Insurance Companies Should Not Be Making Medical Decisions

By Mark Schofield, Attorney at Law


“To make health care more affordable and accessible, we must pass medical liability reform now. And in all we do to improve health care in America, we will make sure that health decisions are made by doctors and patients, not by bureaucrats in Washington, D.C”

-President George W. Bush, Acceptance Speech to the Republican National Convention, September 2, 2004.

Proponents of medical malpractice reform, or “tort reform” as it has become commonly known, argue that medical malpractice lawsuits, and “Plaintiff attorneys,” are to blame for the current state of disrepair in the American Health System. These proponents argue that by passing medical liability reform, they will create a system where doctors and patients make health decisions, not bureaucrats in Washington.
Everyone believes that medical decisions are best made by doctors and their patients, however, it isn’t “bureaucrats in Washington” that stand in the way, rather, it’s often the insurance company and their accountants. Consider the story of Natalee Sarkisian.

Ms. Sarkisian, a 17 year old California teenager battling leukemia. She had received a bone marrow transplant from her brother, however, she developed a complication which led to liver failure. Her doctors at the University of California – Los Angeles determined that she needed a liver transplant, and sent a letter to CIGNA Healthcare on December 11. CIGNA Healthcare provided health insurance for Ms. Sarkisian.

CIGNA denied payment for the procedure, terming it too “experimental.”
On Thursday, December 21, 2007, around 150 individuals, including members of Ms. Sarkisian’s family, friends and some nurses who attended to her, protested this decision at CIGNA’s Glendale office. Hours later, in an e-mail statement CIGNA reversed its decision. “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.”

Unfortunately, the decision was not made in time. Ms. Sarkisian passed away at 6 p.m. on Thursday, December 21, 2007.

Medical decisions should be made by doctors and their patients. They should not be overruled by insurance companies more concerned about a bottom line. Our team of medical malpractice lawyers fight for patient rights and hold insurance companies accountable for the decisions that they make.

http://www.nbc10.com/health/14903904/detail.html?dl=mainclick