Caring for Olympic Competitors Costs Time, Money for Athletes, Physicians Alike

With the Summer Olympic Games concluding on August 11 and the Paralympic Games starting on August 28, the past month has been marked by watching athletes competing at the highest levels. Although the health of athletes is often a talking point in commentary, be it referring to an athlete who has recovered from injury or sustained an injury during the Games, the cost of recovery, maintaining fitness, and even getting routine care is not often discussed by mainstream media. However, both athletes and physicians are affected by the costs of care and how they present themselves on the biggest stage.

The Cost of Athletes’ Care Is Spread Through Multiple Avenues

Every 4 years, athletes living in the United States get the opportunity to represent their country on the global stage in the Summer Olympics, for which they must maintain their physical health to remain at the top of their sport. This requires consistent medical care throughout their many years of training, whether that be physical therapy, massage therapy, mental health services, nutritional counseling, and care for any injury sustained during training. Athletes can incur heavy costs on themselves through their training and care.

The United States Olympic and Paralympic Committee (USOPC) Athlete Healthcare team provides Elite Athlete Health Insurance (EAHI) for a certain number of athletes, with coverage including routine medical care, office visits, therapy, chiropractic care, infertility assistance, pharmacy, vision benefits, and other diagnostic services.¹ These plans are offered to approximately 1000 athletes competing across the summer, winter, and Paralympic games. Federations for each sport have their own requirements for receiving this coverage and the number of policies offered differs from sport to sport. For example, in 2012, the number of policies for athletes competing in swimming was 56 compared with the 150 polices offered to track and field athletes.²

The cost of health care for Olympic athletes can be spread across both the athletes and organizations during their years of prep for the big stage | Image credit: lazyllama - stock.adobe.com

However, even with these policies, the cost of care for athletes can still be overwhelming. According to a report from the Commission on the State of US Olympics & Paralympics,³ the average annual cost per athlete for medical expenses was $9200, with only 16% of athletes reporting they received reimbursement. Further, although 59.1% of athletes reported that they made $150,000 per year, 26.5% reported that they earn less than $15,000 per year, which can make paying for their care hard if it is not covered by an official EAHI policy.

Jim Borchers, MD, MPH, medical director for the Big Ten Conference, said that the amount of cost an athlete has to take on depends on who they’re competing for, where they’re competing, and where they’re training.

“I think that athletes, [institutions, and organizations] sometimes can get caught in the middle of that in trying to determine…exactly who is responsible for those costs,” he said.

Borchers highlighted that a number of athletes who go to the Olympics compete in NCAA sports. Of the 134 US Olympic athletes who went to a Big Ten school this year, 23 are current college students.⁴

“So much of that cost is born out through the institutions or the colleges where they go and compete as well,” he said. “While they’re competing at their institution, they’re also competing in these other national and international competitions. And so much of that cost is reflected back to the institutions.”

Borchers emphasized that these costs aren’t just for the months leading up to the Games, but rather a year-round investment. He pointed out that, as NCAA athletics changes, it could potentially change the way that Olympic athletes are able to receive health care as young adults, as it could affect who can continue in a sport without that financial assistance and affect how accessible those health care providers are during formative years in their respective sports.

The Cost of Physicians Is an Important Factor

Athletes have to take care of their own health between Olympic years as a baseline, but when the Olympics takes place, athletes receive top care from physicians, therapists, and other medical personnel who travel to take care of the athletes.

Borchers pointed out that there’s a team cost in personnel and resources needed to prepare an athlete for the Games, with no small cost.

“I think that some of that cost is borne out through volunteers and hours and personnel, and some is borne out through the resources that they need,” he said.

A total of 58 medical personnel were brought to Paris for the Olympic and Paralympic games to treat Team USA.⁵ This included 30 USOPC Sports Medicine staff members and 28 medical professionals.

“It’s an amazing effort: mobilization by the USOPC, the volunteers, their staff, from a multitude of providers…There’s just a huge effort put forward at the Olympic Games themselves,” said Borchers. “And the ability to mobilize that effort and coordinate that effort with national governing bodies, with all the different athletes that are there to make certain that they have coverage [and care], is a huge undertaking.”

The primary workforce of medical personnel brought to the Olympics is volunteer. According to Stat,⁶ becoming a volunteer physician requires an extensive application process to find physicians with at least 3 years of experience who are currently licensed or certified without any felonies or sanctions. Malpractice insurance of at least $1 million, certification in CPR, and certification in sports medicine are also required. Doctors are assigned to a team to train while being evaluated for their efficacy. Physicians can spend between 1 and 15 years working with a team and training before being chosen to go to the Olympics.

However, given the volunteer nature of this position, the cost to the physicians can be astronomical. According to one doctor who spoke to Stat,⁶ the trial period of becoming a volunteer coach kept him away from his practice for 6 months, which could cost him $250,000 in patient visits. This number alone could keep numerous physicians from being able to volunteer.

“I think it’ll be interesting to see if that continues into the future,” said Borchers. “How much of that can continue? Because we know with health care in general, there’s just more and more stress and challenge on health care professionals. How much can they continue to volunteer their time? I think we’re going to see challenges to that in the future.”

Borchers noted that the ability to be compensated and the liability placed on physicians is a lot to put on volunteers. However, the costs of taking care of athletes could rise should physicians be compensated for their time, which in turn could affect how funds are used.

“I think it’s going to be a continued question of, where do you put your resource to make certain that you’re taking care of those athletes. And the tradition of just expecting volunteerism to make that happen is going to be in question as we move forward,” said Borchers.

Cost of Care a Major Component of the Olympics

Both athletes and physicians shoulder a substantial cost burden to compete at the Olympics and care for the athletes, respectively. This cost can encompass all of care both outside of the Olympics and during the weeks of the games themselves. Being able to recognize these costs, as well as who takes on those costs, gives a better understanding of how Olympic athletes can continue to represent the country in the future.

Although athletes now can get coverage for health care through the USOPC, some athletes still do not get reimbursed for athletic costs and make too little to afford that coverage. Athletes who use the college system to get the care they need may have a feasible way to alleviate some of those costs, but prioritizing Olympic sports may be necessary to keep athletes prepared and healthy for future Olympic Games.

“Just the amount of either care or opportunity to make certain that these folks stay in elite shape and have the ability to recover and train and all those things is a 24/7/365 effort,” said Borchers. “Olympic athletes, many of them have been managed and fostered by the NCAA and the institutions in the NCAA. And how much longer will that go on? I think that’s a big question.”

Olympic athletes require health care to maintain their top performance levels which makes it necessary to also maintain the programs that can help athletes cover their health care—be it through their NCAA university, the USOPC, or EAHI—so athletes and their care teams alike can work to represent their country without excessive financial worry and burden.

References

1. Athlete Healthcare. USOPC. Accessed August 21, 2024. https://www.usopc.org/athlete-healthcare

2. Torres C. Olympians face unique health insurance options. KFF Health News. July 26, 2012. Accessed August 21, 2024. https://kffhealthnews.org/news/olympic-athletes-health-insurance/

3. Passing the torch: modernizing Olympic, paralympic & grassroots sports in America. Commission on the State of US Olympics & Paralympics. 2024. Accessed August 21, 2024. https://static1.squarespace.com/static/642af7d875688d63cfff08be/t/65e1bc1bf438017c9d43ba82/1709292599616/CSUSOP+Final+Report+%28Digital%29.pdf

4. Big Ten leads all conferences with 134 U.S. Olympic team selections. News release. Big Ten Communications. July 27, 2024. Updated August 12, 2024. Accessed August 21, 2024. https://bigten.org/article/blt88c68d3af991b7d1/

5.U.S. Olympic & Paralympic Committee announces games medical staff for the Olympic and Paralympic games Paris 2024. News release. USOPC. March 7, 2024. Accessed August 21, 2024. https://www.usopc.org/news/2024/march/07/-u-s-olympic-paralympic-committee-announces-games-medical-staff-for-the-olympic-and-paralympic-games-paris-2024-

6. Samuel L. It’s not just athletes: doctors at the Olympics have also worked years to get there. Stat. February 8, 2018. Accessed August 21, 2024. https://www.statnews.com/2018/02/08/olympics-medical-team-doctors/