Quote:

---

In Arizona, 98 low-income patients approved for organ transplants have been told they are no longer getting them because of state budget cuts.

The patients receive medical coverage through the Arizona Health Care Cost Containment System (AHCCCS), the state's version of Medicaid. While it may be common for private insurance companies or government agencies to change eligibility requirements for medical procedures ahead of time, medical ethicists say authorizing a procedure and then reversing that decision is unheard of....

[F]acing a $1.5 billion budget deficit, Arizona has cut out all state-funded lung transplants, some bone-marrow transplants and some heart transplants — including transplants for the condition Shepherd has.

"To basically renege on what you promised was [going to] be a chance at life is a very, very bitter indictment of the ethics of the Legislature," says Arthur Caplan, head of the Center for Bioethics at the University of Pennsylvania.

Caplan calls the reversal "awful" behavior because Arizona is going back on a covenant it made with its patients, and because these are patients for whom time is critical — patients who spent months, some years, thinking they were covered.

---

Quote:

---

“Death panels” are already a reality in California, according to the state’s nurses union, which argues that insurance companies are routinely rejecting medical care for patients, leading to unnecessary suffering and in some cases death.

A review of data filed by insurers with the California Department of Managed Care showed more than one out of five requests for medical services—including those recommended by a patient’s physician—were rejected by the state’s largest private insurers, according to the California Nurses Association and National Nurses Organizing Committee (CNA/NNOC). From 2002 through June 30, 2009, insurers rejected 47.7 million claims for care, or 22% of all claims.

During the first six months of 2009, insurance companies in California rejected claims at the following rates: PacifiCare (39.6%); Cigna (32.7%); HealthNet (30%); Kaiser Permanente (28.3%); Blue Cross (27.9%); and Aetna (6.4%).

Deborah Burger, RN, CNA/NNOC’s co-president, said in a prepared statement: “With all the dishonest claims made by some politicians about alleged ‘death panels’ in proposed national legislation, the reality for patients today is a daily, cold-hearted rejection of desperately needed medical care by the nation's biggest and wealthiest insurance companies simply because they don’t want to pay for it.”

Case in point: Nataline Sarkisyan, a 17-year-old Northridge girl who died in December 2007 in a hospital after her insurance company, Cigna, waited until the last hours of her life to approve her for a liver transplant. Prior to the day Sarkisyan died, Cigna twice took her off the liver transplant list in order to avoid paying for her after-care, according to an attorney representing the family in a lawsuit filed against the insurance company.

---