The news of denying the transplant hit the web and all hell broke loose for the Cigna telephone, e-mail, and fax lines as angry people laid siege to them. THIS is what prompted Cigna to reneg on their denial. Not any sort of human concern - they got badgered by the People and slammed on the web and in print.
This post is a follow-up on that whole mess.
Now that the child is dead and the initial firestorm over, Cigna, like any other giganitic corporation, has come out defending their decision as "good policy".
What it does is show - clearly - that profits matter far more than people.
Cigna officers defend decision to let teenager die
"In this case, rather than going through our standard method of appeal, we went directly to not one, but two independent experts in the field who agreed that the procedure in question, given the patient's particular circumstances, would not have been an effective or appropriate treatment," they wrote, evaluating her case on "evidence-based guidelines published by independent physician and medical organizations, as well as expert scientific journals."
So they went and asked a couple "experts" who sided with the profit-oriented managed care company and decided, infamously, that this was a bad use of money.
"UCLA doctors put her on a list for a liver transplant Dec. 6 and a liver became available four days later, the family said," according to the LA Times. "Her doctors told Cigna in a letter that patients in similar situations had a 65% chance of living six months if they received a liver transplant."
Cigna refused the procedure, however, dubbing it experimental. Last Thursday, they reversed their decision, allowing the transplant to move forward even though they considered it experimental and outside the scope of her mother's policy.
By the time news reached Sarkisyan's family, however, the girl was already dead. Her parents opted to take her off life support earlier that day, seeing no hope of recovery.
Now, the really ugly part: Cigna complained in that letter to the family that they and their expert decisions were "unfairly characterized".
"What is often misunderstood is that most health benefit plans, whether public or private, do not cover unproven and experimental treatment related to transplants or other treatments," they wrote. "Coverage decisions under these plans are based on the best scientific and clinical evidence available, often utilizing external experts, without consideration of cost."
I have seen a few comments elsewhere indicating that terms like "experimental" essentially mean "expensive". So the "without consideration of cost" is pure bullshit.
Cigna's decision is another fabulous example of the Banality of Evil which has thrived under managed care.
During a candlelight vigil Sunday, family attorney Mark Geragos said he had evidence Sarkisyan's denial was part of a broader Cigna corporate policy.
"Within the last 48 hours, I received e-mails from CIGNA employees who said that this was a corporate policy - to deny, deny, deny," Geragos said, according to CBS.
Nataline's story made the Christmas Editorial in the Houston Chronicle.
When insurance company officials arbitrarily denied a California patient life-preserving care recommended by her doctor, the case provoked outrage and inspired the hope that medical coverage for all citizens can eventually become law.
Calfornia Nurses Association/National Nurses Organizing Committee Executive Director Rose Ann DeMoro says the Sarkisyan tragedy "demonstrates what is so fundamentally wrong with our health care system. Insurance companies have a stranglehold on our health. Their first priority is to make profits for their shareholders — and the way they do that is by denying care."
A CIGNA spokeswoman defended the company's initial denial, pointing out that it submits transplant requests to physicians with transplant expertise. However, she had no convincing explanation for why the company changed its mind after becoming the target of public ire. According to
CIGNA, it made a one-time exception in a rare and unusual case. The attorney for the Sarkisyan family, Mark Geragos, accused the insurer of cynically changing course because of public opinion and the fact that company officials knew the girl was dying, so they wouldn't have to pay for a procedure, anyway. He promised a civil lawsuit and called on prosecutors to pursue criminal charges against CIGNA.
Cigna is responsible for the death of Nataline.
Universal Healthcare is the answer. (Limiting the power of corporations is another issue, but beyond the scope of this situation.)
I talked about Nataline's situation with a friend in Great Britain who just cannot understand why people here have to worry about healtchcare. She was partially crushed by a horse several years ago and received full treatment and is all better now. (She has a very hard head....)
There was no need for Nataline's family - or anybody else's - to risk losing everything because of illness or injury.
America is WAY overdue for proper healthcare.
Impeach Bush, Bring Troops home; Take care of Americans.
NOTE: NCD means "non-candidate diary" a term I have created to help people sort out diaries that are about something other than the same three names.