Nataline Sarkisyan, only 17 years-old, died shortly before Christmas when Cigna initially refused to approve a liver transplant. Her story reads like it was lifted right out of Michael Moore's Sicko.
In case you missed the documentary in the movie theaters, Sicko was about America's health insurance industry and people who DO have health care coverage but can't get their health insurer to pay. England, France, and even Cuba appear to have better day-to-day coverage than we do. Cuba!
Frankly, I was fully prepared to hate the greedy so-and-so's that run the major health insurance companies, but I have a few questions about Ms. Sarkisyan's case--that I haven't seen answered in the main stream media.
1) Why did the doctor's wait to give Nataline bone marrow transplant until after she'd been "battling leukemia for three years"?
Her liver failed due to a complication arising from the bone marrow transplant, but my question is this: Was she weak from battling the leukemia already? Could she have had the bone marrow transplant earlier and would that have given her liver a better chance at dealing with the stress of the bone marrow operation? And was Cigna involved in that decision as well?
2) Why did the doctors take Nataline off life support?
Cigna reverse its initial decision and decided to pay for the transplant after they'd stopped her life support. Were the doctors not expecting the decision to be changed? Was Nataline required to be able to breathe on her own in order for the doctors to do the operation.
Cigna reverse its initial decision and decided to pay for the transplant after they'd stopped her life support. Were the doctors not expecting the decision to be changed? Was Nataline required to be able to breathe on her own in order for the doctors to do the operation.
3)Why does Cigna need independent experts to second guess the doctors involved in Nataline's case?
Are these "independent experts" doctors or accountants or a set of both?
Are these "independent experts" doctors or accountants or a set of both?
4) Who was going to get the liver if Nataline wasn't going to get it and were they much, much healthier or was this liver going to sit on the shelf for a few more hours, days, or weeks?
5) Why can't the doctors involved in her case be the ones to make the decision? And why shouldn't complications from the first operation make you an automatic approval for a second?
If a health insurance company approves the first procedure, they should approve everything arising from it. The only thing that might give me pause about continuing to do the best you can to keep a patient alive is that her chances for survival are small and she'd be taking a healthy liver that someone else needs with her.
Without answers to these questions and more, who really knows if Nataline should have gotten that liver transplant (in a timely fashion) or whether she should have had the bone marrow transplant earlier. But I do know that someone other than Cigna (or the "independent experts" that Cigna pays?) who is in business to make a profit ought to be making the final decisions on what health care is needed. The gatekeepers for keeping our health care costs down need to be separated from the profit maker, Cigna, on one side and the emotional decisions of the doctors and families involved on the other.
Without answers to these questions and more, who really knows if Nataline should have gotten that liver transplant (in a timely fashion) or whether she should have had the bone marrow transplant earlier. But I do know that someone other than Cigna (or the "independent experts" that Cigna pays?) who is in business to make a profit ought to be making the final decisions on what health care is needed. The gatekeepers for keeping our health care costs down need to be separated from the profit maker, Cigna, on one side and the emotional decisions of the doctors and families involved on the other.
