It sounds terrible if the sole purpose of H-1B is to pay less than the labor is worth.
Of course, this assumes that it actually has to be paid, rather than being used to extort political support.
Paying an exorbitant fee to the government will discourage the activity in the United States.
For academics, it's a global market for talent. There may only be a small number of people in the world who are doing top research in a particular area.
For rural healthcare, if you're a hospital in a very poor, very remote area, and you want to hire say, an anesthesiologist, you have to hire someone who could make very good money working anywhere, but is willing to work at your hospital. $10k is not going to cut it.
Luckily, administrators' salaries and endowments can cover fees, and rural areas are often served by doctors who agree to loan forgiveness programs which help underserved areas.