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Public’s Health Hurt by Outdated Anti-Contracting Law


Mass. should lift restrictions on those seeking career flexibility


Caring for tsunami of patients in the midst of a pandemic is hard enough. Unfortunately, laws in Massachusetts and California make the job even harder by preventing hospitals and all other employers from contracting with self-employed individuals for work if they bring skills that fall within the buyer’s “usual course of business.”


A health care system facing an enormous surge in demand is looking frantically for skilled personnel and specialists to serve the sick by contracting with individuals who can quickly bring desperately needed help to patients—and comfort to their families— with minimal supervision.


Skilled capacity exists to meet public-service needs like this. At least 40 percent of the American work-force effectively supervises themselves, providing a deep reservoir of talent to handle surges in demand like we face today. But in Massachusetts and California, the best that hospitals and other health care facilities can do to increase their capacity is rent individuals of uncertain skill levels who are employed by temp-staffing agencies.


But relying on local temp staffing is how Berkshire Health had to fill in for nurses who were furloughed in March because of possible exposure to the virus. Young specialists like nurses look forward to “going 1099” so they can still practice nursing, but skip the relentless grind and inflexibility. And health care facilities are eager to contract with these experienced professionals.


But since this route to tailored talent is foreclosed in Massachusetts, Berkshire was prevented from contracting with specific individuals who possess the particular expertise it was looking for, since the work was within its usual course of business. “Usual course of business” makes no allowance for 100-year pandemics, hurricanes, or other disasters.


Individual workers also lose under this arrangement. The laws effectively put self employed independent contractors out of business. The workers either have to become regular employees somewhere or go through a staffing agency where they would likely make far less money, as in the Berkshire example.


Successful contractors learn how to work very quickly, finish tasks flawlessly, and then charge a little more for them. Good work at a fast pace and decent rates makes the contractor’s revenue meter spin faster, which is one reason why they rarely return to more traditional settings.