December 22, 2007

CIGNA Healthcare kills someone, and we helped.

The headline on CNN reads "Teen dies hours after liver transplant approved."

17-year-old Nataline Sarkisyan had been in the fight of her life. She had leukemia, one of the most malicious forms of cancer. But she was holding her own in the battle, with the help and support of her family; her brother donated bone marrow.

But complications arose; between the chemo for the cancer, and the imuno-suppressant drug regime meant to prevent rejection of the bone marrow, her liver failed. Fortunately, liver transplants have become much easier to get because doctors have learned that you can divide a liver and not only will it function, it will grow.

So doctors sent a letter to CIGNA Healthcare explaining the need for the procedure; without an immediate replacement, Nataline would die.

CIGNA replied that there was lack of evidence that the procedure would work, and rejected it. Eventually, as Nathaline's health deteriorated, after she slipped into a coma, after she was reduced to a vegetative state, and only after hundreds of protestors rallied outside their Glendal headquarters, they relented and grudgingly agreed to cover the procedure.

Nataline finally went in for transplant surgery, after weeks languishing in a vegetative coma due to her failed liver. She died hours later.

When the doctors made the request of CIGNA, her six-month survival chances were estimated to be 65%. She might well have died anyway; it's no secret that her health was poor.

But without the liver, she had NO chance. WITH the liver, she had a good chance.

We Americans have made a terrible mistake; we've turned our lives over to heartless corporations whose primary purpose isn't our well-being, but paying out dividends to their stockholders. Yes, these huge conglomerates provide healthcare, but only as a way to make money to pay their stockholders.

We pay insurance companies like CIGNA in the belief that when we really need them, they will be there for us. We spend significant portions of our income so that if things get bad, our insurance companies will step in and get us through it.

But it's a lie. Companies like CIGNA will pay - but only if THEY think it's a sound investment. "You'll die without it? Hey, you might die anyway, and our dividends will be less, and that will upset the stockholders!"

We need to stop participating in health plans run by corporate machines that are designed to produce profits for a select few; while a shift to non-profit health plans may not completely eliminate this kind of calculated culling of our ill children, but at least it won't be for the purpose of lining someone's pockets.

CIGNA's delay in approving the procedure substantially contributed to the death of a 17-year old girl. But we put CIGNA in a position to do that. WE decided that our health should be a commodity to be brokered, WE decided that our well-being should be bought and sold like a side of beef.

CIGNA made a life or death decision, without considering either life OR death. And we let them do it.

Last year, CIGNA reported 16.7 billion dollars in revenue. How many people died for that?

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  1. Lawd knows this topic has received its share of attention. And we get no closer to a solution.

    What I can't comprehend is how the doctors themselves lost control of health care. How they let this get away from them. They're as unhappy with the system as their patients.

    Happy birthday, Frank. Man AND Maniac!

  2. I agree. Doctors, suposedly, go into medicine to take care of their patients. Now health care is big business and everybody wants their cut. Why couldn't the surgeons have operated and then battled with the insurance companies?

  3. It should not be up to the doctor to worry about how to be paid.
    The hospital is to blame for having policies that insist on insurance approval.
    They could have discussed the procedure and fee with the parents then went ahead with the procedure and 'let the finances take care of themselves' later. If the parents still refused to do the treatment then it falls in their lap.
    People seem to have no problem taking a second mortgage on their homes to get a HUMMER or a Navigator. ........

    I KNOW there are people that would donate money to the family to help pay those bills!

    Why didn't the hospital just go ahead and do the procedure?
    Why wait for insurance at all?

  4. Doctors in America don't work unless they get payed and insurance companies don't pay. Do you wonder why americans want universal healthcare even though they know the government will muck it up? Here's you answer.

  5. oops! I meant paid! Getting senile

  6. Policydrag wrote: Why didn't the hospital just go ahead and do the procedure? Why wait for insurance at all?

    That's a fair question, and one that I had asked myself at the start. I don't have an answer; my research hasn't produced one.

    My best guess is that as a contracted hospital (one that has an agreement with the insurance company), the hospital agreed not to override decisions made by the coverage provider. This was not uncommon when I worked in hostpital billing 20 odd years ago.

  7. I found your blog rather interesting. Cigna Insurance is one of the few insurance companies which does not have too many negative reports. It seems to pay out the reimbursement in time, in full amount. The customer service is also impressively good. though displays people’s dissatisfaction with the company. Obviously, there are some gaps in the way the company provides its services.