The system must survive!
Somewhere between the great work done by incredibly intelligent people in the field of medicine and the fruits of that labor filtering down to the common person, something goes terribly wrong. The main middle men in this transaction is the health insurance industry – and these people do not care about you. The Hippocratic Oath stops well before their doors – something that is put on display for the world to see by CIGNA in this story:
Surrounded by supporters, Hilda Sarkisyan marched into Cigna Corp.’s Philadelphia headquarters on a chilly fall day, 10 months after the company refused to pay for a liver transplant for her daughter.
“You guys killed my daughter,” the diminutive San Fernando Valley real estate agent declared at the lobby security desk. “I want an apology.”
What she got was something quite different.
Cigna employees, looking down into the atrium lobby from a balcony above, began heckling her, she said, with one of them giving her “the finger.”
Cigna has been doing great since the crash.
Sarkisyan’s story of loss before the story of absolute insult is sadly a far too common occurrence in this wonderful medical system of ours. If those with the power in the health care transaction had a shred of honor amongst them, once would be too much for a thing like this to happen. Sarkisyan’s daughter, however, is not the first and will assuredly not be the last person to die because of lack of coverage – let alone live on, but suffer, because of not enough coverage.
The Sarkisyans contend that Cigna improperly refused the transplant that Nataline’s UCLA physicians said at the time was urgently needed to save her life, and that the company reflexively issued a denial letter without looking into the specific circumstances.
The company said at the time that, for Nataline, the operation would have been experimental and was not covered. Nine days later, amid a storm of publicity, Cigna agreed to cover the transplant.
It was too late. Nataline died hours later.
While the debate rages in the halls of Congress over how to cover the uninsured, the plight of those who are actually fortunate enough to have insurance but wind up getting denied coverage seems to conveniently get lost amongst strawmen arguments over “socialism” and giving things away for free. Even if covered, there are faceless people somewhere out there in an insurance company (would it be terrible to call them Death Panels?) deciding who gets to live or die – known officially as who’s care gets allowed or denied.
Years of lobbying and fighting this out in legal arenas has paid off for the industry though, as the ability to take on the insurance company is not available to the common person:
A Los Angeles judge threw out the wrongful-death complaint, saying it was barred by a 1987 U.S. Supreme Court ruling that shields employer-paid healthcare plans from damages over their coverage decisions.
The millions of people who think they have full health care coverage are, in fact, at the mercy of the good graces of those providers as to whether or not they want to allow any health care recipient to have the audacity to collect on a plan.
In a fair legal system, the people could challenge this. Technically they can, however…
The cost of mounting a lawsuit often far exceeds the cost of the treatment in question, patient lawyer Scott Glovsky said. As a result, few lawyers take them on. That has in effect shut the courthouse doors on most treatment coverage disputes involving workplace health plans, which are the source of medical insurance for 132 million workers and dependents.
If the health industry lobby gets its way in the upcoming health care bill, and the public is forced to buy private insurance with no public-backed option to hold back the cost, this will have the effect of not only giving these careless companies millions of new customers, but extends the benefit of having a nameless & faceless pencil pusher in an office far away decide whether or not you can have the privilege of using the coverage you would be forced to pay for.
