Friday, October 09, 2009

It's the Context, Stupid (Nataline's Story, Updated)

In a tragic, though probably unavoidable, turn of events, a young lady died. She was a daughter, a friend, a student. And that's overwhelmingly sad.

Now, lawyers and activists are looking to turn this tragedy to their own ends, motivated by greed and power. And that, too, is overwhelmingly sad:

I received an email yesterday from a group called "Americans United for Change," who claim that "(t)hrough aggressive earned and paid media outreach, grassroots and online organizing ... has challenged the far right conservative voices and ideas that for too long have been mistaken for mainstream American values."


So personal responsibility, the desire to keep more of one's own hard-earned money, and freedom of choice are simply talking points for the right-wing, and not true American values? Okay.

In the event, the email breathlessly quotes an L A Times piece that avers "Cigna employees, looking down into the atrium lobby from a balcony above, began heckling her, she said, with one of them giving her 'the finger.'" What a reprehensible, inexcusable thing to do. Regular readers know from our on-going series on Stupid Carrier Tricks that we hold no truck for shenanigans by any insurer, and this would be at the top of that list.


Something about the wording rang false, and having seen how the press mismanaged the original story, I decided to re-connect with the Cigna folks to see if there wasn't a bit of, well, context missing. And indeed there was.

The first thing to understand is that, if anyone "killed" Nataline, it was her doctors and the hospital that refused to treat her without being paid. Where was their compassion? Surely a few dollars should have been no impediment to saving a young girl's life. Perhaps it was because this was, by their own admission, experimental surgery - one wonders if their malpractice carrier put the kibosh on it. After all, experimental procedures are generally and routinely denied in all health care financing scenarios (including the MVNHS©).

The other problem with that scenario is that, in this case, Cigna had an ASO (Administrative Services Only) contract with Nataline's father's employer. That is, they were contractually bound by the employer to pay for only those items which the employer had agreed (in advance) would be covered. Again, experimental surgeries would have been near the top of the "no" list.

So we can see that Cigna did not, in fact, "kill" Nataline. But did they, or one or more of their employees, "flip the bird" at her grieving mother?

Yes, one employee did.

From the story currently making the rounds, one is left with the impression that this was an unprovoked, heartless and insensitive reaction aimed directly at a mother who'd recently lost her daughter. Perhaps, though, there was a bit more to this story than what we read in the paper?

I spoke this morning with a gentleman at Cigna who was actually in the lobby that morning, and who actually met with the group of people who had come to protest. What the L A Times story conveniently omits is that Mrs Sarkisyan was accompanied by a group of some 35 or so nurses with placards and loud voices, who descended on Cigna's headquarters. Of course, people are entitled to protest what they see as wrong, but this was a place of business, not a public forum, and so security was called in to control the crowd. Curious Cigna employees looked down from the atrium to see what was going on, and were met with shouts taunting "what's it like to work for a company that kills children?"

Apparently, a few minutes of this was more than enough for one employee, who (unprofessionally but understandably) invoked the obscene gesture. Did Mrs Sarkisyan see it? Probably. Was it directed at her"? Who knows, but she was not, in fact, an innocent bystander. So why is she suing Cigna for this singular event, and why, one year later, is it suddenly "news?"

Because her original case was tossed out, and the only bone which the judge could throw her was this claim of emotional distress. It's a win-win for the lawyers and activists: regardless of whether she prevails, this has rekindled the controversy and gotten Mr Geragos and the "Americans for Change" folks free publicity. Lost in the hubbub is the fact that Cigna had no financial stake in the original claim denial, and the providers who skimped on Nataline's care are held unaccountable.

Truly a sad coda to a tragic story.

[Thanks to Cigna's Chris Curran for his time and cooperation]
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