PAHA stands for “Physicians for American Healthcare Access.”
Physicians for American Healthcare Access (“PAHA”) is a non-stock, non-profit corporation organized under the corporate law of the State of Missouri.
To improve access to health care for all Americans.
Any licensed Physician/Dentist in the USA.
Fellows, residents, and students can also be the members of PAHA.
- Access to PAHA activities
- Access to exclusive member discussion forum
- Essential to conduct local events for PAHA, local chapters
PAHA’s membership year runs from September to August of each year. The membership fee for the year 2018/2019 is $150 for a practicing physician/dentist and $100 for resident or fellow in training.
Donations can be made through the website with any payment card and cheque. Recurring donations can be set up for a monthly, quarterly, yearly interval.
- PAHA is supported by donations and membership fee.
- All board members work without compensation.
- Donations will be used to accomplish the goals and objectives of PAHA.
Political Action Plan
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Actions You Can Take
Senate Bill S948 is a Conrad 30 J1 physician renewal bill, needs to pass for the reauthorization of the Conrad 30 program which always had bipartisan support. The program allows physicians from other countries who finished their residency and fellowship training in the USA, to practice in the federally designated Health Professional Shortage Area (HPSA), where American patients face a severe shortage of doctors. The details of the bill can be found on the senate.gov website.
Reaching out to your two state senators and your congressmen in your area and ask:
- To support or co-sponsor Senate Bill S948 and House Bill HR2895
- Show them the data on how physicians are crucial for healthcare in rural and underserved communities
- Ask your nurses, social workers, case managers, and administrators to write to the senators to support S948
- Ask your Whatsapp group members to share information/powerpoint/template with you to use for the above purpose
- Sign the SHM direct message link on the home page of this website
Please read each section of Political Action Plan under the tab Advocacy
PAHA endorses all advocacy that directly or indirectly improves patients access to physicians. Immigrant and nonimmigrant physicians form the critical components of healthcare access.
The HR 392 seeks to remove the per-country limit in allotment of employment-based green cards. It is a widely supported initiative in the comprehensive immigration reform; however, PAHA’s mission is to focus on solutions for physicians, patients, and healthcare access.
HR 392 involves advocacy for unfair immigration policy based on a very old and unevolved system, with a country cap of 7% for each country, whereas, employment related immigration is very heterogeneous in nature among the countries of origin. Although, HR-392 does talk about a significant problem, leading to unfair situation for employment based legal immigrants, it does not focus on physicians, who area only a very small percentage of all legal immigrants of work visa (3-5%). It also does not focus on the social, economic and clinical burden on the rural and underserved America, where most physicians on visa serve. This way, HR-392 is a useful first step towards an overall immigration reform, but might not be the most physician and patient oriented measure for this problem. Also, physicians should be aware and cognizant about being named synonymously with technology industry workers, as technology industry and healthcare industry have a very different standard and tradition of hiring workers on visa, which is the most important determinant of how immigrants are perceived in the eyes of American lawmakers.
HR392 has a long way to go. While the chances of the bill passing has gone up from before due to it being a part of spending bill, but bill will have a tough time to pass. Just because it is added on spending bill now doesn’t mean that it will pass.
HR392 was added as an amendment on the appropriation bill in a House appropriation subcommittee. There were 4-5 other amendments added as well. That entire bill needs full House approval. Then the bill has to go through House-Senate conference. If it is approved there, then it will go to President’s desk for signature. It can always get vetoed there, if he doesn’t get what he wants in this bill. Both parties have to be on board as well to get them approved. Some lawmakers want some protection for DACA recipients while some lawmakers want wall funding. If they both get what they want, then this bill may make it through. When the House comes back from the recess, they will only have 11 legislation days to get these bills through. They may just decide to continue with current level of funding before the FY ends on September 30 and drop these amendments altogether. They may decide to address these amendments after November 6th after midterms or they may not address them at all.
The U.S Congress enacted legislation (1994) to allow states to sponsor a maximum of 20 physicians each year for the J-1 waiver to work in underserved communities. From time to time, Congress has expanded the slots for each state from 20 to 30. Over the last 15 years, this program brought more than 15,000 physicians to the underserved area.
The foreign national physicians in J-1 visa status for graduate medical education and training are subject to a 2-year home residency requirement. These physicians who wish to remain in the United States after completion of residency training must commit to not less than three years of service in the underserved area.
The best way to help is to CONTACT YOUR REPRESENTATIVE:
You can email/call/mail/send your message on Facebook/Twitter.
You can find your representative by clicking the link below.
Also, look at the Political Action Plan section of this website to get more information.
A separate section is available for advocacy for the Conrad 30 program and help the rural and underserved areas of America to retain their only doctors
Physician shortage and its impact on American health care: How to advocate for physicians’ retention in the rural and underserved areas
Contact Key Senators:
- Amy Klobuchar (D-MN) https://www.klobuchar.senate.gov/public/index.cfm/contact
- Susan Collins (R-ME) https://www.collins.senate.gov/contact
- Heidi Heitkamp (D-ND) https://www.heitkamp.senate.gov/public/index.cfm/contact
- Lindsey Graham (R-SC) https://www.lgraham.senate.gov/public/index.cfm/e-mail-senator-graham
- Roger Wicker (R-MS) https://www.wicker.senate.gov/public/index.cfm/contact
- Tom Cotton (R-AR) https://www.cotton.senate.gov/?p=contact
- Mitch McConnell https://www.mcconnell.senate.gov/public/index.cfm/contact
- John McCain https://www.mccain.senate.gov/public/index.cfm/contact-form
- David Perdue https://www.perdue.senate.gov/connect
- Prominent personalities like Atul Gawande (CEO of new healthcare venture of Amazon, chase, and hatchway)
- Sanjay Gupta (CNN)
- Rudy Giuliani
- Ivanka Trump/Jared Kushner
History of the Conrad 30 program that allows physicians to serve in the rural and underserved areas
Draft letter content:
International medical graduates (IMGs) comprise nearly one-quarter of the U.S. physician workforce. Certification by Educational Council for Foreign Medical Graduates (ECFMG) is the standard for evaluating the qualifications of these physicians before they enter U.S. graduate medical education (GME), where they get national standardized training in medicine. ECFMG uses its experience in assessment to ensure that all physicians entering the U.S. and GME endorses a standardized clinical skill essential to providing safe and effective patient care in the United States. These provisions emphasize the fact that international medical graduates pursuing further training in the United States are held up to the same standards as American Medical graduates regarding “merit” and “skills.”
Majority of these physicians pursue their residency and fellowship training on a work visa, either an H1B or a J-1 visa. In the latter case, they are subject to the 2-year home residency requirement, which majority of them are able to achieve a waiver by serving rural and healthcare underserved communities in the US. Of all Indian physicians on a work visa, more than 70% serve in the federally designated underserved areas. Unfortunately, this is where physicians of specific country origin (i.e., India and China) get stuck in the Green Card/Permanent residency queue for decades due to the massive ever-increasing backlog year after year.
Conrad State 30 and Physician Access Act is a provision which enables the Health Professional Shortage Areas (HPSAs) to avail better health care by retaining these physicians. As per the current rules, international medical graduates /physicians other than of India or China origin have practically no waiting period or backlog once their permanent residency is approved. An approved status helps these physicians serve these communities without having to deal with the sudden disruption of service for the population, which usually wait for months to see a specialist. With permanent status, their service can also be extended to remote areas, where no physician is available, to begin with. However, in reality, these physicians need to renew their work visa every 6 months, and often get denied and or held in their home country (after a forced exit from the United States) for an indefinite period of time, where their patients’ appointments are canceled for an uncertain period, leaving the poor people at a risk of increased morbidly and mortality.
With the upcoming renewal of the Conrad 30 program, the senators as mentioned above are trying to advocate for resolving this problem by adding language to facilitate moving these physicians to a different category to expedite their decade-long waiting.
You can write to these lawmakers to show your support for this cause.