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//</script><noscript><a href="http://www.nytimes.com/adx/bin/adx_click.html?type=cookie&pos=TopAd"><img src="http://www.nytimes.com/adx/bin/adx_remote.html?type=noscript&page=blog.nytimes.com/opinionator/post&posall=TopAd,Bar1,Position1,Position1B,Top5,SponLink,MiddleRight,Box1,Box3,Bottom3,Right5A,Right6A,Right7A,Right8A,Middle1C,Bottom7,Bottom8,Bottom9,Header1,Header2,Header3,Inv1,Inv2,Inv3,CcolumnSS,Middle4,Left1B,Frame6A,Left2,Left3,Left4,Left5,Left6,Left7,Left8,Left9,JMNow1,JMNow2,JMNow3,JMNow4,JMNow5,JMNow6,Feature1,Spon3,ADX_CLIENTSIDE,SponLink2&pos=TopAd&query=qstring&keywords=?"></a></noscript></div><div id="opinionator" class="spanAC blog wrap"><div id="aCol"><div id="header" ><a href="http://opinionator.blogs.nytimes.com/" title="Go to Opinionator Home"><img src="http://graphics8.nytimes.com/images/blogs_v3/opinionator/opinionator_post.png" alt="Opinionator - A Gathering of Opinion From Around the Web"/></a></div><hr /><div id="content" class="hfeed"><div class="post-114325 post type-post status-publish format-standard hentry category-fixes category-_featured tag-economy tag-freelancing tag-health-care tag-jobs entry " id="entry-114325"><span class="timestamp published" title="2011-12-01T21:15:22+00:00"> <span class="date">December 1, 2011, <em>9:15 pm</em></span></span><h1 class="entry-title">Health Care for a Changing Work Force</h1> <address class="byline author vcard">By <a href="/author/david-bornstein/" class="url fn" title="See all posts by DAVID BORNSTEIN">DAVID BORNSTEIN</a></address><div class="entry-content"><p><webonly><div class="inlineModule"><div class="entry categoryDescriptionModule"><div class="thumb"><img alt="Fixes" src="http://graphics8.nytimes.com/images/blogs_v3/opinionator/pogs/fixes45.gif" width="50" height="50"></div><p class="summary"><a href="http://opinionator.blogs.nytimes.com/category/fixes/">Fixes</a> looks at solutions to social problems and why they work.</p></div><div class="entry entryTagsModule"><h4>Tags:</h4><p class="meta tags"><a href="http://opinionator.blogs.nytimes.com/tag/economy/" rel="tag">Economy</a>, <a href="http://opinionator.blogs.nytimes.com/tag/freelancing/" rel="tag">freelancing</a>, <a href="http://opinionator.blogs.nytimes.com/tag/health-care/" rel="tag">health care</a>, <a href="http://opinionator.blogs.nytimes.com/tag/jobs/" rel="tag">jobs</a></p></p></div></p></div><p></webonly><div class="w427"><img src="http://graphics8.nytimes.com/images/2011/12/02/opinion/02fixes-freelancersunion/02fixes-freelancersunion-blog427.jpg" id="100000001202322" width="427" height="309" alt="Sara Horowitz addressed members of the Freelancers Union during a 2009 forum which invited candidates for Public Advocate and Comptroller to discuss the issues affecting independent workers." /><span class="credit">Carolyn Silveira</span><span class="caption">Sara Horowitz, the founder of the Freelancers Union, addressed union members at a 2009 forum on the issues affecting independent workers.</span></div><p>Big institutions are often slow to awaken to major social transformations. Microsoft was famously late to grasp the importance of the Internet. American auto manufacturers were slow to identify the demand for fuel-efficient cars. And today, the United States government is making a similar mistake: it still doesn’t seem to recognize that Americans no longer work the way they used to.</p><p>Today, some 42 million people — about a third of the United States work force — do not have jobs in the traditional sense. They fall into a catchall category the government calls <a href="http://www.gao.gov/products/GAO-06-656" target="_blank">“contingent”</a> workers. These people — independent contractors, freelancers, temp workers, part-timers, people between jobs — typically work on a project-to-project basis for a variety of clients, and most are outcasts from the traditional system of benefits that provide economic security to Americans. Even as the economy has changed, employment benefits are still based on an outdated industrial-era model in which workers are expected to st
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//</script><noscript><a href="http://www.nytimes.com/adx/bin/adx_click.html?type=cookie&pos=Position1"><img src="http://www.nytimes.com/adx/bin/adx_remote.html?type=noscript&page=blog.nytimes.com/opinionator/post&posall=TopAd,Bar1,Position1,Position1B,Top5,SponLink,MiddleRight,Box1,Box3,Bottom3,Right5A,Right6A,Right7A,Right8A,Middle1C,Bottom7,Bottom8,Bottom9,Header1,Header2,Header3,Inv1,Inv2,Inv3,CcolumnSS,Middle4,Left1B,Frame6A,Left2,Left3,Left4,Left5,Left6,Left7,Left8,Left9,JMNow1,JMNow2,JMNow3,JMNow4,JMNow5,JMNow6,Feature1,Spon3,ADX_CLIENTSIDE,SponLink2&pos=Position1&query=qstring&keywords=?"></a></noscript></div><h4>Search This Blog</h4><form method="get" id="searchform" action="http://opinionator.blogs.nytimes.com/"><div> <input type="text" value="" name="s" id="s" /> <button type="submit" id="blogSearchSubmit">Search</button></div></form></div><div class="module box nav nocontent"><ul class="opposingFloatControl wrap"><li class="element1"> <span class="previous">Previous Post</span> <a href="http://opinionator.blogs.nytimes.com/2011/12/01/gun-nuts-in-a-rut/" title="Gun Nuts in a Rut">Gun Nuts in a Rut</a> <span class="byline">By TIMOTHY EGAN</span></li><li class="element2"></li></ul></div><div class="box module socialMediaModule"><ul class ="refer wrap socialSubsBlog"><li><h6 class="kicker">Follow This Blog</h6></li><li class="icon twitter"><a href="http://twitter.com/nytopinionator" onmousedown="dcsMultiTrack('DCS.dcssip','www.nytimes.com','DCS.dcsuri','/Follow-Blog-Twitter.html','WT.ti','Follow-Blog-Twitter','WT.z_dcsm','1')">Twitter</a></li><li class="icon rssLg"><a href="http://opinionator.blogs.nytimes.com/feed">RSS</a></li></ul></div><div class="box module nocontent"><div class=“entry”><p class=“summary flushBottom”><em>Fixes explores solutions to major social problems. Each week, it examines creative initiatives that can tell us about the difference between success and failure. It is written by David Bornstein, author of <a href="http://davidbornstein.wordpress.com/books/how-to-change-the-world/"> “How to Change the World,”</a> and founder of <a href="http://dowser.org/">dowser.org</a>, and Tina Rosenberg, contributing writer for The New York Times magazine and author of <a href="http://books.wwnorton.com/books/Join-the-Club/">“Join the Club: How Peer Pressure Can Transform the World.” </a></em></p></div><p><em> Readers with ideas for future columns can write to the authors at fixes@nytimes.com. </em><br/> <em><a href="http://www.facebook.com/pages/Social-Change-New-York-Times/147881585260868?ref=sgm">Join Fixes on Facebook »</a></em></p></div><div class="box module verticalTabSet"><h4>Inside Opinionator</h4><div id="tabWidget-7" class="wrap"><div class="tabsContainer"><ul class="tabs"><li class="selected"><div class="pointer"></div><div class="wrap"> <img src="http://graphics8.nytimes.com/images/blogs_v3/opinionator/pogs/fixes25.gif" alt="Fixes" class="left" /> <a href="javascript:void(0);">Fixes</a></div></li><li><div class="pointer"></div><div class="wrap"> <img src="http://graphics8.nytimes.com/images/2010/09/16/opinion/Egan_New/Egan_New-custom1.jpg" alt="Timothy Egan" class="left" /> <a href="javascript:void(0);">Timothy Egan</a></div></li><li><div class="pointer"></div><div class="wrap"> <img src="http://graphics8.nytimes.com/images/blogs_v3/opinionator/disunion/disunion25.gif" alt="Disunion" class="left" /> <a href="javascript:void(0);">Disunion</a></div></li><li><div class="pointer"></div><div class="wrap"> <img src="http://graphics8.nytimes.com/images/blogs_v3/opinionator/pogs/townies25.gif" alt="Townies" class="left" /> <a href="javascript:void(0);">Townies</a></div></li><li><div class="pointer"></div><div class="wrap"> <img src="http://graphics8.nytimes.com/images/2010/09/16/opinion/Greenhouse_New/Greenhouse_New-custom1.jpg" alt="Linda Greenhouse" class="left" /> <a href="javascript:void(0);">Linda Greenhouse</a></div></li><li id="overlayTrigger_controller" class="moreContributors"><a href="javascript:void(0);">More Contributors</a><div class="opposingFloatControl tabOverlayShado
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//</script><noscript><a href="http://www.nytimes.com/adx/bin/adx_click.html?type=cookie&pos=MiddleRight"><img src="http://www.nytimes.com/adx/bin/adx_remote.html?type=noscript&page=blog.nytimes.com/opinionator/post&posall=TopAd,Bar1,Position1,Position1B,Top5,SponLink,MiddleRight,Box1,Box3,Bottom3,Right5A,Right6A,Right7A,Right8A,Middle1C,Bottom7,Bottom8,Bottom9,Header1,Header2,Header3,Inv1,Inv2,Inv3,CcolumnSS,Middle4,Left1B,Frame6A,Left2,Left3,Left4,Left5,Left6,Left7,Left8,Left9,JMNow1,JMNow2,JMNow3,JMNow4,JMNow5,JMNow6,Feature1,Spon3,ADX_CLIENTSIDE,SponLink2&pos=MiddleRight&query=qstring&keywords=?"></a></noscript></div></div><div class="box module opinionHighlights"><h4>Opinionator Highlights</h4><div class="entry"><h5><a href="http://opinionator.blogs.nytimes.com/2011/12/01/health-care-for-a-changing-work-force/" title="Health Care for a Changing Work Force">Health Care for a Changing Work Force</a></h5><h6 class="byline">By DAVID BORNSTEIN</h6><p class="summary">With 42 million independent workers in the United States, the Freelancers Union’s health plan may be a model for the future.</p></div><div class="entry"><h5><a href="http://opinionator.blogs.nytimes.com/2011/11/30/on-abortion-and-defining-a-person/" title="On Abortion and Defining a ‘Person’">On Abortion and Defining a ‘Person’</a></h5><h6 class="byline">By GARY GUTTING</h6><p class="summary">A recent referendum in Mississippi suggests important consequences for the logic of the abortion debate.</p></div><div class="entry"> <a href="http://opinionator.blogs.nytimes.com/2011/11/29/giving-where-it-works/"><img alt="Thumbnail" src="http://graphics8.nytimes.com/images/blogs_v3/opinionator/pogs/fixes75.gif" class="w75 right"/></a><h5><a href="http://opinionator.blogs.nytimes.com/2011/11/29/giving-where-it-works/" title="Giving Where It Works">Giving Where It Works</a></h5><h6 class="byline">By TINA ROSENBERG</h6><p class="summary">Most social enterprises struggle to survive. These seven programs make the most of the charitable dollars they receive.</p></div><div class="entry"> <a href="http://opinionator.blogs.nytimes.com/2011/11/27/scaling-the-wall-in-the-head/"><img alt="Thumbnail" src="http://graphics8.nytimes.com/images/2011/11/26/opinion/26stone-img/26stone-img-thumbStandard.jpg" class="w75 right"/></a><h5><a href="http://opinionator.blogs.nytimes.com/2011/11/27/scaling-the-wall-in-the-head/" title="Scaling the ‘Wall in the Head’">Scaling the ‘Wall in the Head’</a></h5><h6 class="byline">By COSTICA BRADATAN</h6><p class="summary">Walls and fences, electrified or not, protect people not from nameless barbarians, but from their own anxieties and fears.</p></div><div class="entry"><h5><a href="http://opinionator.blogs.nytimes.com/2011/11/24/an-electronic-eye-on-hospital-hand-washing/" title="An Electronic Eye on Hospital Hand-Washing">An Electronic Eye on Hospital Hand-Washing</a></h5><h6 class="byline">By TINA ROSENBERG</h6><p class="summary">A video monitoring system is helping to increase hand-washing rates and reduce deadly hospital-acquired infections.</p></div></div><div class="box module nocontent"><h4>Previous Series</h4><div class="entry"> <a href="http://opinionator.blogs.nytimes.com/category/line-by-line/"><img alt="Thumbnail" src="http://graphics8.nytimes.com/images/blogs_v3/opinionator/linebyline/linebyline75.gif" class="w75 right" /></a><h5><a href="http://opinionator.blogs.nytimes.com/category/line-by-line/" title="Line by Line">Line by Line</a></h5><p class="summary">A series on the basics of drawing, presented by the artist and author James McMullan, beginning with line, perspective, proportion and structure.</p></div><div class="entry"> <a href="http://opinionator.blogs.nytimes.com/category/steven-strogatz/"><img alt="Thumbnail" src="http://graphics8.nytimes.com/images/blogs/opinionator/contributors/strogatz75.jpg" class="w75 right" /></a><h5><a href="http://opinionator.blogs.nytimes.com/category/steven-strogatz/" title="Steven Strogatz">The Elements of Math</a></h5><p class="summary">A seri
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