A Path Forward

In 2014 I learned I hit the lotto with genetics when I found out I was a carrier of the deadly BRCA1 gene mutation, putting me at high risk for genetic cancer, accounting for 1% of the world population and less than 10% of all cancer cases following the death of my young cousin... and her mom, my aunt, was receiving care for breast cancer at the same time, at the same hospital.

To prevent the same fate and minimize my potential future healthcare costs, I decided to take preventative steps to ward off cancer, including removing both ovaries and a double mastectomy with reconstruction; over the long haul, it was less expensive than biannual MRIs, Mammograms, and potentially cancer.?I went through the pros and cons with my medical team.

As I worked with my team at Winship Cancer Institute of Emory, my doctor spent a lot of time emphasizing that the first surgery in the series for the mastectomy will be brutal - about four hours long, and my lungs will feel like they collapsed from the machine breathing. I was told recovery was typically from 2 to 3 months. With two young boys at home, I didn't have that kind of time to sit around healing. After research, I determined my best path forward was to get in the best shape possible with some serious lung capacity. So I hired a running coach and a personal trainer. I ran my first Atlanta 10 Miler race at 9:46 pace a week before my surgery.

My surgery was uneventful, and as my doctor predicted, my lungs were on fire. And I was incredibly sore; it took a lot of work to sit up. My doctor and his team did not pity me. A couple of hours after surgery, he had me walking the floor every hour, and we began arm exercises that same night. The next night, I even walked myself to the cafeteria for dinner, drainage tubes and machines attached.

As I walked the hospital for those 48 hours (I earned an extra night due to a fever as I awoke from surgery) I quickly observed it was unusual that I was up and around as I was. I passed rooms where women couldn't even sit up in bed without assistance. I was so grateful I took the initiative to hire and could afford a personal trainer and running coach as part of my wellness team.

Once my fever broke at 48 hours, I was released to go home. I was off of prescribed pain medication with 72 hours of the surgery. Two weeks later, as soon my doctor removed my drainage tubes, I was cleared to run but no weightlifting for the next three months. I bandaged my chest up and headed to Lifetime Fitness to return to running. Ten weeks later, I ran a 15K race with tissue expanders in my chest... at a 9:40 pace! I was back in the office a month post-op.

Today, I am an avid runner, cyclist, and swimmer. Despite being put through extreme adversity for years now, I have demonstrated the power of healthy eating and exercise habits to achieve optimal physical and mental health. I am 5'10" tall and today weighed in at 134 at age 44. And not one person can say I had it "easy." I haven't even had health insurance since October of 2020. Outside of chiropractor visits as a result of people messing with my body while I sleep, preventative care labwork, monthly meds for my thyroid, and one bout with pink eye, which I saw a telehealth doctor for ($40 total), I didn't need health insurance. I spent less money out of pocket without paying for a monthly health insurance premium. I thought about health insurance, but I decided I didn't even need it. And I didn't.

Why am I sharing this? To demonstrate the power of preventative care - not only did I come out of the surgery with a speedy recovery, but my medical costs were significantly less as they continue to be today. I required less time in the hospital; I didn't experience "serious" complications that required any follow-up. Because of my lifestyle, I don't need a lot of doctor visits. And nothing has brought to life the power of a healthy diet and lifestyle like COVID.?The worst possible situation is a woman being in my position and the risk of taking preventative steps being greater due to her current physical health and not being healthy enough to even undergo such invasive surgery. Going under the knife for four hours is not easy.?

So... what if everyone had a plan for health insurance that allocated funds towards preventative care? Think running coach/nutrition coach/gym membership? While it seems expensive upfront, preventative care and a healthy lifestyle pay for themselves in the back-end. 2019, 2020, and 2021 taught us that! The healthier you are, the less healthcare you require. Not to mention no one's health insurance should be tied to their job, and EVERYONE deserves to be healthy.?

With that said, here's an idea to fix the broken healthcare system in America, and it requires cooperation from every CEO across our country as employers are the biggest health insurance customers.?

Move away from traditional health insurance for employees and agree to move to an HSA account for every single employee regardless of whom the person works for. Instead of health insurance, the employer deposits money into that employee's HSA amount, and then the employee goes to the market to buy the health insurance that suits their needs. If the employee leaves that job, the HSA account follows them to their next job, and HSA money rolls over! It controls costs for employers and employees health insurance is no longer tied to their job(s). It gives employees continuous healthcare coverage at the same rate instead of the expensive COBRA option.

Next, these CEOS need to put their egos down and work together to make the following possible for every single legal U.S. Citizen:

Free annual preventative care (annual lab work, mammograms, etc.)

$100 gym membership stipend (we need to move to preventative care)

$200 Nutritionist Budget (preventive care) and educate people on the power of how to buy one ingredient foods and basics of whole foods cooking on a budget.

$200 Wellness Coach budget (preventive care, running coach, etc.)

Move people away from retail pharmacies to home delivery services which are significantly less.

All gym shoes, walking shoes, bikes, skis, swimsuits, wetsuits, goggles, bike helmets, fitness trackers should be tax-deductible and be able to come out of the HSA account.?

Employees then shop out individual health insurance plans on the private marketplace to identify what works for them; employers are no longer responsible for doing this. They contribute equitable funding for all employees across the board. In other words, regardless of the person's health condition, they each receive same dollar amount.

Everyone has the right and should be treated as such to live their life as they choose. If you want to eat a large pizza and wash it down with a six-pack of beer, knock yourself out. Hate exercising and don't mind excess weight? That is your choice. You have a personal HSA account that may or may not cost you more. If you have to pay out of pocket more to cover your healthcare, it is not my business because I no longer would be paying the same amount into the same system. Just like my car insurance. What is happening now is the buildup of resentment for those who work hard to keep a healthy weight, don't drink, smoke, exercise daily, inadvertently paying for those who choose not to do these things with ridiculously high premiums. And that's not right for anyone involved. No one is winning except health insurance companies.

Right now, insurance is the second-highest overhead cost next to labor for employers. Employers paid an average of $13,717 to insure a family of four with $6,797 as the average employee family medical premium in 2020.

Everyone deserves to be treated with respect and an equitable health system tailored to their individual and family needs.