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In a new report conducted by the non-profit RAND Corporation, which is the country's largest independent health policy research program, researchers reported that the United States' health care system relies heavily on foreign-born and/or foreign-related health care professionals. The researchers reasoned that if the U.S. continues to rely heavily on foreign workers, the country might have less incentive to address certain health care issues, which could lead to a less stable U.S. health care system with fewer medical professionals.

For this study, the researchers reported that 25 percent of the primary care physicians working in the U.S. were educated outside of the country. Medical education took place mostly in India, the Philippines, Pakistan, Mexico and the Dominican Republic. The report found that 12 to 15 percent of registered nurses in the U.S. were foreign-born with 5.4 percent of them being foreign-educated. The majority of the registered nurses came from the Philippines, Canada, India, the United Kingdom and Nigeria. 20 to 24 percent of direct care workers, which include nursing aides and home health aides, are foreign-born with nearly 20 percent of them being undocumented. The majority of direct care workers come from Mexico, the Philippines, Jamaica, Haiti and the Dominican Republic.

The report stated that even though the health care system relies heavily on foreign workers, the four categories of visas given out for health professionals to work in the U.S. are not exclusive for health care workers. Health care workers who were both foreign born and foreign educated reported experiencing unethical recruitment methods, discrimination and difficulties dealing with cultural differences. The researchers sated that the foreign-educated physicians probably have the most formalized channels of entry and are usually admitted for medical residencies.

The researchers reported that U.S. policymakers should consider changing certain aspects of immigration laws so that recruiting health professionals can be easier. Furthermore, the researchers believe that policymakers need to improve recruiting practices and workplace conditions for foreigners. The study was published in Health Affairs.