The Crusader: Cynthia Fisher, MBA

Transcript

[0:09] But now they’re destitute because of medicine this is just so wrong on so many levels and I thought okay I sold my company I had done a couple of other entrepreneurial and Adventures and and I thought I’m going to clear my deck,
I’m going to go back to Washington as I did when I had to Pioneer the field of stem cells and and find the pathway and I’m going to go to Washington.

[0:35] Paging dr. cook paging dr. cook dr. Kirk you’re wanted in the o.r. dr. Koh.

[0:42] Music.

[1:06] Hello everyone and welcome to prescription for Success I’m dr. Randy cook your host for the podcast which is a production of MD coaches,
providing leadership and Executive coaching for Physicians by physicians to overcome burnout transition your career.

[1:25] Develop as a leader or whatever your goals might be.
Visit MD coaches on the web at my MD coaches.com because you’re not in this alone.

[1:36] My guest today is not a physician but she’s having an impact on one of the most important topics in all of Healthcare in the United States.
Because it affects all of us.

[1:48] She is a self-described healthcare entrepreneur so let’s hear my conversation with Cynthia Fisher founder and CEO of patient rights advocate dot-org.

[2:00] Music.

[2:05] So regular listeners to our podcast are.
Already aware that the vast majority of the guests that we speak to our physicians but once in a while we.
We have what we call a special interest guest these are people who are not Physicians but they’re having a significant and sometimes critical impact on what we do is physician and.
Today’s guest fits that description quite precisely I think her name is Cynthia Fisher she is a self-described healthcare entrepreneur and I’m really excited to have a conversation with her because
what she does have such a critical impact on what we do.

[2:48] As Physicians so Cynthia first of all thank you so much for being here and welcome to prescription for success.
Thank you Randy it’s a real pleasure and honor to be here with you today.
I’m looking forward to the conversation and what I’m going to do with you is exactly what I do with the physician guest that we have and I’m going to begin with your origin story.

[3:12] My first question is what did you have in mind when you started your undergraduate education did you have
any inkling at that point that you would become such an influential entrepreneur
well Randy you know I had lots of experience in my youth in.
Healthcare in having family members that benefited from Healthcare and also experienced pioneering surgeries.
Type 1 diabetic first cousin best friend and grandmother with CML for
decades and having looked at medicine from secondhand as server as a young youth also exploring biology and physics in college so looking
to a future from college I actually utilize my physics major coming out of it in,
we looked at medicine from an information technology standpoint so after ursinus I joined IBM.

[4:22] And my clients were hospitals and insurance companies and I helped provide back then in the early 80s where the first areas of
actually data automation wasn’t the finance.

[4:36] In bill payments and coverage right that’s where the system started and so those systems needed to talk to women
another and instead of sending tapes I helped them in applications of network and also in data analytics so that started in the early 80s and I also had defense Logistics as my client so fast forward
going after five years with IBM and these clients I.
To Harvard Business School and coming out of Harvard Business School I was excited to have my first job actually utilize
not only the data and the analytics side of experience in healthcare but I got to go back to the biophysics side of cell processing
and using physics and a density gradient two separate cells in that I joined a company called human attics
where I when I left I was really managing their blood bank marketing
division so I was in blood for many years when I with human attics where I saw an opportunity to become an entrepreneur
for an idea that launched and pioneered a whole new industry.

[5:55] And that is I saw a supply and demand need.
For stem cells for transplantation and I’m really excited to hear about this yes so the human addicts equipment separated bone marrow.
And blood peripheral blood stem into a collection of densely nucleated cells of which the
stem cell layers of cells were in those Collections and the cell salvaging equipment in the OR but also the blood processing equipment was utilized to separate blood into its components.

[6:31] Of which
nucleated cell level collection which the stem cells were in was part of that so I got to work with bone marrow transplant errs around the globe
in being able to collect separate and freeze these cells for their therapeutic use.
Info marrow transplant and when the first umbilical cord blood stem cell transplant took place I was running the marketing Division and I thought oh my goodness here is.

[7:00] Blood that is placental and umbilical cord blood thrown out everyday in the birthing Suites at the beginning of Life
which was much needed to successfully transplant patients that were facing.
Life-threatening diseases such as Cancers and Leukemia liking like leukemia and certain genetic disorders like say fanconi anemia so what
I did is I left him in attics knowing that I had a background in logistics from my IBM days and also understanding how hospitals and insurance companies work I thought okay someone needs to help
provide a safe blood product and allow any parent having a baby to be able to collect test
type in store their child’s Cord Blood stem cells for potential future use for not just that child but another family member where
Cord Blood could be readily used even as a half match for both as an alternative to bone marrow in transmutation.
So I became a Pioneer back in 1940 I really did yeah the early days and helped Pioneer a whole new industry and through my business called via cord which exists today.

[8:15] And millions of Cord Blood stem cells have been banked and thousands and thousands of
stem cell transplants and lives have been saved today and we did our first Cord Blood stem cell transplant collection used in transplant back in 1996.
Fast forward many many years later the company still exists and it’s a whole new field that had a very transparent price One Price one patient a little patience and much lower than.
Any of the nonprofit medical centers but a gold standard for the transplant programs we were able to transparently post all of our collection data.
End of direct collection data to the collection family and also to provide the data on every outcome.

[9:08] That’s really remarkable story for a lot of reasons and one thing that I would like to ask you one thing that really.
Fascinates me about this is how you clearly recognized the potential need and the potential.
Marketability of a really significant scientific discovery and you had the wherewithal to.
Turn it into a successful business,
I am of the impression and I think a lot of people are under the impression that that’s an unusual story for a quote science nerd.

[9:48] If you will and I’m wondering
if you could talk about that a little bit that it did you find yourself to be unique among scientists well you know I think there are lots of scientists that
have pursued their interest in in gone into a discipline and
you know you see MD and PhD is that work on Discovery right and basic science and where are able to be experts and
you know we all realize I think it’s about optimizing to get the best outcome.

[10:20] And to deliver it efficiently and effectively and at the lowest possible cost to the individual to their family to society is a goal
pray to delete so that we can deliver broad access of care and affordable rates and.
Humankind can benefit I think most people go into medical science or become Physicians to really fulfill the ideal
that they can make an impact on this planet right and we and I think you know one
thing that perhaps I’m blessed is is that,
I think I have you know great parents that you know I’m blessed that just you know believed in you know gave us the foundation of love and and and a solid education.
And probably the freedom of belief that you could do and be whatever you want it took a lot of hard work and tenacity
hi I’m Rhonda Crow founder and CEO Forum D coaches here on RX for Success we interview a lot of great medical professionals on how they grew their careers
how they overcame challenges and how they handle day-to-day work I really hope you’re getting a lot of great information.

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[12:23] We’ll get back to our interview in just a moment but right now I want to tell you a little bit about physician Outlook
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[13:26] And now let’s get back to today’s interview.

[13:29] Music.

[13:34] Want to get us more into the area of.

[13:38] Healthcare Finance in just a moment and something else that you’re really passionate about but I also want to ask you about one thing because it has to do with the subject that breaks the back of so many practitioners
today and that is Healthcare technology
I know that you were involved with HHS and the and the health care Information Technology advisory committee the electronic medical record that we thought Physicians thought was really going to
make our lives so much better has made us miserable.
Yes have you got any opinion or any insight on how that project went so wrong.

[14:24] Yes I think you just have to follow the money.

[14:27] Randy you know as I mentioned you know back in the 80s the the whole system’s with hospitals and insurance companies was really based on financial data right
and unfortunately when the electronic health record direction– came about the systems,
and the software that it was built for the electronic you know record was really based upon.

[14:55] 1980s architecture
with the epics in this earners of the world that have oligopoly been monopolistic oligopolies
in in the healthcare sector or the Athena Health and the physician practices of the in unfortunately what we saw in what we see and what we have is a result is a 1980s architecture that was based upon billing systems
right
and you look at I think it’s baked in greed quite frankly that’s baked into our health care System that’s really the hospital’s the insurance companies the
group purchasing of pharmaceuticals in the pharmaceutical benefits managers and all the middle players that are in claims data processors.
That are focused on
optimizing the revenues and profits on the capitalizing on the patient’s Misfortune and so the system’s themselves and electronic record has been based upon a financial system.

[15:58] Rather than being based upon patient care.
Quality of care and that record-keeping in I think it’s ripe for a revolution and I sit on the high tech committee to represent patients and consumers.

[16:14] To get access to their data and to this day decades later after the high tech Council has been formed we still don’t have
on our smartphones of readily downloaded
patient data information that we control on our health and can readily share wherever we want to get care across our country and yet we know it’s totally feasible to do it but as you know that the
Congress even had to create a laws to stop the information blocking,
that’s been done to keep patients in the dark and other physicians in the dark because of the hospitals and the insurers and and those players,
keeping the data because it’s a data race to keep those patients.
It really an anti-competitive way keeping them into their Hospital systems and not losing revenues and also not disclosing.
What would otherwise possibly be revealed as perhaps gouging overcharging erroneous care and being able to evaluate.

[17:22] To leave a system in readily go wherever we get care when we live in a transient Society yeah that.
That’s one of the things that really fascinates me the most if one takes.
The time to go back and read the verbiage of the hitech ACT 2008 which it’s really not very long and the amount of money there that they were talking about
compared to the remainder of President Obama’s budget was really relatively small but one of the things that was written in there is that there has to be an electronic medical record and it has to be readily shareable
that’s right there in the act.

[18:01] That’s right never ever happened that’s exactly right and I sit in this committee I will tell you that the that the way to kick it the can down the road and killed by delay is a constant game.
By the oligopolies that are wanting to keep the big data and not unleash it to the very people that need it.
And that is the patient consumer and the patient’s direct physician providers wherever they choose to get their care you that’s a
beautiful segue into exactly what I want to talk about at some length and I’m and I’m sure you do and that is
patient rights Advocate dot-org and you sort of laid the groundwork but go ahead and give us the origin story of where this came from,
five years ago a little over five years gosh can’t believe it’s almost six years ago Obama was still president was the end of his presidency Trump was coming in.
And it was this perfect storm that happened.

[19:02] At the end of my driveway at least it was local I was local it was local and a handyman that had worked with me for 26 years
I was walking out to go to work and he was coming up my driveway.
And I saw a tear in his eye in he approached me to say that he his wife turned 50.
I was lucky enough to say by her primary care you should go get a colonoscopy or 50 had her first colonoscopy and had a surprise medical bill of over six thousand dollars,
by the anesthesiologist for a colonoscopy that’s right in the Boston area well and she paid the bill,
but as they looked at their bills their only son was a junior at his Catholic School tuition was due for six grand and they didn’t have the money to pay the tuition
and he had never asked to borrow money and he asked if he could borrow money and pay me back within 3 months to get.

[20:10] This tuition paid and that they paid medical bill and asked him well what are you paying for healthcare she’s a florist he’s a handyman self-employed.
And they were paying thirty six thousand a year for their premiums as a self-employed it was with after-tax money they had high deductible plans 2000 a person,
and so that takes you to 42,000 and on top of it surprised with this six thousand dollar,
out-of-network anesthesiologist bill and I thought oh my gosh you probably both make 120 All In
you’re paying over 42,000 for healthcare now you got a surprise bill that’s an additional four so that were at like 46,000 with after-tax money.
How do you pay for food how do you make ends meet without going deep into debt and I just started doing the math and I thought this is the system is broken.
Because these are hardworking Americans not looking for any handouts and it was the first time he borrowed but this was a huge embarrassment and at the same time I had just helped.
A former employee of mine when I checked in on her how she was doing she had breast cancer I helped her file personal bankruptcy from her bills oh my good medical bills and she was employed and had coverage and she lost her home.

[21:27] Because of the medical debt so I hope your file personal bankruptcy that same week.
And get out of that hole while another friend we had an emergency medical bill of 56 thousand dollars that she couldn’t pay.

[21:42] And I helped her negotiate that and taken a renter in her apartment.
To pay off her debt okay so this happened a lot going on in your driveway in my driveway on the same week.
And then I think the icing on the cake was I’m not kidding you’re Andy a Mass General nurse one of my employees aren’t came to me for.

[22:05] Helping to fund this is because I sold my company right so I have means and I’m very blessed.
But these are hardworking Americans that came with problems,
come medical deck that was ruining their lives and a nurse at Mass General needed proton beam therapy it was not covered by the Mass General insurance they set her up with a social worker
and literally she had a 38000 GoFundMe account and she asked me if I would contribute and I thought.

[22:38] Wait a minute this is all happening in the same week these are hardworking Americans with coverage these are not the uninsured in the destitute,
but now they’re destitute because of medicine this is just so wrong on so many levels and I thought okay I sold my company I had done a couple of other entrepreneurial Adventures Investments and I thought I’m going to clear my deck
I’m going to go back to Washington as I did when I had to Pioneer the field of stem cells and and find the pathway and I’m going to go to Washington
yeah I’m going to set up my philanthropic interest.
To help consumers which I believe is not just the patient but the consumers are also the employee one who pays for health care and that’s the employers and the unions and every worker and taxpayer.
As well as patients and their families so we are the payers of healthcare not the insurance companies it’s our wages.
It’s our paychecks that pay for healthcare so we have no voice in Washington and I decided to found patient rights Advocate dot-org to represent the voice of the consumer.
In Washington and I went and hired put my philanthropic interest on this interest to go find.

[23:54] By hiring a couple of Boutique law firms you can’t hire the big ones in Glass Houses because they’re all in bed with the cartel right right so you had to find some Boutique lawyers that had you know hutzpah.
And and we’re ready to go fight the fight and we’re mission-driven and shared the core values to not be bought off.
Don’t don’t you think there aren’t those that are bought off whose values are not on that basically had to fire higher this the whoa those are the same values and ask them.
To look at existing laws.
And find out where we have the right to know prices in healthcare before we get care and where we have the right to get access to our health information in our data and to get all of this into the hands of the consumer.
And the patience is our goal and so this is mission-driven and we found for existing laws.

[24:45] Three 800-pound gorillas of them that basically give us the right to have access to knowing prices before we get care.
And unleashing the data and competition and God willing hopefully creating.
The functional competitive Marketplace in healthcare and Empower patients well thank goodness it’s finally happening this is about I practiced,
medicine for almost a half-century I’ve dealt with patients who were wrestling with all of the gotchas.
That came their way after I had done an operation on them I began to find out this sort of surprises that were popping up with these people that I didn’t even know about,
you know I’m in the business of delivering Healthcare and I don’t even know what’s happening to these people so I know that it is an incredible incredible
problem and it just it just really makes you scratch your head through there’s nothing else that I know of that you go out and buy.

[25:52] And take home a high and wait around to find out how much it’s going to cost it’s just so entirely illogical.
So I can’t tell you how thrilled I am that somebody has figured out how this issue can be exposed and addressed and hopefully done away with and.
So how are we doing on that front I realize that it’s a relatively new project but are we going to see the day that,
everybody knows exactly what the price is going to be before they walk into a hospital or the doctor’s office or the Radiology facility or whatever is that is that.
Something they were going to see Randy I absolutely believe so and we have a whole slew of people that also believe that this will happen and the good news is.
Is that we’ve seen mountains moved in Washington.
In the past five years to get toward that goal and I think we’re really.
Two to three years away while that close God willing God willing that the B Administration continued strong to enact on the rules.
Of law that have been put in place to unleash this data to the very patience and the consumers and importantly.

[27:16] The employers and unions that combined.
Represent over 165 million Americans that have coverage under an employer plan the first law that was used was used and found to give.
Patients the rights to get access to all standard charges before they get care.

[27:41] Is the Affordable Care Act so this was done during the Obama time,
but it was never made into rule of law into regulation and so the Trump Administration actually secretary Azar
put it first into rule of law through the executive order by the president of that hospitals and insurance companies.
Have to provide all of their prices and quality to the consumer and the first rule.
That came under Health and Human Services which has been embraced,
by the by Administration and secretary Becerra in fact they even up the penalties to enforce these rules that hospitals as of January first of this year were to show all of their prices post them online.
Every discounted cash price as well as all the go shita rates by every payer in every plan and every code.
Okay so again remember the Coatings based on financial and it’s not perfect but the reality is that’s what we’ve got today
and all of that data is to be in a machine-readable downloadable easily accessible file and on top of that,
300 of the most common procedures.
70 defined by centers for Medicare and Medicaid are to be posted so that their human readable and easily shoppable for any consumer as the start.

[29:05] Okay so in June of this year six months into the rule our organization patient rights Advocate dot-org we did a study and we looked at 500 random hospitals in 50 states and said what’s the compliance level.

[29:20] And we found unfortunately that only five point six percent of those hospitals are in compliance can’t say I’m surprised.
Well you can’t be surprised because the hospital’s also sued not to show their prices in our little train that could patient rights Advocate we wrote and mekas brief with the Supreme Court litigator who drafted it for both a lower court.
On advocating why patients.
Can save their money if they’re better informed to know prices in freedom of speech is to also give us the first amendment is to give us the right,
to know and be informed and we supported the Department of Justice being sued by the American Hospital Association and others and we want,
we won in the lower court we want in the Appellate Court and the good news is Merrick Garland who’s now our attorney general or the country was one of the three judge panel Zone that Appellate Court where.

[30:17] We won hands down in the hospital’s had to show their prices and starting in January
January 1st of next year the penalties are increasing to two million dollars a hospital but let me tell you when HCA brings in billions and billions double-digit billions of dollars a year.
Do you think two million dollars is a high enough fine I don’t ya not not not in my book.
Yeah no no so I think we’re going to have to see licensure accreditation maybe CEO and CFO attestation that they are complying with the law
and not out of compliance are probably factors that are going to be needed to get true enforcement.
In addition to higher fines but it’s a start and the good news is next year next year July first all of the insurance companies.

[31:09] Are to post all of the negotiated rates everywhere we get care outside of the hospitals Outpatient Care everywhere drugs post them online
and let us pull back the curtain so we can see whether our Blue Cross plan or our Aetna plan are actually performing well for us and then finally they’re also supposed to post all of the health claims data of what
they actually pay the hospitals and then that data can be used by Tech firms to basically create the modal mobile apps and the search engine searches to provide an economy online
that could be broadly accessible to any patient on their smartphone right the shop can you imagine when open enrollment
doesn’t just provide what plan you get but it’s going to be what you get in at what price and where and this is going to be huge because what we’re seeing now
is incredible Wall Street Journal just reported this week that the median M RI prices
very by a factor of 10 times across hospitals in earlier Wall Street Journal report looking at hospital data of the posted prices of those that are posting these prices and complying with the law,
found that at Sutter Hospital in California and this is happening within hospitals everywhere said childbirth for a C-section for instance.
One woman same day same team same Hospital paid a little over 6,000 for her C-section all in and another woman paid over 60,000 in the same day same Hospital.

[32:36] For having a baby c-section same coding,
10 X Factor within the same hospital for the same service it just depended on how lucky you were whether or not your insurance plan happened to negotiate a fair price
this is going to be the first time employers are going to get to open the windows have the sunlight shine in and see the data so that they can prevent the price gouging steer their employees to that high value.
Care and manage Healthcare like supply chain so that they can actually instead of seeing runaway increases from premiums actually
cut that cost in half put us on par with every other developed country but when we can pull this back then employers can say I want a fair price will send you to a fair price will reward you with higher wages,
and bonuses and guess what that’s what we got to take into the last Administration is we got to take in the price transparent
surgical centers and docks that were already changing the game as well as the employers that were directly Contracting with them and saving half on what they employees had to pay.
In care that’s huge it’s working its winning and this can be the way it is for all of us.

[33:51] Well Cynthia it’s not often that I get to hear news in the world of healthcare that really gives me an opportunity to feel very optimistic but this is really huge
and I don’t begin to know how to thank you enough for being the one
they took this fight on and it sounds like.
It’s really going to take hold and if I’m right about this there are millions and millions of people across the u.s. that will be indebted to you.
No thank you well you know like.

[34:31] It’s a team you know there are so many people that actually have pioneered doing the right thing
I am delivering great quality of care at known prices up front
that have pioneered this this field and believe and are working so hard to get there and I can highlight dr. Keith Smith and the entire Surgical Center of Oklahoma that I think for 15 years now has been posting their prices in there one price one patient all patient and they’ve only lowered their call
prices over the course of time and why is that.

[35:08] Because their Actuarial is have lowered their own insurance rates and they said well why I’m going to pass those savings on to my patients and the amazing thing that they tell us they’re in a Texas free market surgical that are doing the same thing or OSS surgical in your
Pennsylvania that are posting their prices online all of these dogs are saying Cynthia you know the actuary is a lowering our costs and rates
and we run our businesses knowing the costs and we pass the savings onto our patients because it’s the right thing to do and so they’re saving tens of thousands of dollars on a knee replacement for instance in OSS you can get it for,
thousand dollars and total knee plus all your rehab and every Imaging blood test and care and any follow care,
when you know bills from our Lancaster hospital nearby or in central Pennsylvania and Geisinger whatever are up to 75,000 for.

[36:04] Total me so when an employer and his employees can save.

[36:09] Nearly what would be a whole new employee in the new job you know over 60,000.
On a knee replacement that’s that’s huge and these guys Pioneer did and then the other part of it is.
We showed the employers we shine the light on the employers that said game over.
I’ve got to protect my employees and I got to lower our cost because
I need to control the finances and by doing so they actually create their own Pharmacy benefit programs where they buy expensive outrageous drugs at much lower costs from the Netherlands
right or Canada and they you know go to Walmart and create Employee Program plan
at Walmart with a much lower drug pricing plan and then also create their own network
and and step aside those that are ASO programs or third-party administrators that are lining their own Pockets along with the big plans.

[37:07] The big insurers and this is hard work.

[37:10] But think they are the ones that actually get the credit it’s not me it’s not us we’re just a little train that could that was the conduit
to bring their voices to Washington on how they are already affecting change and winning for the American people and you know we had to avoid Congress.

[37:31] Because Congress is in the bag with the lawyers and the lobbyists of the cartel so true.
Right so tell me we had to just do something smart we couldn’t play on that playing field right.
Because billions of dollars gets written to the politicians both at the state level and at the federal level and that’s sad we have the best damn government excuse my French that money can buy.
Yeah and and and that’s because your fault citizens united for a lot of that in until that’s reversed we had to look
add existing law to say where do we have these rights and the beauty and this is also this is a nonpartisan issue this is what surveyed three times over Harvard Harris poll Trump’s pollster Biden’s pollster.
Ninety percent of Americans agree.

[38:18] That they want Hospital insurance company physician price transparency before they get care and 87 percent of them know that they’ll be able to lower their own costs.

[38:32] When they can get these prices and the beauty is also that Obama and Trump and Biden all agreed,
on delivering Healthcare price transparency that’s so cool what other issue you tell me in this country Randy what other issue do we have a vomit rump and Biden having agreed on delivering.
In health care or in any policy issue and that’s Healthcare price transparency you’re so so right about that and the other thing that that underscores is that if so many seemingly disparate people
agree on this point yet nothing has changed it again speaks to the amount of money that is at work to make sure that it doesn’t change
you know clearly it’s always about the money but it sounds like,
maybe you and your organization and others have shined enough lights on it that we will see some change and Cynthia I’ve just been fascinated by hearing the story I am.
Inspired for the first time in my professional life to that maybe something really really good for the consumer
might happen and I and millions of other people will be grateful to you and your organization for shining little Delight on this and I’ve really enjoyed the conversation but what I’m going to do now is.

[40:01] Move along to what we always look forward to in the show and that is hearing you
speak to us on your own and not be bothered by my questions I’m going to close my Mike and Cynthia Fisher is going to give us her personal prescriptions for success
well thank you Andy if I may first just conclude with how important Healthcare price transparency system-wide is to the American
economy into the American patient is.
That price Discovery is the foundation that will also usher in quality transparency and when people and consumers and employers that help us,
get and choose plans can literally shop the question is what are we going to get and what is the quality of what we’re going to get,
and at what price and those questions start with price Discovery ushering quality.
Transparency and then unleashing the data on patient care because patients want to know will how many surgeries of knee Replacements does this physician.
Perform how many surgeries how many what are the outcomes of those surgeries what’s the infection rate what’s the readmit rate all of this.
Can be actually provided in quality rankings.

[41:27] Along with price Discovery and then I think there’s a really important part of medicine that hasn’t yet been revealed.
Even among clinicians themselves is when we a price Discovery and we have quality transparency we also get to see for the first time.
What is standard of care for instance what is standard of care for a mammogram and will we be able to see this.
Is it based upon the equipment that happens to be in that hospital or is it based upon you know 2D or 3D where is the standard of care and at what price and what is a fair market Price and I think that will be absolutely transformed.
Medicine and once patients are empowered with that they will not be satisfied to not have also access to their own health information
and I think when we see this we then put the patient with that empowerment of price transparency
quality transparency and information about their own personal health and standard of care that then we.

[42:28] Not only the patient on the top of that pyramid but we also move toward a preventative model that the patient knows with financial certainty.

[42:39] What it cost to preventively do diagnostics or preventatively take care of their health with no longer fearing Financial ruin.
For the uncertainty of being overcharged so I’m just very encouraged because I think it has multiplicative effects and its really the foundation of transforming a revolutionising healthcare,
so thank you for that moment to talk about Madden no matter where this country goes Randy whether we go to Medicare for all or we go to a Universal Health Care System plus private insurer.
No matter where we go we all benefit both as benefiting from government based health coverage to private based health coverage on knowing the F fair price.
And choosing quality Care at the best price and being.

[43:28] What is a free functional competitive market for the consumer okay so I’m sorry may I go back to your first question where you are going to give me the time too.

[43:42] You may but I understand and you can head so what’s the question again you can proceed with your prescriptions for Success whenever you’re ready.
Prescriptions for success I think.

[43:52] One is basically know thyself and to know that you we are not limited by anything other than our own.
Minds and Imagination and that hard work and.

[44:08] Tenacity pays off and I think also sort of that seek and you shall find but there are so many people that come across our lives that.
Are so highly knowledgeable and insightful and.
Worldly in their own disciplines of experience that actually can serve as.

[44:33] Really resourceful beacons of light for us.

[44:37] Personally on our personal life paths but also on our professional life paths and.

[44:46] I think you know the what makes the world go round is really relationships
and and people and so many people that are thought leaders in the best-in-class in their field or really making Market differences.

[45:02] Are truly accessible to us and it’s usually one or two degrees of maybe three degrees of separation.
On access to those introductions and I just think that human nature is really.
Good on many levels because I think people so many people when asked really do want to give
great advice or help,
others along the way to China at light and I personally my prescription for success is that was having the wherewithal to kind of get the gumption to go find and ask when needed on,
helping shine light on professional Pathways or an educational hurdle to overcome or even professionally in starting a business.
Going up knowing what I didn’t know and complimenting myself with people that did know and seeking these people to be involved on mission-driven Endeavor to make a big impact in
a big way and all of us have some level of skills and talents could obviously are better than others and probably my best
thing is just being so grateful for the wonderful people I’ve been able to surround myself with in by 2.

[46:25] Help either catapult opportunities to make a bigger impact or just even incrementally along the way shine a light of adjustments and fine-tuning and.
You know to take heed and take time to step back and listen I think another Avenue
is sometimes days are dark and Bleak and hurdle seem insurmountable for all of us and you know they’ll sign wave of life is the highs and the lows and
when we’re facing him no problem sets of life that seem sometimes somewhat unbearable sometimes it’s just going into the calm and taking paws.
And looking with Faith and Hope in light or asking just the universe
God whom you know whomever your is your go to and sometimes it’s just getting into nature or what restores your soul you know maybe a musician goes and.
You know sits at the piano for a couple of hours but it what restores one’s soul to take pause and listen and seek the answers.
And then I think finally is preparation.

[47:36] Is respect of everybody’s time when you are working with people by doing your own part and being very well prepared.

[47:45] And bringing them something of value that enlightens their day.
Intrigues their intellectual Journey where you know you can be additive so I think it’s just that you know it takes a team and working together and it’s no one individual that’s going to make an impact.
And complimenting ourselves you know I kind of think that.
If you ever go to Africa on a safari and you take pictures and you come home and you look at your photo album and you see the zebras are standing side-by-side but.
Their faces are and their heads are pointed in different directions in the giraffes are doing the same and you kind of look at how the animal kingdom is protecting itself,
they are covering 360 degrees and I it’s his human beings we can only see 180.
Degrees if we turn our heads left to right and we don’t see the what’s behind us that’s dark to us and alone we only see half,
of the 360 so if you compliment yourself with a teammate.

[48:54] For a partner or oftentimes it’s a life partner or business partner or a you compliment yourself with.

[49:01] Someone or others that cover the other 180 degrees that you cannot see.
That are dark to you that compliment you or your skills that’s where we actually,
take that Circle we see it we protect it and become so expansive because we see all 360 degrees and we’re being able to learn and protect and grow.

[49:24] And I think finally is just incredible gratitude.

[49:29] For every day and just knowing all we can do is our best and then get up tomorrow morning God willing and do the same and those are my learnings.
Him prescriptions for Success Cynthia thank you so much for sharing with us today I’ve really enjoyed this conversation
you have given me great cause to be optimistic and I’m very appreciative of that before we go I want to give you an opportunity to let our audience know
where you can be found whether it’s email addresses of course how to find patients rights advocate
. Horgan anything else you’d like to share please go ahead yes I can be found online through our organization patient rights Advocate dot-org and my email address is see
Fisher f is a chi are at patient rights advocate dot-org.
And if that’s too long you can use my other email address which is C Fisher at biomed.
20/20.com alright Cynthia a Fisher.
Founder and chairman of patient rights Advocate dot-org it’s been an absolute pleasure speaking with you today and I thank you so much for being here.

[50:48] Thank you Randy it’s been my pleasure.

[50:53] Thank you so much for listening today remember you can get more information about our guests as well as hear them face my rapid fire questions at our patreon site and.
While you’re there you can also subscribe to the podcast give us a rating and hopefully offer suggestions on what you’d like to hear in future episodes.
Thanks very much to Ryan Jones who composed and performs our theme music for us that’s all we have for now so please be sure and fill your prescription for success,
with my next episode.

[51:26] Music.