Koch-Backed Group Seeks Unlimited Inflow of Foreign Healthcare Graduates

The federal government should provide an unlimited inflow of foreign H-1B visa workers into the nation’s healthcare sector, says the immigration director at a Koch-funded advocacy group.

“The [annual] cap [of 85,000 work visas] should be repealed altogether for the healthcare sector, as it is for the university and non-profit sector already,” Daniel Griswold, the director of trade and immigration issues at the Koch-funded Mercatus Center in Arlington, VA, told the House committee on small business.

“Damn, wow,” said Kevin Lynn, founder of Progressives for Immigration Reform. Unlimited H-1Bs “means more nurses from the Philippines and more medical grads from India … It means that Americans who have invested greatly to study medicine at college, or nurses who have studied at a community college, might not be able to practice medicine,” he said.

If ever approved, Griswold’s demand could have a huge impact because it could outsource a huge share of the 12.9 million American jobs in the healthcare sector.

Any expansion of visa worker outsourcing will hit the small town hospitals, which are often a critical part of each legislators’ district, said Hilarie Gamm, founder of the American Workers Coalition. “Critical outcomes will be compromised, good paying jobs and higher wages will be lost, and the best and brightest who hope to stay in their home towns to raise the next generation will be forced to move out of the districts,” she said.

Griswold’s Mercatus Center is supported by unidentified investors and executives in the Koch network of political donors. The center’s board includes Charles Koch and Brian Hooks, the president of the Charles Koch Foundation and the Charles Koch Institute.

The wishlist described by Griswold included many more immigrants and visa workers, plus an unlimited inflow of H-1B visa-workers for the vast healthcare sector:

The H-1B cap [of 85,000 new workers] should be raised to meet the demands of the U.S. labor market … [and] at minimum be doubled to 130,000 [per year]. … a tripling in the number of visas would be even, better, 195,000. That would meet the real demand each year … A higher cap should contain an annual escalator [allowing more H-1B workers] tied to the growth of the high-skilled labor force, and the cap should be repealed altogether for the healthcare sector, as it is for the university and non-profit sector already.

H-1B workers are not immigrants. They are college-trained contract workers who can stay for six years, or more if their employer puts them in a long line for green cards. Roughly 100,000 new H-1B visas are issued each year, and approximately one million H-1B contract workers now hold white-collar jobs in the United States, alongside an additional 500,000 foreign graduates with J-1, OPT, L-1, O-1, or other visas.

The visa workers tilt the white-collar job market away from American graduates because the foreign workers will accept jobs at low wages in the expectation of eventually getting hugely valuable green cards from the federal government.

Many brand name technology companies hire these contract workers either directly or via subcontractors. The savings per cheap visa worker can reach $100,000 per year — so delivering a per-worker boost of roughly $15 million to the investors’ stocks on Wall Street.

Congress has already exempted universities and non-profits, including many hospitals, from the H-1B cap. This exemption has allowed universities and hospitals to keep roughly 100,000 lower-wage foreign teachers, researchers, and doctors in prestigious jobs that are sought by young American graduates. For example, Sanford Health employs roughly 125 foreign doctors and specialists in North Dakota, South Dakota, and Minnesota.

In 2018, federal data shows that companies and hospitals asked for H-1B visas to import 688 therapists, 557 hospital doctors, and at least 130 pharmacists. Because non-profit employers are exempt from the H-1B cap, they likely were able to import nearly all of the foreign graduates they asked for.

But healthcare firms also need a wide variety of skills, including marketing experts, data analysts, insurance professionals, software programmers, and various managers. In 2018, for example, insurance companies also asked for visas to hire 572 data scientists, business analysts, and actuarial experts, and they also hired subcontractors who use many additional H-1B visas to get cheap software graduates from India.

Griswold’s wishlist also includes more college-trained legal immigrants, alongside the extra H-1B contract workers. He said:

Two, the number of employment-based green cards should be increased. The cap of 140,000 should be at least doubled to reflect the growth of the labor force that is most in need of high skill workers. On top of that, the spouse and minor children of the primary green card workers should be exempt from the cap.

Those policies would dramatically boost the employer-sponsored inflow of foreign graduates from roughly 70,000 graduates per year to roughly 240,000 graduates. That flood would create massive job competition for the 800,000 Americans who graduate each year with skilled degrees — and worsen the economic outlook for the millennial graduate.


Griswold also urged legislators to lift curbs on the award of green cards to Indian and Chinese visa workers:

The per-country quotas on employment-based green cards should be repealed. The quotas discriminate against immigrants based solely on their place of birth. They deny legal permanent resident status to well-qualified candidates who have already proven their value to their employers, the U.S. economy and society.

A pending bill — H.R. 1044 — would lift those curbs and end the practice of distributing green cards among many foreign countries — but also create a huge incentive for hundreds of thousands of additional Indian and Chinese graduates to accept the low-wage OPT contract worker jobs in the hope of getting the H-1B visas that allow them to get green cards and citizenship.

In March, Breitbart sketched the damaging impact of the “country caps” legislation that is being pushed by North Dakota Sen. Kevin Cramer.

Griswold told the committee on May 22 that the nation’s migration policy is run for the benefit of business and investors, and he pointedly excluded the concerns of citizens and employees. “We have a demand-driven, industry-driven system,” he said, but “there’s a mismatch between [the immigrant workers] who come in and the needs of industry.”

Griswold declined to answer questions from Breitbart News.

Griswold is one member of a huge and expensive army of advocates and lobbyists pushing for cheap labor.

The army is large and well paid because even slight drops in the cost of labor are enormously magnified when Wall Street converts future profits into present-day stock value. This process is exemplified by FWD.us, which was founded by Mark Zuckerberg and other West Coast investors to reduce the cost of the white-collar and blue-collar labor needed by investors to serve as workers, consumers, and renters.

On the other side, there are few advocacy and education groups — NumbersUSA, the Federation for American Immigration Reform, and the Cente for Immigration Studies. But they are being complemented by a new series of groups formed by American graduates whose sectors have been shredded by the outsourcing visas.

These graduates’ groups include Gamm’s American Workers Coalition and Lynn’s doctorswithoutjobs.com, alongside ProUSworkersNo on H.R. 1044, and The Multinational Coalition Against H.R. 1044/S. 386.

In turn, these groups are backed up by a few sites that are tracking the scale and location of the outsourcing industry in each legislators’ district. The sites include SAITJ.org and H1BFacts.com. “The scope of this thing is really unbelievable,” said one researcher.

Other sites document the conflicts created by diverse foreign business practices in the United States. The non-political MyVisaJobs.com site also provides much information about H-1B outsourcing and green card rewards in multiple industries. The federal USCIS agency provides some data, including some data about the uncapped OPT program.

Some of the groups are trying to lobby U.S. legislators about the harm, unpopularity and political risk of the visa programs — and the proposed removal of the “country caps.”

Some of the advocates emphasize the political risks of supporting legislation that encourages large-scale outsourcing in their local hospitals. Several GOP legislators have lost their seats because of their failure to recognize the public’s visceral opposition to the outsourcing programs. The losers include GOP Majority Leader Eric Cantor as well as Reps. Renee Elmers and Kevin Yoder.

“We are mothers concerned about our children’s future and that of their neighbors,” said Gamm, who preserves her software career by hiding her identity from peers and recruiters. She continued:

We are connecting legislators with actual constituents that have been harmed by [the visa worker] legislation. What ends up happening in conversations with legislators and aides [is that they say] “We don’t really know anything about it.”

In conversations with Democrats, Gamm said, her team of three women graduates shows that legislators’ support for visa outsourcing means they are “directly opposed to “women, minority and diversity.” She continued:

There are so many foreign workers — nurses, health aides, and physicians — that the outcomes are diminishing … and the only people making a lot of money are healthcare providers.

The companies’ preference for hiring visa workers is hollowing out the U.S. technology and science sectors, said Lynn. “Why would Americans invest heavily in education, in learning skills, when you can be were forced out by someone who is willing to work for 20 percent or 40 percent less?” in exchange for a green card, he asked.

The outsourcing is already hitting debt-burdened Americans graduates, Lynn said. For example, Americans must spend far more on their education than foreign graduates, so they need to earn higher wages than foreign workers will accept, he said. For example, Americans medical graduates “leave [college] with at least $1 million in student loans … They are not going to pay their debts by becoming a biology teacher in High School with a salary of $70,000.”

“Americans are losing control of their healthcare delivery,” said Lynn.

Removing the cap on healthcare outsourcing would “result in the colonization of yet another profession by foreign workers,” said Mark Krikorian, director of the Center for Immigration Studies. “Americans who want to go into nursing or medicine would have a harder time pursuing their career goals,” he said, adding “growing your own healthcare workers seems like a pretty important thing for a modern, self-respecting country.”

The outsourcing could change civic life in communities where hospitals play a large role, he said:

It would really alienate the hospital from the community that serves — it would not be members of the community serving members of the community, it would be foreigners performing the service. A couple of doctors does not have an effect, but if there is an enormous share of the workforce [outsourced] it would … create the sense that medical work is appropriate for foreign workers.. … it would almost certainly deter young Americans from going into those fields, as we are seeing with [information] tech now.  If you’re eliminating your domestic training resources, you’re eliminating the possibility of growing your own workforce.

Griswold offered several justifications for his plan to flood the white-collar labor market with foreign graduates.

“American is competing for the best talent in the world, and without reforms, we are increasingly in danger of losing that competition,” he said.

But investors’ preference for importing foreign workers leaves the United States’ increasingly reliant on foreigners to operate the nation’s critical networks, protect Americans’ privacy, and prevent online theft of secret, patents, and funds. The greater reliance on imported workers also reduces the economic and cultural incentives for Americans to earn high-tech degrees, partly because many foreign workers become U.S. managers and then steer jobs to their national, caste and regional peers.

Griswold also argued that the inflow of foreign workers would create opportunities for Americans. “Immigrant workers tend to complement American workers … as immigrants come, in, even lower skilled Americans have opportunities to move up, and be, say, the manager of the roofing team.”

Legislators should focus on training more Americans, not restricting immigration, he said. Legislators should be “equipping Americans to take full advantage of the opportunities,” he said.

But the new opportunities will not benefit Americans if companies can import an endless stream of foreign workers who are eager to take low wages in the hope of getting taxpayer-funded green cards.

Also, foreign workers have their own preferences for foreign managers and foremen, so making it difficult for Americans to win jobs and promotion in foreign-dominated workplaces. For example, Americans in many cities now need to learn Spanish to get some management or even entry-level jobs, such as fast food vendors. Americans in white-collar jobs say they are being excluded from software jobs because U.S. companies have hired Indian workers for recruiting jobs — and those Indian recruiters earn money in Indian’s outsourcing economy by steering fellow Indian graduates into new U.S. jobs, even if American graduates are more capable of doing the jobs.

During the hearing, Griswold also urged legislators to expand the lower-skill H-2B seasonal visa worker program so that it can be used to import foreign workers for year-around work. The H-2B program imports roughly 85,000 laborers per year for landscaping, tourist, resort, forestry, and other jobs, so denying summer opportunities to young Americans. The J-1 visa program also brings in many thousands of foreign workers for seasonal jobs.


Immigration by the Numbers

Each year, roughly four million young Americans join the workforce after graduating from high school or university.

But the federal government then imports about 1.1 million legal immigrants and refreshes a resident population of roughly 1.5 million white-collar visa workers — including approximately one million H-1B workers — and approximately 500,000 blue-collar visa workers.

The government also prints out more than one million work permits for foreigners, tolerates about eight million illegal workers, and does not punish companies for employing the hundreds of thousands of illegal migrants who sneak across the border or overstay their legal visas each year.

This policy of inflating the labor supply boosts economic growth for investors because it ensures that employers do not have to compete for American workers by offering higher wages and better working conditions.

Flooding the market with cheap, foreign, white-collar graduates and blue-collar labor also shifts enormous wealth from young employees towards older investors, even as it also widens wealth gaps, reduces high-tech investment, increases state and local tax burdens, and hurts children’s schools and college educations. It also pushes Americans away from high-tech careers and sidelines millions of marginalized Americans, including many who are now struggling with fentanyl addictions. The labor policy also moves business investment and wealth from the Heartland to the coastal citiesexplodes rents and housing costsshrivels real estate values in the Midwest, and rewards investors for creating low-tech, labor-intensive workplaces.


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