Politicians running for office like to talk about tort reform. There are too many lawyers filing nuisance lawsuits, and it's driving up the cost of health care.
So let me tell you about a 17-year-old girl from Los Angeles named Nataline Sarkisyan.
Doctors at UCLA determined she needed a liver 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.
The insurer reversed the decision Thursday as about 150 teenagers and nurses rallied outside of its office.
But later Thursday afternoon, Nataline died.
Rose Ann DeMoro, of the California Nurses Association, called the final outcome "a horrific tragedy that demonstrates what is so fundamentally wrong with our health care system today. Insurance companies have a stranglehold on our health. Their first priority is to make profits for their shareholders – and the way they do that is by denying care."
Is this a nuisance lawsuit? Well, it won't bring Nataline back to life - but the whole point of punative damages is not to help the person filing the suit. It's to punish the person - in this case, an insurance company - who is being sued.
Admittedly, there are better remedies. The prosecuting attorney ought to bear the burden bringing this to the courtroom, not Nataline's family. The insurance company's stockholders ought not bear the burden. Instead, the people working for the insurance company ought to bear the burden. If the decision was made by someone just following policy, then the person responsible for the policy ought to be the person who goes to trial.
And ought to go to prison, rather than have a multi-million-dollar fine that the company pays.
His opponents deride John Edwards for being a lawyer. Edwards got rich suing over people who lined their pockets by deliberately disregarding the health and safety of their customers. In one case, a little girl was disemboweled because a swimming pool manufacturer couldn't be bothered to fix a problem part - a part that had already been fixed in other models of the pool. It would be cheaper to settle lawsuits rather than to redesign the part, they decided.
That makes John Edwards vermin in other politicians' eyes.
He wrote a book about several of his cases. It's a good read, a real eye-opener - and you can get it, used, at Amazon.com for $1.61. It's worth the effort.
Barack Obama says we need to have everybody involved sit down at a big roundtable, and that will solve the health care crisis. John Edwards says that just won't happen; the insurance companies, the people with the power, won't give up their power without a fight. And although Senator Obama has some really good ideas - my biggest objection to his candidacy is that I think some SOB will shoot him before he can take office - I think Edwards is right on this one.
I'm sorry Nataline. We failed you. Mr. Bush says nobody need do without health care in this country just because they don't have insurance - they can go to the emergency room. But in this case, Nataline died even though she did have insurance.
If you're the praying sort, say a prayer for Nataline's family and friends. They're hurting. And if you pray to a vengeful god, you might mention the corporate officers of CIGNA while you're on your knees.
CIGNA says They Were Right to Refuse to Pay, Killing Girl
EL AVIV (MarketWatch) - Cigna decided not to pay for a liver transplant, then reversed itself, but the 17-year-old patient died before she could undergo the procedure, the attorney for the patient's family said.
Media reports say the Los Angeles attorney Mark Geragos, representing the family of Nataline Sarkisyan, said he would sue the Philadelphia insurer and would ask the district attorney to press criminal charges as well.
In a statement on Monday, two Cigna HealthCare executives expressed condolences to the family but stood by the firm's determination that the patient's plan did not cover the transplant.
Cigna went to "two independent experts in the field who agreed that the procedure in question, given the patient's particular circumstances, would not have been an effective or appropriate treatment," Cigna HealthCare President David Cordani and Chief Medical Officer Jeffrey Kang said in the statement.
Sarkisyan was diagnosed with leukemia at 14 and received a bone-marrow transplant from her brother a month ago, but complications arose and she needed the transplant, the reports said.
Doctors from the University of California at Los Angeles Medical Center urged Cigna to enable the transplant.
At the same time, doctors quoted in media reports said that such a transplant might be futile because the drugs required to support the procedure could worsen the leukemia.
Cigna had initially said that the transplant was experimental and it would not pay for the procedure. The family and supporters protested, however, and Cigna reversed itself.
In the Monday statement, Cigna said it made an exception based on the "unique circumstances of this situation," saying that the procedure was outside the plan's coverage and that medical evidence that it would be effective was lacking.
But Sarkisyan's condition worsened and she was taken off life support on Thursday. She died shortly thereafter, media reports said.
So why does this story have a Tel Aviv byline? Because it was written by Robert Daniel, MarketWatch's Middle East bureau chief, based in Tel Aviv. Why was the Middle East bureau chief covering a story about a Los Angeles girl who died because a Philadelphia-based insurer refused to cover an operation? Is it because the reporters most qualified to handle "senseless death" stories are those in the Middle East?
I wish I were insane
Sanity is just so boring