While browsing through the news headlines today, I came across a story about a 17-year-old girl who passed away from liver failure. Nataline Sarkisyan's liver was malfunctioning due to a rare complication she had from a bone marrow transplant. She needed the bone marrow to survive her on-going battle against leukemia.
The complications from the transplant were so severe, her liver and kidneys were completely damaged. In order to stay alive she needed a new liver immediately. But her health insurance company, Cigna, refused to pay for the organ transplant.
As an excuse for why Cigna denied coverage, the company claimed they do not pay for "experimental surgeries." But Nataline's family fought back and demanded Cigna cover the operation. As soon as the insurance company agreed to pay, Nataline died. Her family is left feeling as though her life was unnecessarily snatched away from her.
Stories like this always hit hard. But in my case, Nataline's death hit harder since I personally knew her for years. We went to the same dance studio, where I watched her grow up, dance, and goof-off in class. When I read the news of her death today, a million negative feelings bombard me at the same time. But one emotion that conquers all is anger.
Nataline was a girl who never had the opportunity to experience a single day of college, or see what it's like to live her dream as a fashion designer. An insurance company determined Nataline's fate, and it's scary to think a nameless, faceless person has the ability to decide whether a person lives or dies.
Nataline's story is just one example of the problems faces with health care. Money comes before saving a person's life, and it is an issue the government obviously does not pay enough attention to. Why pay for health insurance if the company will not cover a life-saving operation? That's the question Nataline's family is asking today.
The family plans to sue Cigna for her death. But I imagine no amount of money could ever relieve the anguish they feel.
Reader Comments ( Page 1 of 3)
1. I hope those responsible for this girl's death are jailed on manslaughter charges. There is no excuse for the inhumanity CIGNA displayed, and no company should ever be allowed to arbitrarily dictate whether a person lives or dies.
Burn the greedy bastards, and burn them well.
Dan at 8:47PM on Dec 21st 2007
2. It's a horrible tragedy and CIGNA was 100% wrong; however, one of the reasons insurance companies don't pay for things is because they are constantly being sued for millions and millions. Money won't bring her back and it surely will not go to someone else on the transplant list either if it's given to grieving relatives.
Mel at 9:01PM on Dec 21st 2007
3. This poor girl was fighting a terrible disease and she finally died because her body organs failed. The organs might have been replaced, the transplants might have given her a few more months of life, but the truth is that she scarcely had any hope of regaining her health. The insurance company paying for her treatment pooled together the money of a lot of people to cover the cost of all the health care she had been provided up to her death. American families all know how much we pay for health insurance and health care. Payments for difficult cases such as this one is one reason why the cost is high. Let's talk about that fact.
Gringuita W at 9:09PM on Dec 21st 2007
4. Mel, I'm curious then to hear how you think insurance companies should be inclined to change their habits. Since this pathological stinginess is universal in every single insurance company in America, how do you suggest they change their ways. Changing companies does nothing. Look at the replete accounts of horrific denials for every insurer out there. And going without insurance means economic russian roulette or foisting it off on the taxpayer.
If you think suing companies won't get them to change their ways, what will?
Somber at 9:10PM on Dec 21st 2007
5. My deepest sympathies to the family.
Insurance companys are among the richest corporations going. They increase premiums from 16 - 36.5% per year, they decrease their surgeries, pharmaceuticals and other procedures covered constantly.
Their profits are large. Litigation means nothing, that is what insurance is for. Being litigious at the time of a loved ones demise is what allows us to rid ourselves of a bit of anger, soon they will realize it will never ease their pain.
I cannot wait until I am done tonight so I can write a lovely email to CIGNA!
rhodalee at 9:12PM on Dec 21st 2007
6. Why Grin. I didn't know you were one of her doctors! How nice for you to come here and tell us how she would and would not have survived the proceedure. How a year of her life is not worth a ding in the insurance company's profit margin.
Of course we could easily foist blame to those oh so greedy medical practitioners. Why, they charge such astronomical prices that it's a miracle the insurance agencies don't go bankrupt! Except that they don't. Medical providers are caught between the insurance agencies and the rising material expenses. The insurance company makes their money when you pay their premiums, and then they make their money again by denying until you die of whatever you had. Then they wring their hands and say "Oh there's nothing we could do." or "It was too experimental to try." when infact the transplanting of livers has been proven for over thirty years!
But hey! You want to make the debate of the "hard cut off?" Name the number. What is the price tag where a human life is no longer worth saving? A million dollars? A hundred thousand? A thousand? Maybe you want to apply it to an age... health care to every one under sixty but if you're sixty one then you're screwed. Or fifty. Or thirty. Or seventeen. Or we can be even more selective. Get HIV? No coverage. Hangnail? Coverage. ALS. No coverage. A broken finger? Coverage. Lieukemia? No coverage. After all we got to keep those premiums low and those profit margins high high high!
You make me lose faith in humanity.
Somber at 9:19PM on Dec 21st 2007
7. Gringuita, I come from Australia where decisions like this are simply not made by insurance companies, they are made by doctors. Clearly, given the facts of this case, the woman's transplant would have occurred immediately had she been in Australia. We have one of those "socialist" medical systems that everyone pays for through their taxes. How much is that? Well, let's look at it like this. The US spend 15% of their GDP on health. Australia? 8%. Let's talk about THAT.
Dox96 at 12:05AM on Dec 22nd 2007
8. It's the government's fault for accepting their bribes time after time. It's crap like this that makes me ashamed to be an American. I'm military so I can't move where I want, so don't tell me if I hate it here to leave. Obama 08! He's the only one who hasn't taken any bribes from these evil insurance companies. All the other candidates have. We need someone smart enough and moral enough to stand up to these bastards!!!
Michelle at 1:22AM on Dec 22nd 2007
9. Insurance is a business that needs to be profitable. If it does not make a profit, there is no way to pay on claims, employees and thousands of other business related costs. Sometimes people are just too ill or broken and all the money or operations in the world isn't going to save them. Death is part of life, it is going to happen to everyone. Because of this patient's illnesses, condition (coma and severe complications), I believe it was best to let her go, it was her time and it was no one's fault. This family should be grateful to have had a daughter for a time, there are no guarantees in life. Why are the people who helped to a reasonable extent now being sued? They should be commended on how much they did expend on trying to keep this very very ill person alive for as long as they did.
Geminate at 2:02AM on Dec 22nd 2007
10. It is a sad happening what had happen in this young lady's life. However, everyone acts as though there is an unlimited resource of medical assistance, body parts and funding to be able to heal all those who have a devistating desease or crippling malfunction of their body parts. Forty - fifty or even 10 years ago, she wouldn't have lived to the point of being in need of the transplant.
Death is the ying to the yang of life. They are a matched grouping. One does not come without the other. It is time for our society to accept that there are limitations of our finite lives and appreciate what was accomplished, rather than looking for a person, place or institution to always be blaming because the ending wasn't what we wanted.
May she rest in peace with the Lord.
Tim H. at 2:27AM on Dec 22nd 2007
11. As a rule, I don't like HMO's at all. However, in this case, I agree with CIGNA's decision. I am the grandmother of a 23 year old grandson who was also diagnosed with Leukemia at age 14, went thru 3 years of chemotherapy, went in to remission, relapsed at age 18, and required a bone marrow transplant. I was his caregiver during the bone marrow transplant process and for about 2 years afterwards. About a week after his transplant, he developed Hepatic Veno-Occlusive Disorder - liver failure, which progressed into kidney failure. He was admitted into ICU at MD Anderson Cancer Center in Houston. His BMT doctor told our family that this happens in only about 10% of BMT patients and that that there was basically no treatment that they could provide except for supportive care, and that whether or not he survived would simply depend on his own body's ability to heal itself - liver and kidneys, which they did. He was released from ICU back to the BMT floor about a week later. He is still, 4 years later, a cancer survivor. However, he was very, very ill for almost a year after his transplant and susceptive to any and all viral and biological illnesses. During that time he contracted spinal menengitis, a severe bladder infection, shingles, and numerous other infections, including GVHD. GVHD, or Graft versus Host Disease is an almost unavoidable after effect of a BMT whereas the graft (bone marrow) fights the host (the patient's body) and the only way to effectively control it is thru medication that regulates the immune system. The medications necessary for life for an organ recipient would have effectively countered the medications necessary to control his GVHD. I have no doubts that my grandson's system could not have withstood the effects of an organ transplant, in addition to all of the other problems that occurred, and always occur, subsequent to the bone marrow transplant.
It is not possible to put a price on a human life from an emotional standpoint. However, organ donations should be designated to those who have the best chance of survival, which I'm sure was extremely low in this young woman's case, sadly enough. At some point, a family has to accept the reality of the situation and let go. I personally think that in this particular case, the doctors involved significantly mislead the family regarding the liklihood of success with this procedure.
Millie B. at 5:11AM on Dec 22nd 2007
12. My prayers go out to the family and friends for their loss.
dungal1 at 7:18AM on Dec 22nd 2007
13. If Nataline was my family friend or even my daughter i would want the insurance company to cover the surgery. To address a previous entry, lets talk about why health insurances is so high. The primary factor that affects insurance rates is the Americian mentality to sue..sue..sue.
Yes I believe this was a tragic story. However there is no guarantee to surgery, so if the insurance company initial response was to cover the surgery the result may have been the same. Denying needed expensive surgical procedures is often the company's way of trying to cover losses from legal expensives.
I'm not a advocate for insurance companies however we need to examine how the abuse of the system affects all. I do think insurance companies should be examined and policies changed to require them to provide affordable insurance for all.
Reece at 9:23AM on Dec 22nd 2007
14. somber and other's have written some wonderful posts here.
and then we have some that indicate a lack of knowledge on why HMO's refuse care sometimes.
let me clarify for you.
HMO's are corporations,they offer medical care management.that is their service.
but first and foremost they are a corporation.
and as a corporation they are MANDATED by their corporate charter to put profit above all else,even if that is detrimental to a clients health.
they must offset as much cost as they can,onto the customer,the local municipality or even to the state and government level.
they are required to put the shareholders first.
so in the HMO's case,it's a contrary system.
the better health care they provide,the less profit they gain,which in turn hurts their shareholder's and future's.
the more care they deny,they better off their shareholder's are,and better off on the trading floor.
it's a redundant and contrary system that is broken.
they pay bonuses to claims adjustors why save the company money,even though this may result in death for a long time client/patient.
this system can work if your selling goods,but becomes decidedly incomprehensive when we take it to the realm of health care.
it's very similar to how a corporation will break an enviromental law.
they save 100's of millions by,lets say dumping waste and not changing how they do it,because the fine is only 20 million.
thats a savings of 80 million.
see what im saying?
it's the money,pure and simple.
but they are required to put money first.
even if your the CEO of cigna,you would be fired if you put the health of your client first before profit.
the system is broken,and needs to be fixed.
till next time..peace.
Enoch D.D.S
enoch at 9:40AM on Dec 22nd 2007
15. While insurance companies need to cover their expenses there is a difference between being solvent and being profitable. The CEO of Cigna, Mr. Hanway, had a total compensation last year of $38.8 million dollars. This was his personal compensation which included a $3+ million dollar bonus.
Several have stated that the surgery may not have been successful and that justified the insurance companies denial. My aggravation about this statement is that the decision to have surgery should not be made by some insurance company nurse or a physician employed by the insurance company calling him/herself an expert. Most of these physicians are retired docs that have not practiced in years!! The patient and her physicians- who were very much among the most respected experts in the field- made the decision that surgery was the patient's best option. These are decisions that should be made by the health care team not a very wealthly MBA.
robinsmd at 11:39AM on Dec 23rd 2007