kenyan-trained nurses leaving to work in the UK, only to discover that the option of UK nursing work had boosted the number of young Kenyans training to be nurses and led to more staying in Kenya. Why not train in a field that provides the opportunity of working at higher pay overseas, as well as staying home in Kenya? (I’ve not located the news stories and studies on this yet.)
• Immigrant Health-Care Workers in the United States, MPI, April 7 2023
• Aging Societies Rely on Immigrant Health-Care Workers, Posing Challenges for Origin Countries, January 26, 2024
• Doctors with Borders: Embracing the Potential of Immigrant Doctors (video), Cato Institute, July 13, 2020
• International Physician Licenses, Cicero Institute White Paper, March, 2019,
• Immigrant Doctors Can Help Lower Physician Shortages in Rural America, American Progress, July 29, 2019
Canada perhaps offers a model for federal reform in the U.S.: Federal government opens up express entry system to foreign doctors (CBC, September 23, 2022):
The federal government is removing a barrier that will make it easier for doctors from other countries to get permanent residency in Canada.
Immigration, Refugees and Citizenship Minister Sean Fraser said Friday that doctors would receive an exemption to allow them to apply for the federal express entry system.