Same thing that happens to most who aren't doing pretty damn financially well in the US, I guess? All their savings gets siphoned into the system, then they die younger than they might have, and less comfortably than they should, unless family takes very good care of them? Then debt collectors try to trick anyone connected to them into paying for medical & other debts they aren't responsible for? The usual.

Anyway, worker visas don't have to be a path to citizenship, so this may fall, for better or worse, under "not our problem", depending on how it's all structured.

Which visa is that for the US? The ones I looked at are dual intent. I'm more familiar with the UK (NHS) where imports are expected to stay. I'm also pretty sure that the dual intent is part of the ability to pay under market rates where the immigration potential is a fringe benefit captured by the employer.

Honestly when the current crop of adults from the 'healthy at any size' era get old it's going to be a medical shit show, I'm pretty sure governments will end up resorting to Canadian style MAID for the poor, sick, and old as no-one will have the money for proper care.

Oh yeah, it’s gonna be real bad when the “our ‘thin’ people would have been considered fairly chubby 40 years ago” millennial generation (mine) gets old.

Science might be about to rescue us from that with Ozempic and friends, assuming those don’t turn out to do horrific things to a person over time. Once some of those go generic and the prices plummet, anyway. But failing that, yeah, it’s gonna be a lot of skinny immigrants helping obese, diabetic 70-year-olds with shot knees & backs get to the bathroom. Or maybe we’ll get robots for that, by then, go full Wall-E, who knows.

Yeah it’s the millennials I’m currently worried about, they’re also quite relatively poor so I suspect not many will be able to afford to retire let alone a high level of medical care.

I’m actually quite hopeful that ozempic mainly works by helping reverses hormonal damage caused by bad diets. Ozempic causes low gut motility which can be very unpleasant and potentially dangerous, there are already conditions with the same effects so it’s possible to benchmark what long term effects will be like (It’s not great). I think there are safe ways to do it and that will be figured out. I think it has already changed the culture for the better. I’m hopeful this high BMI era turns out to just be a phase instead of a one way ratchet. Where I live there are few overweight people so it’s always a bit of a shock to me whenever I travel.

I know that if you have a PhD it's way easier to get permanent immigration status than it is with a MS or BS.

I'd be surprised if the same weren't true for MDs.

Edit: it's an O-1 visa. To get one you need to show "special skills" in your area. For an academic (and I presume for physicians) that would be things like good research publications and so on. You have to be above the norm in some way.

The advantage of this visa class is apparently that it feeds directly into the green card system.

All of society has that Ponzi scheme dynamic, due to the declining utility of a human being as they age, and the extended time that they remain a net loss as technology allows them to live longer.