Comments on: CIGNA Mistakes? Maybe, but Murder…? http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/ The Competitive Enterprise Institute Blog Sat, 30 Aug 2008 15:02:54 +0000 http://wordpress.org/?v=2.6 By: Michelle Minton http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/#comment-40950 Michelle Minton Thu, 27 Dec 2007 14:35:43 +0000 http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/#comment-40950 To respond to "Welcome to managed care hell" CIGNA does not consider liver transplants experimental. The company approves nearly 90 percent of transplant requests. Nataline's specific condition made this particular transplant an experiment. She had been in intensive care for weeks due to complications from her previous bone marrow transplant. There is also a claim (though I can't find an authoritative source) that the anti-rejection medications Natline needed to recover from her bone marrow operation would interact with the medications necessary for the liver transplant. These case-specific factors made a liver transplant "experimental" in Nataline's case. references here: http://www.latimes.com/features/health/la-fi-cigna25dec25,1,7386134.story To respond to “Welcome to managed care hell”

CIGNA does not consider liver transplants experimental.
The company approves nearly 90 percent of transplant requests.

Nataline’s specific condition made this particular transplant an experiment. She had been in intensive care for weeks due to complications from her previous bone marrow transplant. There is also a claim (though I can’t find an authoritative source) that the anti-rejection medications Natline needed to recover from her bone marrow operation would interact with the medications necessary for the liver transplant. These case-specific factors made a liver transplant “experimental” in Nataline’s case.

references here:
http://www.latimes.com/features/health/la-fi-cigna25dec25,1,7386134.story

]]> By: Neil Wetmore http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/#comment-40934 Neil Wetmore Thu, 27 Dec 2007 06:12:05 +0000 http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/#comment-40934 The idea that insurance companies are not responsible for the lives at all costs to their clients, while their only real responsibility is to honor their contract an unattractive. It is however in line with an important and constitutional moral principle. The right to exist as an economically independent individual. The insurance company is a piece of property. It is invested in, and therefore owned, in part, by anyone who owns any shares of stock. Each investor is trying to make money, as is their right. As an enterprise, it must endeavor to be profitable. That being said, the company offers a contract. It does not force. It is not responsible to serve anyone by force. The contract is then agreed upon by a customer. The customer understands, if the customer is attentive to what is being offered, the limits of the coverage. If a circumstance occurs that is beyond the limits of the contract, the company is not morally nor legally obligated to cover the circumstance. Need does not dictate ownership. Liberty does not force man to serve his brother against his will and desires. The idea that insurance companies are not responsible for the lives at all costs to their clients, while their only real responsibility is to honor their contract an unattractive. It is however in line with an important and constitutional moral principle. The right to exist as an economically independent individual. The insurance company is a piece of property. It is invested in, and therefore owned, in part, by anyone who owns any shares of stock. Each investor is trying to make money, as is their right. As an enterprise, it must endeavor to be profitable. That being said, the company offers a contract. It does not force. It is not responsible to serve anyone by force. The contract is then agreed upon by a customer. The customer understands, if the customer is attentive to what is being offered, the limits of the coverage. If a circumstance occurs that is beyond the limits of the contract, the company is not morally nor legally obligated to cover the circumstance. Need does not dictate ownership. Liberty does not force man to serve his brother against his will and desires.

]]> By: Welcome to managed care hell http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/#comment-40932 Welcome to managed care hell Thu, 27 Dec 2007 04:57:34 +0000 http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/#comment-40932 Cigna declined to pay because it considers liver transplants "experimental", even though Tom Strarzl did the first successful transplant in 1967, OVER FORTY YEARS AGO. For $50,000 I can buy any opinion I want from some medical expert who never examined the patient. What that managed care pinhead at Cigna did accomplish was to purchase millions of dollars of bad publicity and public ill will, regardless of the outcome of the criminal and civil trials. I hope Geragos rips their head off with a 100 million dollar verdict. Cigna declined to pay because it considers liver transplants “experimental”, even though Tom Strarzl did the first successful transplant in 1967, OVER FORTY YEARS AGO. For $50,000 I can buy any opinion I want from some medical expert who never examined the patient. What that managed care pinhead at Cigna did accomplish was to purchase millions of dollars of bad publicity and public ill will, regardless of the outcome of the criminal and civil trials. I hope Geragos rips their head off with a 100 million dollar verdict.

]]> By: Michelle Minton http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/#comment-40906 Michelle Minton Wed, 26 Dec 2007 21:43:53 +0000 http://www.openmarket.org/2007/12/26/cigna-mistakes-maybe-but-murder/#comment-40906 The mistake I referenced to in the title, but didn't address in the post, is in my judgment, CIGNA's reversal in its decision not to fund Nataline's liver transplant. If all of the evidence pointed to the fact that a transplant in her specific case would be a waste of money (and reduce the ability to fund other CIGNA members' medical needs) then it should have stuck to that decision, barring any new medical information. By making an exception due to pressure from protesters and media, CIGNA showed that it can stray away from the rules when it wants to, lending credence to critics' claims that the initial decision was arbitrary and malicious. The mistake I referenced to in the title, but didn’t address in the post, is in my judgment, CIGNA’s reversal in its decision not to fund Nataline’s liver transplant. If all of the evidence pointed to the fact that a transplant in her specific case would be a waste of money (and reduce the ability to fund other CIGNA members’ medical needs) then it should have stuck to that decision, barring any new medical information.

By making an exception due to pressure from protesters and media, CIGNA showed that it can stray away from the rules when it wants to, lending credence to critics’ claims that the initial decision was arbitrary and malicious.

]]>