Walk into any American hospital and look at who’s working the floor. Increasingly, the answer is people who look like our families. About 28% of America’s physicians and 16% of its nurses are foreign-born, and no community is more central to that workforce than ours. The Philippines is a major source of the country’s immigrant nurses, while India is the leading source of international medical graduates practicing in the United States. When Americans talk about the healthcare workforce, they are often talking about us.
That workforce helps keep a strained system functioning. In 2024, America spent $5.3 trillion on healthcare — about $15,474 per person and 18% of GDP. Yet about 27 million Americans remained uninsured, and millions more live in communities with shortages of primary-care providers. We spend more than other wealthy nations, yet our health outcomes often lag behind them.
The workforce math is brutal. The country faces a projected shortage of up to 86,000 physicians by 2036, and the nursing workforce faces continuing shortages as experienced nurses retire. Immigrant nurses and doctors have helped fill those gaps for decades, disproportionately including Filipino and South Asian professionals. They often serve in communities where recruiting healthcare workers is difficult.
Here in Central Florida, the shortage is not theoretical. Orange, Osceola, and Seminole counties all have federally designated primary-care shortage areas — as do 66 of Florida’s 67 counties. Florida also faces significant physician workforce pressures. Hospitals throughout the region rely on nurses and physicians trained abroad, including many from the Philippines and India.
So, the immigration debate is not abstract for us — it is a healthcare debate. Every unnecessary barrier to recognizing the credentials of a foreign-trained nurse or physician can make a workforce shortage harder to solve. And every message that treats immigrants as a burden rather than a contributor ignores the people helping care for our families.
None of this is inevitable. It is shaped by policy choices: a system that has historically rewarded specialists more than primary care, too few residency positions to meet projected demand, and a complicated insurance and payment system that creates enormous administrative costs. We spend more than anyone and often tell ourselves we have the best healthcare system in the world. The Commonwealth Fund’s 2024 comparison of 10 wealthy nations ranked the United States last overall, including last in health outcomes.
We can choose differently — more primary care, more nursing and medical training, immigration policies that make better use of qualified health workers, broader access to coverage, and less administrative waste. But policy is not moved by numbers alone. Our community can staff the night shifts and shortage areas and still be an afterthought where healthcare policy is written. Being essential to the system has never been the same as having a say in it. That gap closes only one way: by showing up.
So, show up. Register. Call your commissioner, testify at a hearing, serve on a board. We have earned our place through decades of labor and care; now we must claim our voice. The people keeping America healthy increasingly look like us. When the decisions get made, the people at the table should too. That begins at the ballot box — and the next chance is the November midterm. Go vote.
