21 December 2007

Douche Of The Week 12.21.07

Family Attorney Says He'll Sue Insurance Company That Initially Denied 17-Year-Old Girl a Liver Transplant

The family of a 17-year-old girl who died hours after her health insurer reversed a decision and said it would pay for a liver transplant plans to sue the company, their attorney said Friday.

Nataline Sarkisyan died Thursday at about 6 p.m. at the 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 that caused her liver to fail.

Doctors at UCLA determined she needed a transplant and sent a letter to Cigna Corp.'s Cigna HealthCare on Dec. 11. The Philadelphia-based health insurance company denied payment for the transplant, saying the procedure was experimental and outside the scope of coverage.

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.

Robocop's Comment:

This is happening way too many times. HMO's/Insurance Companies are making MEDICAL decisions. For killing too many people for refusing the service that they PAID for through premiums, CIGNA Healthcare is the "Douche Of The Week". To be honest, CIGNA just represents the real Douche Of The Week, the Health Insurance Industry. They are a runaway train, which follows a course with NO consequences to fear. This is immoral. Behavior like this will even get demands of government control from conservatives like myself. Why? Because I am a human being. May those claims adjusters have a shitty Christmas.


Karmyn R said...

First off - Happy Birthday!!!!!

Secondly - if it was my child - I would sell my arms, legs, and soul to get my child the transplant, regardless of what the insurance company said. Sure - the HMO sucked, but did the parents try and pay for it themselves? Expensive, I know - but hell - I'd sell my house if it meant keeping my child alive.

Robocop said...

This should give us a frame of reference:

"Estimated Liver Transplant Costs
According to the United Network for Organ Sharing (UNOS), estimated charges for liver transplantation are:

Estimated First-Year Charge: $314,600

Estimated Annual Follow-up Charge: $21,900

Following your transplant, you will need several drugs, called immunosuppresives, to sustain your transplanted liver. The immunosuppressive medications may include Neoral, Cellcept, Prograf and Prednisone. The following are estimates and depend on the dosage and pharmacy used. Note that most health plans pay a percentage of medication costs, as described in the next section.

# Neoral or Prograf: Total monthly cost is approximately $1,500

# Cellcept: Total monthly cost is approximately $800 (required for approx. first three months only)

# Septra: Total monthly cost is approximately $7.50

# Prednisone: Total monthly cost is approximately $5.50

# Proton Pump Inhibitor: Total monthly cost is approximately $160 (required for approx. first 3 months only)

# Nystatin: Total monthly cost is approximately $172 (required for approx. first 2 months only)

# Valcyte: Total monthly cost is approximately $2,000 (required for approx. first 3-6 months only)

# HBIG 5cc vial: Cost is approximately $2,190 per injection (hepatitis B only)

# Lamivudine, Baraclude or Hepsera: Total monthly cost is approximately $750 (hepatitis B only)

Debs said...

You heard about the elderly woman who broke her back and they basically told her to go home and die. Thank goodness the hospital refused to let that happen. Have to love the insurance companies. Counting the beans instead of human life.

Anonymous said...

I keep hearing of the horror stories of the medical system down there. I always feel so blessed to live here where the system, although not perfect by any stretch of the imagination, is great and covers whatever needs to be done.

No matter what insurance you pay, it is a rip off. As soon as you need it, or use it once, the premiums go up, and you get limited on the use. We have found that with little things in vehicle insurance and house insurance. It is so frustrating to have a system, so big and so compromised with no vision of it ever changing. It is so wrong.

wolfbaby said...

you know what scares me more is the possibilitie that the govt gets more control of things like this as they are just as bad as the ins co's...