In a public exchange California representative Katie Porter (D) persuaded Centers for Disease Control director Robert Redfield to promise free coronavirus testing for all Americans. It was a breathtaking example of the awesome power of advance preparation and research to help you reach your biggest goals.
Business books, magazines, and websites like this one are full of advice about how to achieve success. Dream big. Build your confidence. Embrace failure. But there's one incredibly simple tactic that will dramatically increase your odds of success. It's not used as often as it should be because it's labor intensive, and not particularly fun. It's spending all the time you need -- and then some -- to learn everything you can, and to reach out to everyone who can help. People in the military have a shorthand for this: "The six Ps." That stands for the phrase: "Prior preparation prevents piss-poor performance."
Porter started out with a single objective -- to obtain a promise from the CDC director in a very public forum that no one in the U.S. would ever be forced to forgo coronavirus testing because of its cost. She showed up to the hearing having marshalled all her facts, and having already presented her findings and requests to the CDC well in advance.
Members of Congress are limited to five minutes when they question witnesses, which is not a lot of time to get a big job done. So Porter had a meticulous plan of attack. She began with a series of questions to other health officials, teasing out the estimated cost of coronavirus testing, which amounts to $1,331. Isolation, if required, can cost thousands more.
Then she shared two disturbing statistics. Forty percent of Americans cannot afford an unexpected expense of $400, less than a third of what they'd need to get tested. And 33 percent of Americans put off medical care that they couldn't afford in 2019.
Next, she referred Redfield to CFR 42 § 71.30, a law which authorizes the CDC "in the director's sole discretion" to authorize payment for the care, examination, and quarantine of people with diseases. He acknowledged he was familiar with the law.
She asked her make-or-break question. "Dr. Redfield, will you commit to the CDC right now to use that existing authority to pay for diagnostic testing free to every American regardless of insurance?"
He began a vague answer saying, "We're going to do everything to make sure..." but Porter cut him off.
"Not good enough. Reclaiming my time." Then she asked again. Since Redfield had the authority to order the government to pay for coronavirus testing for all Americans, would he now publicly commit to doing so?
He began a second answer, saying he would "review it in detail," but once again she cut him off to reclaim her limited time.
"The time for delay has passed."
Porter held up a letter that she and two other members of Congress had sent to Redfield a week earlier. It explained the likelihood that people would forgo testing because of cost, referenced the law that gave him the authority to pay for testing, and it asked for an answer by the day before the hearing. "The deadline, and the time for delay has passed," she said. And then she asked her question again.
Redfield responded that he would be working with HHS "to see how to best operationalize it."
"Doctor Redfield," Porter responded, "You don't need to do any work to operationalize. You need to make a commitment to the American people so they come in to get tested. You can operationalize the payment structure tomorrow."
"I think you're an excellent questioner so my answer is yes," he replied. To some observers it sounded like he finally capitulated. To me it sounded like the answer he'd wanted to give all along but he'd hesitated out of what you might call an abundance of caution.
Either way, it was exactly what Porter wanted to hear, and -- of course -- she was well prepared for what to say next. "Everybody in America, hear that. You are eligible to go get tested for coronavirus and have that covered, regardless of insurance." And, having made the commitment, Redfield echoed her message, saying it was important that people "in the shadows" get the health care that they need during the outbreak. (Porter clarified that only those with serious symptoms should get tested, and that they should call for information before showing up at a facility.)
I've asked the CDC for additional information on how free testing will be accomplished and I'll update this column with any response they send. In the meanwhile, Porter's five-minute conversation with Redfield is a master class in how careful preparation can get you to your biggest goals. It's been viewed more than 20 million times. It's well worth watching.