Sounds like it would have been simpler to just raise it to $160k instead of introducing a $100k fee.

The US has a new GoldCard system actually. : https://www.whitehouse.gov/presidential-actions/2025/09/the-...

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.

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.

> Immigrant doctors should have their own visa classification.

The perfect is the enemy of the good enough

> A very short conversion time leads to a profitable business model where companies sell green cards to wealthy foreign citizens.

I don't buy it. This is spectacularly easy enforcement. A company applying for H1-Bs over and over and over is going to stick out and should get its H1-Bs denied--regardless of whether it is selling them to wealthy foreign nationals or is running an IT sweatshop that people flee as soon as they can.

Any company that isn't abusing the H1-B process will be able to demonstrate all the green card holders that are still working for them.

In addition, if foreign nationals want to come to the US and pay taxes here, we should let them. The US was built on immigration from working-class people--wealthy foreign nationals are kind of a no-brainer.

  Not like the brazen giant of Greek fame,
  With conquering limbs astride from land to land;
  Here at our sea-washed, sunset gates shall stand
  A mighty woman with a torch, whose flame
  Is the imprisoned lightning, and her name
  Mother of Exiles. From her beacon-hand
  Glows world-wide welcome; her mild eyes command
  The air-bridged harbor that twin cities frame.
  “Keep, ancient lands, your storied pomp!” cries she
  With silent lips. “Give me your tired, your poor,
  Your huddled masses yearning to breathe free,
  The wretched refuse of your teeming shore.
  Send these, the homeless, tempest-tossed to me,
  I lift my lamp beside the golden door!”

Cheaper than the $5,000,000 Golden visa proposed by the President, sure, but at that point we're really just haggling anyway so then it's just a difference of degree.