the CEOs of the outsourcing firms have been caught a few times complaining about lazy Americans. And frankly he's right. By Indian or Chinese standards our 50-60 hour work weeks make us lazy. The H1-Bs I know regularly put in 80 hour work weeks. They're young and disposable but they don't care because currency exchange means they're earning a fortune working here. Best case they get a greencard and start doing the 50-60 hr work weeks of Americans, worst case they go back home flush with cash.
The moral? You can't compete with India. You can't compete with a country that has a literal cast system and effective slavery for millions of their citizens. End the H1-B program. Start calling your congressman/woman/thing and ask them why they haven't ended the program. There are other programs for rural doctors. The program is for replacing Americans. Call your congressman and ask. Remind them you and your family and your friends won't be voting for them in their primary. Make sure you say primary. They've gerrymandered the districts. After their Primary they'll win. But they're vulnerable in the primary.
Most of this post is completely incorrect. The rest is only partially incorrect.
First things first, the decision to outsource is never about quality or performance, it's always 100% about money.
Secondly, its not the "exchange rate" that makes working overseas attractive, its the disparity of income. The exchange rate just denotes how many rupees you get for dollars, income disparity is what makes you get more money per hour.
Thirdly, 12 hour working days are rare, its mostly 8 hour shifts, especially for western companies that are subject to laws back home even though the labour is outsourced. As another poster explained, the culture of long hours with Asian companies tends to be more about social rules than work. A Japanese employee might be at work for 12 hours, but thats all about appearance, they have to look like a hard worker by arriving before the boss and leaving after the boss. They don't get any extra work done, a lot of the time they are napping or socialising. This is a common theme across Asia.
In my experience, Indians buck the trend of Asian culture. Most Asian (especially the Chinese) don't like it when the Gwailo demonstrates they know more, so the appearance of knowledge is more important than the knowledge itself. The Indians are the opposite. I once had to run training in Singapore, the ethnic Chinese attended, but never participated. They didn't ask questions or interact much, to do so would have lost them face in front of their colleges. The ethnic Indians on the other hand never stopped with questions. At one point I had to ask them to write them down as I didn't have time to answer them all tonight.
The reason so much outsourcing ends up in India is because they are happy to work under western managers.
Of course with all races, you get the full spectrum from idiot to genius, western, Asian or otherwise, however only certain cultures have a compunction against learning or thinking outside the box. With Indians, you get two types of body shops, cheap ones that employ anyone with an IT cert so they get all the ones that paid for their certs and are pretty much useless. The second kind employs the Indians that are moderately competent, these guys actually earned their grades and are good at performing routine tasks but don't expect much in the way of creativity, the downside of this is that you pay more, probably about the same as hiring flunkies in the US. Those Indians that are actually as good as good western IT workers... We'll they're your colleges. Indians who are a good enough can generally get out of India of their own accord. Most end up in the UK or Australia as India is part of the Commonwealth of Nations which makes it easier to get a visa. Really good Indians will have worked all around the world.