> figure out a way to accomplish this without these people needing to live paycheck to paycheck with the looming threat of a medical emergency able to wipe them

> figure out a way to accomplish this without these people needing to live paycheck to paycheck with the looming threat of a medical emergency able to wipe them out permanently. This is basically how you make people do very sucky jobs, such as construction. Almost no one does it because they like it - they do it because they see no better options. Countries with very rich societies (e.g. some Arab countries) don't have enough people who have no other choice and hence have to bring in plenty of migrants as otherwise the construction wouldn't happen.