"How many linemen do you know that played with you, that've had four, five, six surgeries for their knees?" New Jersey Senator Cory Booker asked the two former college football players sitting across from him in a July senate meeting.
"Many." "A lot," Florida State's Myron Rolle and North Carolina's Devon Ramsay replied almost in chorus.
"And if they're going into their own pocket after giving up their knees, their bodies to make millions of dollars for the university," Booker continued. "And then the university is not even compensating them appropriately, that, according to me is exploitation of a college athlete."
With a sheepish look, NCAA President Mark Emmert defended himself against Booker's arguments, saying "but …uh… medical coverage is much better than before." However, Emmert also acknowledged that there are far too many problems with how the NCAA functions and how it treats its student athletes.
The health insurance system is one of the most appalling and cringeworthy of those problems. Currently, the NCAA requires that every student-athlete who sets foot on campus has insurance for sports-related injuries. But it doesn't require the schools to pay for that insurance. How does such a terrible system persist?
"It's a very straight forward question," said Paul Haagen, co-director of the Center for Sports Law and Policy at Duke University. "Because a better system would cost a lot."
When athletes get injured, not only can their scholarship be revoked if they're no longer able to take the field or court, but medical bills running in the thousands of dollars would have to be paid out of their own pockets. The only time NCAA's catastrophic insurance comes into use for a student-athlete is when expenses reach north of $90,000. There is nothing legally forcing schools to take care of athletes who injure themselves while they are enrolled, or whose sports-related injuries persist after they graduate. For instance:
- When linesman Stanley Doughty joined the Kansas City Chiefs in 2007, his first physical showed he had such a severe cervical spine injury—one that doctors at South Carolina never alerted him to or suggested surgery for—that a single hit could be life-threatening.
- In 2009, freshman Kyle Hardrick lost his basketball scholarship at Oklahoma after he tore his meniscus-and the school never paid for the surgery.
- After Louisville guard Kevin Ware severely broke his leg during a 2013 Elite Eight game against Duke, news circulated that the university could have revoked his scholarship, cut him from the team, and forced his family to pay for Ware's medical care.
Nor does the legal system require football teams as a whole to be covered by medical insurance.
"But the question is, is that the right thing to do?" Haagen asks.
Haagen argues that there are two different issues at play here. One is the responsibility that an institution takes on if it actively promotes and encourages an activity that leads to frequent and traumatic injury. The second is that since college sports are very much a commercial enterprise, whether the costs of treating its players should be internalized.
In Senate meetings in recent years, legislators like Booker and Claire McCaskill have made cries for reform. Northwestern University has pushed for player unionization. Lawsuits have been brought against the NCAA. Former athletes and journalists have shamed the NCAA, pleading with it to do more.
That has led to at least two of the five power conferences—the Big Ten and PAC-12—to announce guaranteed four-year athletic scholarships and promise to improve health insurance. The PAC-12 announced last week that it would cover athletes' medical bills for up to four years after they graduate.
That sounds like a major improvement over the present scenario—which it is—but it is also a reminder of how bad the present scenario actually is for student athletes. After all, four years is not enough for the hips that'll need surgeries later; for brains that will be damaged for a lifetime. It also remains to be seen whether this rule will actually be enforced.
Technically, it probably won't be. Most NCAA legislation is permissive in nature, meaning the organization or the conference is saying that henceforth the member schools are allowed to bring these changes without running a foul of their membership, not forced to. PAC-12 commissioner Larry Scott has already said that they're still largely "relying on the schools to self-enforce this."
Read the fine print and it becomes clear: insuring athletes after they graduate is a choice not a requirement.
"As a conference the PAC-12 has no interest in punishing its schools," said Ramogi Huma, executive director of the National College Players Association and long-time advocate of college players' rights. "They need something that's going to hold them accountable."
And the NCAA is not interested in holding schools accountable. It is only interested in being perceived to hold players accountable.
If the NCAA can punish an athlete for getting a couple of hundred dollars off of his own autograph, and suspend another player for letting a well-wisher buy him groceries, it can surely mandate schools to take care of the athletes' medical bills too. But that isn't how cartels work; that would undermine the working arrangement the NCAA has with the member schools who give it its power. Why would they spend money on enhanced health insurance for damaged athletes when there are administrators and million-dollar coaches to pay and bank vaults full of gold coins from television contracts to swim in?
"NCAA sports is not trustworthy," said Huma. "It has proven far too many times that it only responds to true leverage and power otherwise it does anything that it can to make the problem go away."
And while the PAC-12 has at least given a number to the years that they're willing to take care of the students after they graduate, the Big Ten's October announcement already sounds like a non-committal, vague, and generic statement with no teeth: "improved, consistent medical insurance for student-athletes." And neither conference addressed the injury-related costs athletes incur while they're in school.
"Should [compensation for injuries] be treated as a cost of doing business when it's being run as a business," Haagen says. "I think we are getting there."
"Any protections given today can be taken tomorrow. It's going to be very easy to scale it back slowly and discretely," Huma said. "When you want something guaranteed, it has to be legally binding."
Huma believes that one of the ways to bring real, long-lasting, and uniform change is by passing legislation at the federal, state, or city level, and that real change won't come from voluntary reform. California passed a law requiring universities that generate more than $10 million in media revenue from athletics to guarantee scholarships for injured players, and assist them in premium payments and deductibles.
The steps being taken by the Big Ten and Pac-12 are small, non-binding steps. But at least they are steps in the right direction. Soon, conferences and schools that provide greater services will separate themselves from those that don't, attracting better talent, winning on the field, and therefore pushing others for reform.
"A lot of the cases that are being litigated right now are bringing to attention the commercialization of college athletics," said Warren K. Zola, executive director at Boston College's business school and a counselor for student athletes. "What we have is finally a recognition that students have been generating revenue and their rights and welfare needs to be paid more attention to. That's the big picture, that has been missing."