One of the things we really need is for a skilled graduate or immigrant to be allowed freedom of employment. This stops driving salaries down, because employees then aren't bound to an employer to get their green card or maintain their legal status (giving the employer freedom to put the salary where they want because of desperation). Yes, the H1B portability exists in theory, but in practice they're unusable - with only 60 days of legal unemployed time between jobs, having to secure a new offer before initiating the transfer process, and having any active green card application processes (which can take more than 5 years usually) killed if you transfer, we might as well pretend the portability option doesn't exist.
I would also like to note this reformed H1B shouldn't be awarded to the body-shop-type employers (basically anyone employing over 40% immigrants and over 100 people). Technically this clause exists today, but these body shop companies have a lot of phantom "US Citizen" employees to bloat their total employee numbers and then all the actual staff is imported. Those practices need to be audited more closely at least for the larger companies and curbed.
At the very least, I think it makes sense for someone who has spent 4 or more years in US in the capacity of a student to be given freedom of employability a little more easily, without restricting them to having to go to one of very few employees that can secure them a H1B visa now and commit the first 5-10 years of their career at that one place (or leave the country) to stop being treated worse than illegal immigrants.
More importantly, I think the process needs to recognize the fact that there is no room for company founders, other than the atrocious O1 process which is expensive and time consuming and subjective. I personally believe anyone who can demonstrate basic intent to create a job and shows qualifications for it (maybe after operation of the company for some period of time) should be given a visa with weird restrictions on salary and job title and whatnot, with an audit clause for every 2 years or something. All the existing visa programs are extremely constrained for most founder circumstances (which are quite varied, because founders are supposed to be about finding creative ad hoc solutions).
Disclaimer: Cofounder of a silicon valley startup gone digital nomad because of 2 failed H1B attempts and not being able to justify 2-4 months company-wide paychecks to apply for an O1+lawyer.