How it all Started


"How it all Started"

So you are just told you have a choice, bypass surgery or a nutritional change. Here I am on a gurney and that is what options my cardiologist gave me. I knew all about bypass surgery first hand. My father had a quadruple bypass and I saw him cry for 3 days straight. All three of my uncles had it and one of them died and the other was never the same. I also have 3 sons and this heart disease in my family had to stop! So I thought it would be easy just to eat a little differently. Little did I know how different my life was about to go. You see I was very sick with the heart disease and needed 3 months of bed rest. During that time I learned how to cool Whole Food Plant Based. But mostly I steamed a lot of kale and eat a lot of brown rice and beans. Soon I started feeling better and started to realize I was NOT a good cook. So I went to Dr. and Ann Esselstyn ½ day cooking class. The cost was under $1000.00 and I learned so much. I sent the receipt for payment to Blue Cross/Blue Shield (BC/BS)  and got denied. I thought this is so wrong that they would pay $130,000+ for bypass surgery  but not reimburse me for $1000.00. I thought this was my giveback to Michigan. So I started to go up the chain of command at BC/BS and with each level I got rejected. I finally got to the last level for consideration. Please keep in mind I had one of the best medical coverages they offered. Their reply most important point was “The seminar may have been of value to the Petitioner in his effort to improve his cardiovascular health with a better diet. However, the director can find nothing in the certificate that would require BCBSM to cover it based on record here”.  They went on to say that they would need a diagnostic code and CPT code for repayment and to receive those code you would have to work with BC/BS and the Michigan legislature. PBNSG was born that day in my mind. I thought that if we got big enough we could one day help make  that change. I hope that day will come soon!

Jim BallaComment