[claw-el]

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

[influx]

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

[thijson]

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

[Den_VR]

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

[_DeadFred_]

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

[827a]

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

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

[claw-el]

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

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

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

[827a]

To clarify one small point: You have to be a US Citizen to be an Air Traffic Controller. But, I understand your broader point.

Before raising the fee to $100,000 this week, the "official" fees one would pay to apply for an H1-B were, effectively, $0. Employers would pay a few hundred to a few thousand dollars, depending on their size. There might be some "unofficial" fees like lawyer and advisor fees to help with the process, but in essence: your "wild idea" was the status quo for 35 years.

At the end of the day, relying on temporary immigration programs to backstop critical job shortages isn't sustainable on the long-term. Its not fair to citizens, and its oftentimes not fair to the temporary immigrant either. The more efficient and feasible solution to these shortages is to incentivize citizens to enter these roles.

[milch]

I was told the total cost was about 10k or so including filing fees and lawyers, and so on, and O1 closer to 50k or so. Seems like most of big tech will just try for O1 instead now... I've heard some wild stories over the years of how people "manufactured" eligibility, and/or the kinds of arguments their lawyers made.

[mschuster91]

> The more efficient and feasible solution to these shortages is to incentivize citizens to enter these roles.

If one would purely go by the rules of the free market, the solution would indeed not be immigration, but either automating these jobs away, rationalizing them so you need fewer employees to handle the same workload or raise the compensations and non-payroll benefits to attract more (prospective) talent.

The problem is, it's one thing if you do that for air traffic controllers. Flights are too cheap anyway, making them a bit more expensive to pay for more ATC will also reduce demand which in turn would also have positive benefits on the environment (CO2) and airport residents (noise).

But for stuff like garbage disposal handlers, wastewater facility staff and other jobs on the high-ick, low-pay side of things? These are actually and literally vital for society to survive, but if prices were raised to reflect the fact that you need to pay people pretty huge sums of money to do these jobs? Barely anyone would remain to pay for these services.

In the end, immigration has been used by Western societies as a stopgap to avoid the inevitable conclusion that the wide masses by far do not earn enough money, and now that immigration is drying up - in the case of the US, from the political climate, in the case of Europe including the UK, many people from Eastern Europe going back to their home country during Covid and discovering life there has actually vastly improved over the last decades - the cracks are growing so large they can neither be hidden nor overlooked any more.

[foogazi]

> Immigrant doctors should have their own visa classification.

The perfect is the enemy of the good enough

[bluefirebrand]

We're certainly seeing that "good enough" right now is hollowing out the lower and middle classes in society

So it isn't in fact good enough, it is pure evil

[foogazi]

> hollowing out the lower and middle classes in society

by giving H1B visas to doctors ?

[_DeadFred_]

By grouping everyone so that people can make the argument 'you can't cut this, we need doctors and we'll lose doctors' and paralyzing any action while the majority of slots go to positions where we don't need to import workers/aren't doctors.