WANTED FOR MURDER: Cigna Health Insurance

ThetaBurst · 12-26-2007, 09:50 PM

Quote:

Originally Posted by Marketwatch

Cigna stands by liver-transplant-coverage decision
Insurer initially denied funding, then reversed itself, but patient, 17, died

By Robert Daniel, MarketWatch

TEL AVIV (MarketWatch) - Cigna decided not to pay for a liver transplant, then reversed itself, but the 17-year-old patient died before she could undergo the procedure, the attorney for the patient's family said.
Media reports say the Los Angeles attorney Mark Geragos, representing the family of Nataline Sarkisyan, said he would sue the Philadelphia insurer and would ask the district attorney to press criminal charges as well.

In a statement on Monday, two Cigna HealthCare executives expressed condolences to the family but stood by the firm's determination that the patient's plan did not cover the transplant.

Cigna went to "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," Cigna HealthCare President David Cordani and Chief Medical Officer Jeffrey Kang said in the statement.

Sarkisyan was diagnosed with leukemia at 14 and received a bone-marrow transplant from her brother a month ago, but complications arose and she needed the transplant, the reports said.

Doctors from the University of California at Los Angeles Medical Center urged Cigna to enable the transplant.

At the same time, doctors quoted in media reports said that such a transplant might be futile because the drugs required to support the procedure could worsen the leukemia.

Cigna had initially said that the transplant was experimental and it would not
pay for the procedure. The family and supporters protested, however, and Cigna reversed itself.

In the Monday statement, Cigna said it made an exception based on the "unique circumstances of this situation," saying that the procedure was outside the plan's coverage and that medical evidence that it would be effective was lacking.

But Sarkisyan's condition worsened and she was taken off life support on Thursday. She died shortly thereafter, media reports said.
Robert Daniel is MarketWatch's Middle East bureau chief, based in Tel Aviv.

http://www.marketwatch.com/news/stor...D44831132AF%7D

jdanton · 12-27-2007, 07:36 AM

This is heartwrenching because of the age of the patient.

I would think those who believe there's a better life after this one would be happy for her.

I've seen the general argument in a variety of places as to prioritizing transplant recipients.

Mickey Mantle got one: was that a good decision?

My friend's dad had a little belly ache that lasted a week, so he went to the doctor. Turns out he had fairly advanced stomach cancer and there wasn't anything they could do. He was dead a month later.

My friend was angry at the doctors for not discovering it sooner, although he had no symptoms.

He'd lived a nice, full life and was getting on in years. We're all going to die at some point. He died with little or no pain, and I figure he's ahead of the game.

My friend seems to think that the doctors could have kept him alive forever.

The situation with my mom was she was would have been 92 in June of 2005, but she was dying in March. No matter what we did, she'd probably not see her 92nd birthday.

She was in pain, her memory was shot, and it didn't seem to matter in the big scheme of things whether she died in April or May, so the dr. kept her comfortable, put her in a hospice unit (only because we had a small child in the home with us) and in a few days she passed in her sleep.

I have very mixed feelings about the insurance companies decision in this case.

If there was a reasonable chance that the transplan would have given her several years, it is one thng. If the best it would do would be months, it's another.

Richterscale · 12-27-2007, 07:54 AM

Quote:

Originally Posted by jdanton

I have very mixed feelings about the insurance companies decision in this case.

I have NO mixed feelings about their decision at all. Insurance companies should have ZERO input into what or when a doctor can do for their patient. Insurance companies should have no place in the health care field period.
They add zero benefit, increase health care costs for the U.S. by 30 percent, and are crippling many American businesses, not to mention families.

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