8/11/2009

Private Health Insurance Horror Story #1

Beginning today, I will print a daily horror story about the much loved (it would seem) private health insurance industry.

These stories show how our "for profit" insurance industry has already done all the things they are telling their puppet "teabaggers" to claim a government sponsored plan would do - including "death panels" made up of loser bureaucrats and flunked out and disgraced 'doctors' and 'nurses.'
17-year-old Nataline Sarkisyan, a leukemia patient from Glendale, Calif., died in December 2007, after her parents battled their insurance company, Cigna, over the surgery. Cigna initially refused to pay for it because the company's analysis showed Sarkisyan was already too sick from her leukemia; the liver transplant wouldn't have saved her life.
In an article at the LA Times: Dr. Guiseppe del Priore sums up this immoral and criminal behavior by Cigna and it's unethical "experts":
Sarkisyan's procedure likely wasn't experimental because the outcome was known. Doctors treating her told Cigna that patients in similar situations have a 65% chance of living six months. A 65% chance of surviving six months does not preclude a 50% survival at five years. Furthermore, if consent is not required by the Institutional Review Board, and if others have already reported the procedure, it is not experimental. I helped introduced the radical abdominal trachelectomy in 1997 with IRB approval. It became the standard of care by repeated use as determined by individual doctor-patient relations — ultimately, whether a procedure is experimental can only be decided by a clinician and individual patient.

The third predictable insurance industry stall is the "expert" review. I would define an expert as a doctor who did a transplant or took care of a transplant patient this week. Insurers that review my denials define any has-been, retired, unemployed failure with a medical license an expert, paid to deny care. This is practicing medicine without examining the patient or seeing all the data. In effect, the licensed nurse or doctor working for an insurer is practicing medicine unprofessionally and criminally.

Sarkisyan was killed when the insurer decided to stall. Her family is within its rights to expect coverage for what their doctor determined was necessary, as Cigna promises.
And there you have it! Let's hope that Sarah Palin doesn't use Cigna because her dreaded "death panel" made up of insurance clerks, hack doctors, and washout nurses is patiently waiting their turn to pass judgment on her baby.

Read more about Nataline and her death warrant by Cigna's Death Panel:
Quick update: I got the following comment on Facebook about this post from someone I really don't know:
Jennifer Myers Williams: If you think government healthcare is better talk to a veteran. Better yet, go visit the VA hospital. I'm sure you'll come to your senses.
Now, the interesting thing about that comment and what I didn't realize until I checked out her "employment" info on Facebook, is that this seemingly "neutral" person expressing her opinion actually works for a division of Cigna as a "Catastrophic Case Manager." Those are the folks whe help make exactly the type of decisions seen here by exactly this same company. I don't know whether these employees are being instructed to pretend to be "concerned citizens" to promote their company's agenda or not, but it seems to be becoming quite a trend.




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