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CIGNA Capitulates to Patient Revolt--Incredible Story

by: California Nurses Shum

Thu Dec 20, 2007 at 15:23:32 PM PST

(Tragically, the girl in question, Nataline Sarkisyan, died yesterday evening after this diary was posted. nyceve at Daily Kos has more about the netroots' role in forcing CIGNA to capitulate. - promoted by Robert in Monterey)

I am pasting a release below about the Dec. 20 "Patient's Revolt" that forced heartless CIGNA corporation to approve the liver transplant that could save the life of 17-year-old Nataline Sarkysian.
It's been an emotional day involving hundreds of people, but there are a couple of lessons I want to take away.

First--we have power.  We shouldn't be afraid to use it.  A unique coalition of the California Nurses Association/National Nurses Organizing Committee, a union, together with netroots and the Armenian Community shamed a global insurance corporation into doing the right thing.

Second--we shouldn't have to do this...and every candidate pushing to mandate individuals purchase insurance products from the likes of CIGNA, who would still be in the business of profiting through the denial of care, should think long and hard.  Are the CIGNA's of the world really the people who should control our healthcare dollars?

California Nurses Shum :: CIGNA Capitulates to Patient Revolt--Incredible Story
Here is the full release.  Highlights:

Following Massive Protest, Insurer Authorizes
Transplant for 17-year-old Nataline Sarkysian
CNA/NNOC-Sponsored Protest Sparks Flood of Calls from Across U.S.

In a stunning turn-around, insurance giant Cigna has capitulated to community demands, and protests that the California Nurses Association/National Nurses Organizing Committee helped to generate, and agreed to a critically needed liver transplant for Nataline Sarkysian, a 17-year-old girl in the intensive care unit at UCLA Medical Center.

A national web of friends and family of Nataline, CNA/NNOC registered nurses, doctors, members of the Armenian community, healthcare advocates and netroots supporters pitched in on an unprecedented national day of action on Nataline's belief.  

The centerpiece of the protests was an impassioned rally today sponsored by CNA/NNOC with the substantial help of the local Armenian community that drew 150 people to the Glendale offices of Cigna. Hundreds of phone callers clogged the lines of Cigna offices around the country, all demanding that Cigna reverse its prior denial of care.  

"This is an incredible turnaround generated by a massive outpouring around the country that proves that an enraged public can make a difference and achieve results," said CNA/NNOC Executive Director Rose Ann DeMoro. "Cigna had to back down in the face of a mobilized network of patient advocates and healthcare activists who would not take no for an answer."

The netroot protest was organized by Eve Gittelson an influential health policy blogger who writes on Daily Kos as nyceve, and many of the calls were also the product of work by the Armenian National Committee.

"Natalie is now seriously ill and still has significant hurdles in her fight for her life, but thankfully our combined voices and protests have finally given her and her family hope," said Geri Jenkins, RN, a member of the CNA/NNOC Council of Presidents who works in a transplant unit at the University of California San Diego Medical Center.

"However, it is deplorable and appalling that CIGNA needed to have hundreds of people pounding on their doors and besieging them with calls to take the humanitarian step they should have done long before today," said Jenkins who spoke at the Glendale rally.

Nataline's mother, Hilda Sarkisyan, expressed her profound thanks to CNA/NNOC. "We couldn't have done this without you helping us to stand up against this insurance company and forcing them to finally do the right thing. It is not right in this country for it to take a rally, a protest, and a major press conference to get an insurance company to listen."

"Every politician who thinks the answer to our healthcare crisis is more insurance should stop and think about Nataline Sarkysian," said DeMoro. "Insurance is not care. Paying for insurance coverage is not the same as assuring you will receive appropriate care, even when recommended by a physician as it was for Nataline. Insurance corporations profit by denying care to the sick, and that is no way to run a humane healthcare system."

DeMoro said that CNA/NNOC will continue to encourage patient protests and publicize stories about insurance companies' denial of care, as it has all year through its www.guaranteedhealthcare.org web site, while pressing for real healthcare reform "that takes medical decisions out of the hands of insurers and places them where they belong, in the hands of healthcare professionals and their families."

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This whole thing makes me sick (7.00 / 3)
Apparently doctors at UCLA had fought to keep her alive by any method they could in hopes that Cigna would relent and approve the transplant - a suitable liver had already been found a week ago.

The Armenian community in Glendale is sizable and will surely continue to fight to hold Cigna legally liable for Nataline's death. The question now falls to us Californians - what will we do to ensure this sort of thing never, ever happens again? Insurers commit what nyceve calls murder by spreadsheet as a basic business practice - for their business model to work, insurers need to be denying claims so as to generate profits and prevent patient costs from outstripping income generated from premiums.

This also reminds me that we fundamentally misframe the health care crisis here in America. Too often it is described as a crisis of a lack of insurance - we speak frequently of the "uninsured," of which I am one. But it's not insurance that I feel I lack - instead it is health care. The crisis then isn't a lack of insurance but instead a lack of care. The Sarkisyans, we must remember, were insured.

You can check out any time you like but you can never leave

I want people following Nataline's story to know.... (7.00 / 3)
First of all I want to thank everyone who helped yesterday.  The family made an express point of conveying yesterday their deepest thanks to all the people online and around the country who pitched in.

Second of all, you need to know the timeline.  On Dec. 10, Nataline was at the top of the liver transplant list.  She was strong and healthy, and her doctors were confident that she was an excellent candidate for the transplant and that it would save her life.

CIGNA overruled the doctors' recommendation.  They relied on their own medical experts to suggest the treatment was experimental.  You can imagine what kind of doctors work for an insurance company using their degrees to justify insurer denial of claims.

At the end of the day, they waited too long.  You cannot survive 10 days in need of a liver transplant and a variety of side effects, that had been warned of by Nataline's nurses and doctors, came to be, and took Nataline away.

Nothing CIGNA ever does can make up for this.

I am a healthcare activist for the National Nurses Organizing Committee/California Nurses Association.  We are the nation's largest RN union, the nation's fastest-growing union, and leading advocates for single-payer healthcare.

As an aside (8.00 / 2)
The family has said that their fight against CIGNA is just beginning, so there will be no more Nataline's.  

I am a healthcare activist for the National Nurses Organizing Committee/California Nurses Association.  We are the nation's largest RN union, the nation's fastest-growing union, and leading advocates for single-payer healthcare.

[ Parent ]
This is disgusting (8.00 / 2)
It is amazing how many lives the greedy health insurers of this state can, quite literally, ruin.  

Where was Cindy Ehnes and her staff at the Department of Managed Health Care during all of this?  The DMHC is supposed to prevent tragedies like this from happening.  

And in other news, shares in Cigna Corporation, whose market value is $15 billion, rose today.  And perhaps the doctor who signed Nataline Sarkysian's death sentence got a nice Christmas bonus based on his/her stellar record of contributing to Cigna's bottom line.

The family (8.00 / 2)
reports that their attempts to work with the CA Dept. of Insurance over the past 10 days were frustrating and bureaucratic, at exactly the time they were supposed to be near their daughter.  I do not know the specifics, but this makes sense.

I am a healthcare activist for the National Nurses Organizing Committee/California Nurses Association.  We are the nation's largest RN union, the nation's fastest-growing union, and leading advocates for single-payer healthcare.

[ Parent ]
CIGNA Healthcare and CIGNA Behavioral Health (8.00 / 2)
At times, I have found CIGNA, particularly CIGNA Behavioral Health, infuriating to work with as a provider.

In my case, I was providing services to a patient with CBH benefit.  After many months of provision of service, CBH turned around and deauthorized services.  CBH informed me that the patient no longer had coverage and had previously termed out.

As the patient was no longer in treatment, CBH essentially stuck me with the financial burden for their mistake and the errors of the workman's compensation service provider.

Along with Blue Cross of California, I find CIGNA amongst the worst in communication and least cooperative insurance provider in the State.

BlueBeaumontBoyz Bringing Blue to the Coachella Valley and the San Gorgonio Pass Regions of Southern California

But don't worry (8.00 / 2)
We're going to get everyone covered by these same companies!

This is revolting.  I'm beyond sickened, and CIGNA should have its license to do business in California revoked.  The Insurance Commissioner should hear from all of us.

DMHC (8.00 / 2)
Depending on which Cigna company is involved, it is likely regulated by the California Department of Managed Health Care, not the Department of Insurance.  The DMHC regulates all of the HMOs in the state and the Department of Insurance has no jurisdiction over them.  The DMHC is run by a Schwarzenegger appointee, Cindy Ehnes. Her address is:

Department of Managed Health Care
California HMO Help Center
980 Ninth Street, Suite 500
Sacramento, CA 95814-2725  

(916) 322-2078

[ Parent ]
Can someone explain... (8.00 / 1)
why the doctors didn't just simply perform the procedure?  The stuff I read last night said it would've cost the family $75,000 for the procedure, which they couldn't afford.

Are the doctors culpable here too, for letting her die?  Because that's what I've seen some right-wingers say today about this.

CIGNA Healthcare was obviously wrong in refusing to fund Nataline's operation before it was too late.  But if the UCLA Medical Center doctors cared enough, they could have peformed the operation anyway to save Nataline's life.  The doctors and UCLA wanted to get paid, of course, but why couldn't they have heroically and selflessly giving Nataline a liver transplant despite CIGNA's heartless actions?  There seems to be more blame to go around here than just sickening CIGNA.

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