It’s not healthcare specifically, (that’s just a handy excuse) but a trend that’s become well-established in IT industries and beyond to the wider business world. It’s called: “The Gig Economy”.
It’s not new; businesses are trying more than ever to reduce all human capital costs and offload as much responsibility for their workforce as possible, so yes, freelancers and contractors are becoming more and more the norm, and there is no more “social contract” where a worker trades time and loyalty for steady compensation and benefits. Shareholders do not care about such things, only profit.
On the employer side, it maximizes workforce flexibility, allowing for fast growth or reductions in workforce to suit business conditions. Expanding? Plug in some temps and get cracking. Bad quarter? Drop a few dozen or hundred heads, watch the stock price go up. Every time. A complete commoditization of human capital, which forces keen competition that keeps wages low, and benefits, thin. It’s not that great a deal for the workers, because it creates chaos, uncertainty, and instability when the income stream is unreliable and prone to interruptions when the gig dries up and you have to go find another one. It reduces the value and thus the bargaining power of a worker negotiating their compensation, because someone will always be a little more desperate than you, and willing to undercut your price for what you do. It end-runs around Organized Labor and the worker protections and policy oversight it can provide, when workers are all individual bargaining units and not a collective, creating a ripe environment for abuse without complaints or consequences. And you’re more or less completely on your own for managing the health care, insurance, and retirement savings, again without much bargaining power because you’re an individual.
Optimists thought that global trade agreements would spread American values, work practices and compensation levels to other nations, third-world nations, raising the standard of living for people everywhere. My observation of what’s actually happened is that the low-wage, anti-worker policies of those nations are more and more getting established here instead, forcing a race to the bottom here at home. Like a foreign missionary “going native” and abandoning their faith.
But on the bright side, hey; “shareholder value“, amiright?
I don’t have an answer to fixing it. And I think it will get worse before it gets better – if it ever does get better, because IMO business has gotten too embedded into government and law, which ordinarily would be the gatekeeper and referee for these things. I hope it can be again.