I'm seen the system abused (Infosys definitely, IBM as well), but I've also seen some great results (Microsoft, Epic, Medtronic). I think if there is a reform of the H1B, it should be that the company directly employ the H1B as an employee and not as an at-will contractor like Infosys and Tata, and pay should be in line with American workers to avoid the cost shifting.
Pharmacy doesn't really have that many H1Bs as the TN is more likely from our NAFTA neighbors (there's quite a number of Canadian pharmacists who moved to the good guys in MN, and in AZ, there are quite a number of Mexican trained pharmacists that are very reliable retail and hospital pharmacists on the TN). Academic pharmacists are almost always put on the O1 track if they aren't already TN (especially biotechnology, pharmacognosy, and dosage form pharmaceutics), so it isn't a problem for government or academia if they are good.
And yes
@Sparda29, I do think that autarky encourages better educational infrastructure, and importing should be viewed as secondary. Sure, the Americans can continue to brain drain the world, at the cost that we neglect to fix the consequences of having a mediocre educational system for regular people. From my parent's POV (but not mine), it's a shame that Asians become Americans here and that their grandchildren regress to the mean.
