"What was the worst part about breast cancer?"
I could count on one hand the number of people I would ever dream of asking this question. At the top of the list was a highly intelligent, matter-of-fact past client, now friend, whose cancer had been in remission for a few years.
Looking back, there are so many ways she could have answered. The disfiguring breast cancer surgery. The chemotherapy. The hair loss that temporarily helped itself to what was left of her dignity. The radiation. The hysterectomy. The terminal effect it had on her marriage. Certainly, she had a wealth of choices. Instead, she said, "The $*&%^% paperwork. And the mountain of bills! Definitely the worst part."
When I met Lisa Rachman, she was one of the most talented players in the NBA at the League's headquarters on 5th Avenue. Over the years, she's become one of my closest friends, always as honest as she is unflappable. To Lisa's credit, I can't think of anyone else who would get away with telling me about a breast cancer diagnosis in a voicemail.
"Hey, O'Leary. It's Rach. Sue and I are going to the movies tonight. I'm having a picnic on Saturday in the Park with Fred and I have breast cancer. Give a call whenever you have a sec."
A fellow Chicago-burbia native, I understood the patented Midwestern approach of saying what we're doing rather than how we're feeling, but her message nearly drove me off the San Diego freeway. Textbook Lisa Rachman. By this time she had left the NBA for marketing agency life, and was high up on the food chain with a solid company and an "excellent" PPO health insurance plan with a major insurer. Barely into treatment, Lisa began to realize how uncovered she had been: "I was sitting in my living room in the middle of my chemo sick as hell, staring at about $88,000 worth of bills that everyone said I owed. I couldn't believe it and had no idea what I was going to do. All I could think was, 'My God, I don't want to lose my house.'"
Nine years later, Lisa is still receiving chemotherapy treatment at Sloan-Kettering in New York City and remains relapse-free. She has managed to keep the house thus far, still haggling with the hospital, doctors, labs and insurance company about medical bills several years old while fighting the new ones that appear on a regular basis. She became a licensed insurance agent not to ply the trade, but to know more how the system operated for personal use. She continues to work within marketing, ever vigilant to stay employed to remain insured.
When I awoke one Tuesday morning two years ago to find a company that didn't yet exist stuck in my gray matter, Lisa was the first person I called. I was to create a consumer advocacy that would use healthcare experts to help average Americans stand up to the $2.8 trillion healthcare industry, an H&R Block for healthcare. Lisa's cancer answer, "The $*&%^% paperwork," was a big part of the why.
Since the Affordable Care Act's health insurance exchanges opened on October 1st, we've heard from people of every socio-economic background representing every part of the country. Policy selection in the ACA marketplace or the open market is not easy, as individuals and families have to balance what they need with what they can afford. And as Lisa and millions of others can attest, there's no guarantee that a major medical event won't blindside individuals and their families who select even the best of policies at the office or through an exchange.
The patients who reach out while in the quicksand of catastrophic illness, like the 49-year-old man who was terminated by his insurance company because he had the nerve to contract brain cancer, are equal parts heartbreaking and inspirational. The man's life was literally being fiscally and physically threatened, and still he wanted to "do right" by a billion dollar insurance company that could not have cared less about him. He had the personal ethics that his insurer wrote off long ago as the price of profit.
Lisa is weathering both her financial and physical storm. And thanks to her honesty, the worst part for her breast cancer helps other Americans protect themselves from a catastrophic fiscal loss.
Sarah O'Leary is Founder/CEO of ExHale Health™, a consumer advocacy that uses industry experts to help individuals, families and small businesses successfully manage every aspect of their healthcare.