This is the fix for one of the two fundamental issues with H1B. The second issue is that H1B is tied to employer and you can't switch employer unless receiving

This is the fix for one of the two fundamental issues with H1B. The second issue is that H1B is tied to employer and you can't switch employer unless receiving side agrees to do brunt work of legal "transfer". This gives employers unchecked power to exploit H1B workers. The way this happens is employer - typically a "consulting agency" - takes cut from all payments so H1B salary is just above the minimum required. This issue allowed proliferation of mom & pop shops that would literally import people from places like India and Pakistan by dozens. With cuts of size $40K per person they would rack up millions of dollars doing absolutely nothing but sponsoring H1Bs and running the shop literally in their pajamas from their home. For the first issue of spouses not able to work, I've heard several horror stories where spouse has medical or engineering degree but is forced to sit at home doing nothing. The situation, as I recall, wasn't too bad however because such spouses eventually went on to get F1 visa for studies or H1B themselves so they can work. However path to that was extraordinarily tedious littered with lots of legal issues. I really like UK's work permit system comparatively. It allows to work anywhere in UK once you get permit and avoids employer exploitation. It automatically grants spauces also permission to work. In addition, if you live in UK on work permit for 4 years with paying taxes then you are automatically eligible for permanent residence. As sad it is, UK has taken much more freedom oriented approach for immigrants than US for years.