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Fentanyl, immigration, and home health care

Illegal immigrants are NOT smuggling in fentanyl across the Southern border.

Americans are.

Yet half Americans  – and 6 out of ten Republicans – think it’s those damn immigrants.

I’ve been yelling about opioids of all types for almost two decades…and avoiding it for the last year or so because I’m burnt out on the topic. Yet here it is again, with demagoguing politicians and “news” outlets using the fentanyl crisis to scare the crap out of people by blaming brown folks for a crisis entirely of our own making.

News flash – WE Americans are consuming fentanyl…if we weren’t, there would be no crisis, no awful death toll, no broken families and destroyed communities.

And we Americans are the ones importing fentanyl.

From a Former Border Patrol sector chief:

Virtually none is smuggled by migrants themselves, says Victor Manjarrez, Jr., a former Border Patrol sector chief who’s now a professor at the University of Texas at El Paso.

“The probability that they’re going to carry some kind of illicit narcotic is probably close to zero,” Manjarrez said. “The vast majority of that fentanyl is going through a port of entry.” [emphasis added]

This is clearly a fact-free campaign to demonize immigrants, to scare us into voting for politicians that talk about building walls and banning immigration.

What does this have to do with healthcare?

I’m sooooo glad you asked.

As a nation – and individuals – we are getting older fast. Older = more need for healthcare = need for more healthcare workers.

Where are those workers going to come from? Are your kids signing up to be home health aides? Your neighbors’ kids?


There is a crisis  – but is sure as hell isn’t immigrants bringing in fentanyl.

No, the crisis is in healthcare staffing, so blocking immigration is worsening the crisis.

By far the most projected job openings is in direct healthcare workers in the decade ending in 2026 – 2 1/2 years from now – we’ll need 1.4 million direct health care workers – plus over 400,000 nurses.

States most affected by the healthcare worker crisis include Texas, Florida, Nebraska, Alabama, Wyoming and Maine.

Where are those workers going to come from – especially home health care workers? Today, almost four out of ten home heath aides are immigrants; that HAS to increase if we are going to have enough workers to care for us and our parents and grandparents.

Meanwhile Canada is attracting immigrants by giving health care workers a path to citizenship.

What does this mean for you?

If you want to change your own bed pan, vote to block immigration. 

PS…I dumped Twitter and moved to threads – follow me there at joe_paduda

3 thoughts on “Fentanyl, immigration, and home health care”

  1. I don’t want anyone to change my bedpan, Joe. I want to take care of myself and live to a ripe old age surrounded by my family and friends, and not stuck in some facility. I think we’re trying to treat a symptom here, and the cause is that as a society, we’re not taking care of ourselves or each other. Failure to thrive. We need to stop the madness and take better care of ourselves and each other. Then the available home health aides and others in the medical profession can devote their time to those recovering from procedures, and not just long term care. Just my two cents…

    1. Kim – you and me both…that said, home health aides help keep folks out of facilities – where care can be spotty, loneliness can be a major problem, and…who wouldn’t rather be at home?

      Without aides, more will be moved to nursing homes.

      Completely agree we do need to do more to helpveach other – but reality is we will still need far more health car providers than we will have with the current immigration policies in place.

      be well Joe

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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