Thursday, December 27, 2007

following up on the Nataline Sarkisyan case

Over the weekend, wreese wrote about the case of Nataline Sarkisyan, a 17 year old leukemia patient denied a liver transplant. Sarkisyan died shortly after her insurance company reversed their decision to not approve payment for the procedure, and now lawsuits and manslaughter charges are being thrown to the media.

At this point, in the slow news days post-Christmas, the media is converging like sharks in bloody water, and someone's finally mentioned "the R-word". Rationing. It's a concept no one likes to hear when medical care is being discussed, but the facts of the matter are simple: there is simply not enough to go around.

What "enough" is varies in cases and circumstances. In this particular case, it's organs for transplant. But in another situation, it might be a vaccine, or drugs to treat a deadly communicable disease.

In Nataline's case, it appears to be, at first glance, a situation where public outcry is being raised against a company being portrayed as evil, greedy, only seeking the bottom line, and not caring about the actual health of the individual. And while this might be the case - for-profit companies are almost always driven by the bottom line - it seems to conveniently overlook a lot of the details of the case. Details like her leukemia, the wildly varying reports of transplant's success in saving her life, her overall medical state. But even if these details weren't overlooked, I think the public outcry would still be there, and for that one simple reason: rationing. And in discussing the case, the Cigna representatives made the mistake of framing the dialogue in terms of limited care that not everyone can receive.

No one likes the idea of medical care being rationed, because everyone wants to believe that they'll be covered if something happens to them or their loved ones. Nataline's case clearly shows otherwise.

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