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Unhelpful Legislation

"Unhelpful" is about as nice as I can phrase it.  In the US state of Georgia, a state dominated by Republicans who extol the virtues of small government and less regulation, the party voted in legislation that has made the licensure renewal process for healthcare professionals extra burdensome and requiring additional paperwork.  Of course, since government spending also had to be cut, they reduced the staff that processes licenses.

What's going on?  Georgia now requires healthcare professionals to submit proof of legal residence, legal work permit, or citizenship to get their license renewed.  That is ALL healthcare professionals, even those born in the US.  The initiative is supposed to "weed out" anyone who might not actually be qualified to practice and got a "false" license.

NPR reports on the consequences to healthcare professionals, especially those who received their education outside the US or who were international students when they completed their healthcare degree and are LEGALLY working under various types of visas or other forms of legal work.  The measure has forced 600 nurses and 1,300 physicians out of work because they cannot work in their healthcare facility without and up-to-date license.

There are two major consequences of this xenophobic piece of legislation.  The first is economic.  Assuming the 1,300 physicians make somewhere around the national average of $175,000 per year and the nurses around the US national average of $66,000, those earnings losses have a significant effect on the economy in terms of consumer spending.  The second is to patients.  The legislation is taking away providers from direct patient care situations and increasing the risk for complications.  It is also decreasing everyone's ability to access the healthcare system.  Depending on how long these providers are out of work, the measure could actually cost the healthcare systems in Georgia a whole lot more money in the long run.

The legislation also reveals the gross ignorance of the policymakers involved in passing it.  Internationally educated physicians need to pass a credentials review by the Educational Commission for Foreign Medical Graduates.  Then they have to pass the US Medical Licensure Exam --all THREE parts of it--before they apply for residency programs.  Guess what else?  The exam is expensive and can cost the foreign medical graduate almost $15,000.  Furthermore, the residency programs often repeat the training they received in their home country.  Chance of someone faking credentials?  Slim to none.

Nurses have to undergo a rigorous credentials evaluation through the Commission on Graduates of Foreign Nursing Schools (CGFNS).  The same organization also credentials internationally educated physical and occupational therapists.  Nurses, once they have their credentials evaluated, then have to pass the US nursing licensure exam known as the NCLEX.  If they pass both those hoops, then they need to obtain a legal work visa which usually requires employer sponsorship.  If you have a work visa, you can legally be in the country.  Employers have to pay them too, so they need to get a social security number for tax purposes.  Chance of someone faking credentials or working illegally?  Slim to none.

With a looming nursing and primary care physician shortage, the last thing the healthcare system needs are roadblocks to renewing professional licenses of hardworking healthcare professionals who make a difference every day.  In places where internationally educated healthcare providers help communities address their health needs, and when they speak the same language as the patient, they help reduce system costs by reducing health disparities in minority populations.

Legislation like that which passed in Georgia doesn't weed out illegal immigrants.  It just makes both the public and private sectors of the healthcare system harder to operate.  In the end, it will cost the state more  than just money.

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