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OfflineMrBump
Third prize is you're fired
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Registered: 10/01/02
Posts: 4,263
Loc: Denver, Colorado
Last seen: 4 years, 6 months
The Nataline Sarkisyan Story
    #7801094 - 12/26/07 02:41 PM (16 years, 1 month ago)

surprised this story has not been posted about already...but what is everyone's take on it?

If you dont know the story: A 17 yr old girl died after her health insurer, CIGNA, initially refused  to pay for a liver transplant (calling it an experimental  procedure), then CIGNA  changed its mind due to public outcry, but it was too late.

click here for an LA times article

the decision for CIGNA to pay for the transplant was apparently not so cut and dry b/c Nataline had lukemia, she previously had a bone marrow transplant, and due to complications from that transplant, she was in a vegatative state for the past 3 wks. I have read that the veggie state was med induced to stave off liver failure, and I have read the opposite, so I dont know which is true.

In any event, doctors gave her a 65% chance of surviving for 6 months, and less than a 50% chance of surviving for 5 yrs.

Nataline was 17 years old. The average lifespan of a woman in America is 79.1 years. So, rounding off, for actuarial purposes she had the potential to live another 62 years. In effect, the costs of the transplant and her first year care ($314,000) were chump change to Cigna. Plus, there were already “sunk costs” - business jargon for payouts already made for her prior procedures. So what was the value of Nataline’s life to Cigna?

some things to think about:

Cigna CEO H. Edward Hanaway gets paid about 28 million a yr.

Cigna's corporate catchphrase (or what ever it's called) is  "Cigna. A Business of Caring."

For full-year 2005, net profits were $1.64 billion

However, Cigna does approve about 90% of all transplants, including 90% of liver transplants.

I think its a very sad situation all around. There is a lot of gray area, given the girls medical condition. Should that liver have gone to someone w/ a better chance of survival w/ it? But, despite the docs stating that there was a significant chance that the liver wouldnt take, they still placed her on an organ donor list.

It makes me think that the Republican meme that a single payer healthcare system would take healthcare decisions out of the hands of doctors and patients and put it into government bean counters looks very specious, given that in this case a medical decision was made by a corporate bean counter to deny a transplant that could have saved a patient's life (again, nothing is medically certain, especially in this case)

insurance is like gambling, the insurance companies are betting that you dont get sick and they simply collect your premiums as a profit b/c of your good health. The consumer is betting that he/she will get sick and require medical attention - sometimes expensive and continuous medical attention - and that your ins. co will pay for your treatment. but, the ins. co. is like "the house." they always win. they have the clauses and fine print that allow then to claim a procedure is experimental, or not covered b/c its pre-existing, etc. you play by their rules, or dont play at all.:(


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If it weren't for the bloody corpses, I wouldn't have any corpses at all.

There are two ways to get to the top of an oak tree: start climbing or sit on an acorn.

Are you a carrot, an egg, or a coffee bean?


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Offlinelonestar2004
Live to party,work to affordit.
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Registered: 10/03/04
Posts: 8,978
Loc: South Texas
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Re: The Nataline Sarkisyan Story [Re: MrBump]
    #7801235 - 12/26/07 03:45 PM (16 years, 1 month ago)

It is a sad case.:(
This poor girl had ACTIVE leukemia and her liver had been destroyed by complications from a bone marrow transplant!
I am wondering if transplanting a liver to a leukemia patient was EVEN covered by her policy? (some kind of transplantation for leukemia patients policy?)Obviously insurance companies don't have to pay for what a policy doesn't cover......IMO transplanting a liver in a patient with active leukemia and pneumonia sounds like a waste of a donated liver.



Has anyone ever heard of active Cancer patients getting liver transplants????


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America's debt problem is a "sign of leadership failure"

We have "reckless fiscal policies"

America has a debt problem and a failure of leadership.

Americans deserve better

Barack Obama


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OfflineMrBump
Third prize is you're fired
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Registered: 10/01/02
Posts: 4,263
Loc: Denver, Colorado
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Re: The Nataline Sarkisyan Story [Re: lonestar2004]
    #7801320 - 12/26/07 04:14 PM (16 years, 1 month ago)

Quote:

lonestar2004 said:
It is a sad case.:(
This poor girl had ACTIVE leukemia and her liver had been destroyed by complications from a bone marrow transplant!
I am wondering if transplanting a liver to a leukemia patient was EVEN covered by her policy? (some kind of transplantation for leukemia patients policy?)Obviously insurance companies don't have to pay for what a policy doesn't cover......IMO transplanting a liver in a patient with active leukemia and pneumonia sounds like a waste of a donated liver.



Has anyone ever heard of active Cancer patients getting liver transplants????




I have no idea if something like this would be covered or not...makes me kind of want to review my policy to see how I am covered. am i covered "no exeptions" if I need a liver transplant or are there reasons to deny me specifically written into the contract? how vague and how specific are "experimental procedures" defined?

anyways, to answer youe question: it does not look like organ transplants are used very often to treat cancer. Click


--------------------
If it weren't for the bloody corpses, I wouldn't have any corpses at all.

There are two ways to get to the top of an oak tree: start climbing or sit on an acorn.

Are you a carrot, an egg, or a coffee bean?


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Offlinezappaisgod
horrid asshole


Registered: 02/11/04
Posts: 81,741
Loc: Fractallife's gym
Last seen: 7 years, 7 months
Re: The Nataline Sarkisyan Story [Re: MrBump]
    #7801392 - 12/26/07 04:38 PM (16 years, 1 month ago)

Given the shortage of organ donors she would be pretty far down the list based on those factors alone. Forget insurance coverage issues, the more precious commodity is the organ. You can always find a way to pay or sue the insurer but giving a rare liver to this patient with a rather shitty prognosis anyway is foolhardy. Have you all filled out your organ donor cards?


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OfflinePhred
Fred's son
Male

Registered: 10/18/00
Posts: 12,949
Loc: Dominican Republic
Last seen: 9 years, 18 days
Re: The Nataline Sarkisyan Story [Re: MrBump]
    #7801495 - 12/26/07 05:16 PM (16 years, 1 month ago)

What is the political angle here? Are you saying new legislation must be written to address situations like this?



Phred


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Invisiblegettinjiggywithit
jiggy
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Registered: 07/20/04
Posts: 7,469
Loc: Heart of Laughter
Re: The Nataline Sarkisyan Story [Re: zappaisgod]
    #7801973 - 12/26/07 08:28 PM (16 years, 1 month ago)

Quote:

zappaisgod said:
Have you all filled out your organ donor cards?




Always have! No reason I can see for why anyone wouldn't.


--------------------
Ahuwale ka nane huna.


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