Friday, October 16, 2009

Patient Denied Care For Her Brain Tumor Says Insurers Want You To ‘Die Now, So We Can Save Money Later’

By Lee Fang

Yesterday, Dawn Smith — who has a brain tumor her insurer has refused to help treat — traveled from her home in Atlanta, Georgia to request a meeting with H. Edward Hanway, CEO of the health insurance giant CIGNA. She has been a victim of a series of insurance company abuses, and she wanted to give both Hanway and leaders in Congress a message. Hanway refused to meet with Smith, and instead dispatched his Cheif Medical Officer Jeff Kang to listen to her. Kang admitted that CIGNA’s complex claims unit requires serious changes but said his company would not even review the possibility of paying for her care until November.

Smith, a premiums-paying customer of CIGNA, was diagnosed with a type of brain tumor in 2005, then another one in 2007. Although CIGNA covered her brain biospy and some medication payments, she has battled with the insurer for years because of multiple denials of payment for the specialized care she needs to cure the tumors. After paying out-of-pocket for care in one instance, CIGNA nearly doubled her premiums anyway. In early October, a CIGNA representative told her that the co-pay on her anti-epileptic medicine was being hiked by more than $3,000 a year.

With the assistance of MoveOn.org, Smith has launched a nationwide campaign to not only receive the treatments she deserves from her insurance company, but to help reform the entire system and help all Americans gain quality, affordable healthcare. ThinkProgress asked Smith what message she has for Congress:

DAWN SMITH: I would encourage them to hear the stories from their citizens because, you know, a lot of people talk about the cost [to] children of our future, our grandchildren. But, there are grandchildren dying now. There are children dying now. […] I don’t understand how you can justify ‘die now, so we can save money later.’ Because that’s what it is; that’s what it boils down to.

Watch it:

CIGNA has a long history of denying care for its own policyholders. One of the most infamous cases involves Nataline Sarkisyan, a 17-year-old who died after CIGNA refused to cover her liver transplant. When Nataline’s mother requested a meeting with CIGNA officials, employees of CIGNA reportedly started heckling her from a balcony above the building’s lobby, with one giving her “the finger.”

Rather than use Smith’s or Sarkisyan’s premium dollars to pay for life-saving medical treatments, CIGNA has poured its cash into lobbying against health reform. Those premium dollars are also spent on two private luxory jets, sky-high CEO compensation (Hanway was paid $25.8 million in 2007 alone), and profits.

Think Progress update:

In an e-mail today, Dawn Smith explained that CIGNA's PR officials never explained to her why the the insurance company had denied her coverage nine times. They instead showed her "promotional YouTube videos about other cases they'd successfully resolved."

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