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Wednesday, December 26, 2007

never was fixed

a 17 year old girl with recurring leukemia died the night her damnable insurance company finally approved her emergency liver transplant insurance coverage.

the insurance conglomerate denied her coverage of the liver transplant because it "does not cover experimental, investigational and unproven services" ...

they denied her the liver transplant.

Dec 11 - CIGNA refuses doctor requested coverage

Dec 14 - healthy liver becomes available, but because CIGNA had refused authorization, the family had to make an immediate down payment of $75,000 for the surgery ...

they couldn't afford it.

[an unexpected and torrential public outcry ensues over this refusal for a doctor requested procedure ... thanks interwebs]

Dec 20 - CIGNA relents and approves the procedure.

... a few hours later, Nataline Sarkisyan dies

“Every politician who thinks the answer to our healthcare crisis is more insurance should stop and think about Nataline Sarkisyan,” said DeMoro. “Insurance is not care. Paying for insurance coverage is not the same as assuring you will receive appropriate care, even when recommended by a physician as it was for Nataline. Insurance corporations profit by denying care to the sick, and that is no way to run a humane healthcare system.”


Auffderbach said...

Too bad for her she wasn't here from another country, illegally.
Then she would have received all the medical attention without reguard to payment.

velogirl said...

don't get me started on health insurance. but I have to be honest, I'm not sure socialized medicine would be any better (at least for the affluent).

Casey said...
This comment has been removed by the author.
Casey said...

One thing that I haven't seen mentioned in most reports about this is that the liver transplant probably wasn't going to save this girl's life. She was also being treated for cancer. If she had gotten the liver transplant then the anti rejection drugs she would of had to take would have greatly reduced the effectiveness of her cancer treatments. She was most likely in a no win situation, die from the liver problem or die from cancer.

Mike Hardy said...

Casey probably got the details right but I'm posting to feed the troll auffderbach. Auffderbach, your post is laughably misinformed about medicine and immigration issues at the same time, and it's clear you haven't ever had to deal with a liver transplant. The difficulty involved in qualifying for a liver transplant is beyond what you'd think, and immigration status wouldn't help, that's for sure. Ability to pay is factored very very highly.

Many anti-immigration policies can be defended with arguments that adults can disagree about, but snarky off-topic one-liners don't do anything positive for the image, that's for sure.

Kimberly (aka. DrKim) said...

just very sad. I had a friend nearly die due to an insurance denial once (he later died of the same cancer, but he did have nearly 2 more good years of life (and 6 months of bad...) after receiving more aggressive treatment at a top notch place). However, his case got my employer (UCSB) to add a clause that allows you to go for self referrals to UCLA med. no matter what insurance plan you are on... I know his widow feels like at least his case did some good, if only for a few.

The system is really broke...

Anonymous said...

as someone who had a co-worker go through a liver transplant in her family recently;

and, someone who has seen the inside of waaaay too many civil suits against insurance companies AND medical providers,

in my opinion, this specific story is NOT about the viability of the procedure in the minds of the insurance company.

it was viable to the minds of her doctors.

she died because of money.

that is what this story is about.

and aufferbach - that was a pretty wild thing to say. and incorrect as has been already tol't to you.

hundreds of THOUSANDS of illegal aliens suffer and die every single day while working in america for piss poor wages in piss poor conditions.

and they live fucked up hard lives.
every damn day.

Auffderbach said...

I suppose I might have offended some, so I'll offer an olive branch...however, I have to admit that since I took a job that has placed me in a position to pay lots
of taxes to our government, I now see alot on money wasted that ought
not be.I see having to spend over $4,000 to have my son's collar bone
fixed after a bad crash in a bike race. And that's WITH insurance.

You can't tell me there's not an unfair disadvantage to the taxpayer and I guess that's where I'm coming from...I'm not anti-immigration, I am, however against
illegal immigration because it costs me a helluva lot of money to
pay for their services rendered, when I, on the other hand, pay through the nose for my own family.
Plus, i don't even get a thank you card on Father's Day!

The original comment was meant to be more of a "tongue~in~cheek" than
actual truth.

Hope ya'll can forgive me but I'm sick and tired of government waste
and I personally believe that if the government would take responsibillity for its actions and not tax the crap out of us in order to feed their uncontrolable lusts, we would be able to easier
afford things like insurance, doctors and such.

For the anon that commented how hundred of THOUSANDS die every day in this country, how on earth does anyone even get a funeral after they have died? I mean, with that many bodies all over the place...I shudda been a mortician!

Your friendly neighborhood troll.

Anonymous said...

"suffer and die"

it's inclusive.

and i get so tired of people complaining about taxes.

i really do.

Mike Hardy said...

Auffderbach, I'll accept the olive branch, but will point out that many of those immigrants pay a great deal of taxes via withholding to programs they will never see benefits from, like Social Security.

And their benefit to the economy in general, in the form of us being able to buy cheap pastries at cafes while bicycling around etc is extremely large. Inflation would be much larger without immigration.

The point being that there's no black and white on a lot of these issues. It's a complicated problem, just like insurance and medicine. Abuses are easy to find in both areas making it easy to cherry-pick one and come up with a simplistic solution that would solve that specific case, but the more I investigate insurance and medicine or "government waste" or immigration policy in general the less likely I am to bust out with a single-sentence prescription for any of them.

Not that the current political process is doing a good job at coming up with innovative solutions to anything, but for these problems I'm at least sympathetic to the difficulty. I don't know if I'd do much better.

Auffderbach said...

Mike Hardy,

I appologize for sounding was a knee-jerk reaction.

I have had my share of death of loved ones and friends and should have considered the family before posting.

Having worked in government for some time now, I just see so much
waste that I'm fond of quoting Reagan:
Government isn't the solution to the problem, government IS the problem.

Now I'm off to the political blogs
so I can post bicycle racing comments!

Anonymous said...

Hey anonymous who tires from tax complaining folk.
Go here:

Anonymous said...

god, there's nothing worse than libertarians.

the benefits sucked upon, and responsibilities of the SOCIAL CONTRACT happily and sociopathically ignored as so much inconvenience.

"the people agreed to cede authority to some group in order to gain the benefits of community and safety. If those in power refused to guarantee community and safety, the governed were free to disobey and establish a new political contract."

community ... and safety

those mean more than civil defense and the prosecution of crime.

REBUILD the social contract from the ground up, it is the only way to unearth equality and freedom from the hearts of men.

sufferface said...

I am a general contractor and have a legal gentleman, Rene, from Nicaragua working for me. His Uncle who is not legal has done some odds and ends work for me. One day we were breaking our backs on some concrete demo and the Uncle started crying. I asked Rene why he was crying. I have XM Radio for the job site and it was on a Latino station and they were playing a song that reminded him of his family in Nicaragua.

We sometimes forget that the “illegal aliens” are also human beings that are doing what ever they can to provide for their families. It was tough seeing a grown man cry while shoveling concrete. Of all the “illegal” things a man can do, crossing a line in the desert to provide for his family ranks pretty low.

hernando said...