When Good People Learn to Live with the Gap

There's a scene in Friday Night Lights that has nothing to do with football. Coach Taylor is standing in a hallway, or a parking lot, or some fluorescent-lit room that was never meant to hold this much weight — and he just looks tired. Not defeated. Tired in the way people get when they've been holding something together through sheer will for so long they've forgotten what it felt like before the holding started.

That image stayed with me. Because it's the truest picture I have of what I've witnessed over nine years in Maine's aging services industry.

When President Trump used the word "war" to describe Medicaid fraud, I understood the intensity of that language. Not politically. Not rhetorically. I understood it because what I've seen doesn't feel like routine mismanagement. It feels like erosion. Slow, quiet, destabilizing erosion. And the first casualties were not headlines. They were workers. Direct care staff. Administrators. Case managers. Lawmakers who once worked inside these systems. People who believed they were serving something good.

Over the last several years, many of Maine's well-established non-clinical Medicaid home care agencies have closed. These weren't fly-by-night operations. They were organizations families recognized. Employers workers depended on. There was no singular announcement explaining why. Just quiet contraction. Agencies folding. Waiting lists growing. Benefits technically available — practically unreachable.

And in that gap, pressure builds.

I've watched a case manager stay late because she can't stomach closing her laptop knowing a family will wake up tomorrow still waiting — still stuck — still being told they're "approved," as if approval is the same as help. I've heard direct care workers say I'm trying with the kind of exhaustion that isn't about effort — it's about math. Too many clients. Too few staff. Too little time. I've seen administrators stare at numbers that don't add up anymore — not because they're greedy, but because the cost of providing care doesn't match what the system reimburses. So the options narrow. People patch. People stretch. People improvise.

Pressure changes behavior.

Maine's direct care workforce has been shrinking for years. Agencies compete for the same limited labor pool. Shifts go unfilled. Authorized hours go unstaffed. The math doesn't bend just because the paperwork says the service exists.

Workforce shortages do not automatically create fraud. But sustained pressure changes incentives. When reimbursement structures are strained, oversight is inconsistent, and staffing gaps are chronic, the distance between what is documented and what is delivered can begin to widen.

Not because every person inside the system is corrupt. But because industries under pressure drift. And drift is dangerous because it doesn't announce itself.

What Friday Night Lights understood — and what made it quietly devastating — is that institutional decline doesn't look like corruption from the inside. It looks like good people absorbing impossible loads until the weight slowly reshapes them. Dillon, Texas didn't fall apart because anyone stopped caring. It drifted. And the people who loved it most were the last to see it happening, because they were too busy trying to hold it together to look up.

That's what I've seen here. None of the people around me were villains. There were misunderstandings. There were misinterpretations. But for the most part, people were there to serve the community. That's what makes this so harmful on so many levels — because when a system starts rewarding speed over accuracy, and survival over clarity, good people start carrying contradictions they were never meant to hold. They learn to live with a gap between what they believe they're doing and what the paperwork claims.

Coach Taylor would recognize these hallways. The fluorescent hum. The weight that accumulates when you care about something that the system around you has stopped fully supporting. The particular exhaustion of people who haven't quit — who won't quit — but who are running out of ways to make the math work.

The war on Medicaid fraud is a worthy fight. But if we prosecute the drift without understanding what created the conditions for it, we will keep producing the same outcome. Good people. Impossible pressure. A widening gap. And nobody left who remembers exactly when the holding started.