The Case of the Filipino Nurses
The Case of the Filipino Nurses

 A comprehensive example of migration’s positive and negative economic effects on both sending and receiving countries is that of Philippine nurses who have migrated to the U.S. While the developed world is experiencing severe nursing shortages, U.S. hospitals have found a large pool of experienced nurses in the Philippines. Offering higher salaries and better living standards, U.S. hospitals have had little trouble luring Philippine nurses from their home country.

In fact, in many hospitals these immigrants make up the majority of the nursing staff. Filipino nurses have become such an integral part of the American health system that they have started their own national organization, the Philippine Nurses Association of America. In California, where Filipino immigrants compose about 6 percent of the state’s population, 20 percent of all registered nurses are Filipino (Rodis 2013).

Filipino nurses began arriving in the U.S. as early as the turn of the 20th Century, under the Pesionado Act of 1903, which funded American educations for citizens of the Philippines, a U.S. colony at the time.  The migration streams continued in waves throughout the 20th Century (Rodis 2013).  During the 1970s, the U.S. and other industrialized countries experienced nursing shortages, as more work opportunities began to open to women, making nursing, with its long hours and high stress, a less appealing option. But well-educated and English-speaking Filipino nurses provided the perfect replacement workforce. Without increasing wages, U.S. hospitals were able to fill necessary, but unwanted, jobs with Filipino immigrants.

At the same time, the migration of the nurses has positive economic effects in the Philippines. Once employed in the U.S., the nurses can earn as much as 20 times what they were making back home (Rodis 2013). Part of these earnings is sent home to support family and other dependents. As noted earlier, these funds are called remittances. The remittances flowing back into the country from the migrant nurses help boost the Philippine economy and support the local population. Total remittances to the Philippines have grown substantially in recent years and reached $10.7 billion in 2005, with much of these funds coming from service workers and especially nurses, who compose the largest service sector working group of Filipino emigrants (Lorenzo et al, 2007).

On top of remittances, if and when the migrant nurses return to the Philippines they will bring with them greater amounts of training and experience contributing to social capital. The government has reacted to the potential benefits from emigration by sponsoring initiatives to ease the process. In 1982, for example, the government created a whole new department, the Philippine Overseas Employment Agency, responsible for optimizing the benefits of the country’s overseas employment program (Lorenzo et al, 2007). The Philippine National Bank has also reacted with programs that encourage remittance flows, and special remittance centers have been created in various parts of the U.S.

Of course, there are negative effects as well. When the Philippine nurses come to America they leave behind nursing shortages in their home country. The Philippines is losing one of its greatest sources of social capital—educated workers. In other words, the Philippines is experiencing brain-drain. Moreover, the benefits of government expenditures on education are not coming to bear in the Philippines but rather in the U.S. Furthermore, turnover at Philippine hospitals is so high that even operating rooms are staffed with novice nurses. Because of the depletion of skilled medical workers, hundreds of hospitals in the Philippines have fully or partially closed, and medical care is disproportionately distributed, favoring industrialized cities and leaving rural areas with inadequate coverage (Lorenzo et al, 2007).

The immigration of Filipino nurses also results in certain negative economic effects for the U.S. While the jobs being taken by immigrants would not necessarily have been filled by domestic laborers, American nurses may see nursing salaries decrease as Filipino immigrants enter the labor market with lower wage requirements. In order to obtain visas for the incoming Filipino nurses, U.S. hospitals must prove that they are unable to fill their existing vacancies with American nurses. Thus, it may appear that the jobs are going unfilled.  However, the reason hospitals are unable to fill these vacancies with local help may be due to the low wages they are offering. Hospitals can set wages low because they know they can find foreign nurses who are willing to accept them, meaning that domestic workers are ultimately losing out on certain employment opportunities.

Since the Economic Crisis (2007 – 2009), there are fewer nursing jobs available throughout the developed world. The U.S. and Europe have passed strict visa requirements that restrict the immigration of Filipino nurses as well as immigrant workers in general, in part to reserve job openings for domestic workers. In the Philippines, nursing schools are making it more difficult to obtain nursing degrees in order to minimize the excessive supply of nursing school graduates who are unable to find employment. Now, only about half of nursing school applicants in the Philippines passes entrance exams. The government encourages students to pursue other related careers in medical technology and pharmacology. Nurses are also encouraged to find jobs in call centers for medical related companies (McGeown, 2012).

The Filipino nurses’ example thus demonstrates the varying features of labor migration and the difficulties with analyzing its effects. The sending country, the Philippines, initially gains through emigration because migrants living abroad may support their home country’s economy through remittances. However, because nurses have left the country in such high numbers, the Philippines has lost social capital and wasted investment in its citizens. The receiving country – in this case the U.S – benefits from the immigration of workers because they fill a labor demand at a lower cost than domestic workers.  And yet, because migrant workers often demand lower pay compared to their domestic counterparts, immigration may depress wages as a whole.

Is it responsible policy for the U.S. to recruit Filipino nurses and for the government of the Philippines to encourage emigration of nurses when these educated laborers are needed to support the medical industry their home country? Are these policies fair to nurses in the U.S, whose wages may be depressed by the competition of immigrant workers?

 

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