Angelica 1 Posted December 21, 2007 This article isnt about the Lap Band, its about a poor little girl that died because of money. I blame this on both sides, Cigna, and her Doctors and their need for deep pockets. This is truly a horrific shame. All of these people need to answer for their actions. It took a protest for a little girl to get approved for a liver transplant? I am so upset over this bullshit. ABC News: Tragedy for Transplant Teen After Lifesaving Surgery Denied Share this post Link to post Share on other sites
kagoscuba 0 Posted December 21, 2007 I don't care much for insurance companies either, but CNN reported one fact ABC did not. The UCLA doctors (the girl's doctors) told Cigna that she had a 65% chance of surviving 6 months with the transplant. While the report did not say so, in cases like this that means the long-term survival outlook was even more grim, and that was WITH the transplant. From a triage standpoint, she was not a viable candidate. While that doesn't make her case any less heart-breaking, there were other candidates who probably had far better long term prognosis with the transplant. Sad story. Share this post Link to post Share on other sites
Angelica 1 Posted December 21, 2007 I cant believe her life is less valuable just because shes sicker than someone else. 65% is better than nothing, and she should have been given the opprotunity, at the very least. Share this post Link to post Share on other sites
WASaBubbleButt 41 Posted December 22, 2007 Sadly, the medical system is not a bottomless pit of dollars. There are so many dollars to cover so many procedures. There are many people like her waiting daily and dying daily. There is not enough money and not enough organs. Much as I hate Cigna with a passion (I worked for them, I KNOW how bad they are) I can't disagree with their original stance. Share this post Link to post Share on other sites
DerickM 1 Posted December 22, 2007 agreed, we cannot save everybody and it would be the height of folly to even try. Share this post Link to post Share on other sites
transformer 1 Posted December 22, 2007 If it were your kid who was sick, perhaps your viewpoint would differ... Share this post Link to post Share on other sites
Manatee 4 Posted December 22, 2007 If it were your kid who was sick, perhaps your viewpoint would differ... If you had to pay the full cost of treatment out of pocket, perhaps your viewpoint would differ... Share this post Link to post Share on other sites
WASaBubbleButt 41 Posted December 22, 2007 If it were your kid who was sick, perhaps your viewpoint would differ... The reality may be sad but it does not change. In medicine (any aspect of medicine) you cannot save everyone. It just doesn't work and that's not how life works and it's not how business works. If you were the organ transplant coordinator and you had one liver and three people. How are you going to justify letting two go without? Sometimes you just don't have a choice. You can give it to someone who has a 65% chance of surviving six months or you could give it to someone who has an 85% chance of making it 30 years. How are YOU going to tell the person with an 85% chance of survival that the other person is someone's child? Everyone is someone's child. Share this post Link to post Share on other sites
transformer 1 Posted December 22, 2007 If you had to pay the full cost of treatment out of pocket, perhaps your viewpoint would differ... We can definitely agree to disagree on this one... I stayed awake for three days straight and traveled to five different doctor's offices/oral surgeons in three different cities before I could get my son's broken jaw treated after an accident thanks to the ***damn health insurance company. The only thing the local hospital emergency room would do was suture the laceration on his chin. They x-rayed his jaw (it was broken on both sides near his temples) and kicked us out because they said we had to go to an oral surgeon's office the next morning because no one was on call. We went to the appointment at 10 AM the next day and were told that our insurance no longer covered this doctor either. We went to the pediatrician's office to see if they could help us find someone to treat him. At the next oral surgeon's office 30 minutes away, after we waited for 2 1/2 hours and more x-rays were taken, the doctor refused to work on him because "the fractures were too complex." Next, I had the distinct pleasure of arguing with the insurance company ass on the phone, who couldn't see my child suffering, to convince them that he was in serious pain and needed to be taken care of right away. The insurance a**holes told his father and I to go back home because "it wasn't an emergency and it could wait until the following Monday" (three more days away). Keep in mind his head was deformed, discolored, and swollen, he was without pain medication all this time, and he couldn't eat or talk. He could barely drink without choking. We found out later that he had four shattered teeth inside of his mouth that had to later be crowned at the dentist's office, too (which my dental insurance hardly covered by the way--I paid through the nose for that work to be done). They finally gave us permission to go to the Virginia Commonwealth University Medical Center emergency room in Richmond (1 1/2 hours away from home). At the VCU emergency room, they examined him, x-rayed him again, and then they tried to throw us out on the street in the middle of the night with no place to stay after we hadn't slept for 3 days. NASCAR was in town, so there weren't any vacant hotel rooms in Richmond. We dug in our heels and said we weren't leaving until the oral surgeon in the building next door was ready to see him the next morning. Keep in mind that we had nothing with us--no clothes, no toothbrushes--we had planned to go to one oral surgeon visit at 10 AM two days before. No one at any medical facility we visited helped us out in any way as far as finding somewhere to get food or something to drink. At the oral surgeon's office in Richmond, they gave us toothbrushes and toothpaste and let us use the restroom and gave us towels so we could at least wash our faces. They told us where the snack machines were because we hadn't had anything to eat since the accident. Those were some VERY classy people. Within 1 1/2 hours of arriving there, my son had been given pain medication, was sedated, and his jaw was wired shut. By five PM that afternoon, we finally on our way back home. So, trust me, if it were my kid, I would have found a way to get the surgery done if the physicians on the case had strongly recommended it (and a second opinion confirmed their original recommendation) regardless of the ***damn insurance company. If I had to move somewhere else in order to access specialized treatments, I would do that without blinking an eye. Not fighting for my child would never be an option for me. If this was what my child needed in order to be healthy or to survive, I'd sell everything I own first. It's only money--I can always make more! We all know that this case is only high-profile and being plastered all over the media because it involves a lawsuit led by a well-known "Hollywood" lawyer (Mark Geragos) and the death of an attractive young, white teenager. I wonder how many other people are dropping dead all around our country because the insurance companies are calling all the shots concerning our health care instead of the doctors who actually treat the patients? I hope some investigative reporter latches onto this aspect of the story and digs a little deeper. By the way, I paid for my own lapband because the same damn insurance company won't cover anything that will make us healthier and save them money in the long run! Share this post Link to post Share on other sites
transformer 1 Posted December 23, 2007 Oh...one other thing I was thinking about. Lance Armstrong was given the following odds of surviving his cancer: 65-85% at first, then 50%, then 40%, then 3%. Despite the odds, he believed he could beat it. His fancy team of doctors opted for an innovative round of chemotherapy. He beat the odds and survived his bout with cancer. Now consider this scenario. A guy down the street from you named John Brown finds out he has testicular cancer that has metastasized to his brain and lungs. John has a very positive attitude and believes he can fight this disease. He isn't worried because he has health insurance through his employer. His doctors highly recommend an innovative chemotherapy procedure that shows a lot of promise. the insurance company refuses to pay for the procedure and John Brown dies within a couple of months with his wife by his side. Perhaps the doctors thought the young teen didn't stand a chance in this particular case. However, medical science does not have all of the answers. Miracles happen every single day in hospitals all around the world that cannot necessarily be explained by scientific facts and medical tests (sorry to all of the non-believers out there). People pull through, defy the odds, and prove doctors' predictions about their chances for survival wrong. It's one thing to try to curb costs by not approving unnecessary tests, but insurance companies should not be given the right to play God with people's lives. They shouldn't get to decide who lives and who dies. Just my warped little opinion... Share this post Link to post Share on other sites
Manatee 4 Posted December 23, 2007 Cigna didn't say the docs could not do the work, the company simply said they wouldn't pay for it. Share this post Link to post Share on other sites
DerickM 1 Posted December 23, 2007 Oh...one other thing I was thinking about. Lance Armstrong was given the following odds of surviving his cancer: 65-85% at first, then 50%, then 40%, then 3%. Despite the odds, he believed he could beat it. His fancy team of doctors opted for an innovative round of chemotherapy. He beat the odds and survived his bout with cancer. Now consider this scenario. A guy down the street from you named John Brown finds out he has testicular cancer that has metastasized to his brain and lungs. John has a very positive attitude and believes he can fight this disease. He isn't worried because he has health insurance through his employer. His doctors highly recommend an innovative chemotherapy procedure that shows a lot of promise. the insurance company refuses to pay for the procedure and John Brown dies within a couple of months with his wife by his side. Perhaps the doctors thought the young teen didn't stand a chance in this particular case. However, medical science does not have all of the answers. Miracles happen every single day in hospitals all around the world that cannot necessarily be explained by scientific facts and medical tests (sorry to all of the non-believers out there). People pull through, defy the odds, and prove doctors' predictions about their chances for survival wrong. It's one thing to try to curb costs by not approving unnecessary tests, but insurance companies should not be given the right to play God with people's lives. They shouldn't get to decide who lives and who dies. Just my warped little opinion... sadly, people like lance armstrong and the few others who survive illnesses/harm are the exception that proves the rule. people like him tend to garner alot of attention becuase they survived while many others did not. Share this post Link to post Share on other sites
kagoscuba 0 Posted December 24, 2007 "people like him tend to garner alot of attention becuase they survived while many others did not." Agreed. I just lost a friend to pancreatic cancer less than a year after it was diagnosed. He was 37. As far as all of the scenarios go; it is still a matter of triage and business. An insurance company that issues out money from a sympathetic point of view is not doing their job. If I have a 17 year old...better yet, let's use my 4 year old daughter as an example. She's sick, and has a 65% chance of living for an additional 6 months with a new liver, and probably about a 10% chance of living an additional year. Also on the list for a new liver is a 38 year old man who has a 98% chance of living an additional 10 years with a new liver, who should get it? My 4 year old is obviously the emotional choice, but she's not the objective one. Of course, if the insurance company wouldn't pay, I'd re-mortgage my house, sell my car, and do whatever else it took to pay for the surgery. That's one item I saw missing from both reported stories. Share this post Link to post Share on other sites
transformer 1 Posted January 2, 2008 Of course, if the insurance company wouldn't pay, I'd re-mortgage my house, sell my car, and do whatever else it took to pay for the surgery. That's one item I saw missing from both reported stories. Exactly my point...thanks! Share this post Link to post Share on other sites