I personally don't see this as a problem. If you cannot afford to pay for the workers you need then something is wrong with your business model and you need to

I personally don't see this as a problem. If you cannot afford to pay for the workers you need then something is wrong with your business model and you need to fix it or the community (read:voters) need to deal with not having your service. In the case of a rural hospital it's a combination of several things within the US healthcare system being completely messed up, but shoving H-1B workers in to plaster over the problems is not the solution we need.