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How the Mayo Clinic and Uber Killed Efforts to Help Workers in Minnesota 

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Democrats, controlling the governor’s office, the state house and senate passed a wave of legislation that has some describing Minnesota as a  shining example of progressivism and led The Guardian to declare it the “best state for workers.”

Minnesota might very well deserve that designation as it’s not a very high bar to clear, but the true test of the gopher state’s worker friendliness came when proposed legislation favoring workers threatened the interests of the capital class. The monied interests in this case were Uber, Lyft, and the Mayo Clinic, and when their bottom lines were threatened they all responded with various threats. In each of these instances, Minnesota’s elected officials failed the tests as the legislature and governor quickly backed down.

Here’s a long, enthusiastic thread on everything Minnesota Democrats enacted during this year’s legislative session:

I haven’t had the time to go through all of them, but it looks like a lot of spending that will actually benefit business, and much of it includes means testing, such as a new program that could make state public colleges and universities free for students whose parents earn $80,000 or less (it’s currently funded for the first year only).

There were also some policies that the rest of the “industrialized” world already enjoys, such as free lunches for public school kids. While it’s a sad sign of the times when eradicating school lunch debt for kids is viewed as a major victory, that’s where we are. Minnesota also enacted earned sick and safe time, which provides paid time off for short term absences. From Workday Magazine:

[The] bill that will allow many workers to take up to 12 to 20 weeks off non-consecutively, depending on their reasons for taking leave, and receive partial wages. The program, which will start in 2026, will be modeled after the state’s unemployment insurance program. It will be funded by a tax on employers and their employees at 0.7% of each paycheck, half paid by the employer and half by the employee.

Self-employed individuals and independent contractors will be able to opt in to the coverage, although to do so requires filing an application with the commissioner and paying an annual premium.  The US remains the only industrialized country in the world without a national paid leave policy for its workers. All laudable. But when it came time for Minnesota Democrats to truly take on monied interests, they caved.

Cave #1: Uber and Lyft.

Details of the bill from the Minnesota Reformer:

The bill required transportation network companies, including Uber and Lyft, to pay drivers a $5 minimum fee plus $1.45 per mile and 34 cents per minute in the seven-county Twin Cities metropolitan area. Drivers in greater Minnesota would have been entitled to $1.25 per mile and 34 cents per minute. The minimum rates would have increased with inflation.

Drivers would also have been entitled to 80% of cancellation fees if they already departed to pick up a rider as well as $1.25 per mile and 10 cents per minute if the companies charge customers for a “long pickup.”

Drivers were ecstatic at the prospects of better pay and protections:

But elected officials lacked the courage to stand behind workers when Uber went scorched earth, and in statements to news outlets across the state said the following:

If the bill is signed into law, beginning August 1, Uber will stop operating our ride service outside of Minneapolis-St. Paul metro area. In the metro area, we will only offer premium products to match the premium prices required by the bill.

In the end, Minnesota Gov. Tim Walz vetoed the bill. Uber’s hardball tactics came on the heels of a Minnesota heavy hitter throwing its weight around.

Cave #2: The Mayo Clinic.

The “nonprofit” medical mecca headquartered in Rochester worked overtime to kill efforts at establishing nursing staffing standards and other healthcare protocols across the state. Details on the nurse staffing legislation from The Minnesota Reformer:

The Keeping Nurses at the Bedside Act (HF1700/SF1651), backed by the nurses’ union, would require hospitals to form committees made up of nurses and other hospital staff to create “core staffing plans” that include the maximum number of patients each nurse can typically safely care for.

In response Mayo threatened to take its plans for new facilities and infrastructure worth billions to other states. A Mayo executive wrote the following to the governor and legislative leaders:

Because these bills continue to proceed without meaningful and necessary changes to avert their harms to Minnesotans, we cannot proceed with seeking approval to make this investment in Minnesota. We will need to direct this enormous investment to other states.

Democrats quickly caved. You’d think they could have at least tried a Russia smear campaign they’re so fond of:

Mayo, which had a profit of $595 million last year, demanded to be exempt from the new nursing staff requirements and quickly got its wish.

Low nursing staff levels wouldn’t be the only way it’s failing its patients/customers and employees:

But Mayo’s exemption  created another set of problems. From MinnPost:

While the medical Goliath had its team of high-paid personnel engaged in the conventional type of trying to enact, modify or stop prospective legislation, it was the quite public threat by the institution in a letter to Gov. Tim Walz that is seeming to do [the] trick in exempting it from those requirements imposed differentially on other medical facilities.

The reason, according to a member of the [Democrat] leadership team attempting to ram through the inequitably indulgence, is that “Mayo is different” since it treats “kings and princes.”

Once Mayo sprung a leak in the legislation, cracks began to emerge everywhere as other hospitals declared the double standards unfair,  and soon the entire bill was dead. According to MPR, Mayo executives added in the following in their threatening letter:

For Mayo to move forward with the investment above, the bill must include a path to full exemption from the bill’s requirements for systems, including Mayo’s full system in Minnesota, that meet high standards as demonstrated by use of a software-based acuity tool incorporating nurse input, achievement of Magnet designation and/or critical access hospital designation.

As the Minnesota Reformer pointed out however, what possibly concerned the bigwigs at Mayo the most is that nursing staffing standards could have slammed the brakes on its emerging automation efforts, including an initiative with Google Health. Here’s Mayo touting its automation advances as a way to conserve PPE and protect healthcare workers:

Mayo Clinic has demonstrated the feasibility of using a robotic system to perform simple tasks in a coronavirus disease 2019 (COVID-19) patient room. Mayo’s experiment, which used a manikin in a simulated intensive care unit (ICU) room, shows the potential of robotics to reduce the use of personal protective equipment (PPE) and the exposure of health care workers to COVID-19.

The experiment, described in the February 2021 issue of Mayo Clinic Proceedings: Innovations, Quality & Outcomes, demonstrated the ability of a robot to successfully:

  • Push a button on an intravenous pole

  • Adjust a ventilator knob

  • Push an ICU monitor button to silence an alarm for false alerts

  • Adjust an oxygen flow rate knob

  • Push a nurse call button to “off”

One of Mayo’s talking points on the bill was that it “needs more nurses, not more committees.” Well, it appears that one of the biggest reasons nurses are leaving the workforce in Mayo-dominated Minnesota is understaffing. From the Minnesota Nurses Association 2023 workforce report:

This report identifies chronic understaffing, hospital management, and other working conditions as the top issues driving nurses away from bedside care. It is based on responses by nearly 500 nurses to a survey of more than 2,400 MNA nurses who left a bedside nursing position within the past year and did not take a new position in an MNA-represented hospital. The survey found that the number one issue identified by nurses as the top factor driving them from the bedside was insufficient staffing, followed by stress or “burnout,” management issues, and other working conditions. .

The Minnesota Nurses Association supported the Keeping Nurses at the Bedside Act and accused the Mayo Clinic of “blackmail tactics.”

Mayo, which in 2017 decided to prioritize the care of privately insured patients over those on Medicare and Medicaid, also killed efforts to create a Health Care Affordability Board, which would have monitored health care market trends and provided recommendations and oversight. Mayo didn’t just demand to be exempted from this bill but that it be axed altogether, writing:

This bill is extremely problematic and poses a huge threat to the well-being of Minnesota’s health care system as drafted. It must be removed from the HHS omnibus bill and consideration for Mayo to move forward with the previously stated investment.

Once again, Mayo got what it wanted.

It’s unclear if Mayo would have carried out its threat, but If the national Democrats could set some standards for nursing staffing levels (and for Uber and Lyft drivers), Mayo wouldn’t have another state it could threaten to take its money and flee to. .

In some instances Minnesota was able to make up for the lack of action from the national Democrats, such as the ban on captive audience meetings. A similar national ban is contained in the PRO Act, which unions have been asking for for decades. Clinton, Obama, Biden, and congressional Democrats have been unwilling to pass it, but they insist they’ve been fighting for it for 30 years.

While some of the laws passed in Minnesota will no doubt make a positive impact in working people’s lives, the showdowns with Uber and the Mayo Clinic showed that when push came to shove, they caved to the state oligarchy.

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11 comments

  1. Aleric

    Mayo Clinic is highly overrated, my family lives in that part of the state and consistently received poor to terrible care. Not sure if the people jetting in on their gulfstreams are getting better care than the townies, or it has been coasting on reputation and marketing for decades.

    1. JE

      I know my experience recently with a loved one going to Mayo for diagnosis on an unknown persistent illness was wasted and a simple switch to a different local doc did the trick. I think that you can get good and bad care anywhere, it’s people all the way down.

    2. Candace K

      The main difference is specialized care. If you are going there for certain specialties you can get exceptional care, it tends to be generalized medicine/family/community medicine where they really fall down. This is their training program, so you will get a resident assigned to you for a few months, and then you get a new resident. So locally if you can opt to go to a different provider for family medicine and get referrals for specialized care – that tends to be the best work around. I know a couple of young nurses who work at Mayo, they try to move off of the hospital floors as quickly as possible because they have radically changed the nurse to patient ratio and it is very stressful.

  2. Ellen N Moody

    I am convinced the doctor who in effect murdered my husband with his 11 hour surgery on my husband’s esophageal cancer (instead of beginning with chemotherapy where he’d have got nothing) was a man trained at the Mayo clinic. It was his big boast in his office; he is one of those Kaiser turns to for cancer treatment. Deeply deeply inhumane man.

    1. Duke of Prunes

      I’m sorry for your loss.

      Some of the most helpful major medical navigation advice I received was “surgeons want to cut”. There are studies that compare treatments recommended by various doctors for the same symptoms. Not surprisingly, most doctors will recommend a course of treatment that follows their specialty. Surgeons like to do surgery. It follows the old adage “to a hammer, everything is a nail”.

      I had a serious heart issue. My young cardiologist exhausted every treatment option before sending me to the heart surgeon. At one point, I asked “maybe I should see a surgeon”, and his response was “a surgeon is going to recommend surgery, let’s make sure that’s absolutely necessary first”. I couldn’t argue with that.

  5. Paul Art

    I think that we have reached the point in the USA of completely being unable to heal the rot through ballot boxes. We will now have to wait till capitalism reaches the ‘savage’ stage that Stalin remarked upon that birthed the Revolution in Russia. It is very possible that a turn to fascism might occur along the way.
    Plenty of time to get out.

  6. Gary

    Mayo’s model of salaried docs vs pay per test is what would keep costs down. Obama endorsed Mayo for this reason.

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