From an article in today's New York Times about the growing "grey market" in home health care services for elderly parents:
Gray-market hiring…is largely a financial decision to avoid the fees of home-care agencies, where perhaps $9 of the $20 hourly fee goes to the aide. In a gray-market arrangement, the aide might get $12, a 33 percent increase — although sometimes without benefits, worker's compensation or Social Security — leaving a family able to afford additional hours.
But the Times manages to find the downside:
"Consumers are always in jeopardy when there's an opportunity to make a lot of money," said Val J. Halamandaris, president of the National Association of Home Care, who 40 years ago was chief counsel to the Senate Committee on Aging.