This article was originally published in TIME on September 6, 2023.

There are more than 11 million job openings and only 6 million unemployed workers in the United States, and employers have struggled for more than a year to hire enough people to fill their ranks.

This shortage is having a great impact on our healthcare system. In particular, America’s aging population is exploding and the unmet demand for the caregivers elderly citizens rely on is becoming increasingly pronounced in rural areas and smaller cities and towns where nearly half of all Americans live. The Association of American Colleges (AAMC) predicts a shortfall of as many as 124,000 physicians by 2034, with geriatricians facing a particularly severe shortage. According to a 2021 AAMC report, just 6,124 physicians nationwide specialize in caring for older adults. Per the U.S. Census, “By 2060, nearly one in four Americans will be 65 years and older, the number of 85-plus will triple, and the country will add a half million centenarians.”

Without more immigrants, aging Americans face a bleak future for our ability to age with dignity. And it’s not just our elderly population. We need more immigrants in every aspect of healthcare and the rest of our economy for our country to thrive.

Not only will America’s elderly struggle to find healthcare, but they may also have few choices when hiring help to remain in their homes or securing a position in a residential facility. Today, at least 87 percent of nursing homes in the U.S. face moderate to high staffing shortages, even though most have offered increased wages and bonuses. Representatives from three-quarters of the facilities report a lack of qualified candidates as their biggest obstacle. More than half of all nursing homes fail to comply with daily staffing levels as set by the Centers for Medicaid and Medicare Services. As a result, most nursing homes are limiting new patients, and many face the looming specter of closure over staffing shortages. In Postville, Iowa (pop. 2,400), a residential facility closed earlier this year with little notice, forcing some long-term residents to scramble to secure spots in neighboring facilities.

Read the full article here.