Nurses Sound Alarm as 'Uber for Nursing' Apps Push to Deregulate Healthcare

I got a fond appreciation of uber and other marketplaces that provide accountability using technology ever since.

You are defaulting to the US here (and I doubt Taxi regulation in the US is that homologous either tbh given the complexity of 50 states and then cities on top of that).

Taking the country I'm most familiar with (the UK), Taxis fall into two categories (only one of which is technically a taxi by law if not convention - Hackney and private hire vehicles) both are licensed in different but similar ways by the licensing authorities (usually the local council but not always), some of those laws go back centuries.

Also worth noting, in the UK Uber does operate under the Private Hire Vehicle laws and does have to comply with applicable licensing same as any other "taxi" (private hire vehicle) operator.

They tried to argue otherwise and lost (at the UK Supreme Court so it's essentially settled case law) so they are classed as a PHV Operator and must ensure they only use a properly licensed PHV vehicle and drivers and can't pull the "but they are independent contractors" card out when it explodes in their faces.

It was a little more nuanced than that. The actual case was about whether a private hire operator accepting a booking had to contract with the customer as principal, rather than merely acting as an agent arranging a contract between the customer and driver (which was essentially Uber's argument).

The (UK) Supreme Court said "nah, it's you, nice try though".

Taxis have standardized rates set by the municipality and use standardized meters that are periodically inspected. Ride sharing apps have dynamic pricing and no transparency.

One reason "Uber for X" appears not to have materialized is that the platforms themselves are commoditized, not just the labor. Retailers like Lowe's and Wayfair have built assembly/installation services behind a checkout upsell. They run portals distributing work to their "network of local contractors" .

I got a window into this world through an acquaintance. He has a truck and light trade skills, but mental and reputational legacies of past addiction lock him out of the "anyone good" market. He's on a half dozen platforms, trying to stitch a living doing sink or toilet installs for Lowe's and building bookcases for Wayfair. A negative review gets you demoted from the choice gigs, or even kicked from the platform entirely. It's bleak.

https://www.oecd.org/en/publications/2025/11/health-at-a-gla...

Every serious analysis of the US healthcare system I've ever seen comes away with the takeaway "Americans consume a lot of healthcare services and the expensive part of that is the providers' salaries"

To see how this is possible, enumerate all the other people getting paid, and then compare to a country with a working health care system.

The most obvious difference is that the US spends an absurd amount of money administering health insurance.

What we need is competitive markets, what we get is heavy intervention. For example, https://en.wikipedia.org/wiki/Certificate_of_need system means that to build a new hospital one needs to go to their direct competitors to ask for their permission. Imagine if to open a pastry shop you needed a permission from every other pastry shop in the city - bonkers.

https://savegme.org/

Even if financial constraints were removed, the notion that we could produce twice as many physicians is ludicrous. There simply aren't enough attendings able to supervise a lot more residents, nor are there enough patient cases coming through the teaching hospitals to give that many residents the practical training they would need.

How the board gets approved to be elected is a bit self selected, but in theory it should be controlled by people that have incentives, the same as a public corporation.

Now this is an insurance company and not a provider network,some provider networks are more self owned.

They have no stock holders to pay, but the people running them will pay themselves multi million dollar wages if they can!

The 15% extra administrative cost of insurance and 15% extra administrative burden of applying care are the big culprits, in addition to extra costs on medicine and machinery. But it's interesting. Why is it that a comparatively deregulated and privatized system has so much extra pricing cost from bureaucracy?

The real fix is to make it so their main job is hydrating enough, or the thing half the country hates the idea of (public fountains). IRS can't do either. Independent contracting is still a valuable mode of work, when the contractors are paid enough. So rather than ban forms of gig work, we need to provide good paying jobs and social services, and get the rich to pay their fair share.

I also said this was for the Bay Area - it’s not the norm but it’s not infrequent either

Labor costs are 60% or hospital expenses, I didn’t make that number up and you just glossed over.

And again, I said it was just an issue to be discussed. If discussion leads to it’s not worth discussing, that’s great and a great outcome

You did the thing where you just sort of read what you wanted to read in my comment vs addressing what it said

One movie that made me change my perspective on nursing as a field was the Swiss movie Late Shift. It really opened my eyes to what nurses have to deal with. Yes the US might be different in having lower patient to nurse ratios but at the end of the day I think it's still applicable.