| Dec 24, 2007 @ 11:14 AM |
Unbelievable actions by our private health care providers...Murder Inc.
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Mission_Impossible139
Posts: 222
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The lawyer for California teen Nataline Sarkisyan charged today that the only reason Cigna Health Care officials changed their minds and approved a liver transplant for the desperate girl was they knew it was too late and they wouldn't have to pay for it.
Sarkisyan, 17, died Thursday just hours after Cigna reversed its decision and approved the procedure it had previously described as "too experimental…and unproven." Now the Sarkisyan family hopes manslaughter or murder charges will be pressed.
Their lawyer, Mark Geragos, says he will refer the case to prosecutors for possible criminal charges against the insurer, Cigna HealthCare.
"All of the doctors there unanimously agreed that she needed and should have that liver transplant. And the only entity, if you will, who said no to that in the middle of that medical decision, was some piece of garbage who decided that making a couple of dollars, or saving them a couple of dollars, was worth more than the 65% chance over six months that she would survive," said Geragos.
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| Dec 24, 2007 @ 12:27 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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Gallows_Humor
Posts: 7,784
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if this ever goes to trial..it will have far reaching consequences... but like all the others before it....I expect a settlement will be reached...
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| Dec 25, 2007 @ 8:16 AM |
Unbelievable actions by our private health care providers...Murder Inc.
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Mission_Impossible139
Posts: 222
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It's a message to all that unless you have a gaggle of lawyers, you won't be getting good medical care. Funny how when it comes to medical decisions, the profit driven
CEO's are now involved as much as the doctors. Yea, guys who studied marketing, business models and who drank to excess are in control of your health. And some wonder why most of us are worried?
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| Dec 25, 2007 @ 11:25 AM |
Unbelievable actions by our private health care providers...Murder Inc. |
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lefthandedluckie
Posts: 5,023
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Profit driven Health Care Companies are just that profit driven! Their bottom line is more important than any life!
"ALL" CEO's know if they show profits each quarter and at the end of the year....bonus money comes! For the CEO it means 100's of miilion of dollars! Not only money but those great stock options! 
So, will they kill anyone...yes they will this little girl that is being talked about on this thread was murdered for the bottom line! 
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| Dec 25, 2007 @ 12:24 PM |
Unbelievable actions by our private health care providers...Murder Inc.
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uab_5
Posts: 2,371
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I pray the SECOND act the new DEMOCRATIC POTUSA does is abolish the health insurance companies. 
We all know what the first act will be.
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| Dec 25, 2007 @ 12:42 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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iam7545
Posts: 4,151
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I hate to burst your bubbles -
However -
First -I find it curious that anyone would believe a scum bag attorney like Garagos!
Second - what makes you so sure that any Govt funded insurance would cover this? It is experimental, risky and a liver transplant for this purpose does not have any history of giving very much life to the patient. Do you all really think that Medicare and Medicaid just rubber stamps any recommended procedure?
Third - Do you have any idea how long it takes to get a liver?? The waiting list is over a year and is prioritized by the possibility of success and the need. From what I have read this girl would have likely not been prioritized due to the risky nature if her condition. Look it up!
Had the insurance company approved the procedure there is a high likelihood she would have died waiting.
That was their big mistake!
Garagos is a scum bag and even his feeble attempt to try this case in the media will not get him the millions he seeks for his next Mercedes Benz! While it appeals to the sympathy of the uneducated, a jury will have the facts.
Government run healthcare would not have saved her life!
If you really care about this - stop drinking and donate your organs! The shortage of organs is criminal! Why people do not donate organs is worse than criminal!
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| Dec 25, 2007 @ 1:01 PM |
Unbelievable actions by our private health care providers...Murder Inc.
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SweetNapaGuy
Posts: 4,526
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Before I choose to be outraged at either the "criminal neglect" of an insurance company or the "greedy hand-wringing" of a trial lawyer, I'd want to see the professional opinions of at least one transplant surgeon. The assembled opinions of a bunch of bloggers (both those from neo-cons and those more rational) don't amount to a hill of beans.
Do I believe that insurance companies measure lives in terms of dividends per share? Of course they do. There is a limit to how far-reaching the "monkeysphere" can be, and someone judging the life of someone they don't know versus their next performance review will often forget they're talking about human lives.
However, iam is correct in one area: there are only limited numbers of donated organs. The obligation is to make sure they are used as responsibly as possible, to honor the sacrifice of the donors. This means that people who have low probabilities of survival will be denied a transplant. This also means that people who have displayed behaviors that don't show a commitment towards preserving the transplant (for instance, giving up alcohol) will lose their place in the transplant queue. (Barring major celebrity status or overwhelming wealth, of course.) It's harsh, but the transplant committees have to make harsh decisions, until such time as stem cell research (or some other research) renders non-related transplants obsolete.
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| Dec 25, 2007 @ 1:23 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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lefthandedluckie
Posts: 5,023
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Here is a look at the Cost Benefit Analysis that drove Cigna to deny!
We here at Cigna feel your pain Nataline...but, you are going to cost us too much dearie, accept our heart felt condolences, please! CEO...Cigna!!!
And the Nurses statement.
cigna calculates the cost of life and death
RN's statement on cigna should have listened to Doctors
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| Dec 25, 2007 @ 1:45 PM |
Unbelievable actions by our private health care providers...Murder Inc.
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Gallows_Humor
Posts: 7,784
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On Dec. 11, four leading physicians, including the surgical director of the Pediatric Liver Transplant Program at UCLA, wrote to CIGNA urging the company to reverse its denial. The physicians said that Nataline “currently meets criteria to be listed as Status 1A” for a transplant. They also challenged CIGNA’s denial which the company said occurred because their benefit plan “does not cover experimental, investigational and unproven services,” to which the doctors replied, “Nataline’s case is in fact none of the above.”......
vs......
Posts: 1,824 I hate to burst your bubbles -
However -
First -I find it curious that anyone would believe a scum bag attorney like Garagos!
Second - what makes you so sure that any Govt funded insurance would cover this? It is experimental, risky and a liver transplant for this purpose does not have any history of giving very much life to the patient. Do you all really think that Medicare and Medicaid just rubber stamps any recommended procedure?
Third - Do you have any idea how long it takes to get a liver?? The waiting list is over a year and is prioritized by the possibility of success and the need. From what I have read this girl would have likely not been prioritized due to the risky nature if her condition. Look it up!
Had the insurance company approved the procedure there is a high likelihood she would have died waiting.
typical.....just typical.... 
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| Dec 25, 2007 @ 1:55 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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iam7545
Posts: 4,151
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The physicians said that Nataline “currently meets criteria to be listed as Status 1A” for a transplant. They also challenged CIGNA’s denial which the company said occurred because their benefit plan “does not cover experimental, investigational and unproven services,” to which the doctors replied, “Nataline’s case is in fact none of the above.”......
gallows - wtf does this mean? THERE IS A WAITING LIST - eVEN AT THIS STATUS THERE IS A long WAITING LIST FOR LIVERS! the girl did not live very long - did she?
Of course the Dr's said this. 70-85% of the dollars spent on all healthcare in the USA is in the last 90 days Of peoples lives - I would expect nothing else.
People die from disease. And sir - there are no guarantees that a procedure like this would be successful.
No program will fund every procedure. You are living in a fantasy.
Are you willing to pay for every procedure that a Dr suggests?
Is there any Health Care Program in the WORLD that will do this?
Stop drinking and donate your organs!
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| Dec 25, 2007 @ 2:16 PM |
Unbelievable actions by our private health care providers...Murder Inc.
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uab_5
Posts: 2,371
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I've stopped drinking a long time ago... 
and I've got the "organ donor" check mark on my driver's license.
But the world will have to wait for that fatal car wreck to have them. 
Now then...why should in order to pay Paul the MD, should Guido the health insurer get a cut?
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| Dec 25, 2007 @ 3:13 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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iam7545
Posts: 4,151
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uab - great - I think that your hard head would keep you safe in any car accident!
JOKE!
In the USA we have more medical options available when in dire straits than anyplace in the world.
Of course many surgeons are opting to do botox and breast implants as the patients pay cash!
Merry Christmas!
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| Dec 25, 2007 @ 3:42 PM |
Unbelievable actions by our private health care providers...Murder Inc.
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Gallows_Humor
Posts: 7,784
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Stop drinking and donate your organs!
if I was a drinker...my liver would be shot... so..who would want it ..
oh yeah..btw..
http://www.gao.gov/special.pubs/organ/appendc.pdf3.6 Allocation of Livers. Unless otherwise approved according to Policies 3.1.7 (Local and Alternative Local Unit), 3.1.8 (Sharing Arrangement and Sharing Agreement), 3.1.9 (Alternate Point Assignments [Variances]), and Policy 3.4.6 (Application, Review, Dissolution, and Modification Processes for Alternative Organ Distribution or Allocation Systems), the allocation of livers according to the following point system is mandatory first locally, then regionally, and then nationally. Each patient will be assigned a status code corresponding to the degree of medical urgency as described in Policy 3.6.4 below. Each patient also will be assigned points for conditions as described in Policies 3.3.5, 3.6.2, 3.6.3, and 3.6.4. Livers will be offered for patients with an assigned status of 1 in descending point sequence with the patient having the highest number of points receiving the highest priority before being offered for patients listed in other status categories. Following Status 1, livers will be offered for patients with an assigned status of 2A in descending point sequence with the patient having the highest number of points receiving the highest priority before being offered for patients listed in less urgent statuses. Following Status 2A, livers will be offered for patients with an assigned status of 2B in descending point sequence with the patient having the highest number of points receiving the highest priority. Following Status 2B, livers will be offered for patients with an assigned status of 3 in descending point sequence with the patient having the highest number of points receiving the highest priority.
what do you think 1A meant??
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| Dec 25, 2007 @ 3:59 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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iam7545
Posts: 4,151
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gallows - it is christmas - I am not looking to argue. The point that you have missed is this -
if one had 1-a status there is still a long waiting list for livers. It is unfortunate but true. there is now an entire industry for organs - many third world countries are accused of intentional murder businesses to profit from organ sales.
Glad to hear that you do not drink - your liver will be used wisely.
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| Dec 25, 2007 @ 4:21 PM |
Unbelievable actions by our private health care providers...Murder Inc.
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SweetNapaGuy
Posts: 4,526
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Liver Foundation FAQ
What is the average amount of time that patients wait for a donated liver?
The time that people spend waiting for a liver transplant varies widely. Blood type, body size, severity of illness and availability of donor organs all affect waiting time. Some people who develop sudden and complete liver failure from an acute illness may only have to wait a few days for a transplant. Other people, whose condition is less severe, may stay on the waiting list for many months.
There is no question that the waiting list can be long. There are many variables, so each patient is unique. You can be the next person on the list, only to be bumped down as someone becomes more critical than you.
The real question is, how long did the family have to spend fighting the insurer? If the insurer had simply accepted her 1A designation from the start, would she still be alive today? Would a 17-year-old girl have been able to celebrate Christmas?
And how much of a bonus did the decision-makers at the insurance company receive for fighting the recommendations of the doctors and the transplant committee?
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| Dec 25, 2007 @ 4:29 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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SunBabe
Posts: 12,242
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...but MOST insurance companies/HMOs won't pay for transplants. Period.
Check out your own policies -- it's in the fine print. (I did a lot of research on this awhile back)
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| Dec 25, 2007 @ 4:32 PM |
Unbelievable actions by our private health care providers...Murder Inc.
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SweetNapaGuy
Posts: 4,526
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True. Especially mine. Working for a non-profit, we've got sucky insurance.
However, this insurance policy did cover transplants, and their actuarial tables included the possibility of a 17-year-old having a catastrophic illness. They based their insurance premiums on these risks, and now don't want to pay out.
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| Dec 25, 2007 @ 4:52 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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lefthandedluckie
Posts: 5,023
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I grew up loving baseball and the New York Yankees! During that time there was a centerfielder named Mickey Mantle! One of the best ball players I ever saw!
Seems he had a problem with "alcohol"! Not once a week or so...but every damn day! He damaged his liver. He received a liver so fast it was like a shooting star going by! He had no insurance but, he had a hell'uva lot of money! He got his transplant within a coupla days after the announcement he needed it!
So, the old sayin is true...."Money Talks and Bulls**t walks"!!!!!!!!! 
Mickey Mantle
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| Dec 25, 2007 @ 6:09 PM |
Unbelievable actions by our private health care providers...Murder Inc.
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Nightowl001
Posts: 4,087
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As pointed out in one post, waiting lists for transplants of any kind are based on a number of factors, including viability and availability of MATCHED donor material. Some people have very long waits because their condition does not place them in imminent danger of death from their condition and/or because their tissue immunophenotypiing means that they are very, very difficult to match. It's not like all the available livers are put in the same pool and whoever is next gets the next one.
As for the useless argument that there are no guarantees, there is no guarantee for ANY surgery. About 1 in 200,000 people undergoing routine surgery will go to sleep under general anesthesia and die of unknown reasons presumed to be related to the anesthesia itself. No surgery carries a 100% chance of success, but almost all surgical conditions carry predictable consequences of not being treated.
I imagine there are very few parents of teenagers who, upon hearing that their child MAY or even probabyly will die from a procedure, but they will definitely die without it, would opt for certain death.
It is interesting to me that hospitals can be held liable for turning away paitents in need of some emergency lifesaving procedures, but in a situation like this the hospital administration can say "We won't do this unless we're sure we'll get paid." I don't know who is worse; the insurance industry or the healthcare industry.
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| Dec 25, 2007 @ 8:35 PM |
Unbelievable actions by our private health care providers...Murder Inc. |
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lefthandedluckie
Posts: 5,023
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Nightowl001.....said this..."It is interesting to me that hospitals can be held liable for turning away paitents in need of some emergency lifesaving procedures, but in a situation like this the hospital administration can say "We won't do this unless we're sure we'll get paid." I don't know who is worse; the insurance industry or the healthcare industry."...!!
Very, very good point! I would not want to take a vote!
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