It's a shit ton harder than people realize.... well at least to go anywhere in the industrialized world. Unless you are independently wealthy or have an extremely high demand job.
Billy Bob who's career is working at McDonalds isn't going to get approved.
I'm banking on this actually. My specialties are, and my wife's is as well. So I'm reaching out to companies I know with a presence to see what my options are where I'd like to go, and decide from there. I doubt we will be the only ones though, so we'll see what that ends up looking like.
The only up side is I'm in a very niche specialty with broad experience, have contacts on both sides of the work I do.
I think I'm in a better position than most, and I still think its going to be an uphill battle.