Opinion | Am I a burden on America, asks immigrant son now a Harvard doctor

David Duong grew up in Holland, Michigan. He is deputy director of the Program in Global Primary Care and Social Change at Harvard Medical School.

(This column originally appeared in the Holland Sentinel and is being republished with the permission of the author)

I grew up in an immigrant family; we were poor and on welfare.

My family immigrated to Holland, Michigan from Vietnam in 1991. Our story relied heavily on the generosity of the American people and her government. Our plane tickets from Vietnam to America were purchased with a loan from the government that my parents paid back in monthly installments of $50 over five years.  

For one and a half years, we rented a home that was government-subsidized.  We were nourished because of the multi-colored food stamps that my mother used at Meijer. I received free hot lunches from Van Raalte Elementary School.  Medicaid helped pay for our visits to the doctor. After my sister was born, through the Women, Infants & Children (WIC) food subsidy program, my mom bought fresh fruit, milk, cereal and cheese for our family.

Looking back, I wonder what we would have done without these critical government subsidies. We were a burden on America during our initial three years here – my family was a public charge, we used public resources.

During the three years on welfare, my father worked third shift at a meat packing plant. On weekends, he picked up extra shifts to earn more money. My mother had a factory job as a seamstress and then worked on the assembly line jarring pickles for Heinz. I remember her coming home with a sour smell on her clothes and hair. I remember on the weekends, I would walk the streets with my parents, a large poking stick in one hand and a large plastic bag in the other, gathering aluminum cans from the sidewalks. We would save them, and once a month, return them for 10 cents each.

My parents worked so hard during the years we were on welfare. Despite their hard work, we needed the government’s help. The government subsidies in food, housing and utilities allowed my parents the security to dream a brighter future for their children and, in return, we grew up safe, warm, fed, and clothed. This safety net allowed me to actualize my dream of becoming a doctor.

Today, I have the privilege of caring for all who come through my clinic doors. I now return the support America offered me by helping others who rely on government programs, who dream of a better future, so everyone can contribute to the economy and the fabric of our diverse country.

On October 10th, the US Department of Health and Human Services proposed a new rule which expands the criteria of what it means to be a “public charge,” or a person whom our government determines is likely to be primarily dependent on the federal government for economic support via welfare programs. This new rule allows the government to deny green card status to legal immigrants who use services such as Medicaid, the Supplemental Nutrition Assistance Program (SNAP), and housing assistance. The new rule would force families to choose between accessing vital health, housing and nutrition programs or forego them to strengthen their immigration application.

One stated reason for this new rule is to increase immigrants’ self-sufficiency and decrease dependency on long-term federal government assistance.

This premise is false.

Research has shown that federal assistance programs actually enable families to gain economic self-sufficiency. Long-term analyses show immigrants are a net positive contributor to the American tax base at the local, state and federal level, and immigrants’ tax contributions cover 93 percent of their publicly provided benefits, compared to 77 percent for those born in the United States.

Reflecting on this proposed policy, I wonder what we would have sacrificed – would it have been doctor’s visits or a full belly? Would my parents have been able to dream of owning their own house? Could I have dreamed of becoming a doctor? I am certain my life, and that other immigrant children like me, would have been drastically different if such a policy was in place.

There is still time to act. The proposed federal rule from the Trump Administration must undergo a 60-day comment period (until December 10th, 2018) before it becomes policy.

You can act now: Provide the government with your comments here; mobilize and spread the word about this horrendous proposed policy on social media; contact your congressional representatives. We need to make our voices heard so that immigrant children, children like I was, can have access to programs essential to healthy growth and development – so that we can all dare to dream, and dream big.

Bridge welcomes guest columns from a diverse range of people on issues relating to Michigan and its future. The views and assertions of these writers do not necessarily reflect those of Bridge or The Center for Michigan. Bridge does not endorse any individual guest commentary submission.

If you are interested in submitting a guest commentary, please contact Monica WilliamsClick here for details and submission guidelines.

Facts matter. Trust matters. Journalism matters.

If you learned something from the story you're reading please consider supporting our work. Your donation allows us to keep our Michigan-focused reporting and analysis free and accessible to all. All donations are voluntary, but for as little as $1 you can become a member of Bridge Club and support freedom of the press in Michigan during a crucial election year.

Pay with VISA Pay with MasterCard Pay with American Express Donate now

Comment Form

Add new comment

Dear Reader: We value your thoughts and criticism on the articles, but insist on civility. Criticizing comments or ideas is welcome, but Bridge won’t tolerate comments that are false or defamatory or that demean, personally attack, spread hate or harmful stereotypes. Violating these standards could result in a ban.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.


Doug Degriselles
Tue, 11/13/2018 - 8:52am

You say it enhances your chance of becoming a greater person but on the other side it takes the blame on keeping the underprivileged down, as in the gettos down
Whos to believe

Thu, 11/15/2018 - 3:06pm

David Duong, MPH, MD -- fatal flaw in this .. the Holland, Mich. that you grew up in, no longer exists.

Fact: there are street gangs there, now. "Dutch is much" no longer exists. Do you know how many Latino/Hispanic stores there are, in Holland, Mich.? We're waiting ..

And pontification from "Harvard," which has a $35,000,000,000 endowment, directed by a supermajority of one political party (guess)? How much is Harvard doing for the unlawful? How many Harvard staff have opened their homes to the unlawful?

In fact, no one is sure, how many unlawful are in the USA, per M.I.T. Sloan --


Sir, leadership comes from the front. When Harvard actually leads on this, and is upfront frank and honest about the problems involved, that is when change will happen. And not one second sooner.

Sat, 11/17/2018 - 12:18pm

Harvard Student 32 of them gave us the Mortgage/forcloures crisis in 2004 meeting in pink hotel in Florida.also the bail-out of AIG and bad banks robbt ( Bernie Madoff)us of local saving and loans bank s that pay us Interest on saving account over 10% even under $1000 deposit!

John Budd
Tue, 11/13/2018 - 9:36am

Millions of immigrants immigrated to this country with little to none tax payer assistance for decades. Family, friends , churches, and community provided the needed support. Taking money from one group and giving it to another is socialism.

Tim Athan
Tue, 11/13/2018 - 9:38am

The U.S. does not have a shortage of bright people who want to become doctors. Many must leave the country to get their M.D.

Sat, 11/17/2018 - 12:24pm

My doctor studied medicine in Cuba!

Tim Athan
Tue, 11/13/2018 - 9:58am

I congratulate Dr. Duong on his achievement, but because of it a family in the U.S. that paid into the system decade after decade had a child whose dream of becoming a doctor was dashed.

Thu, 11/15/2018 - 6:45am

Because there is a limit on how many successful people are allowed in to exist in this country.

Sun, 11/18/2018 - 7:34am

Tim, WTH are you talking about? Are you saying that you could not be successful because immigrants were allowed into this country?! You wouldn't be scapegoating, would you? Lol.

Tue, 11/13/2018 - 10:29am

Without commenting on the Doctor part of this story, to say the we should provide a benefit because of the success of a particular beneficiary isn't anymore of reason to do so than is that another beneficiary of the same program ended up in prison is to say we should scrap it. The question legitimately still remains as to whether we should aim to bring in immigrants who can support themselves without government assistance (knowing not all immediately will) vs. bringing others with very little likely hood of achieving and costing a great deal over any foreseeable time frame.

Tue, 11/13/2018 - 2:12pm

I’m appalled by the lack of vision and support by some of these comments. I think the Dr makes the utmost sense and Trump’s policy is criminal and shortsighted - but then what’s new

Sun, 11/18/2018 - 7:42am

Agreed. We must remember in November (2020). Too bad we didn't ALL have a father who gave us millions to squander...

Thu, 11/15/2018 - 6:48am

Let’s replace “...tired, poor, huddled masses” with rich trust fund babies!

Joyce Gregg
Tue, 11/13/2018 - 1:21pm

In the early nineties Dr. Duong’s parents worked as much as they could, and still could not fully provide food, shelter and medical care for the family without assistance. This has not changed in our society. Does anyone envision a society where workers are paid a living wage and a medical system that serves everyone at a price they can afford? Which immigrants to accept and how many is a separate and complicated issue. The decisions should be on a humaniatarian basis rather than a political one.

John Darling
Tue, 11/13/2018 - 3:59pm

Providing a minimal hand up to skilled immigrants is a net benefit to them as well as our society. IMHO it’s also the right thing to do. There are immigrants and asylum seekers all over the globe in desperate need of assistance. We, one of the richest nations on this planet, accept an embarrassingly tiny number to our shores.
David is a shining example of the benefit to our country we get by embracing immigrants. His dedication to the health and welfare of everyday citizens is an inspiration.

Sun, 11/18/2018 - 7:54am

I agree. Immigrants and asylum-seekers don't typically misuse a hand up and are grateful for the help. What has changed is the moral and ethical values of this country's leadership.

Jane Iacobelli
Tue, 11/13/2018 - 4:32pm

Legal Immigrants add value to our country

Ed Haynor
Tue, 11/13/2018 - 5:43pm

It’s very sad that many comments regarding this writer’s opinion have no knowledge of America’s immigrant history. If you have some knowledge of this history, you can determine for yourself, who ‘s intelligent and who’s not.

Tue, 11/13/2018 - 6:31pm

The pinched piety displayed by many of the comments is startling. We are better off for having Dr. Duong here.

Dena T Arner
Tue, 11/13/2018 - 6:52pm

I would like to say I'm shocked at the callous greedy disregard shown in some of these comments, but I'm not. We have a become a country of "I've got mine, screw you". No one - NO ONE - in the country makes it completely on their own. Everyone gets help of some sort - whether that is public schools, public libraries, police and fire protection, publically funded roads, unemployment insurance, etc. We all eventually pay for these services. I would rather invest in a hard working family that is striving, burning to reach the American dream knowing that they will pay that investment back 100 fold than give billionaires and wealthy corporations yet another tax break.

Thu, 11/15/2018 - 4:06pm

You like Dr. Duong seem to believe that either people don't deserve what they have worked and sacrificed for or you believe that the American wallet is bottomless and there need be no constraints on spending.
You say no one has done it on their own and yet how is it that in schools we see kids in the same classroom succeeding while other are failing. You don't seem to believe it is the sacrifice and work of the individual that differentiates success and failure? You probably see people who create businesses/industries greedy while the rest of us simply work at the job in front of us, you don't seem to believe that it was their efforts and insight and sacrifice that created what they achieved? When you say 'NO ONE' did it on their own is to say everyone deserves all of what the achievers delivered. If you have ever watched a soldier in a firefight stand up and go to the aid of another, they do it on their own, others are fighting around them but for a person to standup and do what is necessary when all about them are keeping their heads down is why we have heroes. No, whether it is in the extremes of war, or in the classroom, or it is in the workplace the individual that uses what is available to all others and does more with is because in that moment, in the day, week, year, life time that on their own they stepped up and did more than others. They have earn that mantel of 'self made.'

No man is an island, but each of has a choice and the choice we make with all it entails is what distinguishes us, and that is why America has the abundance.
You may want to give a hard working families all the money others have earned, I would rather put my money to work with those who will improve the lives of many hard working families many times over. The 'poor' in America live a more secure and abundant lives then the overwhelming number of 'poor' around the world because people have used other people's money to create solutions to meet the needs of the many. Do you think it was 'hard working families' that gave us safe drinking water and sanity living conditions, do you think it was 'hard working families' that have given use medicine that have raised the quality of live while extending life, do you think it is the 'hard working families' that have made quality food available to all year around. You seem to young to know when the only way to have vegetables in the winter in Michigan was to can them yourself, or when the fear on mothers' faces was worse than any horror movie could show simply because the rumor of someone might have a symptom of polio, or when the wind whistled through the edges of windows and there was a quarter inch of ice on the inside of the windows, or people had to stoke the coal fire in their furnace. This was Michigan only a few generations ago, and it all was replaced because big companies got money to invest and build what we have today. Whine about the tax breaks, but stop and realize where that money is spent and how it is invested/risked taken to generate returns in the future by developing something people want/need/use.
I am sorry for your 'holier than thou' attitude because what you fail to grasp is how our marketplace economy is what has elevated the quality of life for all that live here.

Sat, 11/17/2018 - 12:36pm

Big companies used your taxpayers money .like in brownfield, big companies come and go..
why? Merger and You lose your job.
outsourcing to overseas ..no taxes for big business ,stay overseas,
SS fund is over $ 3.6 trilloin that money is not returned to Senior to "LIVE" decent after working 40-50 years!
Goverment has no money it takes it from YOU.
how much Money is taken in daily from the Lottery in each state ?

Sun, 11/18/2018 - 1:03am

We hear such things as 'a living wage', 'quality of life', '"LIVE" decent', etc. and I struggle with how to used such terms because I don't know what they mean. There is no definition that we all can use when talking about them, as an example 'living wage', does it means a subsistence [a minimum food, shelter, and food] or does it extend to entertainment such as a smart phone? What does 'live decent entail', is it the same for everyone and does it mean for a person not to have a want unfulfilled? How do you use or define 'live decently'? I ask this question because I think that if we don't have a common definition people are talking past each other. Consider how different generation perceive subsistence living, many in my generation were young children when they first saw a TV, and for many years it was a novelty rather then a center of information or personal time.

Jeff from Mason
Wed, 11/14/2018 - 1:06am

With all due respect, Dr. Duong, things are a bit different today. Your statistics are accurate for legal immigrants, only. I think it's important to note it is very difficult to find someone against legal immigration. From reading your story, at that time due to the agonizing process your parents had to go through to leave Vietnam and the war in the past with the U.S., I believe you were considered war refugees for immigration purposes. This is how your family was able to get a loan to come here, along with receiving all the benefits you mentioned. Your parents also automatically received a green card upon arrival. War refugees today receive far more benefits, the most of any immigration class, and as a result, nearly all stay on assistance for at least 7 years as they can live without working. In Michigan, this cost is approximately $40,000 per person, per year. These costs are all on the state after the first 6 months. These benefits are also granted to people who are granted asylum. Benefits for them won't change upon their arrival. legal immigrants are also entitled to benefits, but not to the extent of the groups listed above. I think what this is addressing is the people who have been here for years without ever applying for a work permit. The programs for war refugees and people who are granted asylum are perpetual, there is no time limit. Lastly, I just want to say kudos to you and your parents. While they needed a little help at first, they worked hard and survived. The did all those things to provide a better life for their children.

A person
Wed, 11/14/2018 - 3:06pm

He is talking specifically about green card programs, which are specifically for legal immigrants. Illegal immigrants can't use most of the resources his family used.

Sat, 11/17/2018 - 12:42pm

DiD Trumps in laws have a Greencard?

Sat, 11/17/2018 - 12:44pm

try being a services mens Familie while dad is overseas!

Thu, 11/15/2018 - 3:25pm

I am concerned Dr. Duong has lived a protected life since coming to this country which has prevented him from learning the reason he has succeeded in America.
It seems that Dr. Duong believes that the American people have an unlimited supply of money so it should be given to on others, he seems to believe that anyone that makes it here deserves special benefits for that achievement, and he ignores any personal responsibilities/accountability of the recipients. This makes me wonder if Dr. Duong has tried to learn about how this country created the abundance he so easily wants to give away.
Dr. Duong seems to be one that has used the helping hands of others through his own efforts to create a quality of life he wants, but he doesn’t seem to believe such should be expected of others. It seems that he wants other people’s money to given without limits, without an understanding of what those who preceded him have built, how they chose to sacrifice and work for freedom and abundance.
America is the most generous land on a per capita basis and yet that seems insufficient for Dr. Duong, he seems to believe there is no cost to others for all he wants given, as if it doesn’t appreciate the work/sacrifice of others to create what he wants given. I doubt if he even understands the ‘Dutch’ jokes about frugality reflects on why there is Holland, Grand Rapids, and Muskegon and how it impacts the levels of success in each.
Dr. Duong has his answer and wants to hear nothing else. He doesn’t describe the problem and barriers to solving it, he doesn’t consider potential unintended consequences, and he doesn’t even want to consider other ideas. He has his answer and wants no other perspective and that is how he shows a lack of understanding of how America is so abundant and the only way it will stay free and abundant.

Fri, 11/16/2018 - 10:17am

Duane brings a great deal of assumptions to the table. We can start with "a protected life;" I am pretty sure that picking up cans for extra money does not reflect a protected life. Instead, what he Dr Duong brings is the American experience of working rather hard, of striving to improve oneself. The family starts in Holland, moves to Zeeland because his parents did land good jobs with Johnson Control and Gentex. There are no handouts when it comes to applying to the University of Michigan or for getting into Harvard Medical school (all this is from a Holland Sentinel profile, August 21, 2013 when Dr. Duong won a Fulbright at age 28).

Helping immigrants to keep their economic balance while their children succeed seems far more like an investment than some sort of give away. Clearly, what Dr. Duong argues for is the sort of support that makes for long-term success. The alternative is the toleration of an underclass, a stopping of achievement, a forcing families into poverty so they can qualify for immigration status. That choice between poverty or immigration status is a wrong-headed policy. Far better to think long-term about how we can help families succeed, whether immigrant or native; that is an investment that reliably pays dividends.

Fri, 11/16/2018 - 1:44pm

Our daughters were picking up pop cans at two cents each [one later earned a couple of degrees from U of M and the other an engineering degree from MSU, both working multiple jobs paying for their degrees] so were our girls no protected. Both daughters, like Dr. Duong, earned their success because of what they did, their sacrifices and efforts. But, neither you nor Dr. Duong mentions that migrants have any role/responsibility for their results [which our daughters were taught]. All you talk about is investing in migrants and not what we should expect them to do with that investment. You seem to only want to give and hope.

I wonder if you have an appreciation of what 'poverty' is in Vietnam or in other parts of the world and how that can influence how they view whether they are part of an ‘underclass’ and what to do with your ‘investment. Do you realize migrants bring a different cultures [even from within a country, like Vietnam from the south to north and in between] that can impact how they use your ‘investment’ in them? I wonder if you have taken the time to understand the American culture and how different it is and why we are different from the rest of the world and what that difference provides.

Reread what I wrote, I did not say we shouldn’t provide a helping hand, my emphasis was on expectation of migrants for actions on their part. I would even add metrics to verify the performance of programs. You talk about dividends, but as with a company paying dividends from an investment, they have to do things with the investment that creates a return on the investment so they can pay a dividend. Why don’t you think that should also be true of those you want to ‘invest’ in?
The 'wrong-head' policy is throwing money at a problem with no expectations for those spending the money and no accountability, very short-term thinking.

Sat, 11/17/2018 - 12:47pm

Foreign Aid to overseas countries? why?we need it at home.$ 40 billion and on and on ?why?

Sun, 11/18/2018 - 1:03am

I may not agree with how the 'forgien aid' is spent, but the idea of investing in activities and people around the world is a practical practice. I think of it as an advertising the idea of America, of keeping people aware that we are still around and aware of them. I don't think they have been the most principled or discipline in how they have spent the money, I surely would like to see more accountability, but that money can be a means of keeping an awareness of America out there and a means of impact open. Just as with any program I believe there should be specific expectations established along with performance metrics and regular assessments and appropriate modification in allotments.

Sat, 11/17/2018 - 12:11pm

you came here because there was war....America ......if there would have been war.you would not have to leave.Like all refugees of wars ..the countries that make war are liable for the living, see WW1 and WW2 where ONE country was held to pay for over 60 years for survivors.

Sat, 11/17/2018 - 12:22pm

17 countries pay there citzin a living allotment Finland, Canada and even Africa Nambia .
Even when they have a job THEY still (time or lengths of employment not secure anymore)l get to keep that allowance.

Sat, 11/17/2018 - 12:40pm

One More item. 2020 Census is coming.the more people the State has the more Money coming into Michigan!
So rehab (see MetroTimes) <Detroit Land Bank house and give Homeless Veteran a home and get the
immigrants a home and we will live again,,,,,1950-1=2004.