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My Left Nutmeg

Death by spreadsheet

by: Scarce

Fri Dec 21, 2007 at 14:13:48 PM EST


(Normally I am loathe to front-page not directly related Connecticut stories but allow me in this instance to make an exception.--Scarce)

In today's Hartford Courant there was a rather nondescript story filed ironically in the Business section. It began like this:

As a protest was being staged against CIGNA HealthCare on Thursday, the company reversed its denial and agreed to pay for a liver transplant for a California girl who is critically ill.

CIGNA had initially refused to cover the transplant for Nataline Sarkisyan, calling it experimental in her case. 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.

Late last night Nataline died.

GLENDALE, Calif.(CBS) ― A 17-year-old girl from Northridge died Thursday night, just hours after insurance giant CIGNA reversed itself and agreed to approve a liver transplant for the cancer survivor.

CIGNA declined to pay for the transplant for Nataline Sarkisyan because her plan does not cover "experimental, investigational and unproven services," her doctors said.

The reversal was announced at the rally attended by a crowd estimated by organizers at 150. Hundreds of telephone callers also clogged lines at CIGNA offices around the nation Thursday on Nataline's behalf.

http://cbs2.com/local/nataline...

The second video was put on YouTube by her brother a few days ago.

Scarce :: Death by spreadsheet
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Yes, CT connection (4.00 / 3)
Scarce, don't worry as it did. I called that connection yesterday.

http://www.dailykos.com/story/...

Maybe you also want to call the CEO of Cigna.  He's a member of the   AHIP board of directors.

Mr. H. Edward Hanway
Chairman and CEO
CIGNA Corp.

CIGNA Corporate Offices*
900 Cottage Grove Road
Bloomfield, CT 06002
860.226.6000




Outpouring of support, and now anger (4.00 / 2)
First from the California Nurse's Association, and then as Missy's Brother points out above, the online blogosphere.

Image Hosted by ImageShack.us


Can we send this to Jim "The Crusher" Amann? (0.00 / 0)
The time for Single-Payer is now!  I wonder what would have happened if this travesty had occured here in Connecticut, especially after our fantastic Supermajority leadership let the ball drop.

This travesty (4.00 / 5)
..probably occurs somewhere everyday, an insured patient being refused coverage for fictitious reasons and subsequently dying. The difference in this case is how widespread the publicity is, fueling the public outrage.

This could happen to you.


[ Parent ]
It already did...... (4.00 / 7)
Almost seven years ago, my wife fell on ice at work and herniated a disc.  She had the least invasive surgery, and that did not work and of course, they no longer perform that particular procedure in the US.  Less than a year later, her disc exploded, pieces of her disc pressing against her sciatic nerve that caused excruciating pain.  We sat in the emergency room for two hours.  It was on a weekend and it was packed and I have to wonder how many were there because they has no insurance at all and were using the ER as their primary care source.  

A week later, she was able to have surgery to extract the pieces of her disc, but was unable to have the spinal fusion that she really needed because Travelers said no, despite the fact that her neurosurgeon and the orthopedic surgeon that assisted said she needed it.  Eighteen months later, she finally received the fusion, but it was too late.  Scar tissue from three separate procedures presses against her sciatic nerve and she is in pain every day.  She also has no feeling in her left foot.  She will never be able to work again and it is a travesty that we have a system where people who are barely qualified to change a light bulb have the power of life and death over us all, no matter how many doctors who say a particular procedure or treatment is necessary.

It amazes me that people who are really no better off than any of us here at MLN, people like those Republican boneheads at CTLP, equate single-payer health insurance with the apocalypse.  I wish what befell my wife and this poor girl in CA on nobody except those who steadfastly oppose the opportunity of health care access because they feel it is "communist" or something stupid like that.  Everytime I heard one of those Republican jackoffs deride universal healthcare by calling it Hillarycare, I wanted to throw a brick through my TV, and I am no fan of Hillary.

Only in America.


[ Parent ]
No "probably" about it (4.00 / 4)
Sick and suffering people are denied treatment every single day, for no better reason than the insurance companies' bottom line.  That medical personel are complicit in this denial is beyond shameful.  

Even more horrifying is that people without insurance very often receive inadequate treatment in hospitals -- they get a "bandaid" on whatever is wrong and are sent on their way.


[ Parent ]
I just heard it on MSNBC (4.00 / 2)
On the "Up To the Minute" segment on Hardball, Melissa Reyberger just mentioned this incident.  I was wondering if it was going to get any MSM airtime.

I changed my heading on this comment because of what I just heard, but the main thrust of this comment was about Michael Moore.  Whatever people's misgivings about Moore, I do not recall any solid refutation of the movie.  One of the scenes that really stuck in my mind was the footage of patients getting dumped because they have no insurance.  I would like to see any opponent of Universal Healthcare to defend any of the actions portrayed by the insurance industry.


[ Parent ]
The inherent lie about having insurance companies at the table (4.00 / 3)
Is that suddenly they are going to stop doing this kind of shit.  

Don't forget what we're watching happen to doctors and Lyme patients - the denial of coverage for Lyme and demonization of doctors treating for it seems directly related to reducing Insurance company claim experience and has a particularly CT flavor to it.

The immediate fatal result of insurance company green shade meddling in the life of this young woman and her family are more dramatic and immediately visible, but in small ways and large, this is the signature "medical insurance experience" writ large - that of having an actuary or insurance clerk's judgment interposed between the patient and doctor, which itself has become more special interest filled in order to eke out a living from a profession that now requires an MBA in addition to an MD.


[ Parent ]
All the more reason to cut them out. n/t (0.00 / 0)


[ Parent ]
Exactly. (4.00 / 4)
I'm glad you drew that connection, Peas. Dr. Jones, the pediatric Lyme doctor from New Haven who refuses to follow the corrupt insurance friendly guidelines published by the IDSA, had his final hearing before the entire CT Medical Board on Tuesday and they upheld the smaller panel's recommendations. What's happened to him is a travesty that has repeated itself with respect to non-conforming Lyme doctors all over the country. And you know damn well who's at the root of it. The same people who refused to grant that 17yo girl her liver transplant.

It is absolutely astounding to me how much access to health care has changed since I was a teenager. At 19, I was diagnosed with Crohn's disease, ultimately requiring 3 separate surgeries over the course of 2 years. There wasn't a peep from my mom's insurance company, no requirement for medical reviews, second opinions, no hoops to jump through. If the doctor recommended it, the insurance paid for it.

I don't know why the greedy drive for profits is so much greater now than it was then, but the change seemed to have started with the creation of HMO's, though I believe that all for-profit health insurers are equally evil in this day and age. If they're not raping you with payment denials, then they're raping you with annual rate increases.

Unfortunately, the impact of insurance company greed has spread far beyond the obvious. Because in order to deny as many claims as possible, insurers need the help of outside medical professionals to perform case reviews and serve as expert witnesses. Those medical professionals are often academics at prestigious medical institutions, whose lucrative fees provide great incentive for them to corrupt the conclusions of their research and their treatment guidelines, not to mention helping to punish doctors who fail to follow those guidelines.

And so you end up with a percentage of the population which becomes chronically ill with little or no place to turn for help. That's the less visible damage that is occurring to our society as a result of our broken health care system.

Single payer, not-for-profit, universal health care is the only viable solution.


[ Parent ]
Teen's death speaks outrage at CIGNA (4.00 / 3)

More mainstream media coverage.


Thanks Scarce (4.00 / 1)
I became aware of this outrage thanks to progressive radio (pretty sure it was on Mike Malloy and possibly Sam Seder filling in for Randi as well). I'm glad you chose to front page it because, as Greenpeas mentioned, it relates to the Lyme disease controversy that I have been trying so hard to educate the public about. And CT is both the Lyme disease and the insurance capital of the world, right?



[ Parent ]
I'm sorry but (0.00 / 0)
any organ transplant that will save a life MUST be
covered by insurance....very very sad what happened to
that girl!   That liver transplant could have saved her
life, or at least extended it!  

As for CIGNA, I remember I was under their health
insurance a couple years ago at my job because where
we work, our CEO and HR dept look for "the best deal"
to give its workers, and CIGNA at the time worked out.
It was okay except I had to pay $30 copay for a monthly
med!!! GRRRRRRR  Now I'm under Anthem Blue Cross which
is better....

This is a good (but very sad) story that could have
been included in Michael Moore's terrific movie, "Sicko";
it would have been a perfect example of how a health insurance company denies needed care, esp. a life-saving
transplant, and then grants it at the last minute, but
the patient dies anyway without receiving the transplant!
The health care system and the insurance companies in this country really need an overhaul, and I think the more people complain and stand up to them, maybe some good will come out of it....but WE THE PEOPLE have to speak up!

"Waiting....waiting on the world to change"  --John Mayer


There hasn't been a day... (4.00 / 1)
over the last two years in which the healthcare crisis has not been mentioned on the MSM, which coincidently parallels the 2008 presidential race.  All I've heard is lip service and band aid proposals from all the candidates except for Kucinich.  Only he has been bold enough to say that we have to take profit out of healthcare.  I wish his candidacy had more traction so he could help move the conversation in that direction.

I have little faith in seeing any type of National Health Service in the US.  It will be up to the states to make it happen, which is too bad because we already have a template in the form of Medicare.  I also have little faith in any type of "task force" that involves anybody from the insurance industry like the one set up here in CT.  This is a legislative and human rights issue, not a business problem that can be glossed over with a powerpoint presentation.


[ Parent ]
Michael Moore has this story front and center (0.00 / 0)
..on his website.

http://www.michaelmoore.com/

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Also, I wouldn't be at all surprised if Moore didn't have a hand in hiring the Sarkisyan's lawyer Mark Geragos. Geragos is one of the most prominent trial lawyers in the country, having represented Winona Ryder, Michael Jackson, Snoop Dogg, and others in high profile court cases.


[ Parent ]
Focus on the war here! There's a war here! (4.00 / 3)
That was the key quote by Nataline's mother in that ABC video.  There is a war on the American people, and the world, being waged by corporate America and carried out by the US government. The evidence is in the numbers; how much more are you paying for health insurance and how big are the profits and even more galling, the bonuses?  The same can be applied to food, gas, heating oil, wages, benfits, and list goes on and on.

I thank you also Scarce for posting this, this is a Connecticut issue, a national issue, and by extension, a world issue.

Bottom line is that it's time for people to wake up.


More from the CBS Evening News (4.00 / 2)


John Edwards calls out CIGNA (0.00 / 0)
"Are you telling me that we're gonna sit at a table and negotiate with those people?" asked a visibly angered Edwards, challenging the health care companies. "We're gonna take their power away and we're not gonna have this kind of problem again."

Edwards also told the audience of about a hundred people at the Score Pavillion in Nevada, Iowa, that it will take a fighter (i.e. him) - and not a negotiator (i.e. Obama) - to take on large insurance companies like CIGNA.

"Anybody who thinks that we don't have a fight in front of us is living in Never-Never Land," he said.

http://www.cbsnews.com/blogs/2...


Some direct action. (4.00 / 2)
I just e-mailed my state rep, Melissa Olson, and gave her a link to this diary.  I suggest that everybody e-mail their reps and senators and let them know that despite the lack of advancement on this issue, we have not forgotten about it.

Insurance companies, doctors, patients (4.00 / 2)
I don't know all the details about Nataline Sarkisyan's medical problems. But, speaking from within the medical field, I can assure you that most doctors are frustrated with dealing with health insurance companies. Far from being in cohoots with them in denying care for our patients (as a few in here may think), we are in fact in the front lines everyday in trying to get our patients' medical care (in the form of medical tests, medications and referrals to other specialists) paid for by their insurances. And how do we do that? By spending much more time than is "medically necessary" on the phones, on paperwork, on dealing with the bureaucracy (such as pre-authorizations, etc.) that insurance companies have put up us hurdles to discourage doctors from performing tests and prescribing medications they think is too expensive for their bottomline.

I have told my patients many times that health insurances are here not to help them. But, to make money from them just like any other insurance business.

Health insurances second guessing of doctors' medical decisions (via denial of coverage) are very common--and is a fact of life if you want to practice medicine in the United States.

The arc of history is long, but it bends toward justice. --Martin Luther King, Jr.


the more people die, the richer they get (4.00 / 2)
Kind of chilling to think about these people making money by playing God.  

This is not about a well written policy and well managed administration of the policy.  This is about overly aggressive cutting of corners and fast and loose justification of denial of benefits -- they literally are deciding who will die in service of their bottom line.

Cutting off chemo patients' benefits that was in the news a couple of weeks ago is the same thing -- the news articles said that employees were receiving BONUSES for pulling the policies (cancelling them) on cancer patients during their chemo treatments.



[ Parent ]
Clinical Doctors are Mostly NOT the Problem (4.00 / 2)
Just wanted to make that clear, ConnecticutYankee. The doctors I accuse of being in cahoots with the insurance industry are primarily academics who moonlight as consultants, case reviewers and expert witnesses. There are also physicians who whore out their services to the insurance industry in order to observe patients and look for reasons to allow the insurers to deny payment (though not all physicians who perform this service are corrupt).

The bigger issue is with the academics because they not only use their expertise to help insurers deny payment, but also bias their research and teachings in a manner that assists the profitability concerns of their insurance benefactors. This behavior causes harm to the masses by poisoning the well of accepted standards of care.

Most physicians are caught on the other end of the disaster, having to spend countless hours dealing with insurance forms and justification letters, not to mention spending far less time with patients than is often necessary in order to make enough revenue to sustain their business.


[ Parent ]
 
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