Yet another Hacker News

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

109 points ravetcofx 1 hour ago 95 comments

bagels 1 hour ago | parent

Seems like illegal wage fixing collusion by employers with the extra step of technology.

Avicebron 59 minutes ago | parent

Another torment nexus banger.

changoplatanero 57 minutes ago | parent

Everyone wants healthcare expenses to go down but the biggest healthcare expense is the salaries of providers. So, hard to give the masses what they want without making a smaller group of people who benefit from the status quo angry.

jtmarl1n 51 minutes ago | parent

I’m sure there is some savings to be found within the insurance industry who regularly reports earnings in the billions.

kraken_cult 51 minutes ago | parent

How about we gut the insurance companies that are blowing the price of everything in healthcare and not leverage the desperation of nurses?

Nifty3929 49 minutes ago | parent

Much like home prices. Everybody says they want homes to be more affordable, but all actions are designed to keep them high and if they did actually fall it would be treated as an emergency.

5mk 45 minutes ago | parent

Physician and nurse salaries account for only 15% of healthcare spending.

https://www.commonwealthfund.org/publications/issue-briefs/2...

responder41 29 minutes ago | parent

to be a bit pedantic, that says they account for only 15% of the excess healthcare spending, relative to other countries. It's not surprising given doctors in the united states have a higher level of training compared with many peer countries, and _all_ salaries are much higher in the united states compared with almost any country.

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?

boredatoms 44 minutes ago | parent

The whole ecosystem of companies trying to make a profit from each thing along the way isnt efficient. Other countries just nationalize instead

0xbadcafebee 36 minutes ago | parent

Physician salary is only 9% of total healthcare cost. The rest of the labor pool is administrative - clerks, management, etc.

Physicians also make 2-3x more than physicians in other countries. Why? Their education cost is also 2-3x higher than in other countries.

Hospitals and procedures are expensive, in part because of insurance. Insurance is high because our society is too litigious. It's also expensive because of consolidated private healthcare systems that can control and mark up prices due to lack of competition.

Other countries spend half what we do on healthcare. And their people are often healthier.

Ccecil 31 minutes ago | parent

Hospital administration costs are 20-30% of healthcare costs. [1]

[1] https://www.trillianthealth.com/market-research/studies/hosp...

BurningFrog 30 minutes ago | parent

We just need to educate a lot more doctors and nurses. That would lower salaries and provide a lot more care.

Last I heard the AMA controls how many doctors can be educated.

BoardsOfCanada 13 minutes ago | parent

In Sweden we had this in the news: https://www.svt.se/nyheter/lokalt/uppsala/hon-pendlar-860-mi... A US nurse moved to Sweden and preferred to fly to San Fransisco to work ten days at a time, then fly back to be off for six weeks, rather than taking a job as a nurse in Sweden. The salaries are very different.

74948494i4 56 minutes ago | parent

Apparently most hospitals make low margins. If this is true, and the goal is to make healthcare more affordable, something has to give, no?

https://www.kff.org/health-costs/key-facts-about-hospitals/?...

It is also unclear how this is any different than traveling nurses which operate similarly.

What is the solution that doesn’t result in at least some large group of people making less money?

gambiting 51 minutes ago | parent

Yeah, maybe it's the idea that hospitals should make profit that should give?

Like, sorry, but not being from the US the whole idea of a "margin" when running a hospital is insane. Hospitals are paid from our ample taxes and the patient pays nothing - there is no room for profit there, not should there be one.

74948494i4 49 minutes ago | parent

How much does your country’s medical professionals make, how long do patients wait for care and what is the level of care as measured by variety and efficacy? Seems hard to compare without normalizing these things.

jazmichaelking 26 minutes ago | parent

>How much does your country’s medical professionals make

Let's assume UK. Less. US physicians earn about twice what their UK peers do, US RNs about 1.5x https://www.commonwealthfund.org/publications/issue-briefs/2...

>how long do patients wait for care

About the same or longer, in general UK consumes less healthcare per person, but...

>what is the level of care

Better outcomes in the UK https://www.pgpf.org/article/how-does-the-us-healthcare-syst... and longer UK life expectancy https://www.oecd.org/en/publications/2025/11/health-at-a-gla... (and of course US has higher levels of chronic illness https://www.healthsystemtracker.org/chart-collection/how-has...

All for far less (share of GDP) than US https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS?locat...

nradov 12 minutes ago | parent

Trying to compare national healthcare systems based on life expectancy is a total non sequitur. Most of the factors which limit US life expectancy relative to other developed countries have little or nothing to do with healthcare (or lack thereof). It's mainly other problems like car crashes, suicide, violence, substance abuse, and sedentary lifestyles.

JoshTriplett 49 minutes ago | parent

Among the things that need to give are 1) insurance companies making no money because there's no margin left in the system for them, and 2) several times as many doctors, which means breaking the protection racket that intentionally limits the supply.

nradov 18 minutes ago | parent

What is the protection racket that intentionally limits supply? The primary bottleneck to producing more physicians is lack of available residency slots. Teaching hospitals are free to add more but for various reasons choose not to. In part I think they're waiting and hoping that Congress will kick in more subsidies through the Medicare program.

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.

howunfortunate 10 minutes ago | parent

> What is the protection racket that intentionally limits supply?

It's the AMA.

"Free to add more" is hiding a LOT of important nuts and bolts of the guild system that discourages new entrants.

nradov 6 minutes ago | parent

Nonsense. The AMA doesn't limit the number of residency slots. Did you even read through the website I linked above?

thaeli 14 minutes ago | parent

#1 seems like a feature, not a bug. The real problem is that health insurers in their current form exist at all.

dividefuel 4 minutes ago | parent

A much larger supply of doctors would presumably lower their pay significantly, right? Will people still want to put in the years and years of training to become a doctor if the pay drops significantly?

lifeisloving 48 minutes ago | parent

Traveling nurses make more than lots of doctors though, so I dont think they're being taken advantage of. However, Im sure this company is trying to take a piece of that traveling nurse pie.

thatfrenchguy 41 minutes ago | parent

It’s a complex problem because a lot of those hospitals are non profit, so they have zero incentives to have high margins because no shareholders to return money to. Higher salaries for executives though…

BurningFrog 33 minutes ago | parent

It's REALLY important to understand that non profits have just as much incentive to maximize their income as for profits.

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

moi2388 24 minutes ago | parent

It’s important to note that in most countries the law even states that they need to pay competitive salaries for these positions, so they can’t even pay them much lower amounts than their non profit counterparts

nradov 24 minutes ago | parent

Most hospitals (both for-profit and non-profit) are terribly inefficient. They burn up clinician time on administrative tasks that could be automated or performed by cheaper office staff or not done at all. And employees often waste a lot of time just waiting around because no one has optimized workflows to shorten queues or eliminate bottlenecks. The incentives are structured in a such a way that there's often little reason to improve.

za_creature 17 minutes ago | parent

Most software development shops (both for-profit and non-profit) are terribly inefficient. They burn up programmer time on administrative tasks that could be automated or performed by cheaper office staff or not done at all. And employees often waste a lot of time just waiting around because no one has optimized workflows to shorten queues or eliminate bottlenecks. The incentives are structured in such a way that there's often little reason to improve.

nradov 7 minutes ago | parent

Ha ha, but it's a matter of degree. Every organization has some level of inefficiency but having seen how the sausage is made I can guarantee you that the average software development shop in a US tech company is significantly more efficient than the average hospital. It's not something that you can quantify in a directly comparable way but anyone familiar with the industry will tell you the same.

za_creature 5 minutes ago | parent

I made a lot of sausage, including for US companies. My personal preference is smoked, not dried.

alliao 24 minutes ago | parent

check the admin headcount vs healthcare worker last time I looked up admin grew exponentially

joe_the_user 23 minutes ago | parent

The exact profit margins of hospitals as a whole doesn't matter. Hospitals are where health care happens but financially, they are simply a platform for a multitude of other private entities which make profits on top of the simple hospital fees - the "Uber For Nurses" thing is just one of many ways this happens, you have everything from data management companies to separately own MRI machines adding to the patient's bill and having a voice in the management of the hospital.

jareklupinski 56 minutes ago | parent

> A companion Roosevelt Institute brief found that some platforms "use data-brokers to determine nurse debt levels and offer lower wages to those with highest debt loads."

thanks free market

antonvs 34 minutes ago | parent

I'm investing in guillotines. I have a feeling they're going to be hot.

im3w1l 3 minutes ago | parent

When something sounds too bad to be true, I think it's fair that we should ask for some kind of evidence to be produced. They cite a Roosevelt Institute article that says

"Gig nursing apps MAY [my caps] determine pay by what the firm knows about how much a nurse was willing to accept for a previous assignment, how often they bid for shifts, or how much credit card or other kinds of debt they might hold."

That kind of sounds like they are overselling a hypothetical. Even just an "insiders familiar with the matter have told us that it IS happening", would make me believe it more.

thomasdziedzic 55 minutes ago | parent

Nurses already deserve higher wages than what they already get, but introducing "dynamic pricing" and competition to under-bid each other is just disgusting.

Nurses form the backbone of healthcare. Treat them as such.

Edit: To those downvoting me, talk to a real nurse and I bet you wouldn't take twice the pay to do half the work they have to deal with.

arjie 28 minutes ago | parent

There's no concept of "deserving higher wages". It's a popular online meme but what on Earth does it even capture? If you value the work higher, then pay them more and you'll win the market for that labour.

There's a good argument to say that sufficiently aggregated marketplaces can launder price collusion, and if we were in such an aggregated marketplace then you could make that argument. But we're not in that situation right now.

The 'Edit:' is even more confusing. If I talk to someone in a profession and I wouldn't take twice the pay they receive to do half the work they do then they deserve higher wages? But that list is huge. Congressmen, Senators, many CEOs, Wagner-group mercenaries, ICE officers, drone pilots. In fact, almost every profession has this 4x effective slippage you're talking about.

le-mark 55 minutes ago | parent

> found that some platforms "use data-brokers to determine nurse debt levels and offer lower wages to those with highest debt loads."

We can assume all gig economy companies do this? Brave new world indeed.

neal_jones 28 minutes ago | parent

Wondering if regular companies are doing this as well.

monster_truck 27 minutes ago | parent

yes

supertrope 8 minutes ago | parent

Uber checked the first few digits of your debit card to filter out police officer credit unions to evade taxi regulation enforcement. They use your phone’s battery level as one factor to estimate your elasticity of demand. They have teams of economists to adjust personalized prices to as high as you can bear and pay for drivers as low as possible.

buran77 55 minutes ago | parent

It was only a matter of time and I said (half) jokingly at the time that Uber is breaking the dam for everyone else to follow. Any regulated system will have its day in front of "disruptors" where the disruption is simply ignoring the regulation with some flimsy excuse, supported only by the money and lack of morals of VCs and startup combinators.

Uber took an axe to taxi drivers which weren't a popular group to begin with so that was easy. With the "disruption" perfected, next up are doctors, nurses, lawyers, electricians, cooks, engineers, the sky is the limit.

Ccecil 34 minutes ago | parent

It has been my observation that the companies all had plans to "disrupt"...but it seems they never had a solid "profitable" plan past when the VC money ran out.

Aside from turning employees into contractors...most of which have not done the math on how much they are losing through having to use your own car with no employee benefits. Doordash/Uber start looking a lot less attractive if you figure in the $.65/mile costs (fuel, repairs, insurance, car purchase price) that you would be paid by most govt or "real" companies. Almost everyone I know who does Doordash makes about $20/hr (which isn't good anyways) and they are not figuring in the costs of the vehicle.

SoftTalker 29 minutes ago | parent

If you set yourself up as an LLC for your uber driving, can you take the standard mileage rate as an expense?

onedognight 24 minutes ago | parent

You don’t need an LLC to do this. Just filing a Schedule C will do.

tasty_freeze 15 minutes ago | parent

My wife volunteers during tax seasons to do tax returns for low income people. It always depresses her when people on the lower runs of the ladder come in and have been doing uber, lyft, doordash, etc or some combination and have nothing more than a hand wave estimate of how many miles they drove. She is the one who has to tell them just guesstimating is not allowed and what might have been a $1000 check back to them is instead a $2000 check they need to write to the government. 9 times out of ten they say, "but I don't have that money" and it crushes her. More than a few get mad at her for not being willing to just enter their guesstimate into the form.

I'm not sure if it is because uber (or whomever they work for) didn't make it clear enough to track it properly or if they simply didn't take it seriously.

nradov 4 minutes ago | parent

Uber give drivers tax summaries with miles driven.

https://help.uber.com/en/driving-and-delivering/article/wher...

alliao 25 minutes ago | parent

so either people aren't mathing or the frictionless experience is actually of value...

mristin 20 minutes ago | parent

I have heard a couple of times -- Uber, but for prostitution.

Avicebron 15 minutes ago | parent

Pretty sure the app is called Seeking.

mrtksn 20 minutes ago | parent

TBF it’s also an engine to push for regulations review. Awful lot of regulations are written for an age that no longer exists and just as many are to make management easier therefore startups pushing the boundaries actually are a correcting mechanism.

Unfortunately some harm can be inflicted bur IMHO it’s better than the alternative.

kotaKat 19 minutes ago | parent

... funny thing, that. How about Uber for Amazon? Literally just gigwork in the warehouses at this point, in four hour shift chunklets.

https://hiring.amazon.com/promotions/anytime-shifts

Glyptodon 16 minutes ago | parent

Not only were taxi drivers not popular but it also wasn't and isn't obvious to most people exactly how or why they were regulated. Especially to people outside of major urban areas.

I do not think this will hold with nursing.

howunfortunate 15 minutes ago | parent

Don't confuse "regulation" with "guild systems".

Taxi drivers were not more "regulated" in any meaningful way, in fact oversight of them was significantly worse than the community-driven Uber rating system (not that that doesn't also have flaws).

Some regulation is bad, some regulation is good. There's basically nothing at all that's good about guild systems and I will celebrate each of them facing open market competition.

hackingonempty 5 minutes ago | parent

> Taxi drivers were not more "regulated" in any meaningful way, in fact oversight of them was significantly worse than the community-driven Uber rating system (not that that doesn't also have flaws).

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.

nradov 2 minutes ago | parent

Taxis have (almost) no transparency. Outside of a few limited places where there are fixed fees for certain routes, you never know how much you're going to have to pay when you get in. With ride share apps the pricing is upfront and transparent.

noir_lord 3 minutes ago | parent

> Taxi drivers were not more "regulated" in any meaningful way, in fact oversight of them was significantly worse than the community-driven Uber rating system (not that that doesn't also have flaws).

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.

bcvvvy 13 minutes ago | parent

That will only happen until they step on the wrong toes.

I can't wait until they disrupt something a cartel or the mafia are in on.

0xbadcafebee 53 minutes ago | parent

The entire 'gig economy' model is exploitation. It only works because of income inequality. It requires a large pool of workers who don't make enough money to support themselves (due to insane healthcare and housing costs, and low wages and benefits) and thus will take any money they can get, despite the poor pay, long hours, and lack of benefits. It's taking a person slowly dying of thirst and offering them a thimble of water in exchange for knitting a sock.

kraken_cult 40 minutes ago | parent

In the case of Uber it's bring your own thimble too

SoftTalker 26 minutes ago | parent

Could not the IRS fix this in one swoop by declaring that "gig workers" are employees?

kraken_cult 23 minutes ago | parent

Presumably, but what do you think the lobbyists are for?

Shank 52 minutes ago | parent

To what degree is this just another symptom of the US healthcare system being flawed and in need of rework? To what degree would anyone use such a service if the costs remained high?

I used Zocdoc in the past to find a doctor and ended up with a doctor who just charged out-of-pocket instead of insurance, and it worked great. Would an app that shows up-front pricing be better for the consumer?

codeddesign 42 minutes ago | parent

This is marketed to hospitals to fill shifts rather than nurse-to-consumer which has been available for a long time.

tantalor 39 minutes ago | parent

The costs are not high. It's the prices that are too high.

skybrian 35 minutes ago | parent

I don't really know, but according to one graph, US nursing salaries are second only to Luxembourg:

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

7777777phil 32 minutes ago | parent

Ratio to average wages is 0.9 last with Switzerland.

croes 14 minutes ago | parent

US not UK

Lammy 28 minutes ago | parent

Red herring; high salaries are fine for people who actually directly interact with patients https://hmpi.org/2026/07/10/the-growth-in-healthcare-adminis...

damascus_kei 22 minutes ago | parent

Breaking: Richest Country has higher wages.

responder41 14 minutes ago | parent

Overall US salaries are also second only to Luxembourg (https://www.statista.com/chart/13093/the-countries-with-the-...)

howunfortunate 12 minutes ago | parent

Evidence?

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"

za_creature 29 minutes ago | parent

> another symptom of the US healthcare system

You know the videos of those couriers eating your food and claiming that it was delivered?

aliasxneo 26 minutes ago | parent

Maybe we'd have more money to fix the problem if "nursing at home" wasn't one of the main medicare fraud schemes that has persisted for years now.

croes 13 minutes ago | parent

It’s the symptom of a system where more and more wealth goes to few people and the rest has to fight for the rest of wealth

wewewedxfgdf 50 minutes ago | parent

Tech bros: "It's Uber and Doge for nursing!"

Like nurses are just an expense.

CapmCrackaWaka 50 minutes ago | parent

Could I use this app to hire a nurse and get a diagnosis from home? If we can start getting even meagre medical treatment to skip insurance / other middle men, I could see this having a great impact on healthcare prices, especially since AI is such a good information extractor, which is 90% of the role doctors play anyway.

responder41 35 minutes ago | parent

Generally speaking nurses in the united states cannot provide a diagnosis, at least without jeopardizing their license. You can already find a doctor using a service like Zocdoc who may cut out middlemen, though regulatory capture has made it close to impossible to meaningfully reduce costs in this way. I would not recommend using AI to diagnose or treat yourself (https://www.nytimes.com/2026/10/27/well/ai-chatgpt-medicatio..., for instance) without the help of somebody highly trained to interpret this information and make good decisions.

lukan 34 minutes ago | parent

Nurses don't really do diagnosis, but follow the ones doctors give. (Except for trivial things)

Otherwise I unfortunately know plenty of doctors that could easily be replaced by an LLM, but for now I prefer a diagnosis from a real doctor (who may use AI as a tool).

nradov 11 minutes ago | parent

If you really believe that information extraction is 90% of what doctors do then you're deeply ignorant about how healthcare actually works and not qualified to even have an opinion on this subject.

za_creature 7 minutes ago | parent

You are deeply ignorant about how healthcare actually works and not qualified to even have an opinion on this subject.

theo939eirn 44 minutes ago | parent

To be fair US health care system is sort of similar to old NYC taxi driver cartels before Uber. Just try to get price quote ahead of procedure...

Ripe for disruption!

jon128 43 minutes ago | parent

Does this mean that as a customer I can select only nurses that don't have fake degrees?

andyjohnson0 35 minutes ago | parent

You'll only get that option on the Premium tier.

dyauspitr 31 minutes ago | parent

Go ahead and downvote me for this, but the medical field in the US especially when it comes to RNs needs a shake up. This is going to sound very crass, but the only skill that your average person on the street doesn’t have that nurses have is to stick a needle in a vein and that’s something that can be taught to a lay person over a week. Pretty much everything else are skills that any person off the street possesses and we would do well to have a lower bar for entry for it.

newyankee 31 minutes ago | parent

While I do understand the importance of training, degrees and experience I see that people in the medical field beyond Doctors seem to have a very holier than thou attitude probably because they have 10 edge cases of how MRI can go wrong drilled into them (MRI technicians), not everyone is comfortable with needles and human body (nurses) and because it seems that only Pharmacists can sort and provide us the right medicines when in fact it can be easily done by some robots.

In before someone says that your reasoning is flawed because that is very incorrect perception of the field. All I see is that regulatory capture has worked very well here and is simply stopping totally novel and practical ideas which work on tradeoffs from even taking off

F7F7F7 9 minutes ago | parent

This sounds like pure insecurity with a sprinkle of Dunning Kruger. Unless I'm missing the joke somewhere? Nurses don't mind needles is the only difference? I must be missing the joke.

phoghed 26 minutes ago | parent

Uber for talk therapy / psychology is dog shit, I’m sure this will be too.

doomspork 26 minutes ago | parent

Lord have mercy. The last thing you want is under paid, lower quality nurses. If you're for that, you've never had a hospital stay.

gxs 7 minutes ago | parent

I feel really conflicted on nurses

On the one hand, a good nurse is invaluable. They do the hard work that doctors won’t/don’t do, and can be so kind and generous during your time of need.

On the other ones, there are so many who mail it in and are just milking the system

Healthcare is so expensive - some nurses are making 500k a year - their union contracts base vary from 200k to 300k for something like 32-36 hours per week

On top of that, they can pretty much work unlimited overtime with zero restrictions. They can work enough overtime hours such that they can nearly double their salary. And that’s how you come up with the 500k figure I posted

Granted, that’s at the top of the range, I’m talking about somewhere like the Bay Area, and does require a ton of overtime, but those extra 100s of thousands add up. These hours can’t be spread around to minimize the amount of time and a half or double pay paid out, per contract they go in order of seniority

This is just nurses and I imagine it’s something similar but with higher rates for specialists like anesthesiologists and still beyond that doctors and surgeons

I don’t begrudge anyone’s salaries, but it’s a zero sum game. There’s a reason why, aside from typical corporate profit maximization, you wind up with a 30k bill for a short visit. Even if you account for the lower rates insurance companies pay, it’s still in the thousands of dollars for treatment where you were seen for less than 30 minutes

Like I said, to be clear, I don’t begrudge anyone’s salaries - this is just an under discussed point when we talk about healthcare costs

Labor is generally reported as 60% of the costs of hospitals - so if you’d ever want to talk about making healthcare affordable you’d have to address this which I feel like is a bit of a taboo subject. Many nurses are in a union which makes it an even more difficult conversation

All that is to say, I can see the motivation behind stuff like this, even if I don’t agree with it