ADI
Pointer/Symonds Lab
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Nurses Neg
Kritik Link: Otherization............................................................................................................. 3
Turn: Racism ................................................................................................................................. 4
Racism Turn Extension ................................................................................................................ 5
Turn: AIDS .................................................................................................................................... 6
AIDS Turn Link Extensions ........................................................................................................ 7
AIDS Turn Link Extensions ........................................................................................................ 8
AIDS Turn Link Extensions ........................................................................................................ 9
Aids Turn Link Extensions ........................................................................................................ 10
AIDS Turn Extensions................................................................................................................ 11
Philippines Brain Drain Turn 1NC Shell ................................................................................. 12
Philippines Brain Drain Turn 1NC Shell ................................................................................. 13
Link: Brain Drain – Generic ...................................................................................................... 14
Link: Brain Drain – Generic ...................................................................................................... 15
Link: Brain Drain – Recruitment Key ..................................................................................... 16
Link: Brain Drain – Generic ...................................................................................................... 17
Link: Brain Drain – Philippines ................................................................................................ 18
Link: Brain Drain – Philippines ................................................................................................ 19
Link: Brain Drain – Filipino Economy ..................................................................................... 20
Link: Brain Drain – Economy ................................................................................................... 21
Link: Brain Drain – India .......................................................................................................... 22
Specific Link: Brain Drain – Philippines and India – Lifting the Cap .................................. 23
Internal Link: Economic Stability Key to Political Stability .................................................. 24
Uniqueness: No Filipino Nursing Migration Now.................................................................... 25
Uniqueness: Filipino Economy High ......................................................................................... 26
Uniqueness: Filipino Economy High ......................................................................................... 27
Solvency Answers: Doesn’t Solve Long-Term ......................................................................... 28
Solvency Answers: Alternate Causality – Poor Working Conditions .................................... 29
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Pointer/Symonds Lab
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Nurses Neg
Solvency Answers: Healthcare................................................................................................... 30
Solvency Answers: Immigrant Nurses Fail .............................................................................. 31
Solvency Answers: Lifting the Cap Doesn’t Solve ................................................................... 32
Solvency Answers: Delay ............................................................................................................ 33
Healthcare Advantage Answers: Status Quo Solves the Aff ................................................... 34
Healthcare Advantage Answers: Status Quo Solves the Aff................................................... 35
Uniqueness: U.S. Largest Importer of Nurses.......................................................................... 36
Domestic Nurses Counterplan 1NC Shell ................................................................................. 37
Domestic Nurses Counterplan: Solvency – Capicity/Funding ................................................ 38
Domestic Nurses Counterplan: Solvency – Funding ............................................................... 39
Domestic Nurses Counterplan: Solvency – Funding ............................................................... 40
Domestic Nurses Counterplan: Solvency – Education ............................................................ 41
Domestic Nurses Counterplan: Politics – Obama Loves It ..................................................... 42
ADI
Pointer/Symonds Lab
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Nurses Neg
Kritik Link: Otherization
Working visas fuel otherization which marginalizes the outsider
Drevdahl & Shannon 7(Denise, Kathleen, PhD RN, MN RN, Advances in Nursing Science
)
Construction of some groups as being more valued and with more due respect and privilege than
others occurs in all societies. Becoming the “other”36—the unwanted outsider—is a process that
“defines and secures one’s own identity by distancing and stigmatizing an(other).” 37(p1933) “Othering”
serves to establish what is “normal” (us) and what is “abnormal” (them). Part of that process is seeing
lower wage immigrants as abnormal in that they are rarely seen as individuals “with agency, skill or
resilience, with capacity to contribute and be an asset to their new communities.” 37(p1935) Instead, they
are burdens to society who use up supposedly limited resources, including medical resources. Consequently,
“othering” leads to negative emotions such as distrust, dislike, and resentment that then are linked to
particular groups according to signifiers such as race, nation of origin, and language. Once an
individual or group has been marked as “not us,” they are seen as existing on the outer boundaries of
society, marginalized by the majority of that society. 38 This positioning away from the Center (ie,
dominant structures, policies, and other sources of power) generally means the marginalized have limited
access to resources, are subject to differential treatment, and exert minimal social influence and
authority.† Although Vasas claimed that “marginalized people are invisible to those in the Center,”38(p196)
this is not the case for the unwanted foreign worker. The Center is constantly reminded of the worker’s
presence through such symbols as the fence being built on the US-Mexican border and the individuals who
serve in the US Border Patrol. Individuals, social structures, and policies that maintain the Center also
function to maintain the margins.38 Thus, immigration policies function to further perpetuate a process
of “othering,” especially with unequal allocation of assistance in securing a work visa.
Vol. 30, No. 4, pp. 290–302
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Pointer/Symonds Lab
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Nurses Neg
Turn: Racism
These nurses are susceptible to unfavorable working conditions and racial discrimination
Kingma 8(Mireille, PHD RN, OJIN: The Online Journal of Issues in Nursing. 13(2)).
One of the most serious problems migrant nurses encounter in their new community and workplace is
that of racism and its resulting discrimination (Chandra & Willis, 2005). Incidents are, however, often
hidden by a blanket of silence and therefore difficult to quantify (Kingma, 1999). Migrant nurses are
frequent victims of poorly enforced equal opportunity policies and pervasive double standards. Some
migrant nurses are experiencing dramatic situations on the job where colleagues purposefully
misunderstand, undermine their professional skills, refuse to help, and sometimes bully them, thus
increasing their sense of isolation (Allan & Larsen, 2003; Hawthorne, 2001; Kingma, 2006). If we
recognize that international migration will continue and probably increase in coming years, the protection of
workers is a priority issue and should be safeguarded in all policies and practices that affect migrant
health professionals.
REJECT RACISM AT EVERY TURN:
BARDNT 1991 (JOESEPH, MINISTER, DISMANTLING RACISM)
To study racism is to study walls. We have looked at barriers and fences, restraints and limitations, ghettos and
prisons. The prison of racism confines us all, people of color and white people alike. It shackles the victimizer as
well as the victim. The walls forcibly keep people of color and white people separate from each other; in our
separate prisons we are all prevented from achieving the human potential that God intends for us. The limitations
imposed on people of color by poverty, subservience, and powerlessness are cruel, inhuman, and unjust; the effects
of uncontrolled power, privilege, and greed, which are the marks of our white prison, will inevitably destroy us as
well. But we have also seen that the walls of racism can be dismantled. We are not condemned to an inexorable
fate, but are offered the vision and the possibility of freedom. Brick by brick, stone by stone, the prison of
individual, institutional, and cultural racism can be destroyed. You and I are urgently called to join the efforts of
those who know it is time to tear down once and for all, the walls of racism.
ADI
Pointer/Symonds Lab
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Nurses Neg
Racism Turn Extension
It is unfair to bring who the US needs and kick out who it discriminates as being ‘unskilled’
Drevdahl & Shannon 7(Denise, Kathleen, PhD RN, MN RN, Advances in Nursing Science
Vol. 30, No. 4, pp. 290–302
)
Having adequate numbers of RNs to care for an increasingly older and potentially frail US population
accelerates immigration processes for those qualified professionals deemed to be in short supply.
However, the same immigration officials do little to provide manual/low-wage laborers with similar
opportunities. In fact, substantial resources are expended in either preventing the immigration of many
low-wage workers or deporting them back to the originating countries. One such attempt is illustrated by
a March 2007 arrest of 360 immigrant workers at the Michael Bianco Inc factory, a military contractor. The
workers were primarily from Central America and constituted the majority of the 500-person factory work
force.30 Since many families were unaware of the raid, family members just seemed to “disappear,” with
working parents (including single parents) separated from their children, and children channeled into social
service agencies. The Washington Post reported that after the raid, 1 child telephoned a hotline asking for her
mother, and a breastfed infant was hospitalized for dehydration when its mother was sent to a detention
center in Texas.30 US law clearly and explicitly discriminates. Although there are federal and state statues
making some forms of discrimination illegal, this is not the case for some immigrants seeking work in the
United States. Visas come with mandatory requirements that are not expected of US native born
residents, including labor certification.31 Thus, current immigration laws contradict basic principles
of tolerance and acceptance making immigration restrictions “a form of government-mandated
employment discrimination.”32(p2) Using the argument of a US nursing shortage as mandate for
increasing professional nurse recruitment in developing countries creates an international
promulgation of injustice. For a nation founded on the concept of equality, this unfairness based solely
on being born outside US territory collides with social justice doctrines. It is ironic that a nation that
often sees itself as a global leader in upholding justice and in protecting the vulnerable has yet to
implement policies that treat all humans as equal.
ADI
Pointer/Symonds Lab
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Nurses Neg
Turn: AIDS
The plan exacerbates AIDS, malaria, and other diseases globally
The Chronicle Newspaper 2007 (Africa News; “Malawi; ‘Brain Drain’ in Health System
Continues Unabated”) Lexis-Nexis
Most nurses who have left Malawi have immigrated to the United Kingdom (UK), offering that country their
services in the past. But now the United States of America (US) is fast becoming another attractive
destination after many nurses are having an extension to their working visa being rejected in the UK, even
after having worked there for nearly 5 years. The American Hospital Association has reported that the
US last year needed an extra 118,000 nurses, a demand that will rise to 800,000 by 2020. In order to
cater for this shortage a little un-noticed provision in the Immigration Bill is expected to be used. This could
intensify the drain of nurses from the developing world. Reaction has been swift and filled with outrage
with Physicians for Human Rights (PHR), a US advocacy group saying that this provision could undermine
the multi-billion dollar effort by the US to combat AIDS and Malaria by potentially worsening the
already existing shortage of health workers in poor countries like Malawi. "We're pouring water in a
bucket with a hole in it, and we (US) drilled the hole," declared Holly Burkhalter from PHR when the
proposals were first made. There is no doubt, the public health sector in Malawi is already badly hit by
the "Brain Drain" in the large exodus of medical professional personnel leaving the country for
greener pastures in the developed world.
DISEASES THREATEN HUMAN SURVIVAL
ZIMMERMAN AND ZIMMERMAN 1996 (Barry and David, both have M.S. degrees from Long Island
University, Killer Germs p 132)
Then came AIDS…and Ebola and Lassa fever and Marburg and dengue fever. They came, for the most part, from the steamy jungles of the
tropical rain forests are ablaze with deadly viruses. And changing lifestyles as well as changing
environmental conditions are flushing them out. Air travel, deforestation, global warming are forcing neverbefore-encountered viruses to suddenly cross the path of humanity. The result—emerging viruses.
world. Lush
Today some five thousand vials of exotic viruses sit, freeze-dried, at Yale University—imports from the rain forests. They await the
outbreak of diseases that can be ascribed to them. Many are carried by insects and are termed arboviruses (arthropod borne). Others, of even
Some, no doubt, could threaten humanity’s very
existence. Joshua Lederberg, 1958 winner of the Nobel Prize in Physiology or Medicine and
foremost authority on emerging viruses, warned in a December 1990 article in Discover magazine: “It is still not
greater concern, are airborne and can simply be breathed in.
comprehended widely that AIDS is a natural, almost predictable phenomenon. It is not going to be a unique event. Pandemics are not acts of God,
…There will be more surprises,
because our fertile imagination does not begin to match all the tricks that nature can play…” According to Lederberg , “The survival
but are built into the ecological relations between viruses, animal species and human species
of humanity is not preordained…The single biggest threat to man’s continued dominance on
the planet is the virus”
(A Dancing Matrix, by Robin Marantz Hening.
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Pointer/Symonds Lab
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Nurses Neg
AIDS Turn Link Extensions
Increasing nurse migration removes nurses from Sub-Saharan Africa and exacerbates the
health crisis
Pittman et al 7 (Patricia, Ph.D., Executive Vice President of AcademyHealth, Health Services
Research 42(3), Part II, June 2007)gw
Sub-Saharan Africa represents the most dire scenario. There, health systems are historically poorly
developed and now, due in part to nurse shortages, some are in a state of crisis. Dovlo reports in this issue that there is
a double burden experienced by these countries: already weak health systems tend to exacerbate the rate of
migration leading to a surge in vacancy rates (Dovlo 2007). In Zambia, the nurse to population ratio is 0.22 to 1,000, a figure that is
more than 40 times less than that of the United States (WHO 2006). Destination countries for African nurses are not limited to the
wealthiest na- tions; there is considerable migration within the region, in particular to South Africa, as
nurses seek better lives. But across this region, governments are indignant when recruiters from wealthier nations
capitalize on the crisis. They argue that there is an urgent need and obligation for wealthy governments to reorient foreign aid to
help improve work conditions and retain health pro- fessionals in source countries.
Nurses are key to solving the AIDS epidemic in Africa
Avert 10 (International AIDS Charity, http://www.avert.org/aidssouthafrica.htm)gw
One measure seen as vital in scaling-up treatment access, while making best use of available resources,
is task-shifting in the health sector. This means permitting health care workers to become involved in
particular stages of treatment provision where currently they are not allowed. Under task-shifting, nurses, rather
than doctors, can initiate antiretroviral therapy; lay counsellors, rather than nurses, can carry out HIV tests, as
well as provide support for orphans usually done by social workers; and pharmacy assistants, rather than pharmacists
themselves, can prescribe ARV drugs.76 77 It is believed task-shifting vastly increases the access points to treatment
and care by reducing the ‘bottlenecks’ in the system created by a lack of staff able to perform certain
tasks. Many campaign groups supported task-shifting and claimed it was crucial to the goal of making HIV
treatment much more widely available. Four prominent HIV/AIDS organisations called on the national and regional health
departments to issue directives permitting the transfer of certain responsibilities and asked professional medical, nursing and pharmacist
bodies to support task-shifting.78 A recent study in South Africa supported task-shifting to nurses, after it found that
the care of patients receiving ART was not inferior when they were monitored by nurses rather than by
doctors.79 Dr Eric Goemaere, Medical Coordinator for MSF in South Africa and Lesotho, said, “Our experience in Khayelitsha and
Lusikisiki, as well as from other countries shows that unless we are able to utilise the skills and capacity of
professional nurses at the primary health clinics, the congestion and overwhelming demand will
negatively impact patient care. Other countries have changed their regulations to allow nurses to start patients on ART and lay
counsellors to administer HIV tests. When will South Africa wake up?”80 In the 2010 budget speech, the Health Minister, Motsoaledi
announced that “human resource capacity” was one of the “teething problems” experienced whilst implementing plans to increase the
number of health facilities providing ARVs from 496 to 4,333.81
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AIDS Turn Link Extensions
Africa needs more than a million healthcare workers and the major cause of this is due US
and Europe taking nurses and doctors away from Africa
Dugger 04 (Africa Needs a Million More Health Care Workers, Report Says. CELIA W. DUGGER
Published: November 26, 2004.
http://query.nytimes.com/gst/fullpage.html?res=9C05E3DE123EF935A15752C1A9629C8B63&sec=health )
Africa needs to nearly triple the number of its health workers if it is to reverse plummeting life expectancies
and combat pandemics of disease, a research group of more than 100 scholars and experts said in a report released today. So far, the
global health debate has focused on lowering prices for AIDS drugs and increasing financial aid from wealthy countries. But money and drugs
will fail unless poor countries have enough people to tend the sick, according to the research group, the Joint Learning Initiative, financed by the
Rockefeller Foundation and the Bill and Melinda Gates Foundation, among others. ''These are not sexy issues like a miracle drug, but they hark
back to the core issues of health,'' said Dr. Lincoln Chen, an author of the report and the director of Global Equity Center at Harvard. The
academics, health officials and other specialists in the Joint Learning Initiative said rich countries
must take steps to slow what the report calls ''fatal flows'' of nurses and doctors from poor African
countries to Europe and North America. By the group's calculations, Africa needs a million more
health workers. Wealthy nations must educate enough of their own nationals, the group says, rather than
rely on doctors and nurses whose training has been paid for by African countries that are losing the fight
against disease. The African Union estimates that poor countries subsidize rich ones with $500 million a year through the migration of health
workers. The group of specialists also supports growing efforts to channel doctors and nurses from rich countries, as well as from nations that
willingly export health workers -- Cuba, Egypt, India and the Philippines -- to volunteer in Africa. It mentioned that the Institute of Medicine in
the United States has recommended an AIDS corps of American professionals to help care for and treat people with H.I.V./AIDS. The Joint
Learning Initiative also called for the creation of an education fund that would pay to educate tens of thousands of health workers who are not
doctors and nurses but are trained to diagnose and treat major killers in Africa -- pneumonia, AIDS, malaria and tuberculosis -- as well as to
perform basic life-saving surgeries like Caesarean sections. Such workers, used for decades in many African countries, are not attractive to
employers in Western nations that rely on credentialed professionals. African countries had banded together at the international assembly of the
World Health Organization this year to push rich countries to compensate them for the loss of migrating health workers, but the group said in its
report that computing who should pay how much and to whom was impractical in the fluid and largely undocumented global market for health
professionals. Instead, it said rich countries should voluntarily contribute to an education fund. ''Political pressures and public embarrassment are
likely to grow as manpower shortages in the midst of health crises become linked to rich country's poaching of medical workers from those same
countries,'' the Joint Learning Initiative's report said. The Joint Learning Initiative commissioned studies that documented the importance of
health workers in lowering death rates for infants, children under 5 and women in childbirth, controlling for the effects of higher income and
female literacy in each country. Researchers found that mortality rates fell with the rise of health worker density, defined as the number of
doctors, nurses and midwives per 1,000 people.
Africa has reached crisis levels in low amounts nurses and nurses are vital to the health
care system
Polt 09 (“Working Abroad as a Nurse A Great Demand for Nurses Worldwide”. By Caroline A. Polt, RN
http://www.transitionsabroad.com/publications/magazine/0403/working_abroad_as_a_nurse.shtml )
in college I dreamed of having an international career. Several years after my sister ventured off to foreign lands to teach English, I decided to
pursue the same route—not as an English teacher but as a nurse. Now it's my sister who is visiting me in a foreign land!
Since the skills and knowledge that U.S.-educated nurses possess are highly regarded internationally, the profession can open doors to a wide
array of possibilities for working abroad. The call for nurses is a cry heard from all corners of the globe, from developed
nations to the developing world. According to the World Health Organization (WHO), "Nurses are the
largest category of health workers. Nursing personnel make up over 50 percent of the health workforce in
every country of the world. In many countries in the developing world, more than 80 percent of health
workers are nurses.” Because of a global nursing shortage and a higher demand for nursing services,
healthcare organizations are faced with staffing dilemmas that are reaching crisis levels in certain places. The
Honor Society of Nursing, Sigma Theta Tau International, reports that "Canada, the Philippines, Australia, and Western Europe are reporting
significant nursing shortages. Reports of shortages are also coming from Africa and South America
ADI
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AIDS Turn Link Extensions
Nurses can effectively treat HIV and AIDS via anti-retroviral therapy
Sanne et al 10 (Ian, founder and director of the Clinical HIV Research Unit, The Lancet,
376(9734),, July 2010, Pages 33-40)gw
This study reports the findings of a prospective, randomised, controlled study comparing nurse-managed
versus doctor-managed ART. A composite endpoint indicative of multiple aspects of ART delivery showed that nurse
monitored therapy was not inferior to doctor monitored therapy. These findings lend support to
observational data from other treatment programmes reporting successful use of task shifting in HIV
care in both resource-limited (South Africa, Rwanda, and Lesotho)[28], [29], [30] and [31] and resource-rich (UK)
countries,[32] and [33] and for other disease management.34 Expansion of ART services is urgently
needed in resource-poor countries to achieve universal access targets by 2010,35 and further expansion will be
needed with the start of universal testing and treating strategies .36 We noted no difference in mortality,
viral failure, or immune recovery between the study groups. This study therefore lends supports to the
strategy of task shifting, and suggests that HIV management by nurses can be safe and effective,
probably even for those starting therapy with advanced HIV infection , although further studies with longer followup might be needed in this subgroup.
ADI
Pointer/Symonds Lab
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Nurses Neg
Aids Turn Link Extensions
US recruitment of foreign Nurses is destroying South Africa's HIV fighting capabilities
Brush 4 (Barbara Brush, Assoc. Prof of Nursing, Boston College,
http://content.healthaffairs.org/cgi/content/full/23/3/78#R49)
While the United States has only recently begun active nurse recruitment in South Africa, former
Commonwealth countries such as the United Kingdom and Australia have already drawn large numbers of nurses
from this area of the world. Between 1998 and 2002 the United Kingdom alone recruited 5,259 nurses from South
Africa, along with 1,166 from Nigeria, 1,128 from Zimbabwe, and 449 from Ghana. The accelerated recruitment
of experienced African nurses is straining an already fragile health care infrastructure in many African
countries, which have been battered by AIDS and deprived of resources because of economic and political
upheaval. Sixteen African countries have an average of 100 nurses per 100,000 population; ten countries average
fifty nurses per 100,000; nine report twenty per 100,000; and three have fewer than ten nurses per 100,000.21 In
stark contrast, U.S. and U.K. ratios are 782 and 847 per 100,000, respectively.22 In 2000 more than double the
number of new nursing graduates in Ghana left that country for positions abroad.23 In response, the Ghanaian
government is now begging recruiting nations to cease taking its nurses. Economic burden. The loss of qualified
nurses places considerable economic pressure on exporting African countries.25 In 1998 the United Nations
Conference for Trade and Development estimated that every professional, ages 25–35, who migrated from South
Africa represented an annual loss of $184,000 for that country.26 Receiving countries obtain the financial
benefit of the migrant’s professional education and training, while sending countries bear these costs. The
loss of valuable workers has been so costly that the South African Nursing Council has proposed an export
tariff on nurses leaving to work abroad.
Recruitment of foreign nurses is negating foreign aid to Africa
Changuturu 5(Dr. Sreekanth Changuturu, M.D., Harvard Medical School,
http://www.nejm.org/doi/full/10.1056/NEJMp058201)
For years, the National Health Service (NHS) of the United Kingdom relied heavily on the direct recruitment of
nurses from African countries such as Botswana, Ghana, Malawi, Nigeria, Kenya, South Africa, Zambia, and
Zimbabwe — all former British colonies. These very countries have been among those hit hardest by the HIV
pandemic; some have a prevalence of HIV infection of 30 to 40 percent, with a majority of the young,
working population debilitated by disease, and are reporting huge nursing shortages themselves. In 1999,
Ghana's losses to emigration included 320 nurses the same number of nurses certified in the country each year; twice
as many were lost the following year. More than half the nursing positions in Kenya and Ghana remain unfilled. As
a result, many health clinics in Kenya have closed and many others are severely understaffed. The nursing shortage
in the developing world is being felt more intensely even as increased foreign aid becomes available to provide
drugs for millions of people with AIDS. If this funding is to accomplish its goal, more nurses are needed to
dispense drugs, monitor patients, run clinical trials, and train new nurses. According to estimates by Harvard
University's Joint Learning Initiative on Human Resources for Health and Development, sub-Saharan Africa's lowincome countries will need to more than double their workforces in the coming years — by adding at least 620,000
nurses — to be able to tackle their severe health emergencies. It seems like a cruel joke to play: providing funds
for AIDS care but simultaneously taking away the nurses who can give that care.
ADI
Pointer/Symonds Lab
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Nurses Neg
AIDS Turn Extensions
Increasing the ability for nurses to immigrate will seriously affect Africa’s health system –
guarantees increased disease spread
The Chronicle Newspaper 2007 (Africa News; “Malawi; ‘Brain Drain’ in Health System
Continues Unabated”) Lexis-Nexis
The provision is intended to assist the US government fill the gap of a shortage of nursing staff needed
for their health system. At present the US has 500 special visas for nurses each year that makes it possible
for nurses and their immediate family members to get a green card and live in the US. The possibility of
recruiting foreign nurses to cater for the needs of the US has drawn some negative responses from
experts from within the US and Africa who have been following the situation of the "Brain Drain"
from the African continent. Experts believe that the lifting of the immigration cap on nurses will have
a serious affect on the African continent's health system where HIV/AIDS, Malaria and Tuberculosis
(TB) are at epidemic levels and hospitals are inundated with patients who need nursing care. Already,
some African countries are demanding that the developed countries tapping into their health system for
personnel should pay some sort of compensation towards the loss of medical care workers.
ADI
Pointer/Symonds Lab
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Nurses Neg
Philippines Brain Drain Turn 1NC Shell
Filipino economy high
Philstar 7/28, (http://www.philstar.com/Article.aspx?articleId=597650&publicationSubCategoryId=200, 7/28/10,
“Economy expected to grow faster in second quarter”)
The economy is seen growing at a faster rate in the second quarter, a senior government official said today.
"The second quarter could be higher than the first quarter as some leading economic indicators have so far
been pointing to that direction," Myrna Asuncion, acting director for policy planning at economic planning
agency, told reporters. The higher car sales, a healthy banking sector, stronger exports and consumption are
just among the positive indicators that drove growth from April to June, Asuncion said. Depending on the
performance of the economy during the period, the government might have to revise its full year target of 5 percent
and 6 percent, Asuncion said. The Philippine economy expanded at a faster rate of 7.3 percent in the first quarter.
Economy recovering but domestic jobs are key
Cabicungan, 7/27, (http://newsinfo.inquirer.net/inquirerheadlines/nation/view/20100727-283329/%20Aquinos-firstSONA-We-can-dream-again, Cabicungan, Gil, “Aquino’s first SONA: We can dream again “)
The President was upbeat in his approach to the economy. He said that “many have already expressed
renewed interest and confidence in the Philippines.” He said that investors had proposed to rent the
Philippine Navy headquarters on Roxas Boulevard and the Naval Station in Fort Bonifacio, Taguig City.
“Immediately, we will be given $100 million. Furthermore, they will give us a portion of their profits
from their businesses that would occupy the land they will rent,” Mr. Aquino said. He said that from publicprivate partnerships, the economy would grow, construct tourism infrastructure and improve agriculture and
possibly be a supplier to the global market. “Creating jobs is foremost on our agenda, and the creation of
jobs will come from the growth of our industries,” he said. This will come, he added, if processes are
streamlined to make them predictable, reliable and efficient for those who want to invest, the President said.
Workers need to stay in the Philippines to avoid downturn
Pesek, 7/31 (http://www.todayonline.com/Commentary/EDC100731-0000031/Kafkaesque-economy-has-last-chance-to-getit-right, Pesek, William, 7/31/10)
Minor successes in reducing the budget deficit were spun as big victories. So was the fast-increasing
number of Filipinos leaving the country and their families to work abroad; the dynamic is really a
weakness. The Arroyo years were a lost period, a time when the nation should have tended to its weak
foundations and didn't. Thanks to the handiwork of the central bank governor Amando Tetangco, the
government was able to sell debt and avoid a crisis. It's no longer enough to rely on the fancy footwork of
monetary-policy makers. It's time for leaders to create jobs at home, improve competitiveness and
increase economy efficiency.
Unstable economy is the perfect opportunity for political instability and illegitimacy of the
government-history proves.
Bienen & Gersovitz 85 (Henry S., Mark, International Organization Cambridge Journals, 39(4),
p. 735)
Although IMF conditionality is rarely by itself a major cause of political instability, a regime that has lost
legitimacy for other reasons becomes especially vulnerable to its opponents during negotiations with
the IMF and during the implementation of an IMF package. The Ferdinand Marcos regime in the
Philippines, for example, has suffered from poor economic performance, but it has faced accelerating
opposition and loss of legitimacy over human rights violations and in the wake of the assassination of
Benigno Aquino, a leader of the political opposition. After the assassination capital fled abroad,
increasing the severity of Filipino debt problems. Fragility has made it more difficult for the regime to
negotiate with the IMF.
ADI
Pointer/Symonds Lab
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Philippines Brain Drain Turn 1NC Shell
Philippine stability key to solving terrorism
De Castro 9 (Renato Cruz, Contemporary Southeast Asia, 31(3), p.399)
In the mid-1990s the Philippines and the United States revived their dormant alliance after China's
occupied Mischief Reef, a small atoll in the disputed Spratlys archipelago and lying 130 miles off the
country's easternmost island of Palawan. On the heels of the 11 September 2001 Al Qaeda attacks in the
United States, the two allies further revitalized their security relationship to address transnational
terrorism. In the process, Manila was able to secure vital US military and economic assistance for its
counter-terrorism/ insurgency campaign against domestic insurgents, i.e. Abu Sayyaf Group (ASG),
the New People's Army (NPA) and the Moro Islamic Liberation Front (MILF). Since that time, the
two allies have taken gradual but significant steps to transform their alliance as a hedge against the
geostrategic challenges posed by China's rising power. This transformation involves deepening the two
countries' military relations through organizational planning, professional training and the
development of interoperability for a long-term mobilization strategy in a potential US-China
military/diplomatic face-off.
Unchecked terrorism will result in extinction
Yonah Alexander, professor and director of the Inter-University for Terrorism Studies in Israel and the United States. “Terrorism myths and realities,” The
Washington Times, August 28, 2003
Unlike their historical counterparts, contemporary terrorists have introduced a new scale of violence in
terms of conventional and unconventional threats and impact. The internationalization and brutalization
of current and future terrorism make it clear we have entered an Age of Super Terrorism [e.g. biological,
chemical, radiological, nuclear and cyber] with its serious implications concerning national, regional and global security
concerns. Two myths in particular must be debunked immediately if an effective counterterrorism "best practices" strategy can be developed [e.g., strengthening
international cooperation]. The first illusion is that terrorism can be greatly reduced, if not eliminated completely, provided the root causes of conflicts political, social and economic - are addressed. The conventional illusion is that terrorism must be justified by oppressed people seeking to achieve their goals
and consequently the argument advanced by "freedom fighters" anywhere, "give me liberty and I will give you death," should be tolerated if not glorified. This
traditional rationalization of "sacred" violence often conceals that the real purpose of terrorist groups is to gain political power through the barrel of the gun, in
violation of fundamental human rights of the noncombatant segment of societies. For instance, Palestinians religious movements [e.g., Hamas, Islamic Jihad] and
secular entities [such as Fatah's Tanzim and Aqsa Martyr Brigades]] wish not only to resolve national grievances [such as Jewish settlements, right of return,
Jerusalem] but primarily to destroy the Jewish state. Similarly, Osama bin Laden's international network not only opposes the presence of American military in
the Arabian Peninsula and Iraq, but its stated objective is to "unite all Muslims and establish a government that follows the rule of the Caliphs." The second
myth is that strong action against terrorist infrastructure [leaders, recruitment, funding, propaganda, training, weapons, operational command and control] will
only increase terrorism. The argument here is that law-enforcement efforts and military retaliation inevitably will fuel more brutal acts of violent revenge.
Clearly, if this perception continues to prevail, particularly in democratic societies, there is the danger it will paralyze governments and thereby encourage further
terrorist attacks. In sum, past experience provides useful lessons for a realistic future strategy. The prudent application of force has been demonstrated to be an
effective tool for short- and long-term deterrence of terrorism. For example, Israel's targeted killing of Mohammed Sider, the Hebron commander of the Islamic
Jihad, defused a "ticking bomb." The assassination of Ismail Abu Shanab - a top Hamas leader in the Gaza Strip who was directly responsible for several suicide
bombings including the latest bus attack in Jerusalem - disrupted potential terrorist operations. Similarly, the U.S. military operation in Iraq eliminated Saddam
Hussein's regime as a state sponsor of terror. Thus, it behooves those countries victimized by terrorism to understand a cardinal message communicated by
Winston Churchill to the House of Commons on May 13, 1940: "Victory at all costs, victory in spite of terror, victory however long and hard the road may be:
For
without victory, there is no survival."
ADI
Pointer/Symonds Lab
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Nurses Neg
Link: Brain Drain – Generic
Nurse migration passes significant costs onto source countries
Giona 07 (Afr Newslett on Occup Health and Safety 2007 Fabrizio Giona )
The main costs of health professionals' migration are paid by developing countries as they lose a
significant number of nurses, physicians, and other health professionals (brain drain). In 2000 over 500
nurses left Ghana to work in other industrialized countries (twice the number of the new generation of nurses
graduating that year). In Malawi, between 1999 and 2001, over 60% of nursing staff left to work elsewhere.
Between 2001 and 2002, a total of 16,000 international nurses arrived in the UK mainly from India, the
Philippines, and South Africa. In 2004, 1,018 new nurses coming from countries outside EU were registered
in Ireland; 59% came from India, 26% from the Philippines, and 5% from South Africa (5). This flight
causes further deficiencies in developing countries. In 2003, Malawi reported that only 28% of its nursing
positions were covered, and in the same year South Africa had a deficiency of over 32,000 nurses (3). The
loss of these professionals destabilizes health systems, making the countries poorer and less and less
able to provide assistance to their patients. The situation is not helped by the small number of nurse
training institutes (only 288 in Africa out of a total of 5,492 in the world, equal to 5.2%) (1). The nurses
remaining in the structures short of staff often face depressing working conditions: morale and work
satisfaction diminish while inefficiencies increase resulting in additional push factors that contribute to
further exacerbation in the lack of nursing staff. The migration of nurses incurs another significant
cost to the source countries: their investment in education and training which in most developing
countries is fully sponsored or strongly financially supported by the government. This relevant
investment is wasted when a nurse or a physician migrates permanently to an industrialized country.
Nursing shortages have serious implications
Booth 02 (The Nursing Shortage: A Worldwide Problem; Rachel Booth, RN, PhD, Dean and Professor, University of Alabama School of
Nursing)
"Nurses and midwives around the globe are leaving the health system, driven away by underpay,
hazardous working conditions, lack of career development, as well as professional status and
autonomy. In addition, there is a sharp decline in new recruits to the profession for similar reasons. If
the world's public health community does not correct this trend, the experts agreed, the ability of
many health systems to function will be seriously jeopardized"(1).
Although thousands of miles and many differences separate countries and cultures, the message describes a
worldwide problem. The simple truth is that nurses are not there for the people who need them most.
Regardless of the country, the public's perception of their nurses resound with great similarities. That is,
nurses hold the system together and serve as the advocate, health provider, educator, and
administrator for making the system work well for them; nurses possess the highest level of integrity
and honesty of any other health care workers and administrators; nurses are the ones who care about
patients and their families; and "nurses are the backbone of the health care systems".
U.S. need for nurses drives shortages in source countries
Aiken 07 (HSR: Health Services Research 42:3, Part II “U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency” Linda H
Aiken, PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology, and Director of the Center for Health
Outcomes and Policy Research)
The United States plays a pivotal role in the global migration of nurses. It has the largest professional
nurse workforce of any country in the world, numbering almost 3 million in 2004 (USDHHS 2006). The United
States has almost one-fifth of the world’s stock of professional nurses and about half of Englishspeaking professional nurses. With a nurse labor force of this size, even modest supply–demand
imbalances exert a strong pull on global nurse resources. A looming projected shortage of nurses in the
United States that could reach 800,000 by 2020 (USDHHS 2002) is thus cause for concern among other
countries also experiencing nurse shortages.
ADI
Pointer/Symonds Lab
15
Nurses Neg
Link: Brain Drain – Generic
Nurse Migration causes health care shortages in developing countries
Senior 10 (Senior, Kathryn Bulletin of the World Health Organization, May2010, Vol. 88 Issue 5, p327-328, “Wanted: 2.4 million nurses, and that’s just in
India”)
In every country, rich or poor, the story is the same. There are not enough nurses. The developed
world fills its vacancies by enticing nurses from other countries, while developing countries are unable
to compete with better pay, better professional development and the lure of excitement offered
elsewhere. A World Bank report released in March describes the severity of the shortage of nurses in the Caribbean and Latin
America alone. English-speaking Caribbean nations currently have 1.25 nurses for every 1000 people; 10
times fewer than countries in the European Union and the United States of America (USA). Around three in
every 10 nursing positions currently remain unfilled and the report predicts that Caribbean countries will be short of 10 000 nurses to
help care for their ageing population by 2025. According to Deena Nardi, director of the Nurse Delegation Programme at the
International Council of Nurses, the Caribbean is particularly prone to losing its nurses. “The global migration of nurses is particularly
severe in smaller island nations such as Jamaica, where 8% of its generalist nurses and 20% of its specialist nurses leave for more
developed countries each year,” she says. Between 2002 and 2006, more than 1800 nurses left the Caribbean to work abroad. “People
do not leave only for higher salaries – moving for better work conditions and the opportunity to
progress professionally are also part of the problem.” “These ‘push’ factors are very hard to fix ,” says
Christoph Kurowski, World Bank sector leader for human development, and author of the report. Nardi stresses that the Caribbean
countries are not an isolated example. “In Malawi, there are only 17 nurses for every 100 000 people,” she says.
In India, nurse shortages occur at every level of the healthcare system. According to Dileep Kumar, chief nursing
officer at the Ministry of Health and director of the Indian Nursing Council, 2.4 million nurses will be needed by 2012 to
provide a nurse-patient ratio of one nurse per 500 patients. “The data show that the states with the
worst health-care human resource shortages are also the ones with the worst health indicators and
highest infant and child mortality,” says Nidhi Chaudhary, from the World Health Organization’s office in New Delhi,
India. In Indonesia there is a shortage of nurses at health-care facilities but, in contrast with other countries, there are also many
unemployed nurses. “The problem here is connected with mismanagement of nurse hiring and placement due to lack of resources,” says
Achir Yani Syuhaimie Hamid, president of the Faculty of Nursing at the University of Indonesia. According to the standards set by the
Ministry of Health, the ideal ratio of nurses to patients in Indonesian hospitals is 2:1 to allow for shift working, 24-hour coverage and
maternity- and sick-leave. “
ADI
Pointer/Symonds Lab
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Nurses Neg
Link: Brain Drain – Recruitment Key
Developing countries need their nurses, suffer from recruitment
Brush et. al, 2004 (Barbera L., Julie Sochalski, and Anne M. Berger. Recruiting Foreign Nurses To
U.S. Health Care Facilities Health Affairs, May/June 2004; 23(3): 78-87.)
As the United States and other developed countries look to international nurse recruits to balance their
national nurse supply and demand, however, sending countries are increasingly questioning the impact on
their own health care systems. In perhaps the most striking example, the Wall Street Journal noted that the
growing number of Filipino nurses migrating abroad is creating a domestic shortage and beginning to
strain the Philippines’ health care system rather than providing an economic benefit as it had in previous
years.18 A growing number of other countries are facing a situation similar to that of the Philippines.
New offshore recruiting initiatives by developed countries have targeted English-speaking nurses from subSaharan Africa, Southeast Asia, and the Caribbean. Experienced nurses, especially those with specialty skills
in surgical, neonatal, or critical care nursing, are in particularly high demand.
While the United States has only recently begun active nurse recruitment in South Africa, former
Commonwealth countries such as the United Kingdom and Australia have already drawn large numbers of
nurses from this area of the world. Between 1998 and 2002 the United Kingdom alone recruited 5,259 nurses
from South Africa, along with 1,166 from Nigeria, 1,128 from Zimbabwe, and 449 from Ghana.19 The
accelerated recruitment of experienced African nurses is straining an already fragile health care
infrastructure in many African countries, which have been battered by AIDS and deprived of resources
because of economic and political upheaval.20 Sixteen African countries have an average of 100 nurses per
100,000 population; ten countries average fifty nurses per 100,000; nine report twenty per 100,000; and three
have fewer than ten nurses per 100,000.21 In stark contrast, U.S. and U.K. ratios are 782 and 847 per
100,000, respectively.22 In 2000 more than double the number of new nursing graduates in Ghana left
that country for positions abroad.23 In response, the Ghanaian government is now begging recruiting
nations to cease taking its nurses.
ADI
Pointer/Symonds Lab
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Nurses Neg
Link: Brain Drain – Generic
Nurse migration leads to detrimental shortages in developing countries
Kingma, 2007 (Mireille. Nurses on the Move: A Global Overview. HSR: Health Services Research 42:3, Part II (
June 2007) http://www3.interscience.wiley.com/cgi-bin/fulltext/117996596/PDFSTART)
Nurses migrating to industrialized countries often leave behind an already disadvantaged system, thus
worsening the working conditions. The nurses who remain assume heavier workloads, experience
reduced work satisfaction and low morale. This contributes to high levels of absenteeism and has an
adverse impact on the quality of care (Chikanda 2005; Dovlo 2005). A country’s health system is
weakened by the loss of its workforce, and the consequences in certain cases can be measured in lives
lost (WHO 2006). The insufficient presence of supervisors, mentors, and educators threatens not only
current care delivery but the preparation of future generations of nurses.
Left with an inadequate nursing workforce, many developing countries lack the resources to implement
programs to improve the health of the poor. In Lesotho, with a shortage of 700 nurses, the implementation
of a government campaign for confidential HIV testing and counseling was postponed (IRIN 2006). In
Swaziland, the nursing shortage is considered the main obstacle for the expansion and long-term maintenance
of critical antiretroviral therapy programs (Kober and Van Damme 2006).
For many developing countries, a serious consequence of the nursing shortage is the heavy nurse to
patient workload, which in turn continues to drive nurse migration. A nurse from the main referral
hospital in Lesotho reports that 70 nurses tend to almost 3,400 patients, an average of close to 50 patients per
nurse (Associated Press 2006). In Malawi, a major hospital reported that half of its nursing posts were
vacant, and only two nurses were available to staff a maternity ward with 40 births a day (ICN 2004). In
Zimbabwe, the Minister of HealthCare and Welfare estimates the nurse to patient ratio to be 1:700 but
researchers found that nurses working in provincial hospitals may work with a nurse to patient ratio of 1:522
while in district hospitals the ratio may be as high as 1:3,023 (Chikanda 2005). Such ratios cannot support
excellence in health care delivery.
ADI
Pointer/Symonds Lab
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Nurses Neg
Link: Brain Drain – Philippines
Nurse exportations hurt the Philippines
Masselink 10 (Leah Masselink School of Nursing, University of North Carolina at Chapel Hill, Carrington Hall, CB #7460,
Chapel Hill, NC 27599, United States)
Despite the contribution of health worker remittances to the economy, the Philippines’ health system
has remained poorly funded: as of 2005, health spending represented only 3.2% of its gross domestic
product, a ranking of 178th among 194 World Health Organization countries (www.who.int). Public
investment in health has actually declined in recent years. The Department of Health’s budget fell from
P15.4 billion (US$275 million) in 2004 to P13.8 billion (US$250 million) in 2005 (Philippine National
Statistical Coordination Board—www.nscb.gov.ph). In addition to being poorly funded, the Philippine
health system is also plagued by shortages and serious mal-distribution of physicians, nurses and other
health workers between urban and rural areas (Lorenzo et al., 2007).
Staffing shortages in the Philippine health care system have been exacerbated by migration of
physicians and nurses (Brush & Sochalski, 2007), particularly from rural areas (Lorenzo et al., 2007).
Migration has also contributed to rapid turnover in urban hospitals (Lorenzo et al., 2007) because
nurses often pursue employment opportunities overseas once they have gained enough experience.
Thus, many domestically employed nurses are relatively inexperienced. Some policymakers have
characterized this trend as “brain drain” and warned that it will undermine the Philippines’ nursing
education sector, its health system and its future as a source country of nurses (Folbre, 2006).
Loss of nurses hurts developing countries’ health care facilities
Bieski 7(Tanya, Salisbury University MD, Nursing Econimis, 25(1).)
Nurses migrate in search of better wages, working and living conditions, as well as educational and career
advancements (Carney, 2005). However, donor countries, who struggle to keep health care facilities
open, are faced with issues including loss of skilled personnel, loss of eco-nomic investment, and high
turnover rates. Loss of skilled personnel is frequently referred to as “brain drain,” where experienced
personnel move to receiving countries leaving behind inexperienced personnel, who must work alone
in poor conditions (Kline, 2003). Prystay (2002) reported that nursing directors in the Philippines were
concerned about high turnover rates, thereby leaving novice nurses to staff hospitals. Kline (2003)
discussed a loss of economic investment in education. Filipino nurses who remained faced poor wages
and working conditions and minimal incentive from government officials to improve wages and
working conditions (Prystay, 2002).
ADI
Pointer/Symonds Lab
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Nurses Neg
Link: Brain Drain – Philippines
Nurses are a key section of Filipino migrant workers
Goode 9 – (Angelo, International Studies Department, De La Salle UniversityEast Asia, 26(2),
June 2009)gw
With human capital as the nation’s wealthiest resource, it might be an idea to visit ideas on good governance within
the realm of political, economic and social processes, which could provide some insight. Among human exports in the
Philippines, nurses and care-givers comprise the biggest chunk of professional labour (see Table 1), and
therefore the following case study on Filipino nurse migration is relevant to this investigation into the role
Philippine human capital plays in economic growth and development.
Remittances by Filipino workers are key to the Philippines economy
Goode 9 – (Angelo, International Studies Department, De La Salle UniversityEast Asia, 26(2),
June 2009)gw
Money sent by Overseas Filipino Workers (OFWs) back to the Philippines is a major factor in the
country's economy, amounting to more than US$17 billion last year in cash remittances according to the World Bank [15]: 43). It
is perhaps for this reason that the Philippine economy performed better in 2007 as compared to previous
years, marking the country as the fourth largest recipient of foreign remittances behind India, China, and Mexico [15]: 43). Not too
long ago, President Gloria Macapagal-Arroyo coined the term Overseas Filipino Investor or OFI for Filipino expatriates who
contribute to the economy through remittances, buying property and creating businesses [25]. Evidently,
national economic and development policies consider and seemingly encourage the export of Filipino
human capital. As it stands however, remittances only prop up the economy in that Filipino families have
more spending power, but the money doesn’t go into national investments that can help development in the long run. Anomalies
such as this draw attention to the importance of labour migration as a development strategy, and the
ways in which migrant remittances can be managed appropriately for the betterment for Philippine
society.
ADI
Pointer/Symonds Lab
20
Nurses Neg
Link: Brain Drain – Filipino Economy
Public Health jobs in Philippines key to their economy
Doikno, 7/28 (http://www.bworldonline.com/main/content.php?id=14916, Diokno, Benjamin, 7/28/100
In the near term, economic recovery may remain weak. Joblessness will continue to increase as job
openings will be limited and as the number of new entrants to the market rises. This means that the
government has to be more proactive. It has to put in place several job creation projects that would
employ people in productive activities -- public health in the countryside, reforestation and cleaning of
rivers and creeks, public construction in rural areas. I have a sense that workers would like to know
what job creation programs by the government are in store for them. At the same time, overseas
workers are wondering whether jobs at home would be available and when, so they can plan their
reentry to the country. Clearly the workers were disappointed. But it’s not too late. Mr. Aquino may
want to continue his conversation with the Filipino people on certain specific issues. He can do it on a
weekly or monthly basis, in a forum of his choice, and in a style that he’s comfortable with. He can start with
jobs and overseas employment policy. Mr. Aquino may then proceed to talk about other equally important
issues: population management, energy, water, budget deficit reduction, poverty reduction.
ADI
Pointer/Symonds Lab
21
Nurses Neg
Link: Brain Drain – Economy
Migrant nurses create economic instability in donor countries
Klein, 2004 (Donna S. Push and Pull Factors in International Nurse Migration. Journal of Nursing
Scholarship. Volume 35 Issue 2, Pages 107 – 111. 23 Apr 2004. http://www3.interscience.wiley.com/cgibin/fulltext/118855563/PDFSTART)
The movement of nurses from donor to receiving countries can create hardships in donor countries
because of the loss of skilled personnel and loss of economic investment in education. The migration of
nurses from developing countries, such as from African countries, results in the loss of “scarce and
relatively expensive-to-train resources” (Buchan, 2001, p. 204). Many African countries have had
significant increases in incidence and prevalence of infectious diseases such as AIDS, malaria, and
tuberculosis, thus placing further demands on already overburdened health care systems. The World
Health Organization (WHO) reported that at the end of 2000, 25.3 million people in Sub-Saharan Africa had
HIV/AIDS (WHO, 2000). Difficulties created by migration particularly from the Sub-Saharan region come
less from the loss of people in absolute numbers than from the loss of the few qualified professionals (Ojo,
1990). The loss of nurses in this region results in even fewer skilled nurses, increased care demands on
the nurses who remain, and further deterioration of inadequate health care systems.
In addition to African countries, some other donor countries also have scarce nurse resources and can ill
afford to lose nurses to migration. WHO (1998) estimates showed the distribution of health personnel per
100,000 of the population. China, India, and Pakistan indicated 99, 45, and 34 nurses respectively per
100,000 persons. In comparison, the US reported 972 nurses (for 1996), the UK reported 870 nurses (for
2000; Buchan & Seccombe, 2002), Australia reported 830 nurses (for 1998), Canada reported 897 nurses (for
1996), and Ireland reported 1,593 nurses (for 1998) per 100,000 persons.
Reports from the Philippines are mixed regarding effects on the health care system and the economy
when large numbers of nurses leave for other countries. The migration of Filipino nurses is an example of
the push factors of the economic conditions of oversupply, minimal employment opportunities, and the
political factors of an aggressive export policy (Hawthorne, 2001). Sison (2002) reported that Filipino
government officials viewed the exporting of nurses as a new growth area for overseas employment. The 175
nursing schools in the Philippines produce more than 9,000 graduates yearly, of whom 5,000 to 7,000
become licensed. Governmental encouragement for nurse migration is understandable, given the amount of
money returned to the country in remittances. Lindquist (1993) reported over $800 million received in
remuneration per year from Filipinos living abroad, money on which the Filipino economy had become
highly dependent. Filipino nurses are sought in many Englishspeaking countries because of the Westernoriented nursing curriculums with English as the primary instructive language, making Filipino nurses
“marketable to foreign countries” (Ortin, 1990, p. 11).
ADI
Pointer/Symonds Lab
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Nurses Neg
Link: Brain Drain – India
Immigration of nurses undermines Indian healthcare and allows epidemic diseases to run
rampant
Davis and Hart 10 (Ted and David, School of Public Policy at George Mason, Review of Policy
Research, July 2010, 27(4), p509-526)gw
High-skill migration in medicine and nursing poses a different set of challenges than it does in IT services. Primary medical care is a
personal service that requires the presence of skilled professionals. The essential nature of health care services means
that the loss of doctors and nurses from developing nations to developed nations may have significant
negative consequences. One fact is certain in this field: many Indian health care needs are not met. The
country suffers from epidemic diseases that have been eradicated in most of the rest of the world, while
treatment of chronic conditions is highly uneven. In 2004, there were six doctors to every 10,000 inhabitants in India (OECD, 2007).
This ratio is about a quarter of that in the United States, which is a major destination of Indian doctors. OECD (2007) reports that
approximately 18 percent of doctors employed in OECD countries are foreign born. India is the largest source country for
these foreign-born doctors. The foreign-born share of doctors in the United States is higher than the OECD average at 25 percent.
The enormous size of the U.S. health sector means that the United States dominates medical migration into the
OECD. Over 50,000 Indian-born doctors and 15,000 medical students/residents live in the United States (AAPI, 2009). Only 3.5
percent of nurses working in the United States were born outside the country, but international recruitment of nurses is
growing rapidly. India is a major target for nursing recruitment (Pittman, Aiken, & Buchen, 2007). The total
number of foreign-born health workers in the United States has been increasing at an annual rate of more than 3 percent .
ADI
Pointer/Symonds Lab
23
Nurses Neg
Specific Link: Brain Drain – Philippines and India – Lifting the Cap
Removing the immigration cap will hurt the Philippines and India – taking away their
nursing staff.
Dugger 06, Celia. "U.S. Plan to Lure Nurses May Hurt Poor Nations." The New York Times - Breaking News, World News & Multimedia.
24 May 2006. Web. 29 July 2010. <http://www.nytimes.com/2006/05/24/world/americas/24nurses.html?_r=1&pagewanted=print>. JRL
As the United States runs short of nurses, senators are looking abroad. A little-noticed
provision in their immigration bill would throw open the gate to nurses and, some fear,
drain them from the world’s developing countries.
the Senate provision, which removes the limit on the
number of nurses who can immigrate, has been largely overlooked in the emotional debate
over illegal immigration.
The legislation is expected to pass this week, and
Senator Sam Brownback, Republican of Kansas, who sponsored the proposal, said it was needed to
help the United States cope with a growing nursing shortage.
He said he doubted the measure would greatly increase the small number of African nurses
coming to the United States, but acknowledged that it could have an impact on the
Philippines and India, which are already sending thousands of nurses to the United States a
year.
The exodus of nurses from poor to rich countries has strained health systems in the
developing world, which are already facing severe shortages of their own. Many African countries
have begun to demand compensation for the training and loss of nurses and doctors who move away.
The Senate provision, which would remain in force until 2014, contains no such compensation, and has not stirred serious opposition in
Congress. Because it is not part of the House immigration bill, a committee from both houses would have to decide whether to include the
provision on nurses if the full Congress approves the legislation.
Public health experts in poor countries, told about the proposal in recent days, reacted with dismay and outrage, coupled with doubts that their
nurses would resist the magnetic pull of the United States, which sits at the pinnacle of the global labor market for nurses.
Removing the immigration cap, they said, would particularly hit the Philippines, which
sends more nurses to the United States than any other country, at least several thousand a
year. Health care has deteriorated there in recent years as tens of thousands of nurses have moved abroad. Thousands of ill-paid doctors have
even abandoned their profession to become migrant-ready nurses themselves, Filipino researchers say.
“The Filipino people will suffer because the U.S. will get all our trained nurses,” said
George Cordero, president of the Philippine Nurse Association. “But what can we do?”
The nurse proposal has strong backing from the American Hospital Association, which reported in April that American hospitals had 118,000
vacancies for registered nurses. The federal government predicted in 2002 that the accelerating shortfall of nurses in the United States would
swell to more than 800,000 by 2020.
“There is no reason to cap the number of nurses coming in when there’s a nationwide shortage, because you need people immediately,” said
Bruce Morrison, a lobbyist for the hospital association and a former Democratic congressman.
ADI
Pointer/Symonds Lab
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Nurses Neg
Internal Link: Economic Stability Key to Political Stability
Economic Instability leads to political instability-empirically proven by Argentina and
Indonesia prove
Change 7 (Roberto, Rutgers University, Journal of Monetary Economics, 54(8), p.2409)
That financial crises are often associated with political instability is undisputable. In two recent and
spectacular episodes, Indonesia 1998 and Argentina 2001, economic and financial difficulties were
followed by massive popular revolts, which ultimately toppled the incumbent governments. In spite of
the notoriety of these and other cases, our understanding of them and, more generally, of the links between
financial turmoil and political crises remains rather poor. Yet such an understanding may be crucial, most
significantly for the formulation and evaluation of public policy. Indeed, some observers of Indonesia and
Argentina reached the conclusion that those crashes were driven primarily by social, institutional, and
political degeneration. One logical implication of that position is that international assistance, in terms of
advice or resources, to countries in such circumstances is not advisable, as it is bound to be wasted in the
absence of deep institutional and political reform.1 That analysis, therefore, denies the relevance of existing
theories of financial crises, in particular those which emphasize liquidity, self-fulfilling panics, and the
desirability of an international lender of last resort, in situations in which political instability seems to be the
dominant force. But the view that crises like those of Indonesia and Argentina are just the manifestation
of underlying political forces relies upon the implicit assumption that the political equilibrium is
largely exogenous with respect to economic and financial events. That assumption is itself questionable.
The popular uprisings in Indonesia and Argentina appeared to be caused by widespread anger about
the economic adjustment measures proposed by the incumbent governments as the best way to
overcome ongoing financial difficulties.2 So it is not too hard to argue that political instability is an
endogenous response to the economic environment.
ADI
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25
Nurses Neg
Uniqueness: No Filipino Nursing Migration Now
In View Of Economic Downturn, US Is Filling The Nursing Demand With It’s Own
Citizens.
Icamina 9 Paul. "U.S. Not Issuing Visas for Nurses | Daily Updates | Pinoy Herald." PINOY HERALD - Bridging the Filipino American
Community. Philippine Daily News, World News, U.S. News, Pinoy News, Washington DC, Northern Virginia, Maryland . 28 Jan. 2009. Web. 29
July 2010. <http://www.pinoyherald.org/news/daily-updates/us-not-issuing-visas-for-nurses.html>. JRL
Nursing jobs are simply not there for thousands of Filipinos hopeful of going to the United
States. At the moment, “The U.S. still needs nurses but it’s not giving out visas for nurses now. It
needs to legislate to provide additional work-related permanent visas for nurses,” says Dean
Josefina Tuazon of the University of the Philippines Manila-College of Nursing.Observers believe visas for foreign-trained nurses will be issued
again this year when the U.S. Congress, upon the urging of patients and the health-care industry, approves the quota for foreign-trained nurses
in view of the recent U.S. recession and
financial crisis, working nurses there now put in additional hours while others are going
back to nursing, thus local nurses are filling local demand.”
that has already been filled up. “Although the U.S. still needs more nurses,
ADI
Pointer/Symonds Lab
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Nurses Neg
Uniqueness: Filipino Economy High
Philippine economy stabilized- unemployment and poverty rate at healthy levels for
economic growth
Entrepenuer,7 (Financial Management and News Site, “Philippine economy exhibits stability.” July 1, 2007,
http://www.entrepreneur.com/tradejournals/article/166584502.html)
It is well known that the President of the Philippines is an economist in addition to being a skilled politician. During her
tenure as President, she has made a series of highly unpopular decisions, which have contributed significantly to the development
of the Philippine economy.
A recent speech reveals the President's pride in her accomplishments. Among her remarks: "Our unemployment rate is the
lowest in a generation. Our poverty rate is the lowest as well. Our economy has reached a new level of maturity and
stability with some of the strongest macroeconomic fundamentals in a decade."
No matter that this remark glosses over the difficulties to come-these are serious accomplishments.
According to International Monetary Fund (IMF) statistics, the Philippine economy grew 5.4 percent in 2006. The IMF
estimates GDP growth in 2007 at 5.8 percent, and also at 5.8 percent for 2008.
A June 14, 2007 posting on the website of the Philippine Daily Inquirer (Makati City, as central Manila is known) of a late 2006
speech by the publisher of a Philippine business news magazine, added detail specific to the country's consumer economics.
Remarking that the Philippines had grown an average of 4.7 percent over the past 22 consecutive quarters with
productivity increasing 25 percent over the past five years, the publisher said, "Economic growth now outpaces
population growth at a ratio of two to one."
What this means for consumers is that the Philippine economy now has the ability to feed, clothe, and educate its
population well into the future.
The publisher said that several industrial sectors-services, agriculture, industry and manufacturing-have contributed
strongly to Philippine growth. "Adding vibrancy to these sectors is consumer spending and the rise of cellular
technology," he added. Personal consumption expenditure accounts for 69.6 percent of the economy's total output [2006].
Much of the volume of consumer spending is based on remittances from Filipinos working abroad. A significant portion of
consumer spending goes toward technology, and cellular technology is prominent. The Philippines is made up of 7,107 islands.
And 98 percent of these islands are currently linked by wireless technology. "For the first time, the country is united by one
medium, the cellular phone," said the publisher.
Internet usage is also a factor. Just under 10 percent of the country's population is connected to the Internet.
Two significant trends: First, food is no longer the biggest item in household budgets. And the second has to do with the coming
generation. "Filipino teenagers now spend more on internet cafes, prepaid phone cards and post paid cell phone bills, while trying
to economize on food, beverages, personal care, transportation, clothes and reading materials."
Philippine peso on the rise – Long term goals to sustain are coming in place
Alcuaz, 7/26 (http://www.businessweek.com/news/2010-07-26/philippine-peso-advances-as-president-vows-to-boost-economy.html,
Francisco, 7/26/10)
The Philippine peso rose the most in two weeks as President Benigno Aquino’s State of the Nation
address spurred optimism that the government’s programs will boost investment and quicken
economic growth. The currency climbed to its highest level in a month as Aquino said talks with
investors offering to build roads and other infrastructure would produce “good” results. In his first
speech to Congress, the president backed bills that would help control the budget deficit and promised
to speed up business registration. Aquino’s address helped to boost “expectations surrounding
economic activity arising from public-private partnerships and lessening bureaucracy,” said Jonathan
Ravelas, a market strategist at Banco de Oro Unibank Inc. in Manila. The peso rose 0.4 percent to 46.12 per
dollar at the close of trading in Manila, according to prices from inter-dealer broker Tullett Prebon Plc. That
was its biggest gain since July 9, and the currency’s strongest level since June 23.
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Uniqueness: Filipino Economy High
Filipino Economy on the rise – Tech export
Anstey, 7/13 (http://www.businessweek.com/news/2010-07-13/philippine-export-growth-quickens-boosting-economy.html,
Anstey, Christopher, 7/13/2010 “Philippine Export Growth Quickens, Boosting Economy”)
Philippine exports rose at a faster pace in May as the global recovery spurred demand for electronics,
sustaining the nation’s economic expansion and supporting President Benigno Aquino’s efforts to boost
incomes. Asian exports rebounded this year as customers in the U.S. and Europe increased purchases
of Philippine-made Texas Instruments Inc. semiconductors and South Korea-produced Hyundai Motor Co.
cars. Still, Bangko Sentral ng Pilipinas may keep its benchmark interest rate at a record-low 4 percent this
week to support the nation’s recovery as the European debt crisis threatens global growth, economists
surveyed by Bloomberg say. “Rising exports would mean more jobs for Filipinos and may spur
investments,” April Tan, head of research at CitisecOnline.com Inc. in Manila, said before the report. “If
the global economy is cooperative, it will make it easier for the president to meet his objectives of
increasing growth and cutting poverty.”
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Solvency Answers: Doesn’t Solve Long-Term
Immigration won’t solve for long
Aiken 07 (HSR: Health Services Research 42:3, Part II “U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency” Linda H
Aiken, PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology, and Director of the Center for Health
Outcomes and Policy Research)
Increased reliance on immigration may adversely affect health care in lower-income countries without
solving the U.S. shortage. The current focus on facilitating nurse immigration detracts from the need
for the United States to move toward greater self-sufficiency in its nurse workforce. Expanding
nursing school capacity to accommodate qualified native applicants and implementing evidence-based
initiatives to improve nurse retention and productivity could prevent future nurse shortages.
Reliance on nurse immigration doesn’t provide long-term solutions
Aiken 07 (HSR: Health Services Research 42:3, Part II “U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency” Linda
H Aiken, PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology, and Director of the Center for
Health Outcomes and Policy Research)
Increased reliance on immigration may adversely affect health care in lower-income countries without
solving the U.S. shortage. The current focus on facilitating nurse immigration detracts from the need
for the United States to move toward greater self-sufficiency in its nurse workforce. Expanding
nursing school capacity to accommodate qualified native applicants and implementing evidence-based
initiatives to improve nurse retention and productivity could prevent future nurse shortages.
Though a viable option to minimally pacify the nurse shortage, it is not nearly a solution
Fong, 2005 (Tony. Nurse visa crisis eases. Modern Healthcare, p. 28. 13 June.)
Facing a national nursing shortage of 150,000, hospitals received some respite in May when President
Bush signed legislation freeing up to 50,000 visas for foreign nurses.
The proposal, included in an $80 billion supplemental appropriations law, frees up visas unused from
2001 to 2004 when heightened concerns about terror created changes in immigration policies that in turn led
to a logjam of visa applicants and delays in processing them.
Only a certain number of visas are issued each year, limited both in total and per country. Unused
visas cannot be carried over from year to year.
``We're doing all we can here to grow our own supply of U.S. nurses, but the current workforce
shortage and the growing demand for care mean that many hospitals must look outside the U.S. for
highly qualified RNs,'' says Carla Luggiero, senior associate director of federal relations at the American
Hospital Association.
Despite the availability of the visas, the level of relief it will provide to hospitals is viewed by those in
the industry to be minor. ``It is certainly not a solution. The nursing shortage is pretty vast,'' Luggiero
says.
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Solvency Answers: Alternate Causality – Poor Working Conditions
Nurse shortages loom because of poor working conditions
Campell 09 (International Action Needed to Tackle Nurse Migration, Nursing Standard, 7/22/2009, Vol. 23 Issue 46, p32-33)
Heavy workloads and insufficient staff impact patient care and health outcomes, are leading some
nurses to question their commitment to the profession, according to a global survey conducted by the International
Council of Nurses (ICN) in collaboration with Pfizer Inc. Titled Nurses in the Workplace: Expectations and Needs, the survey included
2203 nurses from 11 countries around the world. The results, announced at ICN’s 24th Quadrennial Congress in Durban, South Africa,
provide a detailed look at the opportunities and challenges facing nurses today. ‘Nurses represent the largest group of
healthcare providers in the world. We were keen to better understand nurses’ views of their work and
the environment in which they practice across the world,’ said David Benton, ICN Chief Executive
Officer. Nurses globally are thinking about leaving the profession, which will further impact already
burdened healthcare systems, especially in countries such as Kenya,Uganda and South Africa,’ said Benton. ‘It is
urgent to respond to their needs with adequate staffing, greater independence and greater involvement
in decision-making. Nurses must be involved in crucial policy conversations as healthcare systems
grow, develop and change.’
Current hospital working conditions alienate immigrant workers
Oulton 06 (Policy, Politics, & Nursing Practice Supplement to Vol. 7 No. 3, August 2006, Judith A. Oulton,
MEd, RN)
When we give a voice to nurses, we hear them say, “I’m leaving because of understaffing, because we
don’t have the human resources, because the skill mix is not right, because I go home at night and I am frustrated and
unhappy and dissatisfied with myself that I cannot give the kind of care I want to give. I am frustrated and tired because of
the lack of support, because I do not have professional parity, because there is not the teamwork I
wanted to see, because my salary and benefits are not what I want. There is not the opportunity for autonomy and
for control of workload. My promotional prospects are poor.” Nurses are changing jobs, leaving the country, and
leaving nursing. They are leaving because of the lack of access to continuing education, the lack of
professional development, the stress, the workplace violence, the bullying and the harassment, and as
nurses in Ghana have said, because of a lack of feeling valued. In too many countries, there is a critical
shortage of nurses willing to work under the present pay and working conditions offered. And this
shortage is not limited to clinical practice. It also includes nursing faculty, who are needed to prepare
current and future generations of nurses.
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Solvency Answers: Healthcare
Nurse migration undermines effectiveness of healthcare – migration hurts education
Hancock 08 (Nurse migration: the effects on nursing education. International Nursing Review 55,
258–264 P.K. Hancock1, 2 MA Ed, RGN, RCNT, RNT Senior Nursing Lecturer, Centre for Health and Social Care Studies and Service
Development, School of Nursing and Midwifery, The University of Sheffield, South Yorkshire, 2 Honorary International Nursing Adviser,
British Council, Manchester, UK)
Mass rapid nurse migration undermines nurse education globally. Although nurses generally regard
themselves as being apolitical or politically inactive, nurses worldwide need to participate in the
political life of their country. They should look beyond the immediate frustrations of nurse shortages
and recognize that nurse education is the foundation of quality patient care . It is essential that decisions about
its development and delivery are not left entirely to the politicians and business persons if patient safety and the integrity of nurse
education are to be protected. Nursing Associations through the International Council of Nurses should
continue to strive to develop partners in democratic decision making at a variety of levels, both grass
root and global, and to legislate and regulate nurse preparation and training. This is essential if we are
to avoid a situation where as the Philippine Free Press reported in 2006, there are ‘thousands of
graduates who are unqualified to become nurses’.
Foreign nurses mask the problem and don’t solve the root cause of lack of nurses
Kline 3.( Donna, Journal of Nursing Scholarship, 35(2).p.109)
Nursing leaders in the US are concerned about the use of immigration as a means to address the
nursing shortage.
Glaessel-Brown (1998) reported that using foreign nurses as “readily available, expendable workers
postpones sustained efforts to resolve professional problems leading to a more stable work force and
self-sustaining cycles” (p. 327). In her testimony before the House Education and Workforce Committee,
Mary Foley (2001), then president of the American Nurses Association, echoed Glaessel-Brown’s opinion
that using foreign nurses to fill shortage positions only delayed action on the serious workplace issues
that have driven American nurses away from the profession.
Lack of education will still put US in lack of skilled workers
Hemme 7(Barbara, Harper College, Forum on Public Policy: A Journal of the Oxford Round Table, p.11)
Third world and newly industrialized economies are spending education dollars to train a new
workforce. Their initial goal is for the workforce to emigrate, earn currencies that are worth more in
the home country, and then send those monies back to the home country to boost its economy. This
situation can only last so long, before the economy of the new country begins to expand. Then those
countries are likely to try to retain workers, leaving a shortfall for other economies that depend on
them. The United States is falling behind in financing our education systems. Almost daily we hear of
school districts that are underfunded. The other side of this argument is that the school systems should not be
funded because they are outdated and do not meet the needs of our society. No matter which side is correct,
our children suffer from lack of quality education compared to other countries. Eventually even third
world countries and new industrialized countries will become fully industrialized. In the past this
process would have taken decades. Our global society has changed that pattern. If we use China as an
example of this process, one only has to realize that it took them a very short period of time to move
some of their citizens from a poor, working class to a strong middle class who now demand more.
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Solvency Answers: Immigrant Nurses Fail
Foreign nurses cannot adequately communicate in US
Allen 9 (Marshall, Journalist The Las Vegas Sun, http://www.lasvegassun.com/news/2009/mar/10/foreign-nurses-can-fallcommunication-gap/) KRA
Yu “Philip” Xu, a professor at UNLV’s school of nursing who is originally from China, has studied the phenomenon in depth and has
developed a unique training program to address the challenges. Xu’s research has shown that foreign nurses have a
difficult transition to the American health care system. A study he conducted on Chinese nurses in the
United States found they often felt socially isolated and paralyzed by their communication
inadequacies.
Differences in jobs make it difficult for immigrant nurses
Allen 9 (Marshall, Journalist The Las Vegas Sun, http://www.lasvegassun.com/news/2009/mar/10/foreign-nurses-can-fallcommunication-gap/) KRA
Foreign nurses are also forced to adjust to differences in the job description in the United States, Xu’s research
nurses are accustomed to family members doing tasks like bathing and feeding the
patient, and may feel such jobs are beneath their level of education , one of his studies found. In addition, many
international nurses are not accustomed to the amount of independent judgment and time spent
documenting medical care that’s required by the American system, his studies said.
has shown. Asian
The language barrier of foreign nurses can lead to deaths
Allen 9 (Marshall, Journalist The Las Vegas Sun, http://www.lasvegassun.com/news/2009/mar/10/foreign-nurses-can-fallcommunication-gap/) KRA
Language and communication problems can have a direct effect on the quality of patient care, and on
the perceptions patients have of their care, Xu said. An estimated 100,000 people die every year as the
result of medical errors in the United States, and communication problems are believed to be a leading
cause. Xu said
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Solvency Answers: Lifting the Cap Doesn’t Solve
The Nursing Shortage will only increase even with lifting the visa cap
Doheny, Kathleen 2006 (Workforce Management; “Treating the nurse shortage: Nursing
in critical condition; Profession calls for a homegrown cure, not boosting visas for foreign
talent”) Lexis-Nexis
But those who favor lifting the visa cap for nurses-including the American Hospital Association-view it
as a viable short-term remedy as more permanent strategies, such as increasing nursing school faculty,
are gradually implemented. Both sides agree on one point: While the immigration bill is viewed by many
as moribund, the nursing shortage is alive and well and won't be fixed any time soon. It will only
deepen, perhaps reaching a deficit of more than 1 million positions by 2020, according to estimates from
the Health Resources and Services Administration. And the nursing shortage won't just impact health care
industry employers, experts warn. The lack of nurses could eventually affect all employers, either
directly or indirectly, McKeon and others say. ``Waiting times in the emergency rooms are getting
longer,'' says Beth Brooks, a senior partner at JWT Employment Communications, a global recruitment,
marketing and internal communications agency specializing in health care. The nursing shortage is
affecting or will affect ambulatory care, long-term care and doctors' offices, she says. Sooner or later,
nearly every employer will probably have workers affected by the shortage. ``Nursing units are being
closed,'' Brooks says. ``In parts of the country, emergency rooms are going on diversion, sending
patients to other hospitals. Elective procedures are being canceled or delayed indefinitely.'' While she isn't
aware of any study linking the shortage of nurses and its effect on health care with lower worker productivity
or higher absenteeism, the potential for that effect is obvious. Currently, 118,000 registered nurses are
needed to fill vacancies in U.S. hospitals, according to a report released by the American Hospital
Association in April. Shortages at nursing homes also are significant, according to a survey of 6,000 facilities
in 2002 by the American Health Care Association. It found 15 percent of staff RN positions were vacant, and
that nearly 14,000 RNs would be needed to fill those vacancies. From 2004 to 2014, the U.S. health care
system will need more than 1.2 million new nurses, according to a 2005 Bureau of Labor Statistics
report. Recruiting new nurses was viewed as more difficult in 2004 than in 2003 by 40 percent of
hospitals surveyed in an American Hospital Association 2005 workforce survey.
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Solvency Answers: Delay
The time consuming process of getting visa's for foreign nurses makes solving the nursing
shortage almost impossible
Hanlon Law Group 09 (11/19/09, Findlaw Knowledgebase,
http://knowledgebase.findlaw.com/kb/2009/Nov/32307.html) SRS
What makes this shortage all the more difficult to understand is the fact that there are hundreds of
qualified, available nurses from other countries who are willing to immigrate to the United States but,
because of the immigration system, cannot get a visa to enter the country. There are two different
categories of visas foreign nurses can apply for to enter the US to work: nonimmigrant visas and immigrant
visas. Nonimmigrant visas are temporary visas that allow them to enter the US for a limited amount of time.
There are three types of nonimmigrant visas nurses may be eligible for: H1-B visas, TN visas and H-1C
visas. Nonimmigrant visas present a couple of difficulties. First, they are valid for a limited amount of
time, whereas the nursing crisis is an ongoing problem. Second, there are very few available
nonimmigrant visas for which nurses can apply. For example, H1-B visas are only available to those
who have a bachelor's degree or higher and many nurses do not have the required educational degree.
TN visas, on the other hand, are only available to qualified nurses from Canada and Mexico. Lastly,
H1-C visas, which were created specifically to address the nursing shortage, are limited to only 500 per
year and currently only 14 hospitals have the required certification to qualify for the visas. Immigrant
Visa Process Makes it Difficult to Bring Nurses to US The second option, immigrant visas, allows foreign
nurses to receive permanent residence in the US, otherwise known as a "green card." Nurses typically are
eligible for EB-3 visas, or a "third preference employment-based visa." In order to apply for an immigrant
visa, the foreign nurse must be sponsored by a US employer, like a hospital. The employer then must
enter a lengthy application process before the foreign nurse can become eligible to apply for a visa. The
process includes filing an I-140 petition and labor certification with the US Citizenship and Immigration
Services (USCIS) office. Generally, employers seeking to sponsor workers for EB-3 visas also must
complete a lengthy application process with the US Department of Labor (DOL) to certify that there is a
shortage of US workers for the position and that hiring a foreign worker will not have an adverse
affect on the wages or working conditions of US workers. However, nursing is considered a "Schedule A"
occupation. This means that the DOL has pre-certified that there is a documented shortage of nurses and that
hiring foreign nurses will not displace or adversely affect US nurses. The Schedule A designation is
supposed to speed up the application process for employers trying to sponsor foreign nurses by allowing
them to bypass the DOL process and skip ahead to filing the petition and labor certification with the USCIS.
But even with this designation, it still takes the USCIS an estimated 15 months to process an I-140 Immigrant
Visa Petition for a Schedule A nurse. The biggest barrier, however, to bringing more foreign nurses to
work in the US is not the application processing time, but how long it takes after the application has
been processed until a nurse receives a visa. Once the USCIS has approved the application for the
foreign nurse, the nurse then is given a priority date and placed in line for a visa with all of the other
approved EB-3 applicants. The current wait time for an available EB-3 visa number is 3-7 years. So
this means that hospitals who filed successful petitions for foreign nurses as far back as 2002 still may
be waiting for the nurse to begin work. Once the visa number becomes available, then the foreign nurse
must either apply for a visa at the US consulate or embassy in his or her home country. If the nurse currently
is in the US on a different type of visa, he or she then must apply for a change of immigrant status. Either one
of these processes may take months more to process.
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Healthcare Advantage Answers: Status Quo Solves the Aff
The new health reform law will improve the U.S. healthcare system
Krisberg 7/22 (Kim, Medscape, The Nation's Health, 7/22/2010,
http://www.medscape.com/viewarticle/724266)
Millions of Americans will now have access to affordable, quality health insurance, thanks to the historic
health reform legislation President Barack Obama signed into law in March. The long-awaited law is, in part,
the culmination of decades of work by health and public health advocates, such as APHA, who celebrated the
law as a significant step forward in fixing the nation's broken health system. "For nearly a century,
providing quality, affordable care to all Americans has eluded our grasp," said APHA Executive Director
Georges Benjamin, MD, FACP, FACEP (E). "This measure will strengthen our public health system, invest
in prevention, improve the health of the American people and move us closer to providing comprehensive
and affordable health coverage for all Americans." Beyond the insurance reforms, the landmark law, known as
the Patient Protection and Affordable Care Act, is also a momentous victory for public health and prevention.
The law creates a dedicated Prevention and Public Health Fund that will provide $15 billion over 10 years to
support community prevention and research activities as well as strengthen state and local public health capacity.
In addition to the new funds, which represent the largest commitment to prevention and wellness in U.S. history,
the health reform law establishes a National Prevention, Health Promotion and Public Health Council, which will
be chaired by the U.S. surgeon general and tasked with coordinating the development and implementation of a
national prevention strategy.
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Healthcare Advantage Answers: Status Quo Solves the Aff
Squo is solving now for nursing shortages
Ream 10 (Kathleen, ANSR Alliance Contact, Testimony of the Americans for Nursing Shortage
Relief Alliance Regarding Fiscal Year 2011 Appropriations for Title VIII – Nursing Workforce
Development Program) OS
The link between health care and our nation’s economic security and global competitiveness is undeniable.
Having a sufficient nursing workforce to meet the demands of a highly diverse and aging population is
an essential component to reforming the health care system as well as improving the health status of
the nation and reducing health care costs. To mitigate the immediate effect of the nursing shortage and
to address all of these policy areas, ANSR requests $267.3 million in funding for the Nursing
Workforce Development Programs under Title VIII of the Public Health Service Act at HRSA in FY
2011. The requested increase should be directed at the Title VIII programs that have not kept pace with
inflation since FY 2005: Advanced Education Nursing, Nursing Workforce Diversity, Nurse Education,
Practice and Retention, and Comprehensive Geriatric Education. These programs, which help expand
nursing school capacity and increase patient access to care, would greatly benefit from the 10%
increase awarded in proportion to their FY 2010 funding levels.
Health care reform solves the advantage
Mason 10 (Diana, PhD, RN, FAAN, The American Journal of Nursing, 110(7) p. 24) OS
The new law includes federal support for developing the health care workforce, including nursing, with
a particular emphasis on expanding the number and preparation of primary care providers. For the first time,
the federal government will explore using funds from Medicare to support graduate nursing education
through limited pilot projects. Just as there is graduate medical education (GME) funding through
Medicare to support the clinical education of physicians in hospitals, there will be graduate nursing
education (GNE) funding, a breakthrough that has been decades in the making. (An upcoming Policy
and Politics will provide details of the many workforce measures that are included in the bill.)
The law includes various measures to promote primary care, prevention, chronic care management,
transitional care, and care coordination –all services that nurses provide. Advanced practice RNs (APRNs)
and RNs will be highly sought after as health care delivery systems test ways to shift their focus from acute
care to preventing hospitalizations. Many previously uninsured or underinsured individuals will be
seeking care, particularly primary care. Job opportunities in primary care should proliferate. The law
also includes authorization for expanding the capacity of nurse-managed centers, which have been serving
uninsured and Medicaid populations for decades. If nurse-managed centers can expand their capacity, they'll
be able to help the nation meet the increased demand for primary care. The law also includes support for
expanding existing communtiy health centers or establishing new ones in areas where there's a
shortage of health care providers. Nurses will be crucial to such expansion.
ADI
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Uniqueness: U.S. Largest Importer of Nurses
The US is the largest importer of foreign nurses
Aiken & Cheung, 2008 (Linda H. Aiken and Robyn Cheung. NURSE WORKFORCE CHALLENGES IN
THE UNITED STATES: IMPLICATIONS FOR POLICY. Organisation for Economic Co-operation and
Development. 01 Oct 2008. http://www.who.int/hrh/migration/Case_study_US_nurses_2008.pdf)
Healthcare organizations in the United States have actively recruited professional nurses from abroad
for over 50 years in response to cyclical nurse shortages in hospitals and nursing homes (Brush and
Berger, 2002; Aiken, Buchan, Sochalski, Nichols, & Powell, 2004; Aiken, 2007; Polsky, Ross, Brush,
Sochalski, 2007). Until the early 1990s, the inflow of registered nurses educated abroad generally did not
exceed 4 000-5 000 a year (Buerhaus et al., 2004). But in the period 1994 through 2006, the annual
number of newly licensed registered nurses from abroad tripled to more almost 21 000 in 2006 (see
Table 7) making the U.S. the largest importer of professional nurses in the world. Foreign educated
nurses increased as a percent of new entrants from 9% in 1990 to 16% in 2006. Immigration of persons in
the category of practical or vocational nurses has remained constant over time at about 1 400 a year
accounting for about 2% of new LPN entrants to the workforce. For the most part trends in nurse
immigration parallel trends in enrollments in nursing schools. Both enrollments, as argued earlier, and
immigration are driven by employer demand, particularly in the hospital sector. If there are fewer jobs,
nursing school enrollments decline as does nurse immigration because hospitals are not recruiting at home or
abroad.
The US is the primary destination for migrant nurses
Aiken & Cheung, 2008 (Linda H. Aiken and Robyn Cheung. NURSE WORKFORCE CHALLENGES IN
THE UNITED STATES: IMPLICATIONS FOR POLICY. Organisation for Economic Co-operation and
Development. 01 Oct 2008. http://www.who.int/hrh/migration/Case_study_US_nurses_2008.pdf)
The U.S. is the destination of choice for many migrating nurses from both developed and lower
income countries because of high wages, opportunities to pursue additional education, and a high
standard of living (Kingma, 2006). The prolonged nurse shortage in the U.S. and the large shortage
projected for the future have motivated more nurse recruitment abroad by hospital employers and
commercial recruiting firms (Brush, Sochalski, & Berger, 2004). Almost 34 000 foreign educated nurses
took the NCLEX-RN registered nurse license exam in 2005 (44% passed), suggesting a great deal of interest
among foreign educated nurses in working in the U.S. (National Council of State Boards of Nursing).
Close to a third of the estimated 218 720 foreign educated nurses in the U.S. are from the
Philippines. The second most important source region for foreign born nurses is the Caribbean and
Latin America which has contributed almost 50 000 nurses. Western developed countries including
Canada, Western Europe, Australia and New Zealand rank third with a total of almost 33 000 nurses
(see Table 9).
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Domestic Nurses Counterplan 1NC Shell
Text: The United States Federal Government should guarantee that no native applicants to
nursing schools in the United States are denied admission due to capacity restrictions. The
United States Federal Government should also substantially increase financial incentives
for prospective nursing professors. Funding and enforcement guaranteed.
Nursing schools need funding – capacity is the key internal link
Aiken, 2007 (Aiken, L. H. (2007), U.S labor market dynamics are key to global nurse sufficiency. Health
Services Research. 42, Vol.3, Part II, pp.1299-1320.)
Production capacity of nursing schools is lagging current and estimated future needs, suggesting a
worsening shortage and creating a demand for foreign-educated nurses. About 8 percent of U.S.
registered nurses (RNs), numbering around 219,000, are estimated to be foreign educated. Eighty percent are
from lower-income countries. The Philippines is the major source country, accounting for more than 30
percent of U.S. foreign-educated nurses. Nurse immigration to the United States has tripled since 1994, to
close to 15,000 entrants annually. Foreign-educated nurses are located primarily in urban areas, most
likely to be employed by hospitals, and somewhat more likely to have a baccalaureate degree than
native-born nurses. There is little evidence that foreign-educated nurses locate in areas of medical need in
any greater proportion than native-born nurses. Although foreign-educated nurses are ethnically more diverse
than native-born nurses, relatively small proportions are black or Hispanic. Job growth for RNs in the
United States is producing mounting pressure by commercial recruiters and employers to ease
restrictions on nurse immigration at the same time that American nursing schools are turning away
large numbers of native applicants because of capacity limitations.
Nursing shortage is the effect of a professor shortage – funding key
Dugger 06, Celia. "U.S. Plan to Lure Nurses May Hurt Poor Nations." The New York Times - Breaking News, World News & Multimedia.
24 May 2006. Web. 29 July 2010. <http://www.nytimes.com/2006/05/24/world/americas/24nurses.html?_r=1&pagewanted=print>. JRL
The American Nurses Association, a professional trade association that represents 155,000 registered nurses, opposes the measure. The group
said it was concerned the provision would lead to a flood of nurse immigrants and would damage both the domestic work force and the home
countries of the immigrants. “We’re disappointed that Congress, instead of providing appropriations for domestic nursing programs, is
outsourcing the education of nurses,” said Erin McKeon, the group’s associate director of government affairs. Holly Burkhalter, with
Physicians for Human Rights, an advocacy group, said the nurse proposal could undermine the United
States’ multibillion-dollar effort to combat AIDS and malaria by potentially worsening the shortage of health
workers in poor countries. “We’re pouring water in a bucket with a hole in it, and we drilled the hole,” she said.
There are now many more Americans seeking to be nurses than places to educate them. In 2005, American
nursing schools rejected almost 150,000 applications from qualified people, according to the National League
for Nursing, a nonprofit group that counts more than 1,100 nursing schools among its members. One of the
most important factors limiting the number of students was a lack of faculty to teach them, nursing
organizations say. Professors of nursing earn less than practicing nurses, damping demand for teaching
positions.
ADI
Pointer/Symonds Lab
38
Nurses Neg
Domestic Nurses Counterplan: Solvency – Capicity/Funding
Domestic nurse education solutions should be preferred to foreign recruitment
Aiken, 2007 (Aiken, L. H. (2007), U.S labor market dynamics are key to global nurse sufficiency. Health
Services Research. 42, Vol.3, Part II, pp.1299-1320.)
The United States lacks a national capacity to monitor nurse labor market dynamics and has no
national nurse workforce policy, despite dire predictions about impending shortages. Indeed, health
workforce policy was not ranked among the top 10 policy priorities in a recent survey of experts by the
Commonwealth Fund (2004). The implications of health care cost containment policies for nursing supply
and demand are rarely, if ever, considered prospectively. Immigration policies are not part of a broader
strategy to ensure sufficient availability of nurses to meet national needs. There is little coherence
between international development and immigration policies. Unlike many other countries where the
government fully funds nursing students to become qualified nurses, U.S. nurses pay for their own
education, helped by tax subsidies to public educational institutions and limited scholarship and
student loan programs. In recent years, out-of-pocket costs of higher education have increased
significantly. Enrollments in nursing schools are thus sensitive to nurse labor market dynamics, as
exemplified by the reduction in graduations between 1995 and 2001 of up to 25,000 nurses a year. Public
policy, at a minimum, should establish the capacity to monitor changes in nurse labor market dynamics,
consider how changes might impact on longterm availability of nursing services, and offer suggestions when
indicated for public and/or private sector responses.
Increasing incentives to become nurses is critical to solve their impacts and prevent brain
drain
Kingma 2 (Mireille, Director, International Centre for Human Resources in Nursing,Nursing
Inquiry, Volume 8(4), Pages 205-212)gw
The majority of member states of the World Health Organization report a shortage, maldistribution and misutilisation of nurses.
International recruitment has been seen as a solution in most countries. Policy-makers appear to ignore that this can only
be
a short-term measure and a temporary relief — treating the symptoms and often avoiding the disease.
Creating a professional environment that would attract individuals of high calibre to practice nursing
in their national settings is necessary if positive long-term effects are desired. This would help resolve
many of the problems created by the current 'brain drain' experienced by the great majority of
countries. The negative effects of international migration on the 'supplier' countries may be recognised today
but are not effectively addressed.
ADI
Pointer/Symonds Lab
39
Nurses Neg
Domestic Nurses Counterplan: Solvency – Funding
Shortage of nursing colleges in U.S. drives the current influx of health laborers
Aiken 07 (HSR: Health Services Research 42:3, Part II “U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency” Linda H
Aiken, PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology, and Director of the Center for Health
Outcomes and Policy Research)
Production capacity of nursing schools is lagging current and estimated future needs, suggesting a
worsening shortage and creating a demand for foreign-educated nurses. About 8 percent of U.S.
registered nurses (RNs), numbering around 219,000, are estimated to be foreign educated. Eighty percent are from
lower income countries. The Philippines is the major source country, accounting for more than 30 percent of U.S. foreign-educated
nurses. Nurse immigration to the United States has tripled since 1994, to close to 15,000 entrants annually. Foreigneducated nurses are located primarily in urban areas, most likely to be employed by hospitals, and somewhat more likely to have a
baccalaureate degree than native-born nurses. There is little evidence that foreign-educated nurses locate in areas of medical need in any
greater proportion than native-born nurses. Although foreign-educated nurses are ethnically more diverse than native-born nurses,
relatively small proportions are black or Hispanic. Job growth for RNs in the United States is producing mounting
pressure by commercial recruiters and employers to ease restrictions on nurse immigration at the
same time that American nursing schools are turning away large numbers of native applicants because
of capacity limitations.
Federal money needed to support domestic nurse programs- solves back shortage
Dunham, 7 (Will Dunham, Journalist for Reuters, “U.S. healthcare system pinched by nursing shortage”,
http://www.reuters.com/article/idUSTRE5270VC20090308, March 8, 2009)
(Reuters) - The U.S. healthcare system is pinched by a persistent nursing shortage that threatens the quality of
patient care even as tens of thousands of people are turned away from nursing schools, according to experts.
The shortage has drawn the attention of President Barack Obama. During a White House meeting on Thursday to promote his promised
healthcare system overhaul, Obama expressed alarm over the notion that the United States might have to import
trained foreign nurses because so many U.S. nursing jobs are unfilled. Democratic U.S. Representative Lois
Capps, a former school nurse, said meaningful healthcare overhaul cannot occur without fixing the nursing
shortage. "Nurses deliver healthcare," Capps said in a telephone interview. An estimated 116,000 registered nurse positions are unfilled at
U.S. hospitals and nearly 100,000 jobs go vacant in nursing homes, experts said. The shortage is expected to worsen in coming years as the 78
million people in the post-World War Two baby boom generation begin to hit retirement age. An aging population requires more care for chronic
illnesses and at nursing homes. "The nursing shortage is not driven by a lack of interest in nursing careers. The bottleneck is at the schools of
nursing because there's not a large enough pool of faculty," Robert Rosseter of the American Association of Colleges of Nursing said in a
telephone interview. Nursing colleges have been unable to expand enrollment levels to meet the rising demand,
and some U.S. lawmakers blame years of weak federal financial help for the schools. Almost 50,000 qualified
applicants to professional nursing programs were turned away in 2008, including nearly 6,000 people seeking to earn master's and doctoral
degrees, the American Association of Colleges of Nursing said. One reason for the faculty squeeze is that a nurse with a graduate degree needed
to teach can earn more as a practicing nurse, about $82,000, than teaching, about $68,000. Obama called nurses "the front lines of the healthcare
system," adding: "They don't get paid very well. Their working conditions aren't as good as they should be." The economic stimulus bill Obama
signed last month included $500 million to address shortages of health workers. About $100 million of this could go to tackling the nursing
shortage. There are about 2.5 million working U.S. registered nurses. Separately, Senator Dick Durbin and Representative Nita Lowey, both
Democrats, have introduced a measure to increase federal grants to help nursing colleges. Peter Buerhaus, a nursing work force expert at
Vanderbilt University in Tennessee, said the nursing shortage is a "quality and safety" issue. Hospital staffs may be stretched thin due to unfilled
nursing jobs, raising the risk of medical errors, safety lapses and delays in care, he said. A study by Buerhaus showed that 6,700 patient deaths
and 4 million days of hospital care could be averted annually by increasing the number of nurses. "Nurses are the glue holding the system
together," Buerhaus said. Addressing the nursing shortage is important in the context of healthcare reform, Buerhaus added. Future shortages
could drive up nurse wages, adding costs to the system, he said. And if the health changes championed by Obama raise the number of Americans
with access to medical care, more nurses will be needed to help accommodate them, Buerhaus said.
ADI
Pointer/Symonds Lab
40
Nurses Neg
Domestic Nurses Counterplan: Solvency – Funding
Nurse education in need of major funding- CP solves for high unemployment rates
RWJF,10 (Robert Wood Johnson Foundation, “Obama Administration Recommends Freeze on Federal Nurse Education
Programs”, http://www.rwjf.org/pr/product.jsp?id=56174, 2-26, 2010)
Nurse education advocates concerned that prospects are dimming for a major funding boost.
For consumer and nurse education advocates, 2010 is getting off to a slow start.
The year began as efforts to overhaul the nation’s health care system—and provide the first-ever permanent stream of
funding for nurse education programs—appeared uncertain. Then, in early February, the Obama administration proposed
a budget that would freeze the main source of federal funding for nurse education programs.
The administration is now attempting to revitalize support for health care reform, and advocates are still working to
ensure that nurse education programs will get the kind of significant boost this year that they had hoped for last year.
Winifred Quinn, M.A., Ph.D., senior legislative representative at AARP and the Center to Champion Nursing in America, an
initiative of the Robert Wood Johnson Foundation (RWJF), AARP and the AARP Foundation, said the funding is critical.
Nursing education programs, she said, need more money now to hire more faculty so schools can accept more
applicants. Preparing more nurses is a key way to ensure that the nation has the highly skilled nursing workforce it
needs to meet Americans’ health care needs. More money is also needed to help curb the looming nursing shortage,
which threatens to undermine the quality of patient care. Educating more nurses will help fill existing vacanci es,
Quinn said, and that will help lower the nation’s high unemployment rate.
ADI
Pointer/Symonds Lab
41
Nurses Neg
Domestic Nurses Counterplan: Solvency – Education
The U.S. can expand nursing education to overcome nursing shortages
Aiken 7 (Linda, director, Center for Health Outcomes and Policy Research, Health Services
Research, 42(3) pg. 1299 – 1320)gw
The United States has the capacity, in terms of human and economic resources, to become largely selfsufficient in its nurse workforce. There are large numbers of Americans who want to become nurses,
thousands more than can be accommodated by nursing schools because of faculty shortages and other capacity
limitations. The United States has a large enough labor pool and enough resources to expand higher
education to increase nurse supply. Moreover, greater representation in nursing by blacks, Hispanics,
and men could be achieved by expanding nursing school capacity at a time when the applicant pool is
strong.
ADI
Pointer/Symonds Lab
42
Nurses Neg
Domestic Nurses Counterplan: Politics – Obama Loves It
Obama against immigrant nurses, train nurses in the US
Jha 9 (Lalit K, Journalist Int’l Affairs and Gov’t operations, Washington Post,
http://in.rediff.com/money/2009/mar/06bcrisis-obama-opposes-bringing-nurses-from-overseas.htm) KRA
US President Barack Obama on Friday opposed the idea of inviting overseas nurses, including from India, to fill
the huge shortfall the United States is facing right now. America like most of the Western countries is
up
faced with acute shortage of nurses and in recent years it has allowed medical personnel from India,
China and Philippines to immigrate to work in hospitals. "The notion that we would have to import
nurses makes absolutely no sense," Obama told a gathering of health experts and lawmakers at a White
House meeting on health care reforms. Instead, Obama argued that the best possible approach to meet this
shortfall is to train people inside the country. "For people who get fired up about the immigration
debate and yet don't notice that we could be training nurses right here in the U nited States," he said
responding to an observation made by Congresswoman Lois Capps from California.