Editor’s note: The following is a transcript of a conversation between Heather R. Higgins’, CEO of Independent Women’s Voice, and Cynthia Fisher, founder of PatientRightsAdvocate.org, upon receiving the Diana Davis Spencer Lifetime Achievement Award.
Heather Higgins:
So, we’re just going to have a wee conversation, because Cynthia is a very interesting person. And I thought it would be good to start with, you brought your mother who’s almost 95 and doing better than many of us, Marilyn. Tell us a little bit about where you grew up, how you grew up, and the influence of your parents, and I think particularly your dad, when it comes to your business life.
Cynthia Fisher:
Thank you, Heather. And first of all, I want to thank you and Lynn and Foster and your family for the incredible support that you’ve given me on this journey and this effort.
So yes, I’m so honored to have my mother here and God rest his soul, my dear father. And I am honored that I also am lucky, because I got to grow up in a really incredibly rural environment in Central Pennsylvania that was egalitarian. And it was egalitarian in so many ways, where it was a community of Mennonite and Amish farmers and other farmers and tool-and-die workers manufacturing, building. And then also, we had academies like Susquehanna University and Bucknell, nearby as neighboring towns. And I think growing up in a community where everyone lived in the same size house, whether you’re the school teacher or a business person or a farmer who lived in town, and had the same opportunities, and it was an idyllic time.
And I feel very fortunate too because when you grow up in a small town, you’re also held very firmly by everybody knowing who you are and your business and keeping you accountable. And so, I think not only that, that you knew where everybody sat in church and you also knew that if you didn’t say hello when you went into the jewelry store to get a new battery for your watch, and you didn’t use your manners after going to the big city and recognize who owned that store and the employees by their names, you were called out on that. Like, “Oh, we went to the big city, now you forgot your manners,” but you would be held accountable. So I think having that moral compass.
And I do want to thank my parents, who as high school sweethearts, had the 75 years of marriage together before my father passed, it’s pretty amazing. And also very deep faith, a strong moral compass, and also incredibly generous. So, I think that constant giving back and doing so and I’ll call it out, because they did it so anonymously, and incredible opportunities that I’ve had because of the love I came to know from my family and my community.
Heather Higgins:
But you’re also very driven. So you were at IBM, and then you started your own company in an industry that you were pretty much pioneering, banking stem cells. So that rather than wasting this phenomenal resource that could be used by kids who had leukemia or various other family members who might need it. Talk about the role of teams, which I know is very important to you, and how you got this idea and where that led you.
Cynthia Fisher:
Well, I think it all starts also with women’s sports, because I did get to grow up in the kind of Friday night lights environment as well. Football was big, but so were the women’s sports. And I think playing on teams from a very young age was an incredible development tool where you came to appreciate each other and were able to… Everybody knows that you need to find the white space, right? If you’re playing soccer or field hockey or basketball, it’s that free space and you communicate with your teammates on where the ball or the puck is going, and the ability to communicate without words when you play so closely on a team. And then being champions and successfully, iteratively excelling more than you or your teammates would ever imagine, also correlates to the work environment. And probably the most rewarding thing was being able to take the disappointments and maximize opportunity with it, but it always was heightened when you saw someone grow on your team more than they ever imagined that they could do, and what that meant to them and their families.
And so I’m very grateful for the incredible training I had with IBM, and then the opportunities after graduate school to play out and seeing white space while I was at a company in blood processing for pioneering core blood stem cell banking in this country. But it’s often what you have in this team of Independent Women, Heather, because you have this community that you continue to creatively iteratively better communicate to affect change. And-
Heather Higgins:
Thank you, I did not pay for this.
Cynthia Fisher:
But I mean, if you think about it, I mean, speaking of courage, right? The absolute courage that people take on is, I’m going to use these C-words, is contagious, and then it’s that creativity is contagious as well. And there’s just the competence that your organization has is also what I was so fortunate to experience, is with successive practice, with deep dive, and pursuit of knowing you don’t know the answers and seeking out, Heather’s the best at this, is seeking out people that do know the answers and are the best, to bring them into your circle and make us all better. So I’ve just been very fortunate on that on the career, and I was also fortunate to be able to know I could fail. So even starting the ViaCord business, it was the courage to take a risk and say, “It’s okay, and I’m going to learn from failure,” but I kept that playbook to not fail.
And here I am in this philanthropic phase of our lives and Independent Women’s voice has also been incredible colleagues and allies, because we’ve been winning at every play. And together we’ve been able to really pull some major victories for our country on getting access to prices at the federal level and at the state level. So, this has been an incredible team of colleagues to work with you all and have this support.
Heather Higgins:
I’m glad that you were open to failure, but I’m even gladder that you didn’t experience it. Cynthia was very successful with her for-profit companies, and ultimately ended up selling them and then moved into this philanthropic phase. I think, weren’t you at Normandy? Was that what inspired this?
Cynthia Fisher:
Well, I think going to Washington was two things, is one is having the three people come into my life that were in absolute financial ruin that had decent jobs, and had insurance, and had surprise bills that devastated them, and I had to help one file bankruptcy. But in that same month, I had a trip to Normandy and it was so moving to see what the soldiers and these young people and men had laid down their lives and for freedom for others and great service for others, for insurers. And it was so moving that I felt, oh my, I’ve lived my life and I haven’t done a patriot duty in my life and I’m too old to sign up for the military. And it occurred to me that it was a mission and a calling that this is a way I could give back, is to use my skill sets to actually focus philanthropy by using the voice. So Independent Women’s voice, I guess, I get to be a change agent like you.
Heather Higgins:
[inaudible 00:09:25].
Cynthia Fisher:
But it was very moving to me and I said, “I’ve got to do it,” and that’s why I packed my bags and went to Washington.
Heather Higgins:
So Cynthia went to Washington and I first met Cynthia 2017, 2018, somewhere in there.
Cynthia Fisher:
[inaudible 00:09:40].
Heather Higgins:
For those of you who don’t know, in 2009, we helped architect what became the pushback to President Obama’s very popular healthcare plans that Republicans were sure would not be advanced for at least two years and yet were being rapidly advanced. So I was very busy telling the Wall Street Journal what to write in their editorials and telling Rush Limbaugh and Mark Levin and other talk show hosts what their talking points should be, as well as trying to architect a ground war and an air war, and we moved the thing to being very unpopular. I still couldn’t get political consultants to go into the Scott Brown race, so we did that, and that was for Ted Kennedy seat and made that be about healthcare. But what I slowly learned over time as the only repeal pledge on Obamacare that lasted the entire six years, was that Republicans weren’t actually serious about repealing Obamacare. And so I’m frustrated, I want to save our healthcare system, I know how bad it is.
I tell my children that I’m timeless. I do not acknowledge birthdays. I don’t get older. There’s an aging portrait somewhere, but at some point this is all going to catch up to me and I will need a doctor in healthcare and I want it to be good doctoring in healthcaring. And so, I was at a lunch that Foster, Foster Freeze, Lynn’s late husband, had in Washington and added he had different people he knew, basically celebrating him and all the fun things that he’d done and talking about what they wanted to do next. And Cynthia got up and she said the smartest things that I had heard anyone say in the previous seven, eight years of talking about healthcare policy.
So I went over and the waiters had to kick us out of the luncheon room because we were there for two hours after everybody else had left. And it was just this combination of practical experience, deep inside knowledge of how the financial world looks at healthcare companies that plead poverty on the public policy side but are actually minting money and the way the games that they play, and her attempts at price transparency. And so you were leading the charge for healthcare price transparency at that point. You got President Trump to actually do an executive order, finally, written basically by Cynthia, at the end of his first term.
How many of you have children? I’d say most of you, right? Do you all know that your children don’t tend to believe you when you say something, but if they hear it from somebody else, right? So I’d been telling my daughter how amazing Cynthia was and I’m getting like, “Right, right, mom. Right.” And then she goes to work for Pat Toomey, and I get a call from her and she said, “Your friend Cynthia Fisher, everybody knows who she is and they don’t know how she does it.” She has single-handedly stood up to insurers and healthcare, hospitals and pharma and the PBMs, and she has gotten this price transparency stuff done. She’s getting legislation done in the House and the Senate. Nobody knows how a human being is single-handedly doing this against these enormous lobbying forces that are deep-pocketed.
So, you want to talk a little bit about how you’re doing it? You’ve got two very strategic organizations. One, she pretends to be a lefty and then she’s seriously on the right, so, but it helps that she’s got a husband-
Cynthia Fisher:
[inaudible 00:13:18].
Heather Higgins:
… who’s an idiot politically and he gives money to Democrats. So, when you’ve got Democrats in office, she can go talk to Fat Joe and Susan Sarandon and play the game. And then she’s also very much on [inaudible 00:13:31], but you’ve done so many smart things. Do you want to talk about the strategy for getting this over the finish line? Because you just got yet another executive order out of President too, Trump, all done by you. And so, tell us a little bit about it.
Cynthia Fisher:
Oh, goodness. Well, it takes a team. So, I’m so fortunate I have been surrounded by mission-driven and faith-based individuals that are willing to stand up to what I call a cartel.
Heather Higgins:
Because it is.
Cynthia Fisher:
Because it is. Okay, because think about it. How many of us have experienced firsthand or in our family, medical billing after the fact that was way beyond what we expected to pay? Yeah, and just try fighting that. And if you don’t have a price, how do you know you were not fraudulently billed or erroneously billed or billed at the price that was negotiated for your health plan, because you don’t. And what we found is that we have great lawyers and we have great data analysts, and we have found that as long as hospitals and insurance companies hide their prices, they can charge whatever they want, and they are.
And in fact, it’s so bad that we also wear the hat as employers. So having been a former CEO and have sitting on public company boards with thousands of covered lives, members of your workers and team players and their families, do you know that you can’t get coverage as an employer for your workers unless you sign a gag order that your workers can’t know the prices? That’s against the law, thanks to the No Surprises Act that we helped get done in the first Trump Administration with the help of IWF IWB. Thank you. It’s against the law, still happening. And secondly for employers, is you cannot get coverage and even state health plans and public school district health plans, without signing anti-audit provisions that you will not audit the claims, the payment, the bills. You have to, as an employer move monies out for all those premiums every month into a trust account that only the big insurance companies get to spend your checkbook. And you don’t get to control it, unless you fight it.
And some of the companies have fought it in student courts, Kraft Heinz, since the hospital price transparency came out into law, they got to start to see the prices. And in the same hospitals on the same day, once Trump got that done before Biden rolled it back six months ago, but once Trump got it done, we could see that Abby could spend for a colonoscopy, really lovely, but we’re of that age, right, Abby? She could spend 10 times more than I would by the same physician team on the same day for a colonoscopy in the same hospital, same team, all the same coats. Childbirth, same thing. One woman could pay $6,000 for a vaginal delivery, another woman is 60,000 with the same obstetric team on the same day. No one knows.
But the worst part is, is the big four accounting firms we found are in cahoots too because they don’t audit. Think about this, Delta Airlines might spend 1.2 billion on healthcare, and your auditors don’t audit the health spend. Why? Because they make the biggest amount of money on margin optimization for the healthcare industry. So, meeting a senior partner at a big four, I challenge them to say, “Why aren’t you auditing the health plan, total white space? Are you kidding? That’s a huge business opportunity,” to go audit the health plans and lower the costs and look for fraud. We choose not to.
So we have the right to know these prices, it’s going to be so transformative when employers can say, “Game over.” We found that from the lawsuits. Kraft Heinz sued for 1.2 billion, Aetna, Aramark sued for 1.6 billion, Aetna. Ford Motor just sued Blue Cross for a billion of overcharges and fraud from seeing these prices for the first time. This is going to be truly transformative and the generals of our army are going to be the C-suite and the unions, because President Trump, and thank goodness for President Trump, only a maverick like President Trump who really cares that the American worker feels a difference. And more than a dozen, the cost of a dozen eggs. Let’s be real. The amount of hundreds of thousands of dollars of overcharges, millions of dollars of overcharges, it’s absolutely egregious. And think of what that can mean. We will be able to bring manufacturing jobs back. We will be able to compete economically. I’m sorry.
Heather Higgins:
Oh, no, [inaudible 00:18:51].
Cynthia Fisher:
But we have to reduce our healthcare costs because we’re paying two and a half times more than any other developed country. So we cannot compete, unless we economically drive down the cost of healthcare.
Heather Higgins:
So, two more questions. The first is, describe for people what healthcare would look like once we get healthcare price transparency, genuine price, transparency with cash prices, etc. Not estimates, not other games in place.
Cynthia Fisher:
Well, I think the exciting thing from Trump 1.0, when you asked me about the executive orders, because he just was fed up that Biden rolled back actual prices to estimates, and could be presented in complex mathematical algorithms instead of dollars and cents. So he put a knife in it right before they left.
So, President Trump came out of the gates and said he wants radical price transparency, actual prices, comma, not estimates. And what will that look like when you can see cash prices? Look, here in Florida, you can get an MRI, if anybody needs an MRI, don’t leave before, you can get it here. You can go to any standalone imaging center and pay cash money for $250 to 300. And if I were to go home to Boston and go to Mass General Brigham on our Blue Cross plan, 7,500 for an MRI with a $750 copay. Okay? So you have the right to pay cash. It is, I think our economists in the room will agree that the US dollar is a unit of treasure. You will be denied if you have insurance, but you can stand up for it. And oftentimes, the cash prices are 40% lower than the lowest insured rate. So it will be very disruptive, competition can be unleashed, and then let them Uber-ize healthcare and compete for our business at times we want to seek care, and they’re going to have to compete on quality and price.
Heather Higgins:
So-
Cynthia Fisher:
And we should love free market, right? I mean, shouldn’t we all? And this is so bipartisan, because we all know how to be consumers.
Heather Higgins:
Now, one of the things, and I will just as an aside and a comment here, it has been fascinating wading into this fight because a lot of the conservative organizations in Washington are incredibly unhelpful. And the reason they’re unhelpful is that they’re getting money from insurers and pharma and hospitals and PBMs. You also find this with a lot of the patients advocacy groups so that they know that this is disserving their patients, but they can’t talk publicly because 90% of their budget comes from these deep pockets. So we have had these weird conversations with free market groups, where we’re pointing out that you don’t have a market until you can see a price in advance of a transaction. And they are claiming that this is interfering and price controlling and stuff. No, we are just trying to require transparency with prices so that you can have a market to begin with.
So my last question is this. This has been an extraordinary journey for you, which is now going on, I think about eight years of doing this?
Cynthia Fisher:
Yes.
Heather Higgins:
And extraordinarily personally expensive, I am suspecting. We’ve never talked how much you put in it, but it’s a lot, and other people contribute to it. But if you were to have large lessons for people who have an issue that they want to take on, what are some of the lessons that you draw from this experience about how to do it? Obviously, plan on it taking much longer than you thought it would, that’s one. But what else would you advise people, if they have something that they’re passionate about and a change that they want to see happen?
Cynthia Fisher:
Well, I think being a guru by actually deploying people and time to sit and read and go on a deep dive. So we read all the existing laws on healthcare and we just got into the weeds, because the truth is in the numbers and the truth is in the details. So, you got to know the details.
Heather Higgins:
You’re sounding very DOGE-like.
Cynthia Fisher:
Well, it is DOGE, God bless DOGE. And numbers don’t lie, right? So the data doesn’t lie, but you’ve got to get into… And when you read the laws, usually buried in that law or rule is three key sentences that really are either tricky to unwind what you’re really trying to do and it’s Orwellian language, or you need to figure out how to reshape it. And so, where’s the white space and where’s the opportunity? And then where are your fellow mission-driven advocates?
And I think what I’ve been so pleasantly surprised about is, look, everyone has a story. Everyone has a story and they tell you the personal story, and I have never before been this excited because this administration and across every effective agency in this policy, and there are many, there are change agents that want to do the right thing. And on top of it, not only do we have the policy people from this administration, we have deep embedded career people that are fully engaged. That is huge, because they’re on the same side and they are waking up on the side of the angels. To go for the first time, I think, be brave enough and have the courage enough with all this transformation. And I’m going to tell you, what you’ve done for women and for women’s sports, that is the model of not accepting, first of all, crazy thinking and not being silent. And I am really seeing it on every level.
So, Heather, I would just say is that you just keep going, and it’s that tenacity and commitment. And when you show up and you’re a unicorn, when you don’t want anything for yourself, it’s really for the greater good. People are really good at heart. Everybody in medicine went into medicine for their ideal. And unfortunately, the peer pressure, like you saw in the woke agenda, of the medical community capitalizing on every aspect of a patient’s misfortune has become commonplace among our physicians, the administrators, our CPA firms, the consulting firms like McKinsey and Bain, the banking system because they make so much money investing the money in the insurance industries, that everybody does it, has let the greed run amok.
And I think that because everyone’s been so affected, the engagement now to shift that, flip it over and see the truth, I think we’re going to see a truly transformative time in healthcare. And it’s going to take every single one of you and every single one of us to fight every one of those medical bills because you know you’ve been overcharged. Don’t pay it, fight it. It’s going to take every one of us because President Trump in his first administration said we have to have an advanced explanation of benefit. That means prices in advanced to plan care and 90% of care is planned. So, we’re pushing really hard to get that done in the next couple months. That’s going to be true. Everybody’s going to feel it January 1st, next year.
So we need all of you again to raise your voices to say, “We do not want to tolerate the absolute lack of integrity. And what we do want is we want prices, we want bills just like in a restaurant that match the prices. We want payments that match those prices.” So we want accountability, integrity, and Heather gave me this term, to restore trust once again in our healthcare system. And so thank you, Heather, for that, because it is the only way we can restore trust because the truth is in the numbers. And it’s a fight worth fighting for for your families, for everyone’s future. So, thank you.
Heather Higgins:
So the only downside to giving Cynthia this Lifetime Achievement award is that she’s too young. And I know she’s going to go do phenomenal things over the next 25 or 30 years, and so we’ll be back and giving you another award in 25 or 30 years. But for now, I hope that all of you will join me in congratulating Cynthia, an award dearly earned.
Cynthia Fisher:
Thank you so much. Thank you, Heather.
Heather Higgins:
Thank you.