You are trying to conflate two different programs. One is a refugee program and the other is our immigration system. They operate under different rules and laws. From what I read he is talking about our immigration system, not our refugee or asylum programs. So, your doctor who lost everything would first apply for permission to immigrate here at which point they are expected to be able to support themselves. I know when my parents immigrated here they were required to have a job waiting, have insurance, have a place to stay, and a sponsor before they were legally allowed to enter.