There is no doubt labor cost and high medical cost are the primary contributes to losing jobs. The valley might have better access of capital and better talents in various areas to (re)invent a business. Yet, once the business is on track, cost reduction kicks in. There isn't much reason to keep operation in the Valley. Management, then, would need to make a tough decision to run the operation elsewhere.
On the other hands, there is cost to employees. Paying high salary, most employers expect no training offer and start contribute first day at a new job. What worst is this practice applies to new employees fresh out from college.
The so called "H1-B issue" is completely bogus. There is no shortage of very highly qualified technical people in the Valley. But there is a dire shortage of those who are willing to work for peanuts. This is what I have to say to those executives who thought H1-B visas ware a major concern: When you look for a top-of-the line engineer, pay him like you pay your VP of marketing, and see how many applicants you get! When you need an average engineer, you can pay a lot less, but you still need to pay more than what you plan to pay for an H1-B visa holder.
The corporations only need H1B visa-ed employees if they are lower-cost than already present workers. This limits what companies would be willing to pay.
The alternative is auction the H1B visas to the aspiring workers but again their ability to raise capital with which to bid may be limited.
My solution to the H1B issue? Auctions.
Sell 10,000 slots each month (around half again more than we give away now) for whatever money the market will bear. If employers really need these people, they will be willing to fork over the cash. This will also have two nice side benefits
1: A few billion in revenue each year for the government
2: Most concerns about "cheap labor" evaporate as companies will in theory bid away any potential gains from labor arbitrage