Though his future in competitive racing remains cloudy, it was heartening to hear that Jamaica’s Kemoy Campbell had been released from the hospital in New York City last week and is making progress in his recovery from a heart-stopping collapse at the Millrose Games while serving as a pacer in the 3000 meters on February 9.

But Mr. Campbell’s health scare brought to light an issue confronting many athletes in a sport that finds itself facing a number of challenges, from fairness in women’s competitions (hyperandrogenism) to Olympic and World Championships qualifying to healthcare.

In that last realm, it is because athletes like Mr. Campbell are signed to shoe company contracts as “consultants” and to races as “independent contractors” – rather than drafted as “team members” or hired as “employees” – that such individuals need not be provided with benefits including healthcare insurance. And in a sport that constantly stresses both internal and external body systems, that you’re-on-your-own policy is like doing trapeze work without a net.

Thus is Mr. Campbell left to pay his substantial medical bills via the kindness of his shoe company sponsor, Reebok, which pledged $50,000 to Kemoy’s cause, and by GoFundMe.com contributions.  But that is not a system.

On the other hand, as we read in Outside Magazine, American athletes are provided with Participant Accident (PA) coverage by USATF for exactly the kind of medical emergency faced by Mr. Campbell. Overseas, the IAAF Diamond League also provides participating athletes with accident coverage, though that policy does not apply across the board to all IAAF-sanctioned events.  This patchwork system reflects the direction that American healthcare itself has been headed for decades.

As we near the third decade of the new millennium, our society is undergoing a fundamental changeover from what was once a substantial employer-based healthcare system to an increasingly called for Medicare-for-all.  But though the change is happening fast, we haven’t yet reached the tipping point.  The percentage of persons under age 65 with private healthcare insurance rose between 1959 and 1968 to 79%, where it remained relatively stable until 1980. Then the number declined to 67% by 2007, before falling to 56% in 2017 according to statistics from the Henry J. Kaiser Family Foundation.

But even as the system continues to undergo a rapid change, those who still enjoy employer-based private healthcare are anxious to maintain it, though such coverage is being phased out by more and more employers annually. 

This is where vision and leadership are required in Washington D.C. and state capitals across the nation. Not to make an emotional appeal, or to assign blame, but to explain how long-term benefits might accrue under a new design compared to the old one, even as the old still has a substantial foothold in the present day. 

The changes in healthcare are similar to the issue of climate change from the standpoint of our continued dependence on fossil fuels while searching for a new or renewable form of power for the future.

Fossil fuels still have a strong hold on the U.S. economy, representing 78% of energy consumption in the fiscal year 2016. Yet we have begun to address the changeover that will eventually come about one way or the other. In fact, according to the Institute for Energy Research, the changeover has already started in terms of energy subsidies.

In the realm of healthcare, this is not to blindly accept a government controlled system.  Rather, it’s a call to acknowledge the limits of a current long-standing system that no longer meets the needs of a wide enough percentage of the population because people in a globally interconnected, technology-transformed economy are no longer employed in the same way that their parents and grandparents once were. 

Now let’s bring it back to athletics and athletes like Kemoy Campbell.

Even as the IAAF introduced its new Ranking System on 27 February “to bring clarity to the competition structure from national (championships) through to global events, incentivizing the top athletes to support the best competitions”, it continues to keep its athletes, and by extension, the sport itself, marginalized by maintaining their standing as independent contractors. 

Former marathon world record holder Steve Jones once famously said, “Every runner is just a hamstring injury away from oblivion.”  Steve was talking about being able to compete and earn a living if injured, but he might as well have been talking about the ability to pay off medical debt, too.

At a meeting in Chicago on February 26th, the Athletes’ Advisory Council of the U.S. Olympic Committee met with USOC head Sarah Hirshland but also brought along Donald Fehr, who rose to prominence serving as the executive director of the Major League Baseball Players Association from 1985 to 2009 as that sport dealt with the owners’ control of players.

Today, athletes in the sport of athletics (and elsewhere) remain trapped in a system that invites them to events on an ad hoc basis, rather than signing them to circuits as qualifying members with rules and responsibilities.  What the athletes increasingly understand is that they will never see a more equitable balance until a more professional approach is taken, both by them, by the sport’s National Governing Bodies, and by the events, as well.  Only then will a functioning tour with a stable cast emerge that can be forwarded to the public with anything resembling coherence.  And new Ranking System notwithstanding, that is what will constitute a healthy prognosis for the future of the sport. 

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