PhillyInc

I have a suggestion that falls in the category of “if the writer addresses this subject again, please consider…”

The article and other reports indicate Nataline Sarkisyan may have died because the insurance company initially refused to pay for a liver transplant that might have saved her life. My question: Did any livers “go to waste?” More specifically, if Nataline had received a liver transplant, would somebody else have died because that liver she received was unavailable for him?

If so then the media should report that someone lived because of this. If not--if there were enough livers or portions of livers to go around, the urgency for organ donation may be less than we’ve been led to believe.

The true “moral crime” in healthcare is the outrageous compensation given to CEO’s and upper management of health insurance companies. This venality is one reason the U.S. has the highest administrative costs in the world for its healthcare “system.” I am disappointed that the press has not investigated and published more information on this topic.

Your Sunday article about the Sarkisyan case, in its attempt to be circumspect, misses the main points.

1) The business model of an insurer is to enhance its bottom line by paying out as little as possible. How is that compatible with achieving a more healthy society? This has little to do with "free-market" economics where the rewards can go to the newer, faster, better etc.

2) Why does the U.S., with some of the best health science on the planet, lag other western countries where health care is universal, in such broad-based metrics as life expectancy, infant mortality, and morbidity (days lost from work due to illness)? What value-added factor, in terms of the overall health of a society, is provided by health insurers and why is an HMO CEO worth 20 or more times a skilled transplant surgeon?

3) What is the point of developing new, groundbreaking treatments if insurance companies can withhold them from people on the grounds that they are "experimental"? If a liver transplant is $480,000 and insurance companies refuse to pay, aren't we simply rationing care based on wealth, and is that truly consistent with our values? Do we want to empower insurance companies with the ability to impose capital punishment as was done in the Sarkisyan case? The argument by Cigna that they were only denying payment, not treatment is the purist kind of sophistry and should never be allowed to stand.

4) In a capital criminal case, neither the lawyers, the judge, nor the jury (in most cases) have the cover of being anonymous. Why then in a capital health case such as the Sarkisyan affair, should reviewing physicians, where monetary considerations are very much in play, have the cover of being anonymous?