I like my job – it has its moments of discontent, but for the most part I am able to use my nursing background in a creative way, developing and promoting programs for those who are most likely to miss out on access to good healthcare. At times because of immigration status and at other times economic status, all are on the fringes of society and third culture kids do well on the fringes. Sometimes daily and sometimes weekly I speak with women who have been diagnosed with breast or cervical cancer. Everyone of them has a couple of things in common: All are in various stages of trauma and all are desperate for one reason – none of the women I speak with have health insurance. Our program walks them through a process connecting them to health care, and in connecting to healthcare they are linked to life.

It’s in some of those moments that I have a fantasy of a courtroom. The jury would be The People and the trial “Health Care Executives vs. The People”. This trial would tell each womans story – how they came to find out they had breast cancer, the moment of silence that enveloped them as all other words became meaningless other than the big C, the state of shock and disbelief as they walked through the initial days where words like surgery, chemotherapy, and radiation suddenly became routine in their vocabulary and “cut, poison, and burn” became ok to be used on their bodies. Each women would have no mercy on the listeners, telling their stories complete with graphic exhibits. Exhibit A would show a picture of the breast that used to be and Exhibit B would show the head of hair they used to have before they lost both. Exhibit C would give the empirical data on cost of treatment, salaries, cost of insurance, and financial impact on their families.

Each woman would include in their narrative how they came to have no money to pay for treatment and stopped the chemotherapy or radiation recommended knowing that it could well be their death sentence. These details of the cost of insurance and treatment would be juxtaposed with tax returns of the health care executives of the major insurance companies in their state.

• 18 million includes base salary of $1,095,785 plus benefits (Aetna CEO – Ron Williams)
• 17 million includes base salary of $584,243 plus benefits including over 2 million dollars in a sign-on bonus (Coventry Healthcare CEO – Allen Wise)
• 13 million includes base salary of $1,144,000 plus benefits (Wellpoint CEO – Angela Braly)
• 8 million includes base salary of $1,300,000 plus benefits (United Health Group CEO – Stephen Hemsley)

The list would go on and each of the people listed would have a court order to be present, and answer to these women. They would have to face the shock of the women as they processed, with growing astonishment and rage, the information that the salary plus benefits of one CEO could pay the treatment costs of almost all of them. They would need to answer to the righteous anger that would undoubtedly be voiced at the greed and insensitivity of those removed from need and financial burden.

In my fantasy the trial is short but dramatic and of course The People win. It’s front page news and there is both rejoicing for the women and derision and disgust for the healthcare executives. But I am jolted out of my fantasy through the ringing of a phone and one more woman, newly diagnosed and in shock, to be a witness and tell her story in  my make-believe trial.

Bloggers note: All data is taken from FierceHealthpayer.com in their second annual review of health plan CEO compensation. Published in May of 2010.

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