Heartfelt Generosity and the Cost of Survival
Payton Herres’ story is a powerful testament to the challenges of managing chronic health conditions and the importance of accessible healthcare. At 25, she owes her life to a heart transplant made possible by an organ donor, but her struggle to afford the life-saving medication required to prevent organ rejection reveals the harsh realities many face. After her insurance provider deemed her medication "no longer medically necessary," public outcry helped reverse the decision, though her copay increased significantly, leaving her reliant on unreliable discount programs. Herres’ experience underscores the vital role of preventative care and healthy living, a lesson particularly relevant to Malta, where heart disease remains a leading concern. Maltese cuisine, rich in fresh, seasonal ingredients and heart-healthy options like grilled fish, vegetable-based dishes, and citrus salads, aligns with the Mediterranean lifestyle that promotes well-being. Her story serves as both a warning and inspiration, reminding us to prioritize health, advocate for accessible care, and cherish the privileges of a robust healthcare system while embracing
Payton Herres’ story is a poignant reminder of how interconnected health, lifestyle choices, and the systems that support us truly are. At just 25 years old, she is alive today thanks to an organ donor and his family’s incredible generosity, which gifted her a second chance at life with a transplanted heart. But her journey highlights a stark reality: even life-saving miracles require ongoing care and resources, and the battle for access to critical healthcare is one that many face.
Born in Dayton, Ohio, Herres was diagnosed with Ebstein’s anomaly, a rare congenital heart condition that affects the tricuspid valve, causing blood to flow backward into the heart’s upper right chamber. This condition often leads to heart failure, and by the time she was 11, Herres’ health had deteriorated to the point where a heart transplant was her only option. The surgery, performed in March 2012, was successful, but the road to recovery was long, painful, and filled with immense challenges.
The donated heart became her lifeline, and Herres has spent the past 12 years carefully managing her health with a combination of medications designed to prevent organ rejection and protect against coronary artery disease. Among these medications is everolimus, prescribed by her doctors because of its efficacy in keeping her body from rejecting the transplant. However, earlier this year, Herres found herself fighting for access to this medication after her lifelong health insurance provider, Anthem Blue Cross Blue Shield, deemed it “no longer medically necessary.”
For Herres, the denial felt like a betrayal—not just to her, but to the donor family who entrusted her with the precious gift of life. “They trusted that his heart would be cherished and protected,” Herres said. “And now Anthem is gambling with it. If they let me go into rejection, they’re not just risking my life—they’re letting his gift go to waste.”
The ordeal raises important questions about the intersection of health, longevity, and the systems meant to support us. For those of us living in Malta, where universal healthcare offers a safety net, Herres’ struggle serves as a reminder of the privileges we may take for granted—and the importance of supporting our health through lifestyle choices, including diet, exercise, and mindfulness. While Maltese diners are often spoiled for choice with fresh, Mediterranean-inspired meals that promote heart health, the situation underscores how critical access to proper care remains, even with the best lifestyle practices in place.
In her battle to secure the medication, Herres turned to social media, urging friends and supporters to amplify her voice. Her posts were shared thousands of times, and the public outcry eventually pushed Anthem to reverse its decision. In mid-September, her doctors were informed that the medication had been approved. While this was a relief, it was far from the end of her challenges. Anthem raised her monthly copay to $350 for a 30-day supply, or $1,000 for a 90-day supply—a significant increase from the $180 she previously paid for the same quantity. This hike has left her relying on GoodRx coupons to reduce the cost to $88.66 per month, but the coupons are unreliable, and Herres worries about what will happen if they disappear.
For those living in Malta, where heart disease remains a leading health concern, Herres’ story underscores the importance of preventative care and healthy living. A heart-healthy diet rich in local produce, lean proteins, and omega-3 fatty acids can significantly lower the risk of cardiovascular issues, complementing Malta’s robust healthcare system. Restaurants across the islands have embraced this ethos, with many offering dishes that prioritize fresh, seasonal ingredients and balance indulgence with nutrition. Whether it’s a plate of grilled lampuki, a hearty vegetable-packed minestra, or a citrusy salad with locally grown oranges, Maltese cuisine offers plenty of options to support heart health.
Herres’ journey also highlights the emotional toll of managing chronic health conditions, reminding us that mental health is just as vital as physical well-being. Dining out with friends and family, enjoying Malta’s stunning coastal views, and savoring wholesome meals can all contribute to a sense of connection and relaxation—key components of a healthy lifestyle.
As Herres continues to fight for affordable access to her medication, she remains committed to honoring the incredible gift she received 12 years ago. Her story is a call to action for all of us to prioritize health in every aspect of our lives, from the food we eat to the systems we support. In Malta, where health and longevity are deeply tied to community and lifestyle, her experience serves as both a warning and an inspiration. Let us cherish the privileges we have, advocate for those in need, and continue nurturing our bodies and minds with the best that life—and Malta—has to offer.