Nancy Brinker Remarks at FAHP Annual Conference (Nov 2022)
Remarks as prepared for delivery.*
-November 18, 2022-
Florida Association of Health Plans Annual Conference, Orlando, Fl.
Thank you all for inviting me and thank you Audrey for your friendship, and the incredible leadership you bring to FAHP. I always enjoy speaking to this group because FAHP is full of problem solvers. And I have spent my life around people who work to solve problems. That could be because I get restless. Or it could be because as an adult, I was diagnosed with attention deficit issues, making it hard to stay focused for long periods. My mind is a lot like an internet browser – there are 17 tabs open, 3 are frozen, and I have no idea where the music is coming from.
But I do okay for myself. I compensate by trying to tackle big problems, laying out detailed plans, and putting a laser-like focus on getting results. I’ve done it throughout my life, and I’m doing it now through the Promise Fund of Florida.
One thing I admire about FAHP is that your mission is to improve access to high quality, affordable health care through a competitive marketplace. And that to do that, you work to develop cooperative relationships between public and private stakeholders. When it comes to health care, I can’t think of anything more important. Which is why I am excited to update you about our work at the Promise Fund – where our model is built on the same principles as your mission.
My adult life has been spent on health care – cancer care, specifically. And it all began with a phone call decades ago from my sister Suzy. Suzy was beautiful and lively, and a doting young mother to her kids. And the doctors had just told her that she had breast cancer.
At the time, we made sure that Suzy had access to the best care available – even flying her to Houston for treatment at the MD Anderson Cancer Center. There, we watched dozens of women – either poor or new immigrants or non-English speakers – huddled in small waiting areas for hours and days hoping to see a doctor. It wasn’t right. And I remember Suzy telling me, “Where a woman lives, shouldn’t determine whether she lives.”
Suzy fought so bravely. And before she died three years later, she made me promise her that I would do everything in my power to ensure that no women would die from breast cancer. That promise has been the purpose of my life.
So, we founded an organization in her name. We raised and invested $3.2 billion dollars — $1 billion dollars for research, and the rest for education, screening and treatment programs. And we raised awareness, bringing this disease out of the shadows.
I’m proud of those accomplishments. But when I think of the promise I made to Suzy, I’m also haunted by her words in that waiting room. That a person’s location, or language, or economic status… should not determine whether they live. That is why my friends and I created the Promise Fund of Florida.
The Promise Fund has a mission to help women overcome barriers, improve health equity, and reduce deaths from late-stage breast and cervical cancer here in Southern Florida. We do this through a unique patient navigation model, and through partnerships with health care providers and community resources.
We know that when caught early, breast cancer is 99 percent curable, and cervical cancer is 95 percent curable… 99 percent and 95 percent… And yet, there are still too many women dying of these diseases right here in our own backyard. Why? Because our health care system is too complex for many people to manage – especially those with few resources. For these women, an otherwise treatable diagnosis for cancer can still be a death sentence.
Maggie Keswick Jencks was a trailblazer in Scotland. She was diagnosed with breast cancer in 1988 and age 47, and passed away five years later. Before her death, she and her husband worked to found Maggie’s Center, a place where cancer patients could receive support and information. Today, there are Maggie Centers throughout the United Kingdom.
Before she passed away, Maggie wrote elegantly about her cancer experience. And she noted two particular findings:
First, despite her initial fears after her cancer diagnosis, she began to feel better when she took a more active role in her own treatment. Going from “passive victim” to “active participant” was the single most important step she took in dealing with the disease.
Second, the massive amount of materials and options for cancer care were overwhelming. She described it as an “assault of information.” And this was thirty years ago! Maggie said that everyone living with cancer needs a reliable guide to help them.
What Maggie described is exactly what the Promise Fund is doing. We are giving agency to women who might not otherwise feel like they are in control of the situation. And we are giving them experts who can help navigate their own personal situations.
In my own life, I have received a breast cancer diagnosis. And despite the years of background I had in breast cancer, it was still terrifying. Now, imagine being a woman who receives that diagnosis, and who doesn’t have insurance – like the 80,000 women in Palm Beach County who don’t. Or who doesn’t speak English. Or who is the only financial provider for her family and can’t get time off.
These are the women we must help. And we are.
The Promise Fund is not a center for referrals. It is a long-term approach to laying out a course for patients, and then helping them complete it. This can entail almost anything.
We help schedule appointments with the right specialists.
We obtain child care when needed.
We get them groceries if they have none.
And we work with rideshare and transportation companies to ensure they can get to their appointments.
In some cases, this requires our navigators to go the extra mile… literally.
For example, the closest public cancer treatment center that accepts our uninsured patients is in Tampa, nearly four hours away. So, when no other options are available, our navigators drive them there themselves, with the Promise Fund reimbursing them for all travel costs.
But it is absurd there aren’t better options available locally – so we have been working with health providers in Palm Beach County to do more pro-bono work for these patients.
We will not quit on these women, and they know it. As one of our clients Mirna said about her navigator, “She is my confidant. My person in whom I find support.”
The power of this approach is that it engages every level of the community. This is critical. And in doing so, the program itself becomes a force-multiplier.
For many of these women, it is their first time in the health care system. And we ensure they have a positive experience with it. And then they return, often with friends or family.
What we are creating with the Promise Fund is a gold standard model of private sector action. And this is not a model we are keeping secret. We will share it with everyone, so they can learn from our successes and our failures – and replicate in other regions.
And that brings to me a topic everyone tells me not to talk about – politics. I could say that at my age, one gets tired of listening to other people tell you what to say. But the truth is, I’ve never liked people telling me what to say at any age…
The United States has just completed a midterm election. Florida has just completed our statewide elections. Now, it’s time to get to work!
In the decades I have spent working in cancer care, I have seen how cancer is the great equalizer. Cancer doesn’t care about your party affiliation, who you voted for in the last election, or whether you voted at all. Every one of us has a stake in improving cancer care in this nation. And we all need to work together to get it done.
Last summer, the Promise Fund was honored to welcome First Lady Jill Biden for a tour of FoundCare Palm Springs, a Federally Qualified Health Center where we have co-located the Promise Fund Women’s Health Center. This center houses a 3D state-of-art mammography machine donated by Hologic. Prior to the center’s opening in 2020, only 10 percent of FoundCare patients with orders for a mammogram received one. Today, nearly 60 percent do.
The First Lady was there to highlight President Biden’s cancer moonshot initiative. This initiative is seeking to reduce the death rate from cancer by at least 50 percent over the next 25 years. And over time, end cancer as we know it today.
This is a goal we can all get behind. But, meeting it will require cooperation between the public and private sectors, and between our political parties. We must ensure the funding is there to support programs that are demonstrating results.
I am grateful that the Promise Fund has received nearly a half-million dollars in funding from the State of Florida. With this financial support, we are adding 7 new patient navigators giving us a total of 18! And as we can continue to grow this program, we hope others will see this as a model to emulate in their own communities.
Because as we increase early interventions and screening, we will be dramatically lowering health care costs as well. Mary Lasker was one of the greatest health activists of the 20th century. It was an honor to meet her a few years before she died, and I’ll always remember when she told me, “Nancy, if people think prevention is expensive, they should see what it costs to treat the disease.”
She was a wise woman. We know that treating a woman with advanced stage breast cancer will cost more than $200,000. While the cost of providing that same woman with a mammogram would cost $200 or less.
From a public policy standpoint, this is a real win-win. But more importantly, it is a victory for women like Marie.
Marie had been diagnosed with breast cancer three years before she arrived at the Promise Fund. After she had been diagnosed, she had done nothing because she lacked the resources. Fortunately, Marie heard about the Promise Fund through a local Haitian radio station.
The Promise Fund connected her with Sheena, a patient navigator who spoke Marie’s native language of Creole. At that point, Marie’s lump was getting larger and she was in a lot of pain.
Within three weeks of connecting with Sheena, Marie received a pet scan, MRI and had a port placement for administration of her chemotherapy. She is currently receiving chemotherapy and has a good prognosis. Her oncologist is amazed at how well Marie is responding to treatment.
This is the way we can save lives. By taking the tools that we already know are effective, and ensuring that everyone, everywhere can access them. Because it’s not enough to just point people in the right direction and turn a blind eye to the barriers they will face along the way. We must help them overcome the obstacles.
My idol, Marie Curie, who is the only person to win two Nobel prizes in two different sciences, said, “I was taught that the way of progress was neither swift nor easy.”
She is right. Progress is never easy. In my own life, I’ve been hung up on, escorted out of board rooms, and told that what I’m working toward is impossible. But it is not. It is achievable. But only when we work together and refuse to quit.
Thank you for supporting the Promise Fund. And thank you for having me today.