On Accessibility, Affordability, and the People Who Fall Through the Cracks

There’s a message I’ve received more times than I can count, and every time it lands the same way—like something being pulled out of my chest.

It usually goes something like, “You and everyone have been so wonderful, but I can’t afford to keep going, so I’ve cancelled my membership.”

Every single time, I sit with that for a while. It’s not just a cancellation; it’s a person who wanted help, found something that was working, and had to walk away anyway—not because of motivation, not because of results, but because of money.

That’s the part that deeply bothers me.

The Cruel Math of Being Sick

Here’s a reality that doesn’t get talked about enough: the people who need health support the most are often the least equipped to pay for it.

Chronic illness is expensive in ways that go far beyond medical bills. It limits earning capacity; it drains savings; it creates a compounding cycle where poor health leads to financial strain, and financial strain—with all the stress and instability it carries—makes poor health worse. By the time someone is motivated enough to seek real, sustained support for their health, they may already be in a hole that makes that support feel financially out of reach.

I work with a clinic that, for what it offers, is genuinely, almost absurdly affordable. I say that not to brag but because it matters for context—and because even then, it’s still too expensive for some people. “Cheap” is always relative; when your income is compromised by the very condition you’re trying to address, even a modest monthly investment can feel impossible.

That’s not a personal failing; that’s a structural problem.

What I’ve Been Trying to Do About It

I want to be transparent here, because I think honesty matters more than optics.

My private practice is, frankly, subsidized by my day job. I’ve taken on a significant number of pro bono clients because I believe in the work and I believe in the people, but it isn’t sustainable indefinitely. The software, the time, and the resources behind even a single client relationship add up to real costs; passion doesn’t zero out an invoice.

Still, I’ve been trying to build as many on-ramps as I can for people who don’t have the financial runway to access formal coaching:

A free community where people can ask questions, share experiences, and feel less alone in their health journey. A blog—this one—where I share information that I genuinely believe is actionable and useful, freely. A service called “Somebody Wants You To Know” built around the idea that encouragement and connection have real health value. Social media posts designed not just for engagement but for practical, take-it-and-use-it information.

One other thing that most people don’t know the full story behind: I pursued my NBC-HWC board certification in part because it opens the door to insurance billing—a future where the financial barrier to working with a health coach could be meaningfully reduced for a much larger population. That possibility is still developing, but it’s real, and it matters.

I Can’t Do This Alone

I want to be careful not to overstate my own role here, because I’m not under the impression that I’m going to single-handedly fix a broken system. I do think the people closest to a problem have a responsibility to try, though—and to ask for help when they’ve reached the edges of what they can do solo.

So I’m asking.

Not for money. Not for anything specific. I’m genuinely asking the people in my community—the ones who’ve been touched by this work, who’ve seen the gap firsthand, who’ve had thoughts about what could help—to share those thoughts. What would make health support more accessible? What barriers have you seen that I haven’t? Are there models, ideas, or resources I should know about?

There’s also a question I’ve been sitting with that I’ll put out honestly: would people sponsor a client if given the opportunity? Not as charity, but as a direct investment in someone else’s health—knowing that the person on the other end is doing the work, just without the financial cushion to sustain it. I don’t know yet if that’s the right model, but I think it’s worth asking.

The Bigger Picture

Health coaching is still finding its footing in the broader healthcare system. The credentialing infrastructure is improving. Insurance integration is on the horizon. Awareness is growing. We’re not there yet, though—and in the meantime, real people are making impossible choices between their health and their bills.

I got into this work because I believe that the kind of sustained, personalized, human support that actually changes health outcomes shouldn’t only be available to people with disposable income. That belief hasn’t changed; it’s just run into the hard reality of what it costs to deliver that support at scale.

I don’t have a clean resolution to offer here. What I have is a commitment to keep looking for one—and a genuine desire to hear from people who care about the same problem.

If that’s you, I’d love to know what you think.

Rance Edwards is a National Board Certified Health and Wellness Coach (NBC-HWC) with over 2,000 clinical hours of experience, specializing in chronic disease management and lifestyle medicine.

If any of this resonated—or if you’re someone navigating the gap between wanting support and figuring out how to make it work—I’m always open to a conversation. No cost, no commitment; just a chance to talk through where you are and whether there’s a path forward that makes sense. Let’s have a conversation →