MY father, who was born and raised in Panama, became an American citizen by joining the Army when the United States operated the Panama Canal. He moved to the United States in the early 1950s, attended Howard University, met my mother and became a successful architect.
I grew up in Rockville, Md., and had a newspaper route as a child. Even though my family was prosperous, I wanted my own money.
When I was in high school, I heard about labor strikes and other workers' rights movements. I didn't immediately understand how people could put their families at risk financially by joining a strike, so I asked my guidance counselor. She explained to me what labor-management disputes were all about. I thought I might become an arbitrator.
My father insisted that I attend Cornell University, but I told him that it was my decision. He said, "Not if I'm paying for it." I visited the school ready to hate it, out of spite, but I loved it. My studies included a course in economic security, which was about safety nets like Social Security and Medicare. I learned that labor costs were making American products less competitive. My research showed that exploding health care costs were driving up labor costs.
I graduated from Cornell in 1983 with a bachelor's degree in industrial and labor relations, then got two master's degrees at Florida International University, in health care services administration and international business.
After graduating, I worked as a stockbroker, specializing in health care stocks, and advised small businesses about their health care benefits. I did that until the market crashed in 1987. Next I became the marketing director and then executive director for what was then the JMH Health Plan in Miami. Following that, I was an executive for the Neighborhood Health Partnership for five years.
In 1998, Jeb Bush, then the governor-elect of Florida, appointed me as secretary of the Florida Agency for Health Care Administration. It meant moving my family from Miami to Tallahassee and giving up my seats for Miami Heat, Dolphins and Marlins games, as well as those of the Florida Panthers of the N.H.L. That was hard. But when a governor asks you to perform a public service, you can't very well say, "I'm busy that day."
During my tenure, Governor Bush suggested that I talk to his brother George W., then the governor of Texas, about my thoughts on health care policy, which I did. After George W. Bush won the presidency, people told me to expect a call to join the new administration. Even so, I was shocked when it came. In 2001, I became chief operating officer for the Centers for Medicare and Medicaid Services in the Department of Health and Human Services. Two years later, I served as senior adviser to the Treasury secretary and led an effort to reform tax credit policies for the uninsured. From 2010 to 2012, I served on a committee for the Obama administration to help decide Medicare procurement policies.
In 2004, I began devoting more time to Mansa Equity Partners, which I started in 2003 as a holding company for my investments. I'm also managing partner and chief investment officer of the Mansa Capital fund. With $30 million under management, it's Mansa Equity's largest asset.
I attribute my success to my mentors. My Cornell professors first inspired me to connect labor costs with health care costs and helped me understand the future implications. Then I was lucky enough to work for visionaries in the health care industry who saw potential in me. I'm especially proud of my public service, a highlight of my career.
As told to Patricia R. Olsen.
This article originally appeared in The New York Times.