A profile of personal finance guru Dave Ramsey, who has six million listeners tune into his radio program and countless others who rely on him for tips about handling money. But Ramsey’s tips can only help people get so far:

Often it’s even more basic expenses that create the undertow. “The structural stuff swamps them in the end,” says Rebecca Barrett-Fox, a visiting professor of sociology at Arkansas State University who is studying Ramsey’s work. “One person I spoke with said they were doing well ’til their health insurance bill went up by $100 a month, or $1,200 a year. The first year they didn’t go on vacation. But the second year there was no more vacation to not go on.”

Economic volatility is an overwhelming fact for millions of Americans; willpower is finite; and gazelle intensity takes its toll. “Ramsey never talks about the cost of [his strategies],” Barrett-Fox continues. “He does not have good advice for people who have low incomes and are against the wall. If they lose a job, he doesn’t really have anything for those folks.”