The Industry Radar has compiled an impressive round-up of posts and perspectives from around the blogoshere.
It's a well-balanced, comprehensive look at a no-win situation.
UPDATE/BREAKING: My contact at Cigna just emailed me about a new statement, just posted, from Dr. Jeffrey Kang (their CMO).
In it, Dr Kang seeks to clarify three issues about the case:
■ Cigna's role. This is crucial to the whole discussion. It appears that the group plan under which Nataline and her family were insured was a self-funded (ERISA) plan. As Bob has pointed out to me "(t)he plan sponsor cannot in any way obligate the reinsurance carrier to fund a claim. It would appear that Cigna's role in this matter was more of a consulting role than one as a front line carrier. Cigna could have authorized payment of the claim and the plan sponsor could have still refused to cover the transplant. Or, the plan sponsor could have authorized the benefit and Cigna refused to cover it under their reinsurance policy.
In other words, Cigna is pretty much removed from the decision on paying the claim as far as Nataline's family is concerned. Cigna is not their carrier, they are the reinsurer for the employer loss fund."
■ How these decisions are made. We've already touched on this issue, including the use of outside sources. What's new in this release is that it appears that Cigna consulted with three such experts (not two, as originally reported).
■ Why they offered to pay anyway. This is also key: Nataline's doctors still had the final say (which puts the lie to those that claim the carrier withheld treatment; that's always been specious), and Cigna was willing to pay if the providers decided (against overwhelming medical evidence) to go ahead.
I'm still not convinced that this was wise, but I also understand the humanity involved in the decision.
By all means, please read it yourself (available in .doc form here).
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