Posted on 12/21/2007 4:37:17 AM PST by Erik Latranyi
WESTWOOD -- A Northridge teenager awaiting a liver transplant died Thursday after she was pulled off of life support.
CIGNA Insurance Company initially refused to cover the cost of the transplant for Natalee Sarkisian, saying the surgery was too experimental.
On Thursday, friends, family and members of a nurses association held a protest outside CIGNA headquarters in Glendale, urging the insurance company to reconsider. During the protest, Natalee's mother got word CIGNA had changed its mind and would make an exception for Natalee's surgery.
But the decision came too late for Natalee. Just after six o'clock tonight, her condition worsened. Natalee's family took her off life support and she passed away.
Attorneys for the Sarkisian family may pursue legal action against CIGNA HealthCare.
The liberals are carrying on about how we need socialized medicine based on this example while ignoring the thousands of similar stories from countries that have universal healthcare.
Insurance companies suck! Liver transplants are not experimental.
Socialized medicine is not the cure.
Perhaps they wish this so more people can die.
This is just such a sad story though. It goes to show that the insurance industry does need reform... but going socialist is not the answer.
Under the British or Canadian system, there never would have been a question of a transplant. They would have just taken the girl off life support immediately.
Unless, of course, she was designated as a “national treasure”, as they do in the UK. Specially designated People Who Matter (PWMs) get access to all sorts of treatment that would never be allowed to the common people.
There has never been a Socialist system devised, anywhere, that did not include a way for the elite to escape the ministrations of their benevolent creation.
And these DUmmies think that the government will do better in situations such as this? The same government can’t issue passports in a timely manner, but they would be in charge of issuing approval for transplants and other complex medical procedures. What area of our lives that the government has taken over has improved over the past 50 years? I can’t think of one.
It usually entails a trip to the USA and paying cash.
So you have to ask - without knowing the whole story - why didn’t the parents just go ahead and do it, and worry about the bills later ?
Plenty of time to take the insurance company to court after the transplant is done...
Call me a cynic, but something doesn't look right about this case. The parents are holding protests demanding treatment that the insurance company says is experimental and probably ineffective. Then when they win, they immediately take the girl off life support.
It could be coincidence, or it could be that the eeeeeeeevil CIGNA was right all along, and the treatment was not appropriate in this particular case, and faced with the prospect of futile surgery, the parents made the rational choice.
Since we have no additional information, it is impossible to say which is true.
Oh, wait a minute, now the family is talking lawsuit... Hmmmmm...
So, why didn’t the family just tell the insurance company where to get off and work out some way to pay for the transplant out of pocket? Take care of the child first and then worry about costs. You know any jury would award the child a nice lifetime trust from the insurance company.
Out of pocket? Liver transplants cost several hundred thousand dollars.
I wonder what was “experimental” about a liver transplant?
If you are a Person Who Matters (PWM) in Canada, the Canadian government will pay for you to have treatment in the United States that they do not have the ability to provide themselves. PWMs can always count on adequate care. It's the PWDM who wind up dying waiting for a simple procedure.
Of course, one wonders where the Canadians will go for care once the United States health care system has been destroyed along their model.
The Free Republic understatement of the day! I'm a pilot. My experience with insurance companies as far as airplanes go is that they really are no longer insurance companies at all. They are law firms masquerading as insurance companies....
Probably not the transplant itself, but whether a transplant would actually correct the condition.
Just guessing, however, since there are a lot of missing details here.
<sarcasm>
Because everyone knows that it is impossible to get care without an insurer paying for it!
</sarcasm>
In all seriousness though... I wonder that as well. Home equity loans, credit cards, lines of credit... If that is what it took to save my children and I could get them, I don't see any other option but to make use of them.
Exactly,
Thousand’s die on waiting lists in the countries with “universial health care”.
Good point. Maybe if the "friends, family and members of a nurses association" held a fund drive instead of a protest, she'd be alive today.
Then again, maybe her parents believed the insurance company's claim that it was experimental, she'd die, and they'd be stuck with $300K in medical bills.
“I’m a pilot. My experience with insurance companies as far as airplanes go is that they really are no longer insurance companies at all. They are law firms masquerading as insurance companies”
Many insurance companies will deny claims at random just to see if the people will dispute it. Things like denying every 10th claim or large claims are common place.
No source that I can post. My source is a ex-director at a local insurance company and others in the medical field.
The coincidence that “the turn for the worse” happened to coincide with the surgery being approved seems suspicious, to me.
That would explain our experience. We got new insurance a few years back, and my wife scrutinized every bill and EOB form. She is a wonderfully detail-oriented person. Things would get denied for no reason at all, and she was constantly calling to get things corrected.
After a while, they stopped making mistakes. It appears of file has been placed in the "Won't take any sh!t" pile, which is a pretty good pile to be in!
PBR’s correct. It was probably an inborn error of metabolism like Gaucher’s disease or Hurler’s syndrome. There are enzyme defects in both the liver and other organs and people will sometimes grasp at desperate measures seeking a cure.
So what would have happened had they not had insurance at all???
Then again - what would have happened if they were citizens of Canada or Great Britain?
Agreed.
I would really like to know the whole story on this one.
The purpose of establishing a government health care system is so that a government agency can routinely deny medical care in the same manner as the insurance company did in this case -- BUT WITHOUT ANY EXPOSURE TO PATIENT LAWSUITS.
Tell that one to the folks over at DU and see what they think about it.
So what makes this OK and the Terri Schiavo incident not OK? Shouldn’t insurance companies do everything possible to assure someone’s right to life? What makes an insurance company’s decision to not pay for a procedure which assures someone’s imminent death ethical? </stirring the pot!>
I found this on another website:
“The 17-year-old, who has recurring leukemia, has been on a waiting list for a new liver because she developed complications after a bone marrow transplant and chemotherapy.”
Having worked in the health insurance industry for 17 years for big national companies and smaller regional ones, I can tell you this is BS. Health Insurance companies are tightly regulated by the states in which the coverage policies are written. In most states, medical necessity criteria used to deny claims must be scientifically sound AND approved by state regulators.
Any such policy of random denial would be quickly spotted by the regulators. Furthermore, there would be far fewer denied claims if physicians didn't instill unrealistic expectations in patients and order unnecessary tests.
>> There has never been a Socialist system devised, anywhere, that did not include a way for the elite to escape the ministrations of their benevolent creation.
That is a universal truth, my FRiend, and somehow it ought to be front and center where we can all be regularly reminded of it. How about we tattoo it on Hillary’s forehead?
Freep-mail me to get on or off my pro-life and Catholic Ping List:
Please ping me to all note-worthy Pro-Life or Catholic threads, or other threads of interest.
I own a grass strip and used to run a not for profit glider club from my strip. I was told by AIG that I could not use a general liability waiver to protect myself from the club members because, as an agent of the insured, it might prevent them from suing me for negligence if somebody insured with them balls up an airplane on my runway and as a result AIG has to pay a claim for the damages. Essentially, AIG wanted to reserve the right to come after me to recoup their losses, regardless of whether I was at fault or not. That is not insurance. That is a law firm masquerading as an insurance company.
Needless to say, I no longer tow gliders from my strip and I do not allow anyone to operate from my strip besides me. AIG was foolish enough to send me a statement to this affect in writing, which was promptly forwarded to the State Insurance Commissioner. The Commissioners office seems pretty interested in this tact of AIG, although I'm not at all hopeful that anything will come of it.
That’s interesting. CIGNA already paid for a bone marrow transplant that fried her liver. Now they’re looking to get her a new liver, too?
Wow!! You are right on the money with that! Insurance has already socialized our medicine. You can go to this doc, but we won’t pay for that one. You may have 30 days of meds, but NOT 31. According to your numbered diagnosis, we will not pay for treatment. We need to get back to the days of cash medicine. Insurance is and has been a scam from the beginning. That being said, I have it for my kids.
At DU?......This IS socialized medicine! When A family cannot decide what’s right for their children, THAT is socialized medicine....
Is anyone taking into account that the person who was taken off life support was a child? This child did not have the financial ability to pay for the surgery. She was completely at the mercy of her parents and the insurance company. To me, that is the tragedy here.
Before anyone gets started, no, I am not in favor of “socialized medicine” or the S-Chip. It absolutely saddens me when a child’s life is cut short, particularly when something could have been done. God bless this child’s soul.
Can you imagine what would happen if liberals had their way with cloning and universal healthcare?
They would keep cloning and installing parts into people not matter how terminal they might be and regardless of the ethics.
I won’t dispute your contention. As I said, I was looking at it from the consumer’s point of view, where it is very difficult to see any sense in the procedures. To us, it appears random.
It could be they cleaned up their act, generally. Or maybe our doctors got better at filing claims. Hard to say. I will say we have been having remarkably fewer problems in recent years.
Thats the company I have...I hate dealing with them.
They would have been protesting in front of the local government health office. Good luck with that!
Doctors don’t like to tell families that there is nothing more they can do.
Doctors will install parts and do anything....provided they are paid.
Oh, how about the availability of a liver? Just because you are approved for a transplant does not mean one if immediately available for you!
There is a lot more going on here. This girl had leukemia and just received a bone marrow transplant and chemotherapy.
Are you responding to my post? I do not recall taking a position with regards to the EVIL and GREEDY health care providers
I have a friend who had a liver transplant in the fall,,her bills are up over a million already.
Companies like CIGNA however want the private system insurance to collapse as do several other major underwriters. The reason being why not handle the funds for ALL Americans medical cost? CIGNA is a major Medicare HEY MOE as well. The Medicare reforms that Dr Hey Moe Frist pushed through were for opening the door wider to Universal Health Care. The insurers want Universal Health Care as it will make them the handlers of the funds and overseers of how it is distributed under a Universal HEY MOE system.
It's not just the DEMs pushing it the GOP has it's own large group of shills. Bill Frist was one and Fred Thompson was yes indeed another as he and Frist went before HCFA yearly to help secure funding for HEY MOE Universal Health Care in Tennessee. They did it with the blessings of a Republican governor as well. {Note this prompted the Tennessee State Income Tax Revolt.} HEY MOE and it supporters in the GOP nearly bankrupted the state.
“Under the British or Canadian system, there never would have been a question of a transplant. They would have just taken the girl off life support immediately.”
Rubbish. While the Canadian system has many faults, it also performs many organ transplants. When I was in high school a friend there had come from Mexico with his father, who was doing pioneering work in liver transplants at Dalhousie university and a Halifax hospital at the time. Another friend, the cousin of a good friend of mine, got a lung transplant and then a heart transplant and was on the waiting list for another lung transplant before she passed away from complications. If the donor organs had become available in time the operation would have been done immediately.
I don’t actually see in the article that the girl died due to delays caused by the insurance company - she may have just been waiting on a donor organ that did not become available in time to save her.
a lot of missing details here.
Read the The Rainmaker by John Grisham (lawyer). It is fiction but how did he come up with the idea of a cold blooded insurance company?
True details are missing, but I feel experimental, random withholding and other reasons are used to deny treatment. It is based on cost.
Always follow "The Money Trail".
Don’t even need to read the rest of the story. CIGNA is a four letter word in my house. Biggest bunch of incompetent, pathetic morons in the world. They actually refused to pay a bill for me. Took my 8 year old daughter to hospital clinic for breathing problems. They couldn’t diagnose it and sent her across the hall to ER. They also couldn’t figure it out and had her admitted. It turned out to not be serious and a night in an oxygen tent took care of it. I guess he knew better than eight or so physicians. CIGNA refused to pay the bill because the 8th grade dropout in their medical department ruled it to not be an emergency. Then, after we followed all the grievance policies, they called and told me my wages would be garnished. In a meeting that day with HR, they said that CIGNA might be able to garnish the wages. I stood up and said that “they can’t garnish what I don’t have and I quit.” The HR people were yelling “Get back here, you’
re not quitting your job over this.” My company paid the tab that their wonderful insurance company refused.
BTW, they don’t take to kindly when their medical staff is called a bunch of 8th grade dropouts.
“Having worked in the health insurance industry for 17 years for big national companies and smaller regional ones, I can tell you this is BS. Health Insurance companies are tightly regulated by the states in which the coverage policies are written.”
Perhaps it is for some companies. I trust the people I’ve talked with. I also have experienced claims being denied and then mysteriously being allowed after a call to the company.
“Furthermore, there would be far fewer denied claims if physicians didn’t instill unrealistic expectations in patients and order unnecessary tests.”
Those tests are ordered because of liability suits. Did I mention that ambulance chasing Lawyers suck? IMHO
I agree, if my insurance company said no to a treatment my child needed I would have sued them after the fact, but I would immediately gone to the pastor of my church and ask for help. He would have asked the congregation that Sunday for the money and they would have paid it all I guarantee it. but in the mean time I would go ahead and tell the surgeons to do the surgery and promise they will get payment afterwards one way or the other.
We represent the “Culture of Life” here, unless of course there’s a conservative canard quacking away.
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