Saturday, December 29, 2007

9/11, The Mick and Nataline

On September 11, 2001 foreign terrorists struck American soil. The attack claimed 2,551 lives and injured hundreds more.

Shortly after the attack, Congress established the Victim's Compensation Fund and authorized a payout to the surviving family members of the 9/11 attack. Total payout is just shy of $16 billion.

On June 8, 1995 one of the most popular baseball players in the last 50 years received a liver transplant at Baylor University Hospital. Years of drinking had worn down the body of "The Mick" resulting in Hepatitis and cirrhosis damage to his liver.

Mickey Mantle died on August 13, 1995 taking with him his recently implanted liver.

More recently the case of Nataline Sarkisyan has made headlines because she was (some say improperly) denied a liver transplant following a failed bone marrow transplant. The insurance carrier (Cigna) originally denied payment for the liver transplant and then later reversed that decision.

How are these stories related, if at all?

In the case of 9/11, Congress authorized payout of taxpayer monies to the victim's families. There was no legal precedent for the payout, nor was there Constitutional authority to make the payout. Instead, they reacted to public sentiment.

At the time, many questioned why Mickey Mantle was moved to the head of the transplant waiting list. Sure, he was an American sports hero and a wildly popular public figure even long after his playing days. But was someone who willfully abused their body and destroyed their liver deserving of a new liver? Should they be placed ahead of someone younger, who also needed a liver, but had developed liver disease through no fault of their own?

It appears that public sentiment may have played a part in efforts to keep alive a popular sports figure.

Then we have the case of Nataline. After years of battling Leukemia she received a bone marrow transplant the day before Thanksgiving. Her body reacted negatively to the transplant and her organs started to deteriorate, including her liver.

Her insurance carrier was asked to authorize a liver transplant, which was initially denied after consulting with outside medical authorities. They later reversed that decision, perhaps in response to a public outcry.

Congress had no authority to establish the Victim's Compensation Fund but bowed to public sentiment.

Those attending to the needs of Mickey Mantle moved him to the top of the waiting list, perhaps not because his situation was more needy than others, but because of who he was.

Cigna authorized an extra-contractual medical procedure because of media publicity and public reaction.

We are a nation of laws, but we are also a nation that strives to do what is right in the wake of public sympathy. The cold facts of these situations say the victim's of 9/11 were not legally entitled to any monies, the "Mick" was not entitled to special treatment, and Nataline was not entitled to coverage for a second transplant. Yet in each case, the powers that be made decisions that went beyond the bounds of their authority.

There are no clear winners in these situations. Someone will feel short-changed while others will feel justified in their position.

All of these situations and many others will continue to be played out in the court of public opinion as long as there is human suffering and limited resources.
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