Can any good come out of the Nataline Sarkisyan tragedy? Hello Iowa
By John Amato Monday Dec 24, 2007 11:01am
Many C&Lers have followed the horrifying story of Nataline Sarkisyan. She was denied a liver transplant by health care giant CIGNA because they called it "experimental."
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CIGNA has ignored this medical decision and calls the transplant “experimental” as justification for denying the treatment. CIGNA’s refusal of Nataline’s liver transplant—overruling the urgent appeals of an array of doctors and nurses—is indicative of the failures of the new healthcare plan sponsored by Arnold Schwarzenegger and Fabian Nunez. That plan, which is actively supported by CIGNA, requires every single Californian to purchase insurance products from companies like CIGNA, but does not address the problem of denial of care evident in this situation.
After a protest led by the California Nurses Association along with family and friends turned the heat up on CIGNA, they finally approved the life saving procedure, but...
In a stunning turn around, insurance giant CIGNA has capitulated to community demands, and protests that the California Nurses Association/National Nurses Organizing Committee helped to generate, and agreed to a critically needed liver transplant for Nataline Sarkisyan, a 17-year-old girl in the intensive care unit at UCLA Medical Center...
...they acted too late and she died.
The California Nurses Association/National Nurses Organizing Committee today blasted insurance giant CIGNA for failing to approve a liver transplant one week earlier for listen to 17-year-old Nataline Sarkisyan, who tragically died last night just hours after CIGNA relented and agreed to the procedure following a massive national outcry.
An editorial by the Houston Chronical called CIGNA's decision to deny the teen a liver transplant until it was too late "Heartless."
As California and the nation debate how to institute universal health insurance coverage for citizens, the
Sarkisyan case indicates that more must be done than simply covering everyone with a policy. All too frequently, insurance company bureaucrats are making medical judgments that should be left in the hands of a patient's physician... If the staff at the UCLA transplant unit approved
Nataline's procedure, that should have been the end of the discussion. For universal health coverage to be meaningful, such decisions must be taken out of the hands of insurance adjustors and placed with an impartial arbiter whose interest is the welfare of the patient rather than a corporation's balance sheet.
Will the tragedy that struck Nataline Sarkisyan and her family because health care giant CIGNA initially refused a life saving medical treatment become an important story for the voters in Iowa as they begin the process that will determine which candidate will represent each party in the upcoming Presidential election?
Republican voters may face the same situation as the Sarkisyan's. The CIGNA's of the world could care less if a family filled out a GOP loyalty oath or did the Pledge of allegiance to President
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Let's let common sense, people sense, health sense rule, instead of
political non-sense, lobbyist non-sense, corporate non-sense.
For christ's sake, folks, we're talking people's lives, and health.
We need "Single payer" national health insurance, not the corporate welfare version advocated by Obama and Clinton.
Insurance companies ARE the problem
The solution is obvious. The model already exists for us to do this. It doesn't involve insurance companies. They have to go away like the dinosaurs. They cannot be part of solution because it is not in their interest to do what needs to be done, with single payer health care they don't exist. It would be like convening a neighborhood meeting to combat crime and one of the participants is the Mob. Do you see how insane that would be?
WHo's going to invest in the R&D for new medicines and techonolgy is there is a single payer system?
Only the top 1% can afford life extension technologies, a fancy name for medical care without blinking an eye.
The rest of us, forget it.
L.A. Confidential @ 6:
For example, what kind of bills would be arriving in your mailbox if just to stay alive you needed Dick Cheneys medical care?
John @ 5:
Same ones that doing it now, you dope.
Do you even understand what single payer means?
There are a couple of things about this story that bother me outside of the role of Cigna in denying coverage. Because of what I do for a living, I know a lot of people who have had transplants. Granted, these are mostly lung and kidney recipients, but I would think the rules for any solid-organ transplant would be similar. The first thing that rings false is that UCLA waited for a green light from an insurance company. The majority of recipients I know got the organs as soon as they were available, whether they had insurance coverage or not. When someone is listed for transplant, their insurance status is not factored into eligibility. I'm frankly stunned at how UCLA handled this because it jeopardizes not only individual donors, but potentially the whole transplant listing procedure currently in place.
The second thing is this young lady's underlying diagnosis of leukemia. It may be different for livers, but for lungs, kidneys and bowels, if you have a serious underlying health condition, you drop to the bottom of the list--if you are eligible at all. This is not meant to be as cruel as it sounds. The reality is there are way more people who need organs than there are organs available, so preference is given to recipients with the best chance of a good outcome. Donor organs are precious (please consider becoming a donor if you aren't already) and it considered wasteful and medically inappropriate to give them to someone with little hope of recovery. With her history of leukemia and her acquisition of pneumonia prior to transplant, I'm surprised she was still eligible at all. I don't think we have heard the whole story yet and suspect there is more going on here. Of course, if she was getting a living donor lobe from a friend or relative, none of point two would have applied, but there is no mention that this was the case.
That said, it is cases like this that illustrate the absurdity of having a corporate entity in charge of making health care decisions. It is like having the fox run the hen house. Of course they will protect their assets over all other considerations--that's what companies are supposed to do. All this free market bullsh*t is meaningless when the "product" in question is someone's health or life. I wonder what the Congressional reaction would be if one of our Senators was denied a transplant?
She should have:
1. Gone into a irreversible vegetative state.
2. Had her parents smear her husband as an abuser and philanderer
3. Become an Evangelical
4. Wrote a letter to Chuck Norris, Bill Frist, and Governor Jeb Bush asking for them to preserve human life.
Then she would have gotten some help.
How can Cigna even defend their actions surrounding this? Maybe this will be the spark for real change...
Face it folks, Big Insurance Companies will only get into the card game if they can use THEIR DECK. You might as well be hoping for the house to stand behind you while your gambling in Vegas.
Big Pharma and the Corporations have bought the American Government.
It is now up to the people of America to get up off their FAT ASS's, turn off the TV and start getting involved.
WRITE!
CALL!
VOTE!
The Country has to taken back and there is only one way to do that.
Be Involved.
An outcry! Outraged citizens and politicians vow this can not be allowed to happen again! And then...........sadly.............it becomes yesterdays news. Face it folks, nobody really cares. Merry Fucking Christmas
CIGNA IS GUILTY OF MURDER BY SPREADSHEET!
URGE THE CALIFORNIA D.A. TO PURSUE MURDER CHARGES:
http://da.co.la.ca.us/feedback.htm
#9, Michele
You hit the nail on the head. Yeah insurance companies suck, but why give someone a transplant when it's likely they still won't survive. It's not to be uncaring about this, but some people just like to stir things up and fail to find out the facts. It's awful that this girl died, but I'm sure you can find similar stories like this that go on every day. Some people just chose to focus on this to start an argument with the insurance co. Sometimes there is just too much whining going on...
John @ 5:
What?
You think insurance companies do research? You think drug companies figured out how to do liver transplanst, heart transplants?
Pull yer head out.
The medical community, doctors, universities and research institutions funded by the fuckin' government do that!
John @ 5:
The Universities, the Colleges, the Pharmaceutical Industry, the NIH, concerned medical professionals, and when they find a solution to a problem, they'll publish for medical, scientific reasons, not not-publish for corporate, economic reasons.
Scratch 'the Pharmaceutical Industry', I'm on dope.
Bob Loblaw @ 15:
When you go in for your brain transplant, you better hope Cigna is not the one who picks the donor, or, impossible as it might seem, you could end up in even worse shape. (How'd you like to come to after the operation, and start oinking?)
Bob Loblaw @ 15:
Michele @ 9:
OK then tell me why CIGNA initially denied then approved the procedure.
I'm sick and tired of Norway (where I live) blindly following the US down whatever fucked up path its leaders take us. For once it would be nice to see the US following this country. No, the Norwegian health-care system is not perfect, but if you're not happy with the public version, you can pay a little extra and get what you need through a privately owned system. I guess it boils down to where you want your tax-money to end up: Defence-contractors, or the health and education of your children.
Bob Loblaw @ 15:
Using that excuse above that she won't survive applies to everyone of us, none of us are going to survive right? But to not render care that might help them survive a little longer is criminal none the less.
Preacher Boob @ 19:
Yeah yeah, That's your opinion as this one was mine. If you don't like it, you can keep scrolling up and down to the other comments and give your opinion on those. That's your right as this was mine to comment.
A.Citizen @ 16:
actually, these insurance companies/pharmaceutical companies fund much more than the government. not motivated by caring for people, just for profit.
RockmanEnough @ 21:
Exactly. That's the one thing that is always never mentioned in the debate over healthcare in the US: while every other industrialized nation in the world has universal healthcare, they also have the "private payer" option. If you have the money, you can spend it to get "something better" than government HC, but this is conveniently never mentioned in political debates here.
Bob Loblaw @ 23:
no one said you didnt have the right to say it. but dont act all butthurt when you get challenged. dont comment if you dont want people saying something to you.
liberalbiasboy @ 20:
Ask CIGNA.
"... too much whining..." - now there's a candidate for reincarnation.
I don't know all the facts behind this or any of the other coutless story like this - none of us do.
What I do know is everyone wants to be treated charitably with grace and dignity.
We all need to do that for ourselves and for everyone else - all the time. Shame on us when we don't.
Compassion is truly a virtue that the political hacks cheapen to win votes and render it meaningless to those only looking for an ege to exploit. It is a quality we all eventually see as essential as we all eventually will need it. Meanness through a lack of compassion is something that comes from those out of touch with their humanity. That is something we cannot afford.
What I know is that the medical care system in the United States doesn't work very well for many and that everyone deserves good medical care. Not just because they can afford it, or because some corporate entity deems it so, but because we all deserve grace and compassion and the dignity of our existense.
If, as a human race, we can't find ourselves to that awareness then there is little hope for humanity.
Blue Buddha @ 25:
They want you to think that it's a "black and white" issue. That way the majority will give it thumbs down, and they can keep the defence contractors happy. (This was the simplified version.)
Why would having a single payer be the magic solution to this? The Medicare and the VA does not cover many procedures (esp expensive ones) and I would seriously doubt would have covered this procedure (liver transplant less than a month after a bone marrow transplant) esp since cancer within the past 5 years is a contraindication to most solid organ transplant. I think a reality check is in order before storming the barricades......
Don't parents practicing "alternative" health care for their children with extreme conditions (Like the family who recently wanted to stop chemo for their teenage son and use alternatives) get overruled by courts who then allow doctors to intervene on the patient's behalf? Why wasn't Cigna overruled and forced to submit to paying for the procedure? The fact that UCLA didn't proceed with the transplant anyway also highlights the immorality of dollars determining who gets adequate care in these extreme cases. The insurance company and the university of both culpable in her death.
The fact that drug companies have been funding their own research has been part of the problem with scientifically determining the true effects and safety (or lack therof) of various drugs. Taking away profit motive to sell treatments (regardless of effectiveness and safety) and subsequent funding of insurance (again catering to the financial bottom line rather than the health of clients) might lead to more unbiased research being done on different treatments. This could result in actual safe and effective treatments (from all health care philosophies, not just western medicine) being made more readily available and their true effectiveness scientifically validated.
There can be no negotiations with the health insurance companies on this topic.
It is the law: corporations must do everything they can to earn a profit for stockholders. Any action they take that results in a loss to stockholders is illegal.
Health care must be taken out of the hands of insurance corporations, or the laws specific to health insurance companies must be changed.
There is no middle ground.
This can't be said enough: The insurance companies ARE the problem! Why on earth are they included in the solution?! They have had 30 years to figure out how to deliver health care AND make a profit, and so far, they have succeeded at making a profit. Isn't 30 years long enough?! Imagine what we could provide for the health care professionals and institutions, and American citizens, with all the money that is now dumped into the black hole of health insurance industry expenses and profits. We don't need any more taxation to achieve the goal of health care for all Americans. We need to jettison the health insurance industry from the equation, and don't look at that move as being economically disastrous for America, as imagine how great all those people will feel when they finally have to go out into the real world and find something meaningful to do with their lives, something that gives them a sense of satisfaction and that contributes to their communities, rather than literally sucking the life out of their "customers."
Bob Loblaw @ 27:
My point is, that the previous sentence/question makes your and #9"s entire statement totally irrelevant
L.A. Confidential @ 7:
Dick Cheney's health care plan is paid by American taxpayers. So is George Bush's, colonoscopy and all. The health care plan of every government employee and member of Congress is paid by American taxpayers. Perhaps it should be discontinued and these people should get in line for health insurance like the rest of America so they can be the victims of the insurance companies, too. We'd all have better treatment.
Wake-Up Americans we need someone in office to Fight these Guys! We
know two Canidates who (wont,) Hillary and Obama. A vote for Edwards is a vote
to stop this Shit once and for all.
This incident has been blown out of proportion just for the sake of getting universal health care.
I have no objection to universal health care if majority of the Americans benefit from this system.
BTW, the attorney for the plaintiff stinks. Isn't he the guy that lost Peterson case?
Losers!
...such decisions must be taken out of the hands of insurance adjustors and placed with an impartial arbiter whose interest is the welfare of the patient rather than a corporation’s balance sheet.
Hell yes. Years ago I signed up with a new provider that administered the local offices that housed the doctor's offices. At first things were great; one of the things that impressed me was that the doctor could spend as much or as little time with the patient as he or she deemed necessary. However, soon things changed. The insurance company started forcing the doctors to spend less and less time with the patients each day so that they could get more people through the gates. My doctor got pissed, quit, and went into the quick care business.
Billions for the health insurance companies, death and debt for the people
How long have we been doing liver transplants now?!
Since when is a fucking liver transplant experimental?
CIGNA is full of shit and they are murderers!
Hey Stossel how about doing a piece on this story! You piece of shit.
This misses the point. This is happening for the same reason the democrats in congress are enabling corporations and for the same reason the housing market is collapsing and for the same reason people are beginning to live on credit cards and the same reason there is no mansion market collapse and for the same reason jobs have been expatriated and for the same reason elections have been riggeded and for the same reason government has been privatized and on and on and on.
I was preparing to write a rather long and detailed explanation ... then came to my senses.
The 'bloggers' dont read these things in any case. So I saved myself a great deal of what would have been wasted effort.
John doesnt understand. The system is working as intended. It serves the citizen. John is not a citizen.
Dont believe me - study Athenian democracy.
Imagine if doctors just treated the sick and injured based on need and without regard to ability to pay. Doctors deserve to be well compensated, but profit should never be a consideration in making a diagnosis or rendering treatment.
Insurance companies are in the business of making money, not providing healthcare. Imagine if we ran fire departments the way we run healthcare. No insurance, you better have cash or your house would burn down. And it will be burning while the dispatcher waits to get approval before sending out the fire trucks.
As for Nataline, if her doctors said she needed a transplant, who the fuck is Cigna to overrule them?
I always like to think of Xmas day as the day to complain...(all the dashed hopes of the consumerist bauble burst so it goes) ... so go complain about Cigna's corporate malfeasance and dereliction of service to
Department of Managed Health Care
California HMO Help Center
980 Ninth Street, Suite 500
Sacramento, CA 95814-2725
(916) 322-2078
If an MD withheld treatment that resulted in death (s)he could be sued with malpractice. If a person told you they would keep you well and then allowed you to die they might even arrested and prosecuted criminally for manslaughter or criminal abuse leading to death.
Why are corporations not forced to follow the same laws that individuals are? Why are they allowed to break the rules of human decency as long as there is a profit in it?
This is a reflection of a hideous system.
anon @ 41:
Your shorter version is clear as mud. What is your point?
liberalbiasboy @ 20:
How about bad publicity and the mass cancellations of already existing premiums because no one is going to want to pay for coverage they won't get when they need it as a result of having to wait for the pencil pushers to make the approval.
Wasn't there some Congressional testimony by one of BigPHARMA's CEOs who said she quit because her promotions and high salary was based on how many denials like this one she approved? As a practicing physician thrust into an administrative job, she testified that making life or death decisions like approving someone to get a medical procedure that could save their lives was more stressful than actually practicing medicine.
She quit - and blasted the HMOs for trying to make money.
This country was built on the Capitalistic concept and that same concept is starting to kill us off. Any supporters of pure capitalism - the results are Nataline Sarkisayan and other like her in the days to come, cause this will not be the last time HMO and BigPHARMA will literally murder someone in the name of providing multi cost health coverage.
Again, what good is having health insurance if it's not going to cover you when you need it most?
I hope those bastards are thinking about this on Christmas, and I hope that in CIGNA's case, as well as Governor Terminator and his new BFF DLC-Type, Fabian Nunez, have their Christmas ham or turkey stuck in their throat and that Nataline's ghost haunts them until this country has single-payer health care coverage.
tistheseason @ 36:
Good luck with that ............
"It's not about evil companies"
What drugs is THAT guy on !!
Companies and corporations are not immoral, they are amoral.
It reminds me of something my uncle told me when I went to stay at his farm for a couple of weeks. He warned me about the dangers of farm animals and machinery by saying "Never turn your back on anything that doesn't have a conscience."
Businesses don't have consciences.
Tom @ 30:
Single payer is not a magic solution and it's advocates have never claimed such. It is however, much less costly.
The doctors recommended the transplant. Nataline was an approved recipient. End of story.
Be honest and think before you post. You are helping no one with crap like this.
Someone needs to tell Krugman who just praised Clinton's health plan that "requires every [person] to purchase insurance products from companies like CIGNA."
myiq2xu @ 44:
America is still America - if you are in the upper 1%. Remember Bush's base? They are also the democrats base - evidence is the behavior of the democratic congress since 2006. All that has been done has been done for the benefit of the upper 1% - no one else. They are the citizens who are served by this government.
I agree with anything people may say on this subject. But this is a small part of a much larger tapestry.
Want to change things? Well you cant. Why? You have no power. Want power? You will have to become a citizen first.
This reminds me of the democracy of the Athenians. Ever wonder where the phrase exporting democracy comes from? It comes from Athens. The Athenians would conquer an area, loot it and send the loot back to be given to Athenian citizens - exporting democracy. In fact, it was the material goods of the conquered that were exported.
We are doing that in Iraq - exporting democracy.
I am as sad as I can be over this womans death. It wasnt Paris Hilton. She is a citizen.
Who is the government protecting ... you? I dont think so. If anything, the government sees you as a potential threat. But to whom? ... the rich ... corporations ... citizens.
jharp @ 48:
Doctors recommend treatment and procedures all the time and are turned down by Medicare and the VA all the time so I stand by my point. Sorry to burst your bubble by trying to bring some reality to the discussion.....
myiq2xu @ 44:
He is saying that only corporations are true citizens in the New American Democracy. The progress was simple. First, corporations were declared persons and constitutionally recognized as such. Then, since all citizens have a right to lobby the government that is what they did. To the tune of millions of dollars given to representatives' re-election campaigns in return for legislative favors. These days your representative doesn't even read most legislation, they don't write it either, the corporations do. The up shot of all this is that democracy works very well for the corporations. We simple non-corporate people are not represented at all.
That is why you will not get single payer health care until you break the hold the corps have on government. That is why Nancy Pelosi and Harry Reid don't give a shit about your human rights and will never impeach. Is your pathetic little 100 dollar contribution going to help them get re-elected? No? Then as far as they are concerned your needs simply do not matter. As far as they are concerned everything is going just fine. Profits are up. The war is bringing in billions. So what the f*ck are you complaining about?
It isn't like you'll ever do anything about it anyway. You will all just sit here and whine and complain but you probably won't even vote and you most certainly will never get out and protest. Since you will not defend your rights they will be taken away from you and you'll have only yourselves to blame. So cry me a river.
Wow. Is this what passes for intelligent discourse these days? I understand people being "up in arms" over Cigna's actions, however, most of you apparently have not had to face any real insurance battles OR the tragic wait for an organ for transplant or you wouldn't be so surprised and outraged. For God's sake people, this has been going on for years!!! And yes, there is an eligibility list for transplant for a reason. How would you feel if your brother, sister, mother, etc. was passed over for a liver and died waiting because a liver was given to someone who was most likely going to die from cancer or from a massive lung infection after the transplant anyway? Underlying health problems or issues with addiction or non-compliance are factored into transplant eligibility--that's the way it is. I AM NOT SAYING this was the case with this particular girl--just that this is the standard practice under UNOS guidelines. You certainly are entitled to your opinions about how transplant SHOULD be managed, but you are not entitled to your facts about how it IS currently managed. Give me a break! I'm predicting that the reason Cigna is 'standing by' their decision is because they are going to cite eligibility requirements. The point of my post is that it was not just Cigna who screwed the pooch in this case. Something's up with UCLA, too and I don't think they're being entirely upfront about the eligibility issue.
Also, it seems that people don't read very carefully or they would know that Cigna originally approved the transplant, then denied the claim when the girl developed pneumonia, probably because the felt the chance for a good outcome was pretty bleak (not that that should have been their decision), which, frankly, was true. It was that denial after the original approval had already been received that was in question and that was finally reversed--too late. We have to assume that there was no match for this girl when the procedure was originally approved. While she waited, she developed pneumonia. The real tragedy is that she had to wait because there are not enough organs for transplant Timely access to a matching organ would have prevented this whole situation.
Apologies to the thoughtful people in the group, but I have to say to the rest of you, it really is irritating to have a bunch of people who have never had to face the reality of organ shortages, tiny windows of eligibility, having to fight for every scrap of insurance reimbursement, losing friends who die waiting, etc. "enlighten" me with their hostile and juvenile banter about the topic (to the poster who suggested I need a brain transplant--Really? Is that the best you can do? Grow up). As is the case with most things in life, this is a complex, multi-factorial problem. Cigna behaved badly, UCLA behaved badly, and these parents were not willing to accept reality (not that anyone can blame them). I've battled with insurance companies pretty much my entire adult life on behalf of people who need new lungs. We have a problem with health insurance in this country. We have a problem with organ shortages in this country. NONE OF THIS IS NEWS. People die waiting every day because of insurance denials. Every day families play out these personal, heart-wrenching tragedies and they have to face them alone without massive media attention and the legal services of the Mark Geragos's and Gloria Allred's of this world. Maybe something good will come of this attention to Cigna, but I doubt it. UCLA's reluctance to go ahead without guarantee of payment is very telling. There is something suspiciously "Terry Schiavo-ish" about this whole story and if the goal is real change in the American system of health care, I doubt this is the case to hang your hat on.
Michele @ 9:
Don't worry, the "important people" will always have all the health care they want or need.
Someone will always find the bucks for them but not for the rest of us. :(
Corporations and rich people can steal our country only if we let them. They keep us divided and distracted (Look! Something shiny!) while they take more than their fair share.
But when we get mad enough, we join together and open a can of Whoop-ass on the malefactors of great wealth. It happened in 1932.
But first you have to get mad. Tragedies like Nataline's can be the trigger. But don't go to your window and scream, go out and vote. Organize, get involved, donate, petition, march and write.
I love how the politicians (you know, the ones receiving all the PAC money from the insurance industry) love to talk about "socialized medicine." And getting people all worked up about how awful it would be to have government bureaucrats running healthcare.
Let's see, these are the same elected representatives who are supposed to use their oversight responsibilities to ensure that government is working for the people...yet they complain the most. And oh, they are the ones getting "government run" insurance. You think maybe if it were so bad in reality, the greedy bastards might change it and go to private health care insurance?
I say, give me a government bureaucrat any day over some puke at an insurance call center with only the obligation to increase profits and keep costs down.
But the channel 9 news is saying that the corporations are Santa Claus. WTF?
Michele: Preacher Boob was suggesting that Bob Loblaw should get a brain transplant.
John @ 5:
The same people who mostly pay for it now - the federal government. The little-known truth is that many pharmaceutical R&D projects are funded by the government. The government, however, doesn't get any say in pricing, or any return on their investment when the medicine or technology is commercialized.
THis story should not be allowed to die. This is an excellent story to tell over and over until 2008 and beyond if need be.
John @ 5:
You are joking, right
Michele @ 53: