At the end of January, under the radar, Rep. Chellie Pingree, Rep. Jared Golden and 200 other members of Congress took a look at the wreckage of the current American health care system and decided that the problem is that some nurses are making too much money.

Seriously. They signed an open letter about it. The letter, written by Vermont Democratic Rep. Peter Welch (a New Englander who should have more common sense) and Rep. H. Morgan Griffith, R-Va., would be hilarious if it weren’t so stupid. Their target is travel nurses and the nurse staffing agencies that employ them.

“Travel nurses,” for the unfamiliar, go from hospital to hospital for short-term contracts, wherever they are most needed. If a nurse who works in a hospital has to go out on maternity leave for a few months, for example, the hospital might bring in a travel nurse as a replacement. Travel nurses make good money, and they deserve it: Nursing is hard, moving around constantly is hard. Hospitals often rely on them because, while a travel nurse might cost more per hour than a nurse on staff, hospitals don’t have to make the commitment of providing them benefits, or keeping them around all year, even if the patient load drops. Travel nurses are also less likely to unionize. There’s not a lot of slack in the American health care system, as many people discovered during the pandemic, when patients flooded hospitals, non-COVID procedures were canceled and ER patients stayed overnight in hallways. Travel nurses were able to hop from hot spot to hot spot, serving through wave after wave.

The letter, addressed to Jeffrey Zients, the White House COVID-19 response coordinator, expresses shock and dismay that “certain nurse-staffing agencies are taking advantage of these difficult circumstances to increase their profits at the expense of patients and the hospitals that treat them.” No shoot, Sherlock. Literally every for-profit actor in our health care system does that, including many for-profit hospitals, which, at the end of the day, answer to their investors, who expect a particular rate of return. The representatives write that they “have received reports that the nurse staffing agencies are vastly inflating price, by two, three or more times pre-pandemic rates.” The important phrase here is “pre-pandemic.” When the pandemic hit, more people than usual got sick, so the demand for nursing went up. The supply of nurses went down, which means what, kids? That’s right! The price of a nurse’s labor went up!

You reap what you sow. Our government decided to privatize our health care system and let capitalism run wild. And in capitalism, some people get to make lots of money at the expense of others. Now they’re mad that some women are making money. Yes, I’m alleging the stink of sexism here: Nursing, as a profession, is 90 percent female. Meanwhile, 64 percent of physicians are male. You will notice that nobody is complaining about doctors making too much money. (There also are “travel doctors,” aka “locum tenens physicians,” but an industry survey found that the cancellation of elective surgeries meant that hospitals’ demand for them dropped during the pandemic.)

Payroll is the biggest expense for any business, and lots of hospitals and other medical facilities, particularly for-profit ones, would like to see nurses making less money. But nurses are pretty universally beloved, for good reason, and no politician is going to be dumb enough to say they think nurses need a pay cut. Travel nurses and travel nurse agencies make an excellent scapegoat. Capping rates of pay for travel nurses is a clever way to get a foot in the door of capping pay for all nurses and driving down wages overall. After all, folks who travel from place to place every few months are hard to organize into a constituent voting bloc and aren’t likely to have the opportunity to build community political power.


I’m surprised that so many representatives signed on to this letter. After all, Democrats like to say they support health care workers, and Republicans like to say they are pro-business and free market. My mom is a mystery writer, and when we are trying to figure out a mystery or puzzle, she likes to say, “Cui bono? Who benefits?”

Who benefits from cracking down on travel nurse agencies? It sure isn’t staff nurses. See, travel nurse agencies play an important role in the health care economic ecosystem: They provide a bargaining chip to keep staff nurse wages high. If a nurse feels she isn’t being paid what she’s worth (and, generally speaking, she probably isn’t), she can leave her hospital to work for a travel agency, and make more money while seeing the world! This helps keep wages high. My fear is that a crackdown on travel nurse agencies will cause nurse wages across the board to be lowered. Cui bono? Certainly not patients. Do you want your catheter inserted by an exhausted, overworked nurse who’s worrying about how she is going to pay rent?

I don’t expect much from politicians, but I did expect better from Chellie Pingree and Jared Golden. Pingree and Golden should retract their signatures of support.

If they would like to target price-gouging at the expense of patients, I have plenty of suggestions. My friend Lindsey’s dad has cancer. Specifically, myelodysplastic syndrome-induced leukemia. He has a $10,000 copay for his chemotherapy drug. No, that’s not a typo. He has to come up with $10,000 or die. Where’s his outraged letter to the White House?

Victoria Hugo-Vidal is a Maine millennial. She can be contacted at:
Twitter: @mainemillennial

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