Matthew Zachary cleverly called our episode “Nun, Done, and Uninsured.” So before we move forward, I’d like the record to show that the nuns are very much insured.
(I’ve got the headaches and the scar tissue to prove it, Matthew, LOL.)
The trip to Manhattan was worth every minute. Matthew and I had a blast talking through some of the darkest parts of our lives and of modern American medicine. Maybe that’s because we’re both trying to fuel the same patient movement. Or maybe it’s because he’s also Gen X, so we spent the first ten minutes on nun jokes, classic rock, and the 1978 sedan my father bought me because he knew exactly how I drove.
For anyone who doesn’t know him, Matthew was diagnosed with cancer thirty years ago and then built the young adult cancer survivor movement, largely because nobody else had done it.
He opens his show with: “I’m as mad as hell and I’m not going to take this anymore.” And that’s the posture of his whole show.
We talked about our personal run-ins with medicine. How the reproductive specialists watched my ovaries for about a minute and then handed me a label without ever mentioning that my routine of four hours of sleep wasn’t going to make me more fertile. Nobody asked about the Diet Coke I was using as hydration. Nobody asked about the cortisol bath I was living in at work. And I just believed them.
Matthew shared how he went on COBRA at 22, a week after his treatment ended, and found out what insurance charges a young survivor for the privilege of staying alive.
He’s spent 30 years on the receiving end of the dysfunction. I spent 30 years trying to rewrite the rules, and now building around them.
The best stretch was about cash.
Matthew is a Cost Plus member. Four of the seven medications he takes daily are generic, and he says paying cash instead of running them through insurance saves him about $200 a month for the same pills.
Then I told him about my nuns. The way I run their health plan. How I fired Blue Cross, I fired Express Scripts, and it’s better now. And how when a sister needs an appointment at NYU, NYU says they don’t take our plan.
My Nuns Fired Blue Cross. Eight Years Later, They've Saved Millions.
For the past eight years, I’ve run the health plan for a group that I call “my nuns.”
NYU would rather turn away a nun than take the money. Though that’s starting to change.
We also got into why change is slow.
The asymmetry of sophistication between a multi-trillion-dollar industry and a Senate health staffer who doesn’t know what he doesn’t know. Why the money in politics doesn’t corrupt so much as it guarantees the industry gets to frame the issue first. And the new fiduciary rules that could take the PBM business model apart, if anyone enforces them.
Matthew closes every episode by asking his AI which three pop culture characters his guest would be. I got Dana Scully, Michael Clayton, and Olivia Benson. I’ll take it.
Listen below, and subscribe to Out of Patients while you’re there.