"It all really started with the Hart-Celler Immigration and Nationality Act of 1965. Three months prior to this legislation, Medicare and Medicaid passed in the United States, and almost overnight, 20 million people had health coverage. The problem was, there weren't enough doctors to take care of everyone. Part of this bill was designed with attention to the physician scarcity in the U.S., especially in what are called "shortage areas" across the nation."
"These are urban and rural communities that lack a sufficient number of healthcare workers, and where hospitals tend to be under-resourced, and a large number of patients are on Medicare and Medicaid. These aren't usually the kinds of places that appeal to most American-trained doctors. If you have options, you might not jump at the chance to practice medicine in a small rural town in Arkansas, for example."
Over the past sixty years, immigrant physicians have become a core component of the U.S. medical workforce, now comprising nearly one quarter of physicians according to a 2023 AAMC report. The Hart-Celler Immigration and Nationality Act of 1965, coinciding with the rapid expansion of Medicare and Medicaid that extended coverage to about 20 million people, exposed a shortage of physicians. Policy responses targeted shortages in under-resourced urban and rural "shortage areas" with high proportions of Medicare and Medicaid patients. American-trained doctors often avoid these locations, leading immigrant physicians to staff hospitals and clinics in underserved communities and reshape access to care.
Read at Harvard Gazette
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