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Real H-1B reform should use the laws of supply and demand to dictate the need for additional workers. If wages for a particular profession are stagnant or falling, new workers are obviously not needed. However, if wages are rapidly rising then it shows that the supply is inadequate for the need. Lack of sufficient skilled workers could impair employers here in the US. For instance, years ago the government changed regulations requiring nursing homes to provide physical and occupational therapy. All of the sudden, it would not have mattered what you were paying there were just not enough therapists to meet the demand. The growth in wages was so rapid that only the bigger assisted living facilities could compete and the smaller ones were being squeezed out. The therapist market at that time was a heavy H-1B user. Without access to these additional workers, many smaller assisted living facilities would have closed.

To petition for an H-1B professional visa would require that the need for foreign workers be demonstrated with rapid wage growth that considerably exceeds the overall market growth level. I haven't really thought it through fully, but I could envision a system were the Department of Labor certifies that a certain profession had an annual salary growth in excess of whatever the threshold is set at. The Immigration Service could then issue a number of visas linked to that level of growth for the profession. As an example, let's say that overall wage growth for the economy was 1% and the wage growth for "widget maker" was 3% (or 3 times the overall rate, the trigger in this example). Then and only then could visas be issued in this profession. A formula could also be set to determine the number of visas to be issued. For example, 0.1 of the growth rate times the number in the profession. If there were 1,000,000 "widget makers" then (0.1 x .03 x 1,000,000) would allow 3,000 visas for "widget makers" in this example. If the threshold wage growth level continued to be met or exceeded, additional visas as per the formula could be issued. If the wages had leveled off, then visas could no longer be issued in that profession. In this way, industries that truly face a worker shortage and have been paying wages growing at rate considerably faster than normal can continue to do business until domestic supply has caught up. However, workers in a profession where there is no great shortage and wages are not exceeding the threshold growth levels would not have additional workers brought in to depress their wages or take their jobs.