Healthcare conversations often focus on patients, providers, insurance companies or the rising cost of medical care. Less often do we stop to consider what happens when the people who spend their careers caring for others can no longer afford healthcare themselves.
I spoke with someone this past summer whose story struck me. For more than three decades, she spent her career helping others improve their health. She is neither a physician nor a nurse. She never imagined retirement approaching within the next five years and being concerned with whether or not she can afford healthcare herself after spending decades in a therapist-related role.
Like many family caregivers, she spent years caring for seriously ill family members. The physical, emotional and mental demands eventually became too much. She reached a point where continuing to work a traditional 40-hour week was no longer a viable option.
The irony of working in healthcare
To protect her own health, she reduced her work schedule to fewer than 30 hours per week. That decision helped preserve her well-being, but it also created an unexpected consequence. She incurred an economic hardship and lost affordable access to employer-sponsored health insurance.
The insurance available through her employer now costs $1,000 per month, an amount that would strain the budget of many working adults. At the same time, she earns too much to qualify for state-sponsored health insurance programs.
She now finds herself in a place millions of Americans know all too well. She falls into the gap. Every day she goes to work providing healthcare services that help improve the lives of others. Yet she cannot reasonably afford health insurance for herself. That contradiction deserves our attention.
This is not simply about one individual, yet it raises larger questions about how our healthcare and insurance systems function for experienced workers who have spent decades contributing to society.
Should someone who has devoted an entire career to healthcare face losing affordable health coverage, simply due to reducing their hours to protect their own physical or mental health? Should there be greater flexibility for experienced workers approaching retirement age? Could there be transitional insurance options for long-term healthcare professionals who have spent decades serving others but are no longer physically able to maintain full-time employment?
These questions do not have clear, easy answers.
Why the irony
Health insurance in the United States is tied to a complex combination of employment status, income, age, employer benefit structures, federal regulations and state eligibility requirements. Employer-sponsored insurance often depends on maintaining eligibility for benefits, which means reducing work hours can result in losing employer contributions toward premiums. For individuals who need to purchase private coverage independently, the cost can be prohibitively expensive. This creates a particularly difficult gap for people who earn too much to qualify for Medicaid yet too little to comfortably afford private insurance.
This gap affects workers in many professions. However, there is something particularly striking about seeing it happen to someone whose life’s work has been helping others maintain their health. The irony is difficult to ignore.
We often encourage people to prioritize their physical and mental well-being. We talk about avoiding burnout, reducing stress and creating a healthier work-life balance. Yet for many workers, reducing hours to protect their health may also mean losing access to the very healthcare that helps them stay healthy.
This situation creates a difficult choice: continue working beyond your physical capacity to maintain health insurance or reduce your workload and risk becoming uninsured. Neither option seems like the outcome we would hope for.
What can we do?
This topic is not intended to criticize any one employer, insurance company or government program. Rather, it is an invitation to ask whether there are opportunities to rethink a system that sometimes places dedicated workers in impossible situations.
Perhaps the discussion should extend beyond politics and focus instead on practical solutions. Could there be phased insurance programs for employees nearing retirement? Could years of service within healthcare professions carry additional consideration? What about employers, policymakers, insurers and healthcare organizations working together to bridge this gap for experienced workers who have spent decades serving their communities?
I do not pretend to know the best solution, though I do know when a healthcare provider cannot reasonably afford healthcare, it signals that something deserves closer examination. Research often begins with a single observation. Education begins with asking thoughtful questions. Perhaps meaningful change begins the same way.
Featured image: Photo by Marek Studzinski on Unsplash
Edited by James Sutton
