A letter to my kids about last week

Candidly, I have been struggling with how to write about the recent shooting of UnitedHealthcare CEO Brian Thompson — and all the vitriol surrounding it. History is being made all around us, so the only thing that make sense to me was to write something that I hope my own kids (almost 2 and 4) will read when they’re old enough. I asked a few close friends for feedback, and they encouraged me to publish it with a broader audience. Like me, they have been struggling to process the events of the past few weeks. This is outside the norm for Second Opinion, but it’s all I have to say at this moment. Have a wonderful evening.

Dearest M and T, 

I assume you won’t read this letter for at least a decade, and by then this news cycle will long be over and the public will have moved on to different topics. Perhaps by then we’ll have even made some meaningful progress in the right direction when it comes to securing your future — a cleaner planet, affordable education and housing, a more equitable health care system, and so on. I’ll admit that I’ve been feeling more cynical of late we're making meaningful progress. It has felt like one step forward, two steps back.

These past few weeks have been emotionally devastating for many people in the industry where your mom works. The CEO of the world’s largest health insurance company - Brian Thompson (known as “BT” to his friends) - was shot and killed in the streets of New York City, near where you live. The police now have a prime suspect, an Ivy-league educated young man who had a bright career ahead of him before all this happened. We don’t know what drove him to make this decision yet, or even if he’s guilty, but there are already plenty of theories circulating online. The whole thing is tragic on many, many levels. 

I'm writing this letter to you because I, your mama, have been involved in the healthcare industry for more than 15 years now - first as a reporter in newsrooms, then as an investor and advisor to lots of companies trying to make things better. And I intend to stick with it. It's been emotional few weeks for the people in my circle and network to witness the dialogue surrounding this event. I understand the impulse to stay quiet and stay out of it. It's often safer in these hot button situations to do so (take my advice on this one). But there is something essential that hasn't been said, and I hope it's something that will resonate with you.

Kids, you do not need to be complicit when confronted with a broken system where people are getting hurt and are struggling every day. You do not need to sit quietly on the sidelines. But even as you grapple with what’s broken, I hope you can still have faith in people. And to know in your heart that violence isn’t the answer — as we’ve seen from history, it invariably results in undermining the legitimacy of your stated mission or cause.

Our healthcare system here in America is indeed not doing right by its most vulnerable in its current form. You're probably familiar with these data points as I intend to share them with you in future conversations that we’ll have at the dinner table and as I walk you to school, but as it stands at the end of 2024:

• We have the highest cost health care in the world, and some of the worst patient outcomes;

• The U.S. is one of the only countries that still bankrupts people who are sick and vulnerable;

• Our population is getting older and sicker, but our birth rate is declining (I am terrified about the burden we'll be placing on your generation);

• We have the highest maternal mortality rate of any country in the developed world. 

• Health care visits between doctors and patients are now about 6 to 8 minutes-long, and our providers are reporting record levels of burnout. 

• We have a system that pays based on the volume of procedures, not patient outcomes. 

The list goes on and on. 

Yet, your mom meets people every day - both inside and outside the system - who are advocating to make it better. Some of these individuals have determined that the best path to creating that change involves working from within health care's largest corporations. There are valuable lessons to be learned in doing so -- health care is extremely opaque, and I’d argue it takes some inside knowledge to be able to fix it. 

Others have found that change must come from the outside – and there are reasons to buy into that logic, too. Over the past few decades, there's been an emergence of a “shadow” health care system that involves patients paying in cash for access to care (versus using insurance). There's this increasingly broad awareness that patients must be in the driver's seat when it comes to their care, and that they deserve access to their own health information. This is all positive in my opinion, because it's forcing the incumbents to adapt after years of resistance.

I personally know and interact with dozens of entrepreneurs every month who are working every day to do the right thing. Most of them do it knowing that the odds are stacked against them. But they are doing it from a place of passion: To build a better system for patients and caregivers and disrupt the status quo. 

In the polarizing world we live in, we sometimes forget that there are also incredible communicators (writers and reporters) out there every day driving awareness of what's wrong. Functioning democracies need journalists who are unafraid to shine a light and break down complicated topics in ways that people can understand. Let's not forget, too, about the vital role of policy and advocacy. There are so many powerful levers to drive change everywhere you look, and that gives me reason for optimism even in the darkest moments. 

I did not know BT. But I can tell you that he was a person who deserved to be recognized for his identity outside of work, as we all do. I have interacted with people this week who knew him well, and have felt crushed by the news. As my friend -- the psychiatrist Dr. Monika Roots -- texted me this morning: "At the end of the day, people are humans... they are not their job. They are mothers, fathers, children, siblings."

And yet, I also understand the anger that the public feels about how our health care institutions operate. Many of us have been touched by this in one way or another by the system, whether it's an erroneous health care bill or a denied claim for a treatment. It’s brutal when it happens and deeply unfair. We must do everything we can to fix it.

I hope that you'll find your own path to get involved in this work, and that you will remain open to any opportunity to provoke dialogue and learn. Change can be much slower than we would like because we live in a democracy. As the former Winston Churchill once said, “democracy is the worst form of government, except for all the others.”

We need our communicators, our advocates, our healers, our innovators and our entrepreneurs. I believe your generation will be defined by its change agents. Previous generations have let you down in some fundamental ways, so you’ll have to be. None of us can deny that you've been dealt a difficult hand, and you will feel an immense burden.

Even as you grapple with all of this bad stuff in the world, it is my greatest hope that you will be kind. I also hope that you'll learn to keep questioning and thinking critically (I can't even begin to imagine how advanced AI-based misinformation will be by the time you become young adults). So I deeply look forward to the conversations that we'll have at the dinner table with Dad, where you'll tell us that we’re old and wrong and you’ll teach us all the things that we don't know. 

Please keep endlessly questioning everything and to form your own opinions about the world in the process. Be curious. Respect people who see the world differently than you do. It's perfectly reasonable that your views evolve over time. Don't let anyone tell you otherwise. 

And don't forget to do your homework. 

Love always, 

Mom