They are doing that now too, however the problem is that h1b is used for roles outside of tech, believe it or not, and if you measure everything by Bay Area tech salaries a bunch of necessary but lower paying jobs will go unfilled
So rural people get screwed because most doctors won't go to a rural hospital, and the rural hospital doesn't have the budget of a fancy city, so it can't entice doctors, rural people get screwed.
That would be a market based solution that allows everyone to get the talent they need without driving down American wages.
But the point isn't about helping Americans, it's about being peedormatively against letting in brown people.