Of Liver Transplants and Vacuum Cleaners

I don’t spend much time on politics here, but I am compelled now to join the chorus of voices crying out against the health insurance industry here in the U.S. We are drawing very close to crisis mode, and the media is actually stepping up to bring it to a head.

As reported by the Hartford Courant newspaper, protesters gathered outside the Glendale, CA headquarters of CIGNA HealthCare to protest the reversal of their decision to cover a critical liver transplant for 17 year-old Nataline Sarkisyan, calling it “too experimental”. You can read the details by clicking on the above link.

During the appeal process, doctors had to induce a coma to keep her alive until she could receive the transplant she’d already been promised. Finally, after a barrage of protest and media coverage, they re-reversed the decision, saying they would “make an exception in this rare and unusual case”. Rare and unusual in the amount of bad press they were getting, is what I assume they meant. And then of course, to add the cherry to the top of this mud sundae, “Our hearts go out to Nataline and her family, as they endure this terrible ordeal.” There are words for that, but I will not assume that only adults read this blog.

When I was on a mission trip in Cordoba, Argentina, the resident missionary there told me a story about a time he bought a vacuum cleaner at a small, independent store. When he got home to use it, it immediately fell apart. So he took it back, demanding a refund, but the store refused, and would not budge. So he took the only recourse available to him: he stood out on the sidewalk, showing people the busted vacuum, and telling them that the store sells crap without a refund policy. He drove so many customers away that the store finally relented, and gave him his money back.

Is that where our Health Insurance industry is headed? Where you have to organize a demonstration, or form a Facebook Causes group, or put a loose change jar at every grocery store check-out in the neighborhood to pay for what ought to be covered by your exorbitant monthly premiums? Will we soon see the health giant CEOs burning in effigy on the nightly news?

“But at least the story has a happy ending,” you say. If only that were true. After the claim was approved by CIGNA, but before surgery could begin, 17 year-old Nataline died, according to ABC News.

Onto the hands of an industry already caked with dry black blood, the flow now runs fresh and red in full public view.

God have mercy.

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About rwiksell

I am a former church-planting pastor, currently active as a wedding minister, and the leader of a spiritual discussion group at a local bar called Scotch & Soda. By day, I am the graphic designer and production manager for a historic print shop called Traders Printing, located in downtown Springfield, Missouri. My wife Christina and I have been married for 9 years now, and we live in a turn-of-the-century bungalow on the north side of Springfield with our dog Abbi, and our cat Charlie.
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12 Responses to Of Liver Transplants and Vacuum Cleaners

  1. LaTisha says:

    That is such a sad story. Insurance companies have been crooked for so long that now it’s coming to the light. It is just so sad that Nataline had to pay the price for people notice. I have noticed a trend…people don’t fix the problem until a life has been taken. So, I think that it’s safe to conclude that there is not much value to life anymore. If life was valued, abortion to babies vs. euthanasia of animals would not be an issue.

  2. LaTisha says:

    That is such a sad story. Insurance companies have been crooked for so long that now it’s coming to the light. It is just so sad that Nataline had to pay the price for people notice. I have noticed a trend…people don’t fix the problem until a life has been taken. So, I think that it’s safe to conclude that there is not much value to life anymore. If life was valued, abortion to babies vs. euthanasia of animals would not be an issue.

  3. shakedust says:

    This is very sad.I have given this sort of thing a lot of thought, and I think how the blame is passed out is too simple. I think that the insurance companies can be heartless, but mostly because we give them no choice. This is an unpopular perspective, but I do ask that you hear me out.Imagine that you are a healthy individual and have to make the choice between two insurance plans. One costs 10% of your income, but it will not pay for most experimental procedures. The other costs 40% of your income, but it will pay for almost all experimental procedures. Most healthy people would pay the 10% and the company that charged 40% would probably go out of business because only the people who needed the experimental procedures would sign up for the plan.My position is that the heartlessness of insurance companies is only there because the market has determined that only the heartless insurance companies should survive.While I see the cause of the problem, I don’t know that there is a good way to address it. I do think government intervention is necessary to realign insurance company incentives, I have serious questions as to how effective that would really be.The one good thing that can come from this is that fear of having the brand name (like Cigna) dragged through the mud might encourage insurance companies to loosen their policies to pay for some of these procedures. Expect your rates to go up when they do, though.

  4. shakedust says:

    This is very sad.I have given this sort of thing a lot of thought, and I think how the blame is passed out is too simple. I think that the insurance companies can be heartless, but mostly because we give them no choice. This is an unpopular perspective, but I do ask that you hear me out.Imagine that you are a healthy individual and have to make the choice between two insurance plans. One costs 10% of your income, but it will not pay for most experimental procedures. The other costs 40% of your income, but it will pay for almost all experimental procedures. Most healthy people would pay the 10% and the company that charged 40% would probably go out of business because only the people who needed the experimental procedures would sign up for the plan.My position is that the heartlessness of insurance companies is only there because the market has determined that only the heartless insurance companies should survive.While I see the cause of the problem, I don’t know that there is a good way to address it. I do think government intervention is necessary to realign insurance company incentives, I have serious questions as to how effective that would really be.The one good thing that can come from this is that fear of having the brand name (like Cigna) dragged through the mud might encourage insurance companies to loosen their policies to pay for some of these procedures. Expect your rates to go up when they do, though.

  5. The Coreman says:

    Shakedust, you’re right that the blame can not be easily distributed. In my limited knowledge and experience, here is how I distribute it (and I could be wrong.)1. Tort lawyers, and their greedy clients. Malpractice lawsuits are so regularly frivolous that malpractice insurance premiums have skyrocketed, forcing doctors to charge more for their services.2. Pharmaceutical companies. They bank on insurance paying for their drugs, so they can charge what they want, as long as they are able to convince doctors and consumers to use it. They convince doctors by providing ridiculously expensive incentives to prescribe them, and they convince consumers through their incessant advertisements, which are also ridiculously expensive. Finally, they focus much more on lifelong treatments of illnesses than on actual cures, because every time you cure a patient, you lose a customer.3. Insurance companies. This is just standard giant corporation heartlessness, if you ask me. In some ways it’s no different from the oil companies or the cable companies. All they can see is the bottom line, and forget that they’re gambling with people’s lives. And I think the “too experimental” excuse was just that. These companies and their lawyers have found just the right language for their policies that they can weasel out of just about anything. Few companies seem to have realized that when you treat your customers fairly, you will eventually gain a good reputation, and you will start to steal customers from the bad companies, and that can offset the expense of doing business fairly.

  6. The Coreman says:

    Shakedust, you’re right that the blame can not be easily distributed. In my limited knowledge and experience, here is how I distribute it (and I could be wrong.)1. Tort lawyers, and their greedy clients. Malpractice lawsuits are so regularly frivolous that malpractice insurance premiums have skyrocketed, forcing doctors to charge more for their services.2. Pharmaceutical companies. They bank on insurance paying for their drugs, so they can charge what they want, as long as they are able to convince doctors and consumers to use it. They convince doctors by providing ridiculously expensive incentives to prescribe them, and they convince consumers through their incessant advertisements, which are also ridiculously expensive. Finally, they focus much more on lifelong treatments of illnesses than on actual cures, because every time you cure a patient, you lose a customer.3. Insurance companies. This is just standard giant corporation heartlessness, if you ask me. In some ways it’s no different from the oil companies or the cable companies. All they can see is the bottom line, and forget that they’re gambling with people’s lives. And I think the “too experimental” excuse was just that. These companies and their lawyers have found just the right language for their policies that they can weasel out of just about anything. Few companies seem to have realized that when you treat your customers fairly, you will eventually gain a good reputation, and you will start to steal customers from the bad companies, and that can offset the expense of doing business fairly.

  7. shakedust says:

    I’m currently in business school and I will point out that if an executive’s (at a for-profit company) main priority is not the bottom line, that firm will almost certainly not be in business five or ten years from now.I wonder a lot about how issues like this can be fixed. Here’s my perspective on the issues you list.1. Can anything be done about this? Every time legislation is proposed to limit lawsuit payouts, people who were seriously wronged through medical malpractice are brought to the fore.Also, patients should be allowed to sue. The real question is where to draw the line (or if a line should be drawn) in financial terms regarding payout for malpractice.2. I actually feel for pharamceuticals. I would not want to be put in the position of investing billions into a drug that may or may not work, then having people hate the company for trying to make a profit. Sure, Canada has lower prices for drugs, but that is actually part of why American drugs are so expensive. The drug companies are trying to make up what they don’t make elsewhere on us.That said, I am very bothered by the fact that most drug representatives are attractive women. This tells me that drug companies are encouraging doctors to recommend drugs based on reasons other than the drugs’ effectiveness.3. I already covered this. The market has determined that only the heartless survive. If you were a nice guy in the insurance business twenty-five years ago, you probably aren’t in the insurance business today. Blame consumers.This brings me to a final point. If you do not like the current situation, there are two ways to address it.1. Vote with your wallet. Research to find which companies are the worst and avoid insurance and drugs from those companies <>if possible<>.2. Contact your elected officials to get the rules changed and make sure that the ones in place are enforced.

  8. shakedust says:

    I’m currently in business school and I will point out that if an executive’s (at a for-profit company) main priority is not the bottom line, that firm will almost certainly not be in business five or ten years from now.I wonder a lot about how issues like this can be fixed. Here’s my perspective on the issues you list.1. Can anything be done about this? Every time legislation is proposed to limit lawsuit payouts, people who were seriously wronged through medical malpractice are brought to the fore.Also, patients should be allowed to sue. The real question is where to draw the line (or if a line should be drawn) in financial terms regarding payout for malpractice.2. I actually feel for pharamceuticals. I would not want to be put in the position of investing billions into a drug that may or may not work, then having people hate the company for trying to make a profit. Sure, Canada has lower prices for drugs, but that is actually part of why American drugs are so expensive. The drug companies are trying to make up what they don’t make elsewhere on us.That said, I am very bothered by the fact that most drug representatives are attractive women. This tells me that drug companies are encouraging doctors to recommend drugs based on reasons other than the drugs’ effectiveness.3. I already covered this. The market has determined that only the heartless survive. If you were a nice guy in the insurance business twenty-five years ago, you probably aren’t in the insurance business today. Blame consumers.This brings me to a final point. If you do not like the current situation, there are two ways to address it.1. Vote with your wallet. Research to find which companies are the worst and avoid insurance and drugs from those companies <>if possible<>.2. Contact your elected officials to get the rules changed and make sure that the ones in place are enforced.

  9. The Coreman says:

    Although your pro-business perspective rubs me the wrong way, I really can’t contradict you.The only thing I’ll say here is that it’s fine for a businessman to make the bottom line his top concern, just so long as he doesn’t make it his only concern.

  10. The Coreman says:

    Although your pro-business perspective rubs me the wrong way, I really can’t contradict you.The only thing I’ll say here is that it’s fine for a businessman to make the bottom line his top concern, just so long as he doesn’t make it his only concern.

  11. shakedust says:

    Indeed. Please believe that if I had my way, everyone who needed to have procedures done would have them done, and those who didn’t need it wouldn’t.

  12. shakedust says:

    Indeed. Please believe that if I had my way, everyone who needed to have procedures done would have them done, and those who didn’t need it wouldn’t.

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