The Wall Street Journal has a front page story (still firewalled?) about Nataline Sarkisyan tomorrow. While not terrible, one gets the idea that folks in the health insurance industry still think this is a PR problem, not a problem in the way health care funding impedes decent health care.
Karen Ignani, president of America's Health Insurance Plans, the main industry lobby group, said it's addressing the desire for health-care change by making its own proposals for universal coverage. Last month, it offered a proposal for guaranteeing access to individual health insurance to anyone who applies. The industry has long opposed that idea in practice.
The group also plans to work with medical societies on how to finance or cover experimental treatments. "We're not taking a P.R. approach to this but a policy approach," she said. "People want us to solve the problem, not just discuss it."
Still, Robert Laszewski, a health-care consultant in Washington, said the industry often muffs its public-relations strategy. Cigna's delay in reversing its decision on Nataline's transplant "shows just how tone-deaf" the industry is, he said.
Health insurers have also been fighting a legal battle in California over their right to rescind the policies of members who make misstatements on their applications. Critics say the insurers sometimes use small errors as an excuse to withdraw coverage. "They don't get the critical nature of the debate," said Mr. Laszewski.
Cigna's excuse is that they weren't saving themselves any money, after all the employer paid, they were third party administrators:
Cigna said it wouldn't have benefited financially from denying the transplant because it only administered the health plan of Nataline's father's employer. In reversing the decision, it said it would pay for the transplant itself.
"We are asked to make the right clinical decision by our employer customers, so it would have been unfair to make them pay for it," said Dr. Kang, Cigna's chief medical officer.
Would Cigna please provide a copy of their contract with the employer to show that they have no incentives to keep costs down? I'm willing to bet that Dr. Kang was misleading us in this.
Cigna, of course, decided to blame everyone else, too:
Cigna defended its handling of the case. "I'm perplexed that this has become a campaign issue," said Jeffrey Kang, Cigna's chief medical officer. "It is highly unlikely that any health-care insurance system, nationally or internationally, would have covered this procedure."
I'm glad that John Edwards is speaking up on this and that the Sarkisyan family is working with him to help Americans review what needs to be done, whether he becomes the nominee or not. It will help the other candidates get some backbone when dealing with the needs of reform.
I'm a fan of single payer because it is lower cost than any other program available today in the United States. No, it doesn't fix all problems and the cost of health care is absurdly high compared with other developed countries, but if we can cut 10-15-20% of the cost of payments out of the system and get our costs down to those found in Medicare, VA or real HMOs, that would be a start. Despite the claims of the Republicans in their debate on Saturday night, there is no evidence that health insurers are part of the solution.