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Insurance okays transplant as teen dies
Filed under: Teens, Health & Safety: Babies, In The News
Nataline Sarkisyan had leukemia. I say "had" because it is no longer an issue for her. She passed away last week. She had undergone a bone marrow transplant from her brother, but a complications with her liver meant she needed a transplant. Her insurance company, however, decided that there wasn't enough evidence showing the transplant would work in her case. So they denied the claim.
She fell into a coma and died, just hours after the insurance grudgingly reversed its position and approved the procedure. Earlier in the day, about 150 nurses and students protested outside the insurance company's offices, presumably prompting the company's change of heart. Unfortunately, it was too late. Despite CIGNA's gracious decision to "make an exception in this rare and unusual case and... provide coverage should she proceed with the requested liver transplant," Nataline passed away later that evening.
I'm no expert on insurance, but it seems to me that when faced with a choosing between paying for a procedure that might save someone's life and just letting them die, one would go for the former. Alas, insurance companies don't seem to be in the business of saving lives; they're more interested in generating profits. I'm not sure that socialized medicine is the perfect answer, but I'll bet there are a lot of parents -- Nataline's included -- who would say it couldn't be any worse.
She fell into a coma and died, just hours after the insurance grudgingly reversed its position and approved the procedure. Earlier in the day, about 150 nurses and students protested outside the insurance company's offices, presumably prompting the company's change of heart. Unfortunately, it was too late. Despite CIGNA's gracious decision to "make an exception in this rare and unusual case and... provide coverage should she proceed with the requested liver transplant," Nataline passed away later that evening.
I'm no expert on insurance, but it seems to me that when faced with a choosing between paying for a procedure that might save someone's life and just letting them die, one would go for the former. Alas, insurance companies don't seem to be in the business of saving lives; they're more interested in generating profits. I'm not sure that socialized medicine is the perfect answer, but I'll bet there are a lot of parents -- Nataline's included -- who would say it couldn't be any worse.
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ReaderComments (Page 1 of 1)
3-17-2008 @ 11:39AM
Jeffrey John Hodapp said...My mother died without a liver transplant and at the same time my brother died without a bone marrow transplant. My whole family was poisoned by Cincinnati Barrel, Inc. when they illegally dumped carbon tetrachloride in our drinking water. We paid everything we had to keep them alive, our land, retirement funds and years of our lives. My brother only had medicaid and my mother had medicare, both were denied transplants although the hospital would not admit this. They claimed there were no matches. They don't find a match when you can't pay properly. After my brother died and the bills were paid, we found that his chemotherapy drugs were diluted by a corrupt pharmacist. This of course served to strengthen his cancer rather than cure him.
This destroyed my family and still haunts us years later. There's a saying here in America, "Don't get sick and don't get old." The fight against socialized medicine is a ploy to keep the profits high and people weak and powerless. We are all a serious illness away from poverty and disaster. I have no answers. Profiteering destroys lives. Maybe revenge and a second American revolution is the only answer.
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12-22-2007 @ 8:21PM
Derek said...Oh yea social health care is awesome! Everyone gets approved for a new liver!!! meaning everyone who needs one will be on the list! So Nataline, she would have been approved but I doubt she could have lived the 9 months it would have taken to get her a new liver. People fail to realize that you can't just go to the grocery store to get a new liver. They cost money... ALOT of money, esp if you need it right away. The insurance company is in it for the greater good of the business, yes people it is a business. They can't go bankrupt giving away livers to high risk patients, robbing patients with a lower risk the chance to live. It isn't perfect, and I'm sure there are plenty of horrible people in the industry... but everyone who applauds social health care seems to forget there are just as many horrible people in the government.
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12-22-2007 @ 9:31PM
mamaloo said...Derek, I'm not saying you're wrong, but as an Ontarian with social health care (though not perfect, but then nothing is) who recently watched Sicko to get an idea of what American health care is sort of about, and I gotta say: I can't believe Americans don't riot in the streets for better health care. I cannot believe that it's actually possible for an insurance company to deny anyone care or medicine if their doctor deems it necessary.
Canadian social health care may not be perfect, but holy moly is it ever miles above the kind of care Americans receive via their health insurance companies!
It's not so bad already that this young woman must face certain death if a transplant can't be found in time, but to have to fight a health company for the right to even get on the transplant list?! That's cruel and absurd.
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12-23-2007 @ 1:26AM
Dee Dee said...I'm not sure that if one of your loved ones had a chronic condition and needed expensive medical treatments and then had their insurance deny them coverage you'd feel the same way Derek. Am I right? Transplants aside, I realize there's a shortage of organ donors but that could change if given the right focus and hope on the subject. What about all the other medical treatments they deny?
Look at the ranking of the US's quality of care and life expectancy compared to all the other countries out there. PITIFUL. We should be enraged and stop letting our fear of "Socialized" medicine stop us from getting necessary medical treatments. Other countries do it, we should be able to as well. The big corporations who are getting super rich off of our citizens should not be allowed to play god. For PROFIT. Unbelievable. It's a complete shame and so embarassing.
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12-23-2007 @ 3:34AM
Derek said...First off... Sicko only shines a light on the negative side of US health care and a positive on socialism. While the movie's single minded agenda is less aggresive than Moores' previous films... they are certainly not documentaries.
I am a wonderful capitalist! I work hard, found a job that has an excelent health care package. And live a very healthy life, I take very good care of me and mine.
I think that is what is wrong with America... people trash their bodies, have children without the proper income and a support structure there to maintain themselves... then blame society for their woes. While I have empathy for the millions of children who lack proper healthcare... the sad truth is... their parents are to fault.
My wife, works with a woman who came from Canada... that woman's grandmother just died. It was a sad case of extreme negligence on the side of the hospital. BUT thanks to it being a social system, the family can do nothing about it. In the US that doctor risks a lawsuit, inquists, and even sponorship loss all of which can ruin a career. Those same things drive doctors in our country to care more. While we may lack life expentancy (also notice how over half our country is obese) Our medical system has put out more advancements than any other country and it will continue to as long as it has proper investment.
Once again I re-iterate, its not a perfect system, it could use a tweeking, but not in the direction everyone thinks it should go... GOVERNMENT CONTROL is not the answer.
Everyone hates George Bush, it seems like... calling him King George. Yet those same people turn around and contradict themselves when they want to hand over more of their rights and privledges to the government.
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12-23-2007 @ 10:39AM
Dee Dee said...Tee hee...Such a hopeful and positive attitude you have Derek.
May your family suffer from one of the many unexpected genetic
diseases out there. May your progeny have excellent heath benefits...
and maybe also a huge trust fund, possibly supplied by you. May their
doctors be wise and experienced. May the profiteering
insurance moguls and powers-that-be decline prescribed treatments and
drugs prescribed by your truly honest and good doctors.
May they lose the ability to work, go to school collect income, and create an
adequate "support structure". May you learn first hand that the drug
lobbyists and insurance companies will not give you the best products
and care that you know you need. May they lose coverage all together due to "lapse in coverage" then "pre-existing condition".
May you and your offspring lose everything, houses, businesses,
health and vitality. May you sit and watch one of those "millions of
children" go without what you know they need until it's too late. (Remember also,
they began with an excellent health package and you're obviously in a high
tax bracket yet they're still being denied care, prescribed drugs etc. They'd like you to start taking a third tier drug just to rub it in. Be prepared to chose between your boat and your grandchild's $6,000 per month drug bill sir.)
All for the profits of your system that needs
"tweaking". God Bless our brave profiteering insurance industry. May it
happen to you even several generations down the line. They'll have no one to
blame but their parents.
12-23-2007 @ 9:36PM
Derek said...Wow, just wow Dee Dee... that is truly despicable of you. No matter my differences with people, no matter my religious or political views... I would never... wish harm and misfortune upon someone or their families.
And with that, I sincerely hope for good fortune upon you and yours.
12-23-2007 @ 3:43AM
SKL said...All I gotta say is, anyone who watched "Sicko" to get an idea of the US health care system has a very warped view of it.
I don't know for sure what motivated the insurance company, but frankly, if the child didn't have a good chance of survival after the transplant, she should only have been allowed to have it if there were no healthier patients on the waiting list. Giving an organ to a patient who is likely to die means trading one tragic death for one probable and one likely death. I am one hundred percent sure that a socialized medicine system would not have afforded this girl a better chance. Not unless she lived in some super-rich country where nobody gets denied anything ever.
Yes, insurance is a business, and business is not evil. There are other alternatives, none of which are better overall. No existing or imagined system can prevent children from developing fatal illnesses.
I am quite aware that Canada has serious issues in its health care system, and I am sure it would be noticeably worse if they couldn't come to the US for needed services when they can't get them there. But if you all want to taste socialized medicine, feel free to move there and check it out for a while. My family and I are quite satisfied with insurance being a business rather than a government bureaucracy. We'd like to keep it that way.
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12-23-2007 @ 3:56AM
SKL said...And I agree with Derek that irresponsible Americans make health care access far worse than it needs to be. Most Americans run up unnecessary costs that the insurance companies and their clients have to pay for. They choose to smoke, overeat, sit around, drive carelessly, abuse alcohol, and so on, thus putting a huge strain on the entities that get stuck paying for all of this. Then these same people are seen whining when they don't get all the services they feel "entitled" to. Actually they should be ashamed because they are making access more difficult and expensive for others who make responsible choices yet experience health issues that they could not prevent.
If the US insurance industry were really as "heartless" as many people believe, they would cut off everyone who smokes, uses illegal drugs, or is obese. Personally I think that would be a breath of fresh air - ahh, accountability! Then there would be plenty of money to pay for liver transplants for sick children, assuming they had enough livers to go around. And why should I care what happens to those who get cut off? They make their own choices and I'm really tired of paying for them.
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12-23-2007 @ 9:00AM
Justin said...All I gotta say is... Amen SKL!
About time someone flat out says it.
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12-23-2007 @ 10:31AM
mamaloo said...Most of your other services are government run, police, fire, social services, public works... I fail to see why health care is the bogeyman. But, my comments certainly won't change anyone's mind.
And, if there is legitimate negligence on the part of any care provider, Canadian citizens have exactly the same recourses as Americans do. Malpractice insurance is alive and well up here in Canada, too, you know!
Whatever the faults of the particular system Canada has (which is different than other systems, socialized medicine merely means that access is universal regardless of income or prior condition) I am forever grateful and willing to live within it's limitations to guarantee that when I am injured or sick I can walk into any hospital, be examined, treated and followed up and never once have to worry that the decision to seek medical help could be a financial burden.
If my son has a temperature of 104 degrees in the middle of the night, I can walk into an emergency room and have him treated immediately whether I have no income or whether I make a million a year. My son will be given everything that health care can offer, regardless of his parent's financial situation. There are no co-pays to worry about, no HMOs to work within, no special government programs we need to qualify for before being seen.
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12-23-2007 @ 12:32PM
Lynn said...Thank god I live in Canada. THANK GOD.
NO matter how anyone will ever argue that the American way is better and ours is so flawed, I am eternally grateful for our system.
I personally have never known anyone to have a problem up here. Of COURSE stories about neglect are going to be published, they make good news! And they sure as hell DO get sued for malpractice, don't know where anyone got that misconception. There have been news articles that actually, its getting as bad as the States for suing!
There is NOTHING, absolutely nothing, like the knowledge that no matter what happens with our income or employment status, we have health coverage. My children will always have access to cheaper-than-the-US drugs, round the clock medical care and there is no question of whether or not I can "afford" a procedure for my sick child. Sure it has flaws, everything does.
And no one I know of actually complains about shouldering any burden of people not taking care of their health, that we all "share" this universal care, that because I make a lot of money I should have better healthcare. I have never heard ANYONE talk like that. But hell, that's what makes us Canadian baby!
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12-23-2007 @ 12:50PM
SKL said...Lynn, I've seen multiple Canadians post that certain high-risk fetuses should be required to be aborted so they are not a strain on the Canadian public health care system. So maybe I am reading from different sources than you.
I agree it is nice to know you can always get medical care in an emergency. For your information, the same is true in the US, regardless of financial status. The difference is that if you go to an emergency room and you CAN afford it, you will have to pay later. The result of this is that there is more money in the system so people can get higher quality emergency whoever they are. I know a number of people whose lives were saved by advanced procedures in world-renowned US hospitals and they didn't have to pay a penny.
Oh, and those cheaper drugs you are getting in Canada were largely developed by profit-motivated US (or sometimes non-US but still non-socialized) pharma companies. Lucky for you there is a profit motive somewhere in the world - e.g., in this country which happens to have a population 10x that of Canada, so you can piggyback off our developments. It's a bit hypocritical for people to enjoy the benefits of a for-profit system and then knock it. But it's certainly not uncommon.
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12-23-2007 @ 1:14PM
Dee Dee said...The harder they come the harder they fall. "Wonderful Capitalists", to quote Derek, are also wonderful sick folks for the insurance agencies. They love people like you.
Who gives the insurance companies and drug companies their biggest profits? The ones with the most to lose! You seem to think you're above it.
When we work hard our whole lives, and do right, and then have to contend with anonymous insurance bureaucrats to give loved ones neccessary care it's the ultimate eye-opener. I do believe you are a prime candidate for that kind of experience. You seem so assured that it can't happen to you or yours. Believe me it can! It just might. Are you really to blame?
I also want to correct a typo in my second post. It should read $16,00 per month drug costs, not $6,00 per month.
12-23-2007 @ 1:17PM
Lynn said...Well, as for posts, I NEVER believe most of what I read. I don't know them, I don't know that they aren't a "troll" (and I know the comments you are talking about, the BC multiples, the comments shrieked "troll" trying to cause trouble) Anyone can come on here, claim they are Canadian, then type what they want. I said "personally" I don't know anyone like that. The internet is a breeding ground for anyone who likes to cause trouble.
As for the drugs, I am pretty sure its just our Canadian legislation that makes sure we can all afford it. The drug companies are not losing out that badly. The markup on them is atrocious, and they will take whatever the US allows them to, sure, its free enterprise, but I for one, am glad that we have a government that steps in for the common person.. Big deal, the companies wanted a profit and invented. Hurray for them. Should we look back at every for-profit organization and get upset at those who "piggyback" ? Does that mean they should gouge every consumer? No, not for medical essentials. You invented Plasma tv's? Hell, have at, gouge us, take as much money out of pockets as you can. Medicine for your dying child? Perhaps there should be limits.
And please, piggyback? Don't get even get me started on our Alberta Oil that everyone is fighting over.
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12-23-2007 @ 3:58PM
SKL said...Actually I wasn't talking about the BC multiples, so this attitude must be widespread. And as for them being non-Canadian trolls, why a bunch of non-Canadians want to pretend to be Canadian just to post saying they are angry their dad died due to refusal of services caused by insufficient health care resources? That's a stretch. I believe these things absolutely happen and they are not unusual. No, the US system is not perfect, but you can't have an honest discussion if it's so unbalanced as the comments above.
But hey, I'm glad that you're glad to be Canadian. Please stay up there don't come crowding our hospitals when you need something they won't give you. And I'll do the same.
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12-24-2007 @ 9:25PM
Lynn said...See, everytime someone actually attempts to point out that American companies are taking advantage of Americans, or that perhaps, somethings are just wrong, we are all jumped on, and told to stay in Canada.
Ugh, wrong place for any intelligent debate or discussion. SKL, you posted TO ME that:
"Lynn, I've seen multiple Canadians post that certain high-risk fetuses should be required to be aborted so they are not a strain on the Canadian public health care system. So maybe I am reading from different sources than you."
Ummmm, sorry, I forgot to read into that to see that you were talking about someones dad dying due to lack of services, gee, my mistake. I thought that aborting high risk fetuses was pretty self explanitory, must be my cold Canadian brain that was mistaken with your post and didn't realize it was a dying dad.
How on earth were you NOT talking about fetuses? Please read what you post, so we can have a good hearty debate, because now nothing you said makes any sense, and any purpose is lost. You rebutt with information that is totally contrary to what you posted.
Anyways, I rebutted to your post about the fetuses, and those were obviously trolls. I am kinda done with this, I like a good debate but this isn't one.
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12-25-2007 @ 12:02AM
Dee Dee said...Yes and what's worse is that those of us who are run into the ground by insurance and drug companies who're born and actually LIVE in the US are told to move to Canada by those who feel they are above it all. Talk about getting kicked while you're down. Now *That's* despicable.
12-24-2007 @ 6:07PM
SKL said...Lynn, I said I wasn't talking about the BC multiples. I am sure those are not the only fetuses that were ever conceived in Canada. Hence, I did not say I was not talking about fetuses. Indeed I was, but you are not following me.
I am not sure which "BC multiples" you are even talking about. But I am talking about a different discussion about high-risk birth (not multiples) where multiple posters complained they should be aborted. One of such posters' theory was that these high-risk births were sucking resources out of the system and that was a factor in his dad's death. Other posters didn't have the deceased dad issue but did feel that the system in Canada is too strained to allow high-risk fetuses to be born, so they should be aborted for the common good. I just happened upon this discussion accidentally - I don't make it my life's work to look for Canadians bashing the Canadian health care system. I didn't think it was necessary to reproduce the exact discussion so you would understand me. My first and second posts on that topic were factual, you just misinterpreted them.
You obviously found a similar discussion relating to some "BC multiples" that I didn't even know about. So apparently this is not an unusual argument up north. Maybe nobody would say it to your face, but apparently lots of people are thinking it.
I don't believe all of these people are "trolls" and I think if you do believe that, you are sticking your head in the sand.
And none of this has anything to do with your Alberta oil fields. My comment on piggybacking was not that it is wrong to do it, but that it is wrong to accept a benefit and then knock the system that gave rise to the benefit. Hypocritical. Ignorant too. If the profit motive for medical advances ended, you would potentially suffer regardless of whether you are currently paying more or less for the benefits.
Anyhoo, given that you aren't understanding anything I say, I agree this is not a useful forum for discussion. Besides, it is clear you just want to insist socialized medicine is the best, not listen to other perspectives.
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12-27-2007 @ 12:43PM
the goddess anna said...On a tangently-related subject, I'd like to add my two cents. I am former military, and was discharged on a disability. In short, my left knee is not constructed properly, and I need a replacement. The Navy did not want to pay for it, and so discharged me. As a Navy wife, I still have the same military care (through Tricare), and I still cannot get a new knee. The reason: I'm too young (25), and they would have to give me a new one about 10 years down the line. It is cheaper to feed me pain killers for the pain, and to supply physical therapy (if I wanted it) than to operate now and possibly down the road.
For those of you who don't know, the military's healthcare system is essentially socialistic. I pay nothing, and I can go see my doctor/hit the emergency room/recieve generic prescription drugs with no fees. Of course, I have to schedule appointments months in advance, and wait hours for service. Just because it's free (it's not, of course, taxes pay for it and we pay taxes) does not mean that it's a good deal.
I have to say, though, that we do have a choice. We could pay for private insurance. We're cheap/poor, so we don't, but I take solice in the fact that it's available. And I'm glad that in America we have choices (that aren't necessarily there in socialized countries).
On topic, it didn't seem like the girl had a high chance of survival. If she had the transplant, and died, that would have been a wasted liver. I know that sounds cruel, but if the percentages are low, than other people with a better chance at success should have priority.
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