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Jan. 31, 2022, 8:16 a.m. EST

‘Uber for nurses?’: Initiative targets healthcare for a ‘gig work’ law

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By Levi Sumagaysay

Healthcare, the nation’s fastest-growing industry, could be next in the push for laws to expand gig work.

A measure filed this week with the California attorney general’s office seeks to ask the state’s voters in November to classify nurses, dental hygienists, occupational therapists and other healthcare workers who secure work online or through apps as independent contractors. The proposed measure was submitted by a law firm that worked on Proposition 22, the record-breaking $200 million-plus initiative campaign funded by Uber Technologies Inc. /zigman2/quotes/211348248/composite UBER +2.47% , DoorDash Inc. /zigman2/quotes/222973991/composite DASH +5.97% , Lyft Inc. /zigman2/quotes/208999293/composite LYFT +0.51% and Instacart that allowed those companies to bypass a state law that would have classified their drivers as employees instead of contractors.

California voters passed that law in 2020, but a state court declared it unconstitutional, a ruling that the gig companies are appealing while attempting to replicate the law in other states and nations. The state’s laws often become a model for other states, so there is a possibility of a similar trajectory with healthcare, which is expected to add more jobs than any other occupations this decade, growing to be the nation’s largest industry by 2030, according to the U.S. Bureau of Labor Statistics.

See also: More on the record-breaking $200 million-plus fight to preserve the ‘gig economy’

The group behind the ballot initiative, which calls itself Californians for Equitable Healthcare Access, is not revealing its backers yet. If the initiative qualifies for the November ballot and is passed by voters, it would allow employers to treat healthcare workers as independent contractors if they secure assignments from digital platforms and satisfy several criteria, including that they largely determine their own schedules, are free to accept or reject work without penalty and can accept work from other platforms and sources.

“Healthcare professionals deserve to have flexibility to choose where and when to provide services, and facilities deserve to be able to find these independent healthcare providers quickly and easily to support their patients, particularly under changing conditions,” a spokesman for the group said.

The initiative is being introduced as venture capitalists pour millions of dollars into new healthcare-worker staffing platforms, some of which operate in a similar fashion to popular on-demand apps — and as hospitals struggle to retain nurses and other healthcare professionals who are burned out because of the coronavirus pandemic. Despite the healthcare staffing issues the COVID-19 pandemic has exacerbated, experts in labor history and the healthcare industry who spoke with MarketWatch called the initiative “a terrible idea,” “malicious” and “a huge union-busting move by the VC industry.”

“We do have a challenge with staffing problems [in healthcare],” said Laurel Lucia, director of the healthcare program at the UC Berkeley Labor Center. “I don’t see how this is the solution. Removing labor protections and benefits for healthcare workers will be bad for both workers and patients.”

‘Nursing… is fundamentally different from gig work’

At least one of the platforms that have sprung up to modernize the healthcare industry agrees. Trusted Health, a San Francisco-based startup that recently raised $149 million in venture funding, matches nurses to jobs all over the nation by having them create profiles on its website, offering them salary calculators, licensing guides and more.

But like many traditional staffing agencies, it takes nurses on as W-2 employees, not independent contractors, and offers them healthcare benefits, access to a 401(k) and more.

“Now more than ever, we feel an obligation and privilege to help ensure that nurses can sustain the work they’re doing,” said Sarah Gray, founding clinician at Trusted Health. “We need them and someone needs to be caring them.”

Special report: Best New Ideas in Healthcare

Gray called travel and contingent nursing a “cornerstone” of the nursing industry and cited a Trusted Health survey of more than 3,300 nurses that found 71% of them wanted scheduling flexibility. But she added that wherever or however nurses work, they should have access to “robust” benefits.

“Nursing… is fundamentally different from gig work,” she said. “There’s a high barrier to entry. It’s a professional career, and in order to sustain that career and provide high-quality care, nurses need to have that proper care themselves in the form of employee benefits.”

Besides the threat of the gig-economy model itself, Gabriel Winant, a history professor at the University of Chicago and author of “The Next Shift: The Fall of Industry and the Rise of Healthcare in Rust Belt America,” called the proposed initiative “one of the most malicious things I’ve ever seen.”

Winant said the for-profit model in hospitals that rely on not running at full capacity at all times is causing the understaffing problems we’re seeing now, and says this type of law would make it even worse.

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