They're calling it 'murder by spreadsheet' — CIGNA refused for 20 days to OK a liver transplant for Natalee Sarkisian, a teenager who died today, ironically only shortly after demonstrators and a tidal wave of bad publicity forced CIGNA to reverse its negative decision.
The 20-day delay, during which the family had to decline at least one suitable transplant opportunity due to lack of funds, is said by the family to be the proximate cause of death — although this was a very complex medical case.
We need national health insurance. (Not insurance companies for everyone.)
yes. and the whole healthcare system will be more efficient than what we have now, if it is done right.
I”m quite skeptical of stories like this. I really, really want national health insurance. The waste in our present system is appalling. I don’t like insurance companies in general. BUT stories like this are almost always reported incorrectly by the media. My guess is that a rational national health insurance system would likely have denied this girl a transplant as well, but that’s just a guess.
Well, I can actually believe this story, given my partner’s experience with Cigna. She was diagnosed with a rare form of cancer in late November, 3 days before Thanksgiving. Got to see a top-notch gynecological oncologist 2 days before who wanted CT scans etc STAT. Got the appointment for the day after. BUT Cigna shut down their pre-approvals the day before thanksgiving. Yes, indeedy, there was no one at Cigna to process the paperwork, AT ALL, the day before Thanksgiving. Well, the oncologist said “Stat,” so we went ahead.
Cigna denied the CT’s originally. So, my partner got on the phone, said “rare cancer” and “closed Cigna office” a lot. Eventually, she was retroactively approved. What we learned:
1. The radiology center wanted $1,800 from us for the tests.
2. They accepted the $700 as payment in full when Cigna finally approved everything.
It’s at the point I realized that people with OUT health insurance subsized the insurance companies.
Yes, we need a single payer, governmental program NOW!
BTW: It’s 6 years out, and my partner remains cancer-free. Her employer eventually dumped Cigna.
Look, my point is that Cigna might be evil and that we certainly need national health insurance, but
1. She was in a vegetative state before any liver was available. That suggests that a transplant would have been a waste of a good liver that went to someone else who needed it.
2. Her doctors in the appeal, the ones with the most stake, estimated 6 month survival of 65%. That’s terrible odds from people who have incentive to be optimistic.
3. Other doctors estimated that the liver transplant given the underlying leukemia (which was not in remission since the bone marrow transplant had only been recently performed) would have not been successful at all.
So you must understand that had the situation been under a national health insurance plan, the procedure would still have been denied.
Elliottg has a point. Every system of health care imaginable will involve some sort of allocation system, and not every single person will get what they want. (Prices, after all, are a form of rationing too.)