This is not accurate.

To get my US Green card, all that was required was an HIV test and a standard US doctor's affidavit that I wasn't disabled.

That's a far cry from a "rigorous physical exam".

I'm having a hard time understanding why someone with HIV or a disability would still be excluded. The US has pretty strong protections for people with disabilities, which makes me feel like we're supposed to honor and include those people. I wonder what the logic is that prevented us from extending that philosophy to immigrants.

HIV is also more of a chronic condition as apposed to a public health hazard these days. It's cost of perpetual treatment isn't significantly different from dozens of other conditions or diseases, and the risk to the public is similar to other diseases like Hepatitis.

Anyone have insight that I'm not understanding?

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Edit: elliekelly gave a well-thought out reply below that makes logical sense, even if I disagree with the policy

US laws are for US citizens. Note the many and onerous restrictions that prevent US law enforcement agencies from blowing up US citizens from drone aircraft, which self evidently do not apply to noncitizens.

Can confirm. My brother-in-law’s wife just became a permanent resident. Immunization was the main concern.

And the museum on Ellis Island says that only a small fraction of immigrants were sent back. So thinks hardly changed.

They were primarily concerned about infectious diseases, and most people were kept in holding until it passed or they died.

I don't know your specific situation but I followed an LPR's process to get the green card and it involved a rigorous health exam, including vision, thorax, immunology, vaccines and who knows what else.

The price was in the hundreds of dollars in a somewhat poor country.

The doctor was very clear that he could have been refused because of the results he never saw.

It's speculated that STDs are also tested, but as I wrote, he never saw the test results.

Yeah but it's mostly about immunizations. You can still immigrate if you're disabled but have a caretaker.

No - if you are considered likely to become dependant on state or federal aid you can be denied. https://www.uscis.gov/greencard/public-charge

To play devils advocate - what's wrong with this?

I was always under the assumption that immigrants were suppose to benefit the native population. Which in this case they likely wouldn't?

Someone can be both "likely to become a public charge" under the law (which is not yet in effect because three federal courts have ruled it unconstitutional) and also of great benefit to the country.

He's not an American, but Stephen Hawking, for example, was a "public charge" whose substantial medical bills were largely covered by the NHS[1] and the cost of his 24-hour nursing care was made possible through grants.

And while Hawking is an extreme example in both the cost of his care and his ability, a determination that someone is "likely to become a public charge" can apply to just about anyone who might find themselves in need of Medicare. An otherwise healthy 20-year-old with a family history of Parkinson's or Alzheimers. Or, to get even more dystopian, an otherwise healthy 20-year-old with a genetic marker for Parkinson's or Alzheimers. The cost of long term care for these diseases is astronomical but I'm certain there are many Parkinson's and Alzheimers patients that have made substantial contributions to society.

[1] https://www.theguardian.com/commentisfree/2017/aug/18/nhs-sc... (Written by Hawking himself)

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123440/

The law saying “likely to be a public charge” is already in effect and is decades old. The recent change that is currently blocked is only about the factors being considered when making that evaluation (specifically, usage of various types of government assistance).

Hawking and other successful people would also handily qualify for visas based on achievements.

Cost, governments are not benevolent entities.

Your sponsor can sign off that you won't become a public charge and they'll become your caretaker.

That’s not quite true. You are probably thinking of the fact that when you sponsor someone for a green card you are required to promise that they will not use government assistance for x years, and if they do you will have to repay it.

Yup, that's what I meant.

What’s that, about the top 1% of disabled people?

Indeed, what should we do about the other 99%?

Canadian permanent residency class immigration visas still require a full chest x-ray for tuberculosis.

Same for green card and a bunch of other stuff.

In fact applicants must show the X-Ray upon arrival at the port of entry.

As opposed to a partial chest X-ray?

"The TB skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin on the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm."

In health care as a care giver we do it this way to see if we have it. I am not sure why they would not do it this way as opposed to a chest X-ray but I am going to go out on a limb and guess you could probably limit or maybe slow down the reaction with antihistamines or some other means I am not sure of where a chest x-ray would be impossible to hide evidence of TB.