When you're reliant on healthcare and live in America that is first concern before anything else. Not to turn a post political, but the employer-tied healthcare situation in America is borderline a form of slavery. In tech it is simply well-paid slavery. I rarely if ever take vacations, and due to healthcare requirements cannot explore starting my own company or being without an employer to take an extended sabbatical from work. I am well compensated for my role and generally do well but if I lose my health insurance my life can be measured in months. It's a stressor that is hard to describe.