Must-View of DATELINE: NBC segment aired on Sunday, Jan. 24, and featured on Michael Moore's YouTube channel and website. I cannot get this video to post to the Political Videos forum, but everyone should watch it:
http://www.youtube.com/watch?v=3h4KzRf2wzMNataline Sarkisyan's Parents Come Fact-to-Face With Former CIGNA Executive Wendell PotterFrom: mmflint | January 25, 2010
When Nataline Sarkisyan was denied the liver transplant her doctor thought could save her life, her mother and father brought her fight to the doorsteps of CIGNA insurance. By her side was American SiCKO Donna Smith and the California Nurses Association. The media picked up on the story which quickly became a public relations nightmare for CIGNA because of the real nightmare the Sarkisyan family was living. With no other choice, CIGNA finally approved Nataline's liver transplant but it was too late. Nataline died two hours later.
Wendell Potter was a CIGNA executive at the time. He saw the Sarkisyan's struggle from the inside of the profit-making company and knew that CIGNA would do whatever possible to protect the bottom line. Previously, potter had attended the premiere of 'SiCKO' with a large group of other insurance insiders set with the task of debunking the movie. But, instead, Potter was swayed and later said, "When I saw the movie, Ill be honest: I thought it was a real good documentary. I knew from my own studies of other healthcare systems that it was an accurate portrayal of those systems and how they are able to provide universal coverage."
Nataline Sarkisyan's death was the last straw for Potter. He resigned from CIGNA, blew the whistle on the industry, and became an activist for health care reform.
Here he is face-to-face with Nataline's family for the first time.
TRANSCRIPT:
January 25th, 2010 7:36 PM
Critical Condition
Are you covered in case of emergency? These families thought they were
http://www.michaelmoore.com/words/latest-news/critical-conditionBy Ann Curry / Dateline NBC
<...>
It's just days before Christmas and Hilda Sarkisyan is out shopping, getting ready to host dozens of guests at her Southern California home. But it's not a holiday party the family is throwing...
They are preparing for a memorial service that will mark the 2nd anniversary of their daughter's death.
Hilda Saarkisyan: Everybody's getting ready for Christmas Eve, the-- Christmas day. And here I am shopping for her memorial. (cries) And it really bothers me so much.
Nataline Sarkisyan died at 17, after a three-year battle with leukemia. Her family's grief is compounded by a large dose of anger: Their fury aimed at an insurance company they say had a role in hastening Nataline's death.
Hilda Sarkisyan: Nataline was another file they just shred.
Nataline was first diagnosed with leukemia at 14.
Hilda Sarkisyan: She started having headaches. She started losing weight.
Rounds of chemotherapy followed. And when the chemo didn't work, Nataline's doctors suggested a more aggressive therapy -- a bone marrow transplant.
All of it was paid for by CIGNA and the insurance policy purchased through her father's job. A bone marrow transplant alone can cost as much as 700,000 dollars.
But after the procedure, a complication. Nataline's liver was failing. Her medical team at UCLA said an emergency organ transplant was her only hope.
Hilda Sarkisyan: The doctors are telling you that "Your daughter needs-- a liver transplant. We have a liver. We don't have clearance."
CIGNA denied the transplant-- which would cost a half million dollars or more. The company had hired two doctors who determined that the procedure would be ineffective and unproven in Nataline's case.
Nataline's doctors said a new liver had a 65 percent chance of extending her life by many months-- time they could use to keep fighting her leukemia. But the Sarkisyans were finding out that insurance companies don't usually cover medical treatments that are considered unconventional or unproven.
Andrew Rubin: There will always be denials. And I'm gonna say something very controversial. Denials are okay. It's-- it's a mechanism to keep the insurance and the consumer in check. The problem with the denial is healthcare is not always black and white.
To a family facing the loss of a daughter, it seemed there was only one right answer.
They appealed while precious days passed. Then more than two weeks.
Hilda Sarkisyan: They just said, "It's experimental. We're not gonna approve it. Sorry.”
But Nataline's mother wasn't taking no for an answer. The family took their case public-- calling the local media, and staging a rally outside Cigna's Glendale, California offices.
Hilda Sarkisyan: The reason I'm here today is to fight the insurance company CIGNA for denial of my daughter's coverage for the liver transplant. I need my daughter back. CIGNA is wrong.
Joining the fight was the California Nurses Association, a labor and lobby group that took up Nataline's cause.
Liz Jacobs, R.N.: We came with our banners, and we-- we had placards and we had signs. We ended up occupying the lobby of CIGNA headquarters.
The family's pressure tactics, it seemed, were working.
Wendell Potter: It got the attention at the highest level of the corporation.
Few were in a better position to know what was going on inside CIGNA'S executive suites than Wendell Potter. At the time, he was the company's chief corporate spokesman. And this was a P.R nightmare.
Wendell Potter: One of the most difficult that i'd ever dealt with.
While the family was protesting, CIGNA had a change of heart. The company agreed to pay for the transplant as a compassionate exception.
Hilda Sarkisyan: She came and whispered in my ear. "Hilda, they just reversed their decision. Nataline's gonna get her liver." I was so happy, so excited, i was screaming.
But the struggle was far from over. Nataline's condition was deteriorating. The family left CIGNA and rushed to the hospital. Even though the transplant had been approved, it was too late. Nataline died just hours later.
Hilda Sarkisyan: If something had happened to her after the liver transplant, you would say, "It's not meant to be. Okay, we tried our best." But no, they did not give us a chance.
Nataline's death was a turning point in the life if of CIGNA executive Wendell Potter.
Wendell Potter: It was devastating for me. I remember when I heard the news, just closing the door and wanting to be alone for a while.
Three weeks after Nataline's death, Potter decided to leave his job, no longer able to defend an industry that he says puts profit before patients.
Wendell Potter: I felt that as I was climbing the corporate ladder that somewhere along the way I misplaced my moral compass. It's the profit motive that-- really drives these companies.
Potter is now a whistleblower of sorts, calling for insurance reform throughout the national healthcare debate. He has taken his message to the media. And to lawmakers in Washington.
Wendell Potter: There's such power concentrated in the hands of now seven very large for-profit insurance companies.
He says the lesson from Nataline's case is that insurance is a business like any other-- with companies beholden to shareholders. When it comes to expensive treatment decisions, he says insurers have an undeniable conflict of interest.
Wendell Potter: Often there is a corporate bureaucrat who stands between a patient and his or her doctor making decisions.
Potter says investors keep close tabs on the profit margins at insurance companies. In fact, in Wall Street jargon money spent on patient care is called a "loss."
Wendell Potter: The medical loss ratio is a measure of how much of every premium dollar that these companies "lose "-- paying medical claims.
CIGNA said in a statement to Dateline that it "makes all coverage determinations on the basis of the best available medical evidence, regardless of cost. CIGNA... had no stake in the coverage decision."
The company points out that in Nataline's case, it was acting as an administer for Mr. Sarkysian's employer, and the employer would ultimately pay for the medical costs. But Potter says the contracts between employers and insurers often contain incentives for keeping the cost of claims low. We asked CIGNA if it had any such financial incentives and requested details about its agreement with Mr. Sarkysian's employer, but the company declined to comment.
Susan Pisano: There's not a benefit to a health insurer in denying claims that should be paid.
The health insurance industry trade group says that nearly 98 percent of the time, claims are paid quickly-- And that's good for the bottom line.
Susan Pisano: For one thing, claims-- payment is highly regulated. For another thing, employers have choices. They can take their business from Insurer A to Insurer B. Our companies really compete like mad.
Now, the Sarkisyans are determined not to let Nataline's story fade away. They're taking up the cause of reform in her name.
Two years after her death, Nataline Sarkisyan's bedroom is largely untouched. The only change, some painful mementos of her parents' battle with their insurance company.
Hilda Sarkisyan: When I come to this room I do cry. I miss her. Sometimes it helps me heal. But I wish she was here.
Although their insurance company CIGNA ultimately agreed to pay for a last-ditch transplant that might have prolonged Nataline's life-- the decision came too late.
Hilda Sarkisyan: They kept on dely-- denying, denying, denying, and delaying the procedure for my daughter. She could have gotten that liver.
Many months later, the Sarkisyan's outrage hadn't diminished.
Hilda Sarkisyan: I want to ask them why they did this. I want to know why.
They flew from California to the Philadelphia headquarters of CIGNA Insurance. Accompanied by activists from the California Nurses Association, they wanted answers from the CEO.
Hilda Sarkisyan to security guard: I need to see Edward Hanway.
Guard: He's not available.
Hilda Sarkisyan: Why not? This is our life.
Mr. Sarkisyan: This is my daughter. You guys denied her liver transplant, she died.
After being stopped at security, a company spokesperson came to the lobby.
Hilda Sarkisyan: I'm Hilda Sarkisyan, Nataline Sarkisyan's mom.
Mr. Sarkisyan: So you guys have to tell your people when you're selling the insurance. You have insurance, but you're not covered.
Hilda Sarkisyan: I'm here all the way from California to give you a message and I want to see the CEO. Who is he to decide? Who is he to make a decision?
Chris: I know exactly how you feel.
Hilda Sarkisyan: Okay.
Chris: And it was horrible that it happened.
Hilda Sarkisyan: That's all you can say. That's it? Are you guys sorry for this?
Chris: I am not familiar with all the details of your case.
The Sarkisyans left without seeing the CEO and without the answers they'd hoped for.
What they got was a crude gesture from a CIGNA employee who looked down on the confrontation from an upper floor.
Hilda Sarkisyan: I said, "Do you work for CIGNA?" He gave me the finger-- both fingers to a mother like me. So what does that tell you?
For that gesture, CIGNA sent a letter of apology the Sarkisyans. But the family has little other recourse against the company. After Nataline died, the family sued CIGNA, but the case was thrown out before it was even heard. The Sarkisyans found out that in most cases, if you get your insurance through your job, you can't sue for damages.
Jamie Court, consumer advocate: In America in fact you can sue for most things. You can sue for some ridiculous things. But you can't sue when a loved one dies because an insurer didn't give them the care that could have kept them alive.
Changing the law in order to hold insurers more accountable for treatment decisions has become a mission for the Sarkisyan family.
In their fight for reform, they're about to meet an unlikely ally: Wendell Potter, the CIGNA executive who resigned in the wake of Nataline’s death.
Wendell Potter: We're not talking about evil people. I say that the system is evil.
Now, Potter has accepted an invitation-- arranged by consumer advacates-- to the Sarkisyans’ home.
On the way, he collects his thoughts for what may be a difficult meeting.
Wendell Potter: I just wanna tell her that Nataline certainly didn't die in vain. You know, it may be helpful to both of us in some way to meet and talk.
Wendell Potter, approaching door: Mrs. Sarkisyan? Hi. I'm Wendell Potter.
Hilda Sarkisyan: Hello.
Wendell Potter: How are you? Thank you very much for inviting me into your home.
Once inside, Potter searches for words.
Wendell Potter: I can't imagine the anger and the hurt. The only thing i may be able to say is that Nataline’s life was so essential. She's changed my life. And it was really because of Nataline that I decided to leave my job and-- ultimately become a real advocate for reform.
The family wants to talk about the day that haunts them: the joy of CIGNA's approval... quickly followed by despair. Too little, too late.
Hilda Sarkisyan: Why do they have to wait until that moment? Did you know that I did not know my daughter was gonna die that day? I did not say goodbye to my daughter. Did you know that?
Wendell Potter: I did not know that.
Hilda Sarkisyan: I did not know she was gonna die.
Wendell Potter: I can't speak for anyone but myself. But I was hopeful. I—I was really hopeful that-- that it-- it could-- it could happen in time to save Nataline's life.
The family shares their memories of Nataline-- A poem that she wrote during her battle with cancer. It moves Potter to tears.
Hilda Sarkisyan: So you know how it feels. (crying)
Their meeting ends with a visit to Nataline's room...
Wendell Potter: What a beautiful girl she was.
...and a promise on both sides to work together for reform.
Wendell Potter: I'd be honored if we could somehow work together and try to help change things.
Printer-friendly format
Email this thread to a friend
Bookmark this thread
(1000+ posts)
Send PM |
Profile |
Ignore
