The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

A Long 10 Months

Posted by Alan on December 19, 2007

It could be a long 10 months. If California enacts ABX1-1, the health care reform compromise worked out by Governor Arnold Schwarzenegger and Speaker Fabian Nunez, we’re in for a public relations war that will start out nasty and get worse from there.

ABX1-1, the Health Care Security and Cost Reduction Act, is a framework for health care reform, bereft of funding. It will take effect only if voters approve a financing initiative supporters will seek to qualify for the November 2008 ballot. When it comes to health care reform, passions run deep. Many participants in the debate have a near religious belief in the rightness of their cause. And health care itself is an emotional issue. Taken together, these factors will tempt partisans on both sides to make bold, dramatic and emotional attacks on their opponents.

In fact, it’s already started. Daniel Weintraub, posted a story on the Sacramento Bee’s CapitolAlert web site concerning the California Nurses Association plans to march on offices of Cigna in protest of the company’s denial of a liver transplant for a critically ill 17 year old. The nurses see this as proof that ABX1-1 is fatally flawed as it fails to address the problem of denial of care. However, after being challenged for claiming the denial was made based on the cost of the transplant, the Nurses Association now admits the transplant was denied because Cigna considered it experimental and, consequently, not covered. (Cigna’s conclusion will be examined under the state’s independent medical review system.)

What’s hypocritical about the California Nurses Association protest is that their preferred solution, a state-run single payer health care system would be no better. Instead of an administrator who works for a health plan deciding whether the treatment is experimental, the decision would be made by an administrator working for the government. As Mr. Weintraub notes, “It’s misleading for the nurses to imply that their plan somehow would give every patient every treatment they requested. It wouldn’t.”

The plight of this teenager is sad. Manipulating her situation to support misleading attacks proved too tempting for the California Nurses Association to resist. That’s sad, too. Unfortunately, while they were the first to succumb to this enticement, they won’t be the last.

Note added December 21, 2007: A few hours after Cigna agreed to cover the transplant, the teenager passed away. While Cigna normally does not cover experimental treatment, the company made an exception in this case. Doctors at UCLA, where she was being treated, said patients in situations similar to Nataline’s who undergo transplants have a six-month survival rate of about 65 percent. My condolences and sympathy to her family.


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