[claw-el]

I believe the main ‘change’ of this $100,000 fee is the composition of labor. A doctor applies for H1B too and various other non-tech job applies for H1B too. Startups and hospitals have a much higher chance to not willing to pay for the fee and we will just end up with less ‘doctors’ in the 85,000 H1B visa approvals.

[influx]

Given the cost of healthcare in the USA and the AMA artificially limiting the number of doctors, I'm skeptical this fee will change anything.

[thijson]

I saw a comment in another thread that the AMA recognizes the problem of a deficit in new MD's. According to the comment, congress provides funding for MD residents, and that is the real bottleneck.

[Den_VR]

Don’t forget that the real utility of these H1B is for citizens of countries that exceed their EB quotas, which are primarily India and China just on the basis of their demographics. Without more serious reform of the immigration system I see this as a positive step towards raising the bar on those extra quotas.

[_DeadFred_]

This. H1B should still have to align with America's immigration goals of allowing people form all over the world in, not just certain countries. It was hard to get the entrenched systemic bias for western europeans opened up and it seems like H1B is now captured in the same way by a few ethnic groups.

[827a]

Its a fair point, but this $100,000 fee should not have been the flashpoint causing half the United States to care about this issue, and it being the flashpoint has got us arguing for the wrong thing. Immigrant doctors should have their own visa classification. There's no reason they should be competing in the H1-B lottery with Big Tech, especially now that its so expensive.

That isn't on the table right now. Its possible that it could be, as sometimes you need to have a problem before people will feel incentivized to solve it. On the other hand: We've had a serious medical care provider shortage since, like, the early 2000s; over 20 years of Bush (R), Obama (D), Trump (R), and Biden (D) to have solved this obvious problem; and no one has. Chesterton's Fence sometimes exists for a reason.

[claw-el]

I want to clarify that I am not trying to argue but genuinely curious what is the ‘right solve’ here.

If we create an exception for doctors, what about ‘medical lab technicians’, ‘wastewater treatment professionals’ or ‘air traffic controller’? All these jobs faces shortage in US right now. If we leave it up to the executive branch at the time to determine exceptions, we will just end up in a situation in exceptions going to the industry with the ‘best’ lobbyist.

I am not in a position to decide a policy like this, but I have a wild idea. Why not lower the application fee for H1B (or make it free) or even make it super easy to apply. Right now, the companies that are willing to abuse the H1B system will do so because they know the higher the application fee, the less competition they have to get those 85,000 slots. If every doctor, speech therapist, medical lab technologist is applying for H1B, it would totally crowd out the H1B abusers and it might no longer be worth it for them to try to game the system. Just musing on ideas, not that I can implement any of these.

[foogazi]

> Immigrant doctors should have their own visa classification.

The perfect is the enemy of the good enough