Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
And where did I state that she should not have received a transplant? In fact I've stated the opposite, and that the insurance company should be sued.
Why? She'd have died waiting for a liver anyway. From what I heard on the news, she was on the UNOS list only for a few weeks. The average wait time is almost a year. Her death is not CIGNA's fault.
Why? She'd have died waiting for a liver anyway. From what I heard on the news, she was on the UNOS list only for a few weeks. The average wait time is almost a year. Her death is not CIGNA's fault.
They already had a match...and the bigger question is what the heck is the insurer delaying treatment the doctors claim is necessary and proper in the first place?
The Sarkisyan family claims that Cigna first agreed to the liver transplant surgery and had secured a match weeks ago. After the teen, who was battling leukemia, received a bone marrow transplant from her brother, however, she suffered a lung infection, and the insurer backed away from what it felt had become too risky a procedure.
"They're the ones who caused this. They're the one that told us to go there, and they would pay for the transplant," Hilda Sarkisyan said.
Geri Jenkins of the California Nurses Association said the Sarkisyans had insurance, and medical providers felt comfortable performing the medical procedure. In that situation, the the insurer should defer to medical experts, she said.
"They have insurance, and there's no reason that the doctors' judgment should be overrided by a bean counter sitting there in an insurance office," Jenkins said.
Doctors at the UCLA Medical Center actually signed a letter urging Cigna to review its decision. Nataline Sarkisyan was sedated into a coma to stabilize her as the family filed appeals in the case.
They already had a match...and the bigger question is what the heck is the insurer delaying treatment the doctors claim is necessary and proper in the first place?
The Sarkisyan family claims that Cigna first agreed to the liver transplant surgery and had secured a match weeks ago. After the teen, who was battling leukemia, received a bone marrow transplant from her brother, however, she suffered a lung infection, and the insurer backed away from what it felt had become too risky a procedure.
"They're the ones who caused this. They're the one that told us to go there, and they would pay for the transplant," Hilda Sarkisyan said.
Geri Jenkins of the California Nurses Association said the Sarkisyans had insurance, and medical providers felt comfortable performing the medical procedure. In that situation, the the insurer should defer to medical experts, she said.
"They have insurance, and there's no reason that the doctors' judgment should be overrided by a bean counter sitting there in an insurance office," Jenkins said.
Doctors at the UCLA Medical Center actually signed a letter urging Cigna to review its decision. Nataline Sarkisyan was sedated into a coma to stabilize her as the family filed appeals in the case.
Mm-hmm, and what makes you think she'd have survived the procedure or that as a cancer patient just having undergone chemotherapy that she would even be a candidate for a liver transplant?
I don't buy that she'd have been any better off in the UK or Canada. If the family secured a donor "weeks ago" that meant a living donor, and living liver donations were only recently approved in the UK and are still very rare. So, she'd have died under the NHS's care too.
Well gee, who knows if she would have survived?? I'm guessing the odds would have been better than if she didn't have the surgery. Because she is dead.
That is why we have insurance, right? To do the things required to give us the best chance of survival?
The doctors were ready to perform the surgery and in fact were apparently begging Cigna to give the go ahead, so I am guessing that yes she was in fact a candidate.
It would have been a high risk procedure. I'm certainly no fan of insurance companies, but it's too bad they are going to get sued over this. It's this type of lawsuit that causes all of our premiums to go up. Insurance companies don't pay when they lose lawsuits, the people that pay are the insured who have their insurance rates raised. All the associated costs with the lawsuit, including any judgement, is paid by people who have CIGNA insurance.
Besides, if the medical center wanted to proceed with the operation they could have, and let simply let the insurance situation play itself out later.
Additionally the insurance company wasn't the ones that took the child off of life-support, it was her parents. For them to say CIGNA murdered their child is wrong.
But nobody has answered - why is the insurance company the one deciding whether to approve the high risk procedure or not? If the doctors feel it is viable and there is a chance that the life will be saved, what moral right does a claims examiner have to reject this? And this after they had previously approved it to begin with?
And they had to put her in a coma to stabilize her in the first place ...while they argued with the insurance company. So she wouldn't have been on this life support to begin with.
I do agree that the hospital probably bears some responsibility as well, but this is what happens when health care becomes all about the bottom line and maximizing profits.
But nobody has answered - why is the insurance company the one deciding whether to approve the high risk procedure or not? If the doctors feel it is viable and there is a chance that the life will be saved, what moral right does a claims examiner have to reject this? And this after they had previously approved it to begin with?
And they had to put her in a coma to stabilize her in the first place ...while they argued with the insurance company. So she wouldn't have been on this life support to begin with.
I do agree that the hospital probably bears some responsibility as well, but this is what happens when health care becomes all about the bottom line and maximizing profits.
Again, do you think this transplant would have been performed in a country with socialized medicine on such a high-risk candidate? Patients are allowed to die all the time in the UK for the exact same reasons as they are here: money. Blame the ins. companies all you want, but don't say it's all just about profits.
But nobody has answered - why is the insurance company the one deciding whether to approve the high risk procedure or not?
It's not a perfect system. If doctors were able to guarantee insurance company payments for every high risk procedure they wanted to do, then available funds would dry up and there wouldn't be any money left for people to use for routine appointments, unless they jacked the rates up.
Besides, the insurance company only decides to approve or disapprove payment for a procedure. The hospital, doctors and medical experts decide whether or not to go ahead with the procedure. The Medical Center could have performed the procedure and let the appeals process work out the payments later.
Again, do you think this transplant would have been performed in a country with socialized medicine on such a high-risk candidate? Patients are allowed to die all the time in the UK for the exact same reasons as they are here: money. Blame the ins. companies all you want, but don't say it's all just about profits.
I know you feel you had some bad experiences in the UK personally, but other posters have posted that they had more positive experiences. And they are ranked 18 in the world by the WHO for health care, we are 37.
In any case - I am not trying to make this another "let's have a national health care debate.
Do you agree that insurance companies should be able to reject coverage for procedures that medical experts agree are viable operations for the symptoms of the patient and are covered under the insurance terms for the patient? In this case the insurance company - after it first approved, then later denied the procedure, apparently did so on the grounds it was "Experimental" when the doctors said this was not the case at all. What should the ground rules be?
Up to 500 heart patients die each year while they wait for potentially life-saving surgery, a report has said.
An editorial in the British Medical Association journal Heart said that the only way to prevent these deaths would be to perform the operations as soon as the heart condition was diagnosed.
This is what happens in the private sector, it said, but NHS patients are often put on a waiting list because of other pressures to health service resources.
MOD CUT
Shows an apparent shortcoming of the NHS, but I wonder what the number is of people in America who never "get on the list" for the surgery because they can't afford to have it in the first place, though... it's easier not to ration healthcare according to need/costs when it's already rationed according to profit/ability to pay.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
