Two years ago, on December 20, 2007, Nataline Sarkisyan died.  She was just 17 years old.  Her mother and father grieve the loss of their angel.  And every Christmas season from now until they pass from this earth, the Sarkisyan family will embrace Nataline’s memory and wonder what might have been.

Nataline needed a liver transplant.  Her insurance company wouldn’t pay. In spite of protests by friends, family, bloggers and even the nurses of the California Nurses Association/National Nurses Organizing Committee, the insurance company held fast until it was too late for Nataline.  The denial of care decision was reversed, but she died without the transplant. 

This December 20th, we heard much about the great victory coming in the Senate with the health insurance reform bill touted by the President as historic.  Having passed one major hurdle with the vote taken early Monday, the Senate bill will likely pass sometime before Christmas Eve and will then need to be reconciled with the House effort before the President can sign whatever Congress presents him and claim his full measure of political victory. “Seven Presidents have tried and failed,” we hear already as the rhetoric advances much more readily than real healthcare reform

But what about Nataline?  And all the others?

Make no mistake, given the chance, Republicans would protect no life, no health as a matter of right outside of the womb.  It seems the staunch conservatives’ love of God and his laws claimed to forbid abortion ends in the birth canal when survival of the fittest and market-based healthcare becomes the right of those financially privileged babies and parents while the poor ought to quake in the shame of their entitlement mentalities. 

And the Republicans simultaneously trashed any “government run” healthcare while scaring the bejeebers out of seniors about having some cuts to Medicare benefits.  As a man who has only spent four years of his life on this planet without government run healthcare (through the VA and his Congressional position), John McCain should know better.  He does know better.  They all know better.

This is no criticism of one party or person alone or a left-leaning advocate blaming the left for its failure.  This legislation just doesn’t protect us from the healthcare denials and financial ruin so many people have suffered in this nation.  This legislation is not the protection of a human right.

But what of children like Nataline under this new and already proclaimed as historic Senate health reform effort?  Would future Nataline’s have a better chance at survival under this reform?  In a word: No.  In fact, in order to maximize profits and to do an end-run around a few of the insurance restrictions this bill would put in place, the potential will now be much greater that more deaths like that of the young Nataline Sarkisyan will be required for the insurance giants to hold onto their profit margins.

Those who support the bill will argue that insurance companies will no longer be able to use pre-existing conditions to deny coverage.  OK.  And insurance companies will not be able to rescind policies retroactively, except in cases of fraud and the like.  OK.  And insurance companies will not be able to impose lifetime caps on benefits, though “reasonable” annual benefit caps will still be allowed (wink, wink).  OK.

But where are the protections against denying treatment ordered by physicians like the ones who argued for Nataline’s liver transplant?  Where are the immediate avenues to appeal that would offer the only way to really save lives like Nataline’s when insurance companies practice medicine and deny treatments?  There are no such protections in any of the reform plans in Congress or even envisioned by the President. 

Nataline’s death would still be a more profitable decision than approving her treatment.

If Nataline had received her liver transplant, would she have lived to go to college?  Have her dad give her away in marriage?  Have children? Grandkids?  To become the fashion designer she longed to be?  We cannot answer that without fail. 

But what we do know is that her doctors believed the chances were good enough to try.  It was her insurance company’s bottom line that was the deciding factor – ask Wendell Potter, the former CIGNA spokesman who is now talking from outside the industry, how this played out inside CIGNA, if you wonder even a bit about the process.  Market-based insurance means just what it says.  It is not patient-based healthcare; it is market-based health industry profit.  Nataline’s death protected that bottom line.

This weekend I heard that insurance company stocks have reached their most profitable place of the past 52 years since the passage of the Senate’s health bill seemed more assured.  (See today’s Reuters article: http://www.reuters.com/article/idUSN2123786320091221?type=marketsNews) The insurance industry is most pleased today. 

So, how does our healthcare future look in this nation under either the Democrats or the Republicans?  How many more Nataline’s will we tolerate before we demand we truly reform the system to strip the profit motive from the medical-care decision-making process?  I do not know.  Apparently our capacity to watch our fellow citizens suffer is quite high.

All I know today is that my friends, the Sarkisyan family, are grieving again.  Two long years since that horrible day and just an instant since they said goodbye to Nataline, it seems all at once.  Such is the grief of a parent.  And they are good enough and decent enough people that they would spare every other parent in this nation a similar fate by seeing true healthcare reform place the medical decisions – the life and death choices – in the hands of those medical professionals who have the best motives possible for the outcomes rather than protection of stock prices and CEO salaries and bonuses.

Where is our collective compassion?  Can we embrace Nataline’s memory and ask our elected officials if what they are proposing for us protects our children in the future?  If we don’t, we will see more not fewer Nataline-like stories in the holiday seasons to come.

Dickens wrote long ago in his holiday tale, “A Christmas Carol” of Tiny Tim Crachit, the child struggling with illness within a family with hard-working parents who could not provide him enough healthcare for his condition.  Though that classic was written long ago with characters eventually rescued by an enlightened Scrooge, we see no such enlightenment forthcoming in this healthcare debate in modern America in 2009.  We are not moving more aggressively away from those tales of horror but more surely toward an emboldened policy of healthcare based on privilege and on greed. 

As Dickens wrote:  "This boy is Ignorance. This girl is Want. Beware them both, and all of their degree, but most of all beware this boy, for on his brow I see that written which is Doom, unless the writing be erased." 

Of all we can say of this healthcare reform effort, let’s not be ignorant about who wins and who loses, at least.  This has not been about the Nataline Sarkisyan’s of America.   And this holiday season, God help us, every one.