At this year’s Grammys, as she accepted the award for best new artist, Chappell Roan made an appeal to the labels and industry reps in the audience to “offer a liveable wage and healthcare, especially to developing artists” – and in so doing, heated up long-simmering tensions in the music industry over artists’ wellbeing and remuneration.

Roan said that after she was dropped by Atlantic Records, a subsidiary of Warner, in the 2010s, she had little real-world job experience and “could not afford health insurance”. She added that “it was devastating to … feel so betrayed by the system”. She is now signed to Island, a subsidiary of Universal Music Group (UMG), and her speech seemed to be addressed specifically to major labels, whose profits have soared in recent years even as revenue for artists has gone down.

Musicians including Sabrina Carpenter, Charli xcx and Noah Kahan have backed her, each matching a $25,000 donation she made to the music mental-health charity Backline, but her speech was also met with a scathing op-ed by Jeff Rabhan, a former chair of the Clive Davis Institute of Recorded Music in New York, who called her comments misguided. His piece was widely maligned, but was symptomatic of an industry fretting at the prospect of its longstanding labour practices being revolutionised by artists.

Stories of overwork, poor mental health and precarious contracts are common among artists; fresh concern over pastoral care has been triggered by the drug-related death of the singer Liam Payne, who was dropped by his label amid his addiction struggles. Jillian Banks – AKA pop musician Banks – found success in the major-label system with her first two albums in the mid-2010s, and says that, as a major-label signee you are “not really viewed as a sensitive human that creates art – you’re now a product, and so they are viewing everything through the lens of trying to make you make money for them”.

She describes the label-mandated schedule she had to adhere to early in her career as “essentially inhumane – it was every day, interviews and shoots all day long, flying here and there … if you said you weren’t OK with it, there was always some sort of backlash”. Eventually, she had to begin cancelling promotional opportunities because of burnout.

Joey DeFrancesco, co-founder of the United Musicians and Allied Workers (UMAW) group, says that labels “should certainly be providing benefits” like healthcare to artists such as those in the development stages of their career. “[Those artists] are often signing contracts where the artist is working for this label in an extremely full-time capacity – the label is providing the PR, the booking agents, all these parts of a musician’s life, so the artist is very much working for that label,” he says. “In such circumstances where you’re working full-time for an employer, the employer is supposed to give you benefits. But so often what happens is that employers intentionally misclassify employees as independent contractors or freelancers, not technically employees under legal definition, [so they] don’t give them benefits.”

Musicians signed to UMG, Sony Music Entertainment (SME) and Warner Music Group (WMG) – the “big three” major labels – and their subsidiaries qualify for insurance through the Sag-Aftra union throughout the period that they are signed with the label. UMG and SME also have partnerships with the Music Health Alliance (MHA), a non-profit organisation that provides musicians with healthcare advocacy and support at no cost. (In some cases, this may be offering assistance in applying for Medicaid.)

Last week, UMG announced a further partnership with MHA called the Music Industry Mental Health Fund for UMG artists and the broader industry. It’s certainly necessary: the UK mental-health charity Mind says that musicians are up to three times more likely to suffer from depression than non-musicians, owing to the insecure nature of their income, pressure from fans and labels, and access to alcohol and drugs. (Representatives from UMG and SME declined to comment on the record; reps for WMG were not immediately available for comment.)

This coverage does not account for Roan’s appeal for broader artist support, including for those who may be tied up in development deals that ultimately result in contract termination. David Airaudi, manager of indie-pop star Steve Lacy and author of forthcoming artist handbook Made Art, says “There [have] to be systems in place to take care of the artists that drive our business,” but that “we’ve gotten so far away from that over the years.”

“It’s profits over people – when you put for-profit entities in charge of products that are the result of human suffering, trial, toil and soul, you’re going to get a disconnect,” he says. Airaudi says that putting the onus on labels to provide this kind of support shifts focus away from an industry-wide problem, in which overstuffed touring schedules can become “incredibly taxing”, resulting in mental-health issues; and where managers don’t always teach financial literacy to their artists.

Globally, there are pushes being made for fairer artist compensation. Following Roan’s Grammys speech, the UK songwriting group Ivors Academy announced plans to lobby for better treatment of songwriters, including label-funded daily expenses, minimum royalty cuts from master recordings to songwriters, and more. Early last year, Rashida Tlaib and Jamaal Bowman introduced a bill to the US Congress called the Living Wage for Musicians Act, which would require streaming services to introduce a subscription fee that would go directly to artists and to put a percentage of non-subscription revenue into a new royalty fund which would pay out directly to musicians. (UMAW worked on the bill with Tlaib and Bowman.)

Earlier this week, industry executive Troy Carter – an early manager of Lady Gaga – pledged on Instagram that his label, Venice, would write healthcare stipends into its contracts, although it’s unclear whether Venice has any signees or operates beyond distribution services.

Both DeFrancesco and Airaudi say that there will always be musicians who fall through the cracks of any industry-wide pushes for healthcare, and that ultimately such initiatives are stopgaps for a country without a centrally funded national health service. “The vast majority of UMAW members are not on major labels,” says DeFrancesco. “We need musicians, like all workers, to be demanding better healthcare from their employers, but also getting organised politically to defend the Medicaid that we have right now and then expand it further into that single payer system.”

In the meantime, says Banks, major labels don’t seem willing to budge on their treatment of musicians. “The way the culture is set up, it’s kind of about quantity over quality, where everything’s about money and a major label can sign an artist for one song, and if it doesn’t work out, let’s move on to the next,” she says. “If they were to actually develop artists, they would have to invest in healthcare.”