Hospital Sisters Health System CEO: Immigration policy requires nuance, not extremes – Becker’s Hospital Review | Healthcare News
“Help us, one and all, to build bridges through dialogue and encounter, joining together as one people, always at peace.” —Pope Leo XIV, shortly after accepting the papacy
As president and CEO of Hospital Sisters Health System, a Catholic nonprofit that has been caring for Midwestern communities for 150 years, I have been reflecting on how we wouldn’t be here or have that rich history without immigrants.
Like the U.S., HSHS was founded by immigrants. Our founders were 20 non-English-speaking women — the Hospital Sisters — who arrived from Germany with the clothes on their backs, a powerful sense of faith and resolute courage. In 1875, the Bishop of Alton, Ill., had sent an SOS across the ocean looking for help building healthcare for his community. Fortunately, the Hospital Sisters answered that call, and our patients and communities have been well served for more than a century.
As I listen to the current debate on immigration, I hear a propensity to lean toward extremes within a false binary. One extreme believes all “illegal aliens” pose imminent threats to our daily safety, with plenty of anecdotes of criminal activity. The other extreme holds that all “undocumented persons” are model neighbors and hard workers who, if given support and opportunity, only strengthen our communities. If these are the only choices, it’s no wonder the solutions are equally limiting: to deport all immigrants living in the U.S. without legal status to keep us safe from crime, or to leave open our borders and maintain sanctuary cities to protect people who are blameless on every count.
There were 47.8 million immigrants living in the U.S. as of 2023, according to the U.S. Census Bureau’s American Community Survey. Nearly 75% of them were in the country legally as naturalized citizens, legal permanent residents (also known as green-card holders) or holders of temporary visas.
Given these facts, we must reject the certitude of these two extremes and find a way to grapple with the nuances of immigration, especially for sectors like healthcare. Creating prohibitive barriers to entry for skilled professionals and enacting mass deportation of all noncitizens would be devastating to our healing mission and to the mission of many other healthcare providers.
Across our rural communities in central and southern Illinois and northeastern Wisconsin, HSHS relies on international staff to fill nursing vacancies and to address physician shortages. Our patients and communities benefit from the willingness of foreign-born health and medical graduates who seek to practice here in the U.S. Many of them have expressed the desire to stay permanently if it were just a bit easier to gain legal status.
HSHS international physicians and nurses come to the U.S. to serve. With the pending wave of physician retirements expected across the U.S., we are even more reliant on their willingness to serve. In fact, deploying international caregivers is a key strategy to address workforce challenges in rural locations like ours. Over the past three years, HSHS has seen a 75% increase in international nurses to address labor shortages in our core markets. More than 180 international nurses are expected to join us in early 2026, accounting for 6% of total nursing staff and filling 42% of current nursing openings. Among our employed physicians, currently 7% hold J-1 or H-1B visas, and we expect that number to increase.
Recognizing that immigrants make up an essential labor force to sustain healthcare services, we must find a bipartisan path forward that recognizes the intrinsic worth and human dignity of our friends and neighbors who may be noncitizens.
Policymakers need to pay attention to the entire American experience — not just what’s happening in large, metropolitan areas but also the real void working immigrants fill in rural areas. Yes, we must pursue realistic and immediate solutions to enhance border security. At the same time, we must resolve the status of Dreamers, hire more immigration judges and simplify rules that create unproductive barriers to people willing to serve in our country. Policymakers need to look outside our borders, too, working upstream to improve safety and sustainable development in low- and middle-income countries in Central America and elsewhere. Their safety and security impact our own.
Although many of us strive to build bridges and avoid extreme views and false binaries, we all come to this conversation with a bias. My bias comes from the 20 courageous German women who immigrated to the U.S. more than 150 years ago with love in their hearts. Those women sought to “build bridges through dialogue and encounter” — an aim Pope Leo XIV recently highlighted in his first public address as pope. Let’s overcome our propensity to fall into extremes over immigration policy and seek instead to mirror the Hospital Sisters’ example of “joining together as one people” to serve the common good of all.
Damond W. Boatwright is president and CEO of Hospital Sisters Health System, a Catholic nonprofit with 13 hospitals and 130 care sites in Illinois and Wisconsin.