Get sick: get SCREWED !

[Nictoe]

Teen dies after insurance nixes transplant funds

12/21/2007

Filed by David Edwards

A 17-year old died just hours after her health insurance company reversed its decision not to pay for a liver transplant that doctors said the girl needed.


Nataline Sarkisyan died Thursday night at about 6 p.m. at University of California, Los Angeles Medical Center. She had been in a vegetative state for weeks, said her mother, Hilda.

"She passed away, and the insurance (company) is responsible for this," she said.

Nataline had been battling leukemia and received a bone marrow transplant from her brother. She developed a complication, however, that caused her liver to fail.

Doctors at UCLA determined she needed a transplant and sent a letter to CIGNA Healthcare on Dec. 11. The Philadelphia-based health insurance company denied payment for the transplant.

On Thursday, about 150 teenagers and nurses protested outside CIGNA's office in Glendale. As the protesters rallied, the company reversed its decision and said it would approve the transplant.

Despite the reversal, CIGNA said in an e-mail statement before she died that there was a lack of medical evidence showing the procedure would work in Nataline's case.

"Our hearts go out to Nataline and her family, as they endure this terrible ordeal," the company said. " ... CIGNA HealthCare has decided to make an exception in this rare and unusual case and we will provide coverage should she proceed with the requested liver transplant."

Officials with CIGNA could not immediately be reached for comment Thursday night.
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"I draw the line in the dust and toss the gauntlet before the feet of tyranny, and I say secession now, secession tomorrow, secession forever."

[Biscuit]

Wheres the compassion in this??
Just because the insurance company withheld the money, does that mean that the doctors still cant do the needed transplant/operation??
Come on!!.....they could have saved her life, and worried about payment later

[theLIBERTARIAN]

Nictoe, that is the top story in Google News' health section right this instant. Here is another story about health insurance in general:

Uninsured More Likely to Die From Cancer Following Diagnosis


THURSDAY, Dec. 20 (HealthDay News) -- People diagnosed with cancer who don't have health insurance are more likely to die because they are less likely to get screening tests and so are typically diagnosed with advanced disease, a new study from the American Cancer Society finds.

The finding proffers strong evidence that differences in cancer survival are directly related to lack of access to health care.

"If you are uninsured, and you are diagnosed with cancer, you have a 60 percent greater chance of dying from cancer than if you were insured and diagnosed with cancer," said Dr. Otis Brawley, chief medical officer at the cancer society.

"There is not a cohort of insured and a cohort of uninsured cancer patients that have the same five-year survival," Brawley added. "It's always the uninsured who do worse."
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Bing News - The Best Place To Get Your News

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[theLIBERTARIAN]

[Biscuit]

I think it shows just how much people are in love with money....over and above everything else....even life!!

Sad, because money does'nt really mean anything when you look at it....its just an object, it can be replaced, but a life cant.

[barstow wiz]

[bestsynd]

Patient Dies After Cigna Health Insurance Company Agrees To Pay For Liver Transplant – Nataline Sarkisyan Dead From Leukemia



(Best Syndication) The parents of 17-year-old Nataline Sarkisyan's will sue Cigna health insurance company after their daughter died without receiving a liver transplant. The families attorney, Mark Geragos said Cigna "maliciously killed" Nataline because it did not want to bear the expense of her transplant and aftercare.

Cigna called the procedure experimental. The immunosuppresant drugs given to transplant patients can increase tumor growth. Three years ago Nataline was diagnosed with leukemia, a form of cancer. She received a bone marrow transplant from her brother and later developed complications causing her liver to fail.

Why did Cigna change their mind

[bestsynd]

Health Insurance And Screening Saves Lives – American Cancer Society Reports Death From Prostate Breast Colon Cancers Reduced Among Insured



(Best Syndication) It may seem self evident, but a new study confirms that people without health insurance are less likely to receive screening and are more likely to be diagnosed at a later stage for cancer. This leads to worse outcomes and a lower survival rate.

The American Cancer Society released the results of their study on Thursday. The society used data collected from the National Cancer Database which is compiled from hospitals and paid for by the American College of Surgeons and the American Cancer Society.

What about Prostate Colon Breast Cancer Rates?

[Nictoe]

Why We Need Single-Payer Health Care

Does This Happen in Canada?

By MARK T. HARRIS
December 31, 2007

The story of 17-year-old Nataline Sarkisyan's recent death from liver failure was tragic. But it was a uniquely American brand of tragedy. Only in the United States would the medical fate of a sick child be left to some private company's idea of what constitutes necessary care.

The Northridge, California, teenager died after her health insurer, Cigna Healthcare, spent critical weeks denying approval for the liver transplant her UCLA medical team said was her last hope. Only after public protests by her family and the California Nurses Association embarrassed Cigna did the company reverse its decision. But it was too late. The decision came the same day Nataline died.

What is wrong with this picture? Like all insurers, Cigna relies on hired medical advisors to evaluate a treatment's medical appropriateness under the terms of a policy. In this case, Cigna's "evidence-based" medical guidelines led it to deny the recommended liver transplant, categorizing the procedure as "experimental." This was a complex medical situation, of course. But all the more reason why the patient's actual medical team should have been the only authority to determine the appropriateness of treatment. In fact, there was uniform support for the transplant from UCLA's medical experts. Instead, the insurer's conduct became a case study in the worst possible outcome that can result from the involvement of a for-profit insurer in medical decisions.

But the case also suggests something is wrong even when things go right under the present health system. Obviously, insurance companies stay in business by paying most claims. No one would buy their products if they didn't. But they also stay profitable by trying to avoid sick people as customers, and whenever possible by not paying claims.

Who among us cannot speak from personal experience about the frustrations of getting a legitimate claim paid? Years ago I once found myself in a hospital emergency room in Chicago with an acute kidney infection. I spent two days in the hospital and was successfully treated. I also ended up with about $4,000 in medical bills. Fortunately, I had health insurance through my employer. But fortunate can be a relative thing when you're dealing with an insurance company. Shortly after returning to work I received a letter from the insurer informing me that my hospital stay was not covered since it was for a "pre-existing condition." The plan excluded pre-existing conditions during my first year of coverage.

By what stretch of the imagination could an acute infection and emergency hospitalization constitute a pre-existing condition? Was it because I had always had a kidney? This was the question I had when I called the company's claims department. The claims rep couldn't answer my question and said he would get back to me. A short while later I received another letter from the company informing me that my hospital stay would now be covered.

The insurer's attempt to avoid paying my claim was clearly wrong. So why would they do it? Was it just an "oversight?" Or was there some cost-benefit analysis somewhere that showed if an insurer denies coverage in 100 similar cases, X number of policyholders could be expected not to challenge the decision, thus saving Y dollars? Insurance companies are not penalized for rejecting claims, of course, unless fraud can be proven in court. But the fact that insurers will often quickly reverse a rejected claim when the customer protests suggests the rotten core at the heart of their system.

I also once sought chiropractic care, which my insurer covered at 70 percent of the cost of care. But the catch was that the insurer paid 70 percent of what they considered a reasonable fee for the particular service. Of course, their idea of a reasonable fee was always lower than the doctor's. The absurdity of this was brought home when my doctor actually lowered her per visit cost by a small amount. Naively, I thought my out-of-pocket costs would go down. Wrong. The insurance company responded by re-adjusting downward their definition of a "reasonable fee."

All this is otherwise known as the "let's see what we can get away with" approach to quarterly profits. Such experiences among policy holders are hardly out of the ordinary, and they raise a pertinent question: Do we really want a health care system that encourages those who pay for care to find ways not to pay for care?

Contrary to the free-market hype of Republicans, inefficiency runs rampant in a health system controlled by private companies. Lavish executive salaries, marketing costs, and stock dividends all eat up financial resources that could be used for actual health care services. But contrary also to the reform hype of most Democrats, a more closely regulated mishmash of private insurance and employer plans combined with new public benefits, tax credits, and subsidies is not going to resolve the current system's failings.

Both Hillary Clinton and John Edwards propose mandates that will require the public to purchase health insurance, a potential boon in new profits the insurance industry can only welcome. In return, they expect the insurance industry to cooperate with reforms to improve their products. Barack Obama's health plan differs fundamentally only in leaving out a purchasing mandate. But either way the candidates are sidestepping reality: for-profit and health care go together like oil and water. In fact, as the California Nurses Association and other single-payer advocates note, mixed public-private systems always seem to end up favoring the private sector's efforts to corral the most profitable patients and services. Invariably less profitable patients and services become the burden of public resources.

Unlike most modern nations, Americans have allowed their health care system to be undermined by a business culture that apparently sees no aspect of the human experience as off-limits to those who prefer dollar signs to social responsibility. Currently, millions of uninsured as well as insured Americans are not getting timely or adequate medical care because of unaffordable costs or concerns over high deductibles and co-pays. Or, sometimes, as one Northridge family learned, because their insurance company is more concerned about profits.

The CEO of Cigna Healthcare's parent Cigna Corporation, H. Edward Hanway, earned about $21 million in total compensation in 2006. You just have to ask. Is this right? Do children who use the Canadian health care system die to make other people rich?
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"I draw the line in the dust and toss the gauntlet before the feet of tyranny, and I say secession now, secession tomorrow, secession forever."

[theLIBERTARIAN]

[bestsynd]

Health Insurance Company And Policy Premium Comparison Chart – Which Provides Lowest Monthly Payments



(Best Syndication) Health Insurance premiums can involve complex processes to compute. We have conducted a survey of insurance companies based on the lowest possible monthly premium amount. There are many variables involved in the process including health conditions, number of people covered and your job. It is difficult to find coverage if you are pregnant or plan to get pregnant.

In our survey we picked a man born on January 1st 1970 with no health problems living in southern California. For our evaluation, the subject would be single, a non-smoker and not a student. The man used in our survey did not have high blood pressure or other health conditions which could increase the premium. We were looking for the lowest possible rate, but if you have any condition listed, it is advisable you make that known when you apply.

Health Insurance Company Comparison Rate Chart

[Nictoe]

[Guitarras Reyes]

The Russian cure for crappy healthplan and healthplan debates, including debates such as GIRL SCOUT COOKIES BEING DELIVERED SOON, is Vodka.

"I swear ta God it is"
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www.myspace.com/suejacobsband
Hecho en E.U.A. COMING SOON!

[Nictoe]

The ER Effect as Evidence of a Deteriorating System

Just How Good is Your Health Insurance?

By JEFF SHER
January 24, 2008

It's been difficult to generate a groundswell of public opinion for real change in our deeply flawed health care system because most of the people who have medical insurance believe having insurance is equivalent to having guaranteed access to quality health care.

The insured may have empathy for the nearly 50 million uninsured in this country, but they seem to believe that the problems of the uninsured are not also their own problems.

Consider then the recently released study by a team of researchers from the Harvard Medical School. The researchers found that emergency room (ER) visits increased nearly 18 percent in the 10 years ending in 2004, while the number of hospitals operating ER's fell 12 percent during the same decade.

The result is that patients wait longer now for treatment in emergency rooms. Waits for all types of treatments increased by 36 percent from 1997 to 2004, the researchers found. Heart attack patients waited eight minutes for treatment in 1997, but by 2004 they were waiting on average 20 minutes. One in four heart attack patients can expect to wait as long as 50 minutes or more before being treated.

This is yet another example of the deteriorating condition of our health care system. The ER problem affects patients whether they have insurance or not, no matter how "good" that insurance is.

And if you are admitted to the hospital, make sure you carefully check the bills the hospital sends you. It has been estimated by experts in the field that up to 80 percent of all hospital bills contain multiple errors. In fact, just checking the bill yourself very likely will not find all the errors.

There is a new and growing layer of the medical bureaucracy composed of billing specialists who will review your hospital bill for you and get paid either by the hour or as a percentage of the savings they generate for you by correcting the errors in the bill. Since hospital stays easily run in excess of $10,000 per day, even an insured patient's share of a bill can mount up quickly. This is particularly true in the case of the high deductible plans that have become popular in recent years (as employers try to shift costs to employees).

Just add these issues to the growing list of obstacles to obtaining the health care you need, such as insurance company denials of coverage for treatment before the fact, denials of claims for reimbursement after the fact, difficulty in obtaining referrals to the appropriate specialists, not to mention the problems you may have obtaining insurance if you ever become unemployed or self-employed. Let's put it this way: if you have any kind of chronic problem, or have had even a mildly serious problem in the recent past, you most likely will encounter difficulty obtaining a policy and you very likely will pay very high prices for it if you do get one. And if you have had a serious illness that has any chance of recurring or which studies show has even the slightest chance of rendering you more susceptible to other serious complications in the future (even the distant future), don't expect to find insurance at all.

Almost everyone knows someone else who has encountered difficulties in obtaining the medical care they need, yet we persist in believing we have the "good" coverage.

Perhaps people who think like this should have their head examined. Except most likely they will find that kind of treatment is not covered by their insurance.
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"I draw the line in the dust and toss the gauntlet before the feet of tyranny, and I say secession now, secession tomorrow, secession forever."

[msyoung227]

What about (1) Christian Scientists -- who don't believe in hospitals or doctors, no how, no way? Would they be forced to buy an insurance plan?
(2) Jehovah Witnesses - same thing; (3) people who are 100% holistic and only go to naprapaths of alternative healers? And what is affordable to a person who does odd jobs for $20-$30 a day and has a wife and child? $100? $50? $40? You can't compare this with Social Security, because although you are putting in money and your employer matches it, you don't get social security withdrawn if you don't have a job.