Nataline Sarkisyan

From Richard Blair at All Spin Zone, a discussion of how health insurance works:

She was ready for a liver transplant (a relatively routine procedure in this day and age), but even though hers had failed, her family’s insurance company would not approve the procedure by claiming it was “experimental”. In other words, a bean counter at Cigna made the decision that since they had already shelled out a lot of cash for the bone marrow and kidney transplant, that the cost of a liver transplant and followup care was just too high.

The actual costs?

According to the United Network for Organ Sharing (UNOS), estimated charges for liver transplantation are:

Estimated First-Year Charge: $314,600
Estimated Annual Follow-up Charge: $21,900

With a life expectancy after the transplant of 62 years, follow-up care for Nataline would have cost Cigna about $1.3 million. Seems like a lot, doesn't it? Until you notice that Cigna's CEO has an annual compensation package of almost $29 million.

Does it look like someone's priorities are just the least little bit screwed up?

Insurance began as a way of spreading risk among a larger pool of participants, the same way corporations did. Now that it's proven to be a cash cow for its investors (mark you, "investors" does not include policyholders), the risk management, as Blair points out, is all about not exposing the company to the possibility of actually having to pay claims.

This is another area in which it appears that the American public is ready for a change but that interlocked complex of business and political interests known as our "government" isn't too enthusiastic about the idea. (How odd!) And of course, the insurance industry operates behind a screen of invisibility.

John Edwards is far and away the favorite on this issue -- he's the only one who has given any indication of being ready to back the insurance companies into a corner and start taking them apart.

Footnote: The family's attorney is referring the case to the prosecutor's office for possible criminal charges.

Footnote 2: Where are the Terry Schiavo-niks? The senate resolutions? The legislation giving federal courts the authority to interfere in the decisions of insurance companies?