The idea of requiring a high salary is reasonable, but I'd make it rather e.g. 120% of the median salary in a particular industry.

If you can't find somebody skilled enough here to work for 200k or less, then you should probably be paying 200k or more since you're looking for a role that is niche and low supply.

This fee is a great way to ensure that there's very little medical services available to rural populations and to help kill science in the US among other things.

Doctors, pilots and other genuinely essential professions are well covered by a number of other visa categories, such as EB-2.

I don't think the EB-2 process allows the applicant to stay within the US while waiting for the priority date to become current so staying in the US and working during that 3-12 year period won't work without another visa type.

Rural hospitals are lucky to have any doctor on staff let alone a cardiologist. They are mostly staffed by nurses for quick patch-up work and life flights to major medical centers.

H1B doesn't solve the problem of poor communities getting poor healthcare. Frankly, it costs too much to become a doctor which limits where doctors can be employed. Plenty would like to work rural, but not with $500,000 in student loans. And no, that's no joke. I have a nephew going to medical school in Idaho and that's what his loans are.

A serious problem should not be treated with a band-aid and if you think a band-aid is ok do not be surprised the problem gets worse.

Part of the shortage is also because very few people can afford to become doctors.

In many cases, the rebalancing that is needed is from subspecialties to community based primary care in rural and other underserved areas. Some new medical schools appeared in the 1970’s to address the need for more family medicine docs. What happened was completely predictable… more subspecialists. Graduates follow the money trail when choosing residencies and fellowships.

Don't post docs usually come over on J-1s (if they aren't using practical training)?

"My rural patients are so much more insufferable than my urban ones"

https://old.reddit.com/r/medicine/comments/1nkb8f9/my_rural_...

It seems that the reasons for missing doctors are... complex.

I retired from medicine, having spent my career at a well-known institution in the upper midwest of the U.S. Over the course of my tenure there, I took care of patients from all parts of the world, all walks of life. Some of my most cherished patients hailed from rural farm communities. Whatever that commenter’s issues might be, this doesn’t line up with my experience at all. The work of the physician is to tailor their work to meet the needs of the patient by understanding their needs in ways that may be difficult to discern through ways other than empathic understanding.

There was no prediction or conclusion made whatsoever, it was a number of for the Internet quite high quality personal observations. If you are unable or unwilling to accept the personal observations of those people, here doctors, then the issue is on your side.

We also know that there indeed is a significant difference in culture, we can see that in elections and elsewhere. That too is a "known bias", which you also ignore.

For example:

https://www.aspeninstitute.org/blog-posts/the-electoral-coll...

https://www.sciencedirect.com/science/article/abs/pii/S07430...

https://en.wikipedia.org/wiki/Urban%E2%80%93rural_political_...

So differences in general are real, and you cannot simply dismiss any anecdotes as "bias", especially since there never was a claim for that thread to be anything more than that.

This divide is also not the same all over the globe, the US may be more extreme (example: https://www.uva.nl/shared-content/uva/en/news/news/2024/03/t... -- "Compared to the US, UK and Canada, overall levels of urban-rural electoral divides are still substantially lower in most European countries, due to centrist parties attracting support from both urban and rural areas."). That too has some interesting comments showing this in that thread, with the bad anecdotes coming mostly from US doctors.

So, if we're using the reddit thread you yourself have presented as evidence of the general sentiment on this topic, I think the parent commenter is correct in arguing that there is no particular universal trend here. These experiences probably have more to do with the simple randomness of where you work and what kind of personality you have.

To go further, I believe there’s good data on cost of living, geographically. It would probably be wise to use that in the formula as well, so as not to disadvantage smaller areas, where cost-of-living and salaries are lower.

I like the goal of making sure visa works are paid well for where they live.

I would not want to restrict the visa worker geographically though. Or alternatively I am unsure about the overhead of tracking the location visa holders and enforcing salary changes.

Might also have unintended knock on effect of encouraging job growth in low cost of living areas.

The percentage could be reasonable, but I think it's too easily gamed. You just know the company would try and say they are bringing in entry level people for whatever they want and use whatever lowest median they could find. There needs to be a fairly significant minimum salary to avoid such monkey business.

An H1B job should be cushy. Otherwise, the company should simply raise salaries to find local workers.

I don't think it's easy to game the median number, or the third quartile number if you prefer. Unless the salary distribution is severely bimodal, it should work reasonably.

The h1bs are often used to abuse that system by just importing someone willing to work for x, with the added bonus of it being very hard for them to ever leave your company.

If you couldn't undercut H1B salaries there is little incentive to use them except for their desired purpose (you can't find any local workers).

And if foreign workers are a "better deal" because they take more abuse (due to terms of their immigration) this further disincentives fair competition and makes the long-term problem larger.

> There is a lot of under-employment for highly qualified US citizens.

No, there isn't. Even with the current AI mess, the unemployment for highly-qualified software engineers is 2.8%: https://www.ciodive.com/news/june-jobs-report-comptia-data-I...

The AI is now decimating the jobs for the recent CS graduates.

qualified nurses are having to get jobs at retail, etc to survive. For some sectors, it's importing cheap labor (aka wage suppression).

You also are missing another possibility, the nurse jobs can just disappear and patients will be left with worse care.

What now?

What I care about is the current system isn't being used to find hard to find labor, it's used to bring in cheap labor in an abusive situation.

We as a nation are really better off if we bring in the best in the world to work here with a cushy salary.

https://www.uscis.gov/working-in-the-united-states/temporary...

You're believing and repeating the propaganda. The H1B was sold to Americans as for this purpose and then very deliberately turned into a loophole for importing massive amounts of foreign labor.

How silly is it to accept the idea that Big Tech companies like Google, Microsoft, and Tesla are not be able to hire Americans for any role they want. They're the richest companies on the planet!

These companies use the H1B to increase their labor supply, suppress wages, and gain indentured workers.

If they couldn't cheat by importing cheaper foreign labor they would have to compete against each other much more than they do for American workers.

This is all about big companies rigging the system. They do not care if it's good or bad for America, the foreign workers, or anyone else. It's simple greed.

and entirely different propaganda is that without being able to hire so many people constantly, the work just doesnt happen, and companies downsize to save money rather than grow to make more money.

a greedier facebook doesnt dump a ton of money into VR or ai glasses.

It was never, ever that they "can't find someone".

There are extraordinarily few roles handed out to H1Bs where there aren't enormous numbers of domestic options. Indeed, by far the biggest users of H1Bs in tech are shitty consulting firms like Cognizant, Infosys and Tata doing absolute garbage, low skill development.

Yes, there are exceptions. There are truly unique talents in the AI space, for instance. Not someone to build Yet Another agent, but someone who actually understands the math. They are extraordinarily rare in that program. And for those exceptional talents, a $100K fee would be completely worth it. But they aren't going to pay it for an army of garbage copy-paste consultant heads.

In actual reality it's just a way to push down wages by forcing Americans to compete with the developing world in their own country. In Canada we have "TFWs" filling the same role. It is a laughably unjustified, massively abusive program.

I'd much rather push everything into the salary of the person being hired. Both because it ends up raising the median salary for local workers and because it stimulates the local economy where that person is brought in. It's also a yearly fee. I think there's value in getting a very capable person working in your company and having a high salary is one way to make such roles highly competitive. A highly capable person will ultimately make everyone they work with more capable.

https://thefactcoalition.org/tariffs-manufacturing-tax-break...

EDIT: This is a proposal by 1 senator - not Trump.

"The proposal would increase the wage floor for H-1B visa recipients from $60,000 to $150,000, eliminate the Optional Practical Training (OPT) program, and replace the current lottery-based selection process with a highest-bidder system."

EDIT: This is a proposal by 1 senator - not Trump. https://www.newsweek.com/h-1b-visa-change-proposal-2132484

But that would be a free market that respected human rights, and Americans don't want that! Equality? Freedom? That's just marketing!

So just open USA borders to anyone that passes screening (security / health / etc)?

What about gov subsidized welfare / healthcare / education / ...? Would you end all that? If not end it how would you handle the situation with current citizens vs the influx of foreigners who will expect these things be provided for them? And if those who show up start to vote for communism or some other ism that you do not like what will you do?

It is ridiculous. Do you have a citation for the $50K number?