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When is Government Regulation Good? When it Keeps People from DYING!

Posted by Ben on December 21, 2007 at 5:21 p.m.
Insurance companies should not have the power of life and death in medical decisions.

As Oregonians and Portlanders alike know, a little beer regulation goes a long way for us in getting the pints we deserve.

But what happens in a case when the lack of regulation causes you to die?

That's what happened today, when a teenager in California died because her health insurance company would not allow for a desperately-needed liver transplant. From the CNN article:

Nataline [Sarkisyan] 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 December 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."

In their letter, the UCLA doctors said patients in situations similar to Nataline's who undergo transplants have a six-month survival rate of about 65 percent.

So, a private health insurance company, with the advice of doctors suggesting a 65% survival rate, at first decided to deny coverage. Their delay indirectly lead to Nathalie's death, whose condition and body simply could not survive the wait.

Here's my question: why the hell are we allowing for-profit companies to hold the power of life and death over our sick and dying? What sort of government would allow for-profit companies to be responsible for ensuring our people get the care they need, when they need it? Health care decisions should not be business decisions. It's that simple.

This, my friends, is where regulation should exist. To coddle large corporate entities at the expense of our continued well-being (and for their continued profit) is absurd and morally bankrupt. Say what you will about the free market, but if situations like this exist then it shows me that, sometimes, it's not the best thing in the world to just "let the market sort it out." Let's follow the lead of most other first-world nations and do what's best for our people.

If people have to sweat every illness, and if people have to beg insurance companies to allow for life-saving treatments, then something is terribly wrong with America. Our Country's sick. And I don't know if I trust our big insurance conglomerates to make the right decisions to cure it.


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Comments

Comments from site editors have a darker background than comments from everybody else.
  • Doesn't this seem like basic common sense in its most obvious form? Can anyone give a good reason arguing the opposing view? To me, in light of multimillion dollar salaries for the suffering-in-these-hard-times insurance executives, I can't see any good reason why this isn't mended, other than just the usual political blathering.

    Is there a good reason why for-profit companies should decide these questions?

    Thanks for the opinion piece Ben -- good stuff.

    Posted by: metroknow on December 22, 2007 at 11:29 a.m.
  • I still think something is fishy about this whole thing...much of which involves her parents actually ending her life....

    As for regulation....sure if it was in place before this happened and was exacting enough to effect this case. But now it would do no good. This little incident will cause this company to lose 10's of millions of dollars. They must be thinking "If we would have paid a few hundred thousand in the first place..."

    Other insurance companies around the country will take notice.....this incident will save many more lives than any regulation.

    Posted by: THartill on December 22, 2007 at 11:53 p.m.

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