A health insurance v.p. becomes a patient.
Over the years, this column has frequently been critical of health insurance companies. I have described insurance companies as insensitive and profit-seeking. But the industry does have some leaders who care. Lorina Marshall-Blake, vice president of government relations for Independence Blue Cross, is one of them.
In addition to her work at Blue Cross, Marshall-Blake is the associate minister of the Vine Memorial Baptist Church in Philadelphia and a volunteer at the Linda Creed Breast Cancer Foundation. She devoted her energy to this cause because almost everyone she knew had been touched by breast cancer. Because of her knowledge of preventive measures, she did everything she could to minimize her own risk.
She was fastidious about annual mammograms, visits to the gynecologist, diet, and exercise. That’s why she was so shocked a year ago when the phone rang and the voice on the other end said: “Lorina, you have cancer.” She was 52 years old.
As she tells the story of her journey through breast cancer, she talks with the speed and intensity of anyone who has recently been traumatized: “Do you believe that they gave me the news over the telephone? Nobody should ever receive news like that on the telephone. And then they had the audacity to say, ‘Are you OK?’ So I said to them ‘No, I am not OK, but I will be.’ ”
When she hung up the phone, she sat in her office alone and confused. “I did everything I was supposed to do,” she thought. “How did this happen to me?”
She felt so overwhelmed that she could not imagine coping with this horrible news. Nevertheless, in the back of her mind, she knew she simply had to. So she sat in her office, wondering who could help. Fortunately, she had access to current medical information through the chief medical officer at her job. He helped her sort through volumes of options and statistics, and she decided to have a lumpectomy followed by radiation.
Like many with breast cancer, she talks about how she “went through it” but, unlike many, she also talks about how she came out of it. In her words: “You either have to deal with it or dwell on it.”
She attributes much of her resilience to her faith. Following her religious teachings, she determined that in order to survive, she had to turn her energy to helping others. So she redoubled her efforts to get the word out about this disease, which strikes one in eight women. Although this path gave her meaning and contributed to her resilience, there were many days when she wanted to stay home and cry. She kept going because she knew there were other women who needed her. In the process, she met some women she considers close friends. And now she says she has a great deal to be thankful for.
Fortunately, Marshall-Blake had insurance, Personal Choice, that covered all of her medical care. And, like many who are traumatized, she saw a psychologist. “There are some things we just can’t deal with on our own,” she said. “This was one of them.”
Although Personal Choice reimbursed all of Marshall-Blake’s medical care, it paid for only about half of her psychological care. She was able to pay the remaining $70 or so per session herself.
I asked what she would say to other women who were suffering similar pain and confusion but could not afford $70 per week: “I would tell them that if the help they want is not covered by their insurance, the help is out there somewhere. There are wonderful programs such as the Wellness Community, which offers support, fellowship and hope. I would tell them that the key to survival is information. And information is out there.”
If she had the authority to change the reimbursement structure for mental health care, would she make it more equitable? After a brief pause, she said: “You know I can’t answer that one.” Despite her politically appropriate answer, I wished she did have the authority. I wished that even more after her next statement.
“This past year has changed me in fundamental ways. Life has become more urgent. Knowing the reality that I could die, everything and everyone I love in my life became even more valuable. I have a fresh view of what is important and what is not. For example, my job is still very important, but it no longer drives my life. My love for my family does.”
Hearing that, it was nice to know that, inside an industry that sometimes behaves in a very uncaring way, we can find some very caring people.