When we discuss expanding H1-B visas for high-skilled workers, we are usually envisioning individuals employed in various high-tech industries. Probably because, as Suzy Khimm writes, lots of CEOs of tech companies complain about the lack of high-skilled workers. Also, a lot of centrist TED-talky types like to discuss this problem and will often use it as jumping off point for arguments about the necessity of promoting STEM studies and engaging in broader education reform.
This is all well and good. But if we are going to to take a targeted immigration approach, we should really take a look at industries with high unit-labor costs, the obvious example being the health care industry. Now we don't usually get a lot of complaints from healthcare industry representatives about the need to bring in more doctors, but as Yglesias notes in this piece, doctors get paid a lot more in the United States than they do in other Western countries despite not providing superior care. Most of our future fiscal problems relate to healthcare costs, so bringing in more doctors should be a no-brainer.
I am in favor of immigration reform that is more liberalized generally and brings in workers of all types. But if we are taking the targeted approach, we ought to look for professions where there is a large unit-labor cost differential between the U.S. and other Western countries and exploit that arbitrage opportunity through immigration reform.
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