Lisa Priest reported in “Health minister cites rules in cancer case, The province can’t fund ‘every hope mission’ to US’ aide says”, (Globe and Mail, Mar.12, 2008):
“The Ontario Health Minister sympathizes with anyone battling an illness, but he stopped short of offering any help to a cancer patient who paid $60,000 in the United States to have a massive tumour removed.
"There are rules that require an individual to apply for approval before receiving treatment out of country," Laurel Ostfield, press secretary to provincial Health Minister George Smitherman, wrote in an e-mail yesterday. "These laws are in place to preserve our public health-care system because if we funded every hope mission that presented itself, the system would be unable to keep up with the demand."
The comments follow a Globe and Mail story about Sylvia de Vries, who despite having an enormous tumour and fluid totalling 18 kilograms, could not obtain timely treatment in Canada. The Windsor, Ont., woman went to Pontiac, Mich., where a surgeon excised the tumour - 35 centimetres at its longest - along with her ovaries, appendix, Fallopian tubes, uterus and cervix. As well, 13 litres of fluid were drained during the October, 2006, operation.
Had she waited two weeks for treatment, Ms. de Vries would have faced potential multiorgan failure, rendering her unstable for surgery, wrote Michael L. Hicks, who performed the operation.
Sylvia de Vries and her husband, Adriaan, of Windsor spent their own money to get her potentially life-saving surgery in the United States for ovarian cancer.
To pay for the $60,000 worth of treatment, Ms. de Vries drained her savings, maxed out her credit cards, took out a line of credit and relied on friends who threw a spaghetti-dinner fundraiser that brought in $11,125.
The Ontario Health Insurance Plan would not pay for her ovarian cancer treatment, because she did not fill out the prior approval form before receiving out-of-country care. OHIP also says no medical documentation was submitted that indicated that a delay in obtaining the service in Ontario would result in death or medically significant, irreversible tissue damage.
Figures obtained yesterday reveal the number of patients approved for out-of-country care has nearly tripled over the past five years.
In fiscal 2002-2003, there were 2,083 patients approved for out-of-country care. Since April, 2007, a total of 6,132 patients have had their treatment approved, according to Health Ministry spokeswoman Joanne Woodward Fraser. (Those numbers do not include the referrals of emergency neurosurgery and cardiac patients sent to the U.S. for care.)
The number of people denied out-of-country treatments has also increased, though not nearly as much. In fiscal 2002-2003, 225 patients were denied funding through the program, compared with fiscal 2007, in which 388 patients have so far been denied.
To have an out-of-country treatment approved, the procedure must not be one performed in Ontario, cannot be experimental and should be deemed medically appropriate. However, patients can have out-of-country treatment funded even if it is available in Ontario so long as there is a delay that would cause irreversible tissue damage or death. Part of the form must be filled out by the patient's physician.
Yesterday, Progressive Conservative health critic Elizabeth Witmer called on the Health Minister to review the case of the ovarian cancer patient.
"They need to look at some of the extenuating circumstances and if it's deemed to be warranted, I think they have to recognize some of the challenges she faced," Ms. Witmer said in an interview. "... They need to very seriously review the situation."
Also yesterday, lawyer Kate Sellar, who represents Ms. de Vries, said the Health Minister's sympathy is not enough.
"Ms. de Vries can show that she meets the medical requirements for treatment in the U.S., but wasn't able to comply with all of OHIP's processes and procedures," Ms. Sellar wrote in an e-mail. "The minister should step in and make sure she doesn't pay for her choices with her life savings."
Ms. de Vries had bounced around the Ontario health-care system before a U.S. physician diagnosed her with ovarian cancer. He operated on her four days later.
"It's ludicrous," Ms. de Vries said yesterday. "Where's the judgment and the integrity in all of this?... I'm disappointed with the bureaucracy of it all.""
*
Here we go again: another Ontario patient, another victim thrown into HSARB, that mysterious government star-chamber of monopoly-medicine, where the failed promises of Liberal medicare are appealed.
The smarmy gall of McGuinty's government to spin that patients – who were unable to obtain treatment in Ontario's Liberal health-care-monopoly - are to blame for not filling out some forms. Where is the part where the Liberal government is held liable and accountable for failing to provide their end of the socialist-medicare bargain? Dalton’s gang is held harmless, while patients in the mythical Liberal health care system suffer!
Once again, where would patients from Ontario go if they couldn’t find treatment in the States? The Dalton McGuinty Liberal health-care monopoly is failing on what should probably be seen as a criminal scale.
Didn’t we just go through almost the same scenario a year ago locally in St. Catharines, with Suzanne Aucoin?
Didn’t Ontario Ombudsman Andre Marin tear a strip off Ontario's Liberal health-care system then?
Didn’t the Liberals pledge to improve things?
Didn’t St. Catharines single-payer-pushing healthcare-monopolist Liberal MPP Jim Bradley...
...{see: Can Jim Bradley explain why he "stood up and said 'I hate doctors'"?
or:
Jim Bradley and the entropy of Ontario's health care
or:
Liberal medicare unbelievably scary}...
...attend Aucoin’s memorial and blab about vague 'inequities in health care' - as if he had nothing to do with what his own Liberals did to Aucoin?! {..talk about Bradley's cognitive dissonance here! Bradley and his Liberals were the problem!}
Don’t the Liberals know that HSARB is a bell-weather for their failing monopoly?
Since Aucoin, have the Liberals improved procedures, access and staffing so that HSARB may become a help, not a hindrance, to those Ontarians who were victimized by the McGuinty's Liberal health-care monopoly, and who were forced to get treatment elsewhere (mostly in the U.S.)?
This is another example of Liberal health care duplicity, where the Liberals are practising two-tier medicine: the patient gets sick in Ontario and is greeted by a health-care waiting list, or, goes to the States and is treated with health-care.
The Liberals, in the meantime, collect the patients' taxes, but fail to provide the supposedly-promised "universal" treatment; and even better: no Liberals are ever held liable for the death and destruction which they create.
What a socialist scam.
************
Lisa Priest previously wrote on Mar.11, 2008, on the same subject, titled “Even huge tumour can’t secure care in Ontario” (Globe and Mail):
“Inside Sylvia de Vries lurked an enormous tumour and fluid totalling 18 kilograms. But not even that massive weight gain and a diagnosis of ovarian cancer could assure her timely treatment in Canada.
Fighting for her life, the Windsor woman headed to the United States. In Pontiac, Mich., a surgeon excised the tumour - 35 centimetres at its longest - along with her ovaries, appendix, fallopian tubes, uterus and cervix. In addition, 13 litres of fluid were drained during that October, 2006, operation.
And there was little time to spare: Had she waited two weeks, she would have faced potential multiorgan failure, rendering her unstable for surgery, according to a letter from Michael L. Hicks, who performed the four-hour operation at St. Joseph Mercy Oakland.
"Based on my exam and experience as a gynecological oncologist, I felt it necessary to perform surgery within two weeks," said the letter written by Dr. Hicks, provided to Ms. de Vries's lawyer, Kate Sellar.
Sylvia de Vries and her husband, Adriaan, of Windsor spent their own money to get her potentially life-saving surgery in the United States for ovarian cancer.
But a devastating cancer diagnosis was only the beginning of Ms. de Vries's troubles.
The Ontario Health Insurance Plan says it won't pay for the $60,000 cancer treatment because Ms. de Vries did not fill out the correct form seeking preapproval for out-of-country care.
As well, it says no medical documentation was submitted that indicated a delay in obtaining the service in Ontario would result in death or medically significant, irreversible tissue damage.
That administrative misstep has left Ms. de Vries, a 51-year-old corporate communications manager, with a staggering cancer bill. She has drained her savings, maxed out her credit cards, taken out a line of credit and relied on friends to hold a spaghetti-dinner fundraiser, which earned $11,125.
"I feel abandoned; I was fighting for my life," Ms. de Vries said. "... I definitely would like to get some money back but more importantly, I would like to see the situation rectified so [other patients] don't go through this."
Ms. de Vries's case raises questions about OHIP's out-of-country health coverage program, which was put under a review more than a year ago after cancer patient Suzanne Aucoin of St. Catharines, Ont., was denied funding for treatment she received in the United States.
Only after ombudsman André Marin intervened was Ms. Aucoin reimbursed $76,018.23 in January, 2007, to cover costs associated with the colorectal cancer drug Erbitux, among other expenses and legal fees. (She has since died.)
At the time, Mr. Marin described the out-of-country approval process as "literally impossible for patients and physicians to understand."
Just two months before Mr. Marin made those comments, Ms. de Vries was trying to get access to that same program.
To have an out-of-country treatment approved, the procedure must not be performed in Ontario, cannot be experimental and should be deemed medically appropriate. However, patients can have out-of-country treatment funded even if it is available in Ontario so long as there is a delay that would cause irreversible tissue damage or death. Part of the form must be filled out by the patient's physician.
Patients denied preapproved, out-of-country treatment can appeal their cases to the Health Services Appeal and Review Board. And that is what OHIP has suggested to Ms. de Vries.
But her lawyer, Ms. Sellar, said such an appeal would be futile: Since Ms. de Vries did not fill out the out-of-country form before receiving treatment in the U.S., she cannot win the appeal.
Health Minister George Smitherman has the discretion to reimburse Ms. de Vries for treatment, if he chooses to do so. Ms. de Vries said she contacted her MPP, Sandra Pupatello, about it. In the end, she was told she had to go through the appeal process.
Bill Hryniuk, a past chairman of the board for the Cancer Advocacy Coalition of Canada, said cases like Ms. de Vries are "happening quite a bit." The problem, Dr. Hryniuk said, is that "no one is in charge. No one is in charge of the case and the patient bounces around. ... It really is a bad system. Really, it's no system."
Even after Ms. de Vries obtained a CT scan in the U.S. that suggested she had ovarian cancer, she still couldn't get treatment in Ontario. She was referred to a gynecologist who would not take her as a patient because she had dismissed his practice partner some years earlier. Another gynecologist said he did not believe she had ovarian cancer. And a general surgeon said she needed a gynecological oncologist.
At that point, in October, 2006, her condition was worsening - so she tapped her savings and went to the U.S.
After the surgery, she tried to get into the cancer system in Windsor, this time for chemotherapy. In November, she was told there was a six-week wait for chemotherapy, and she ended up getting chemo in the U.S. as well.
Ron Foster, vice-president of public affairs and communications for Windsor Regional Hospital, which includes the Windsor Regional Cancer Centre, said such a wait even back in 2006 would have been unusual - that it may have been as long as three weeks. Today, chemotherapy begins within one week of being referred by a doctor, he said.
Several improvements have also been made to the out-of-country process. A bulletin describing the program was mailed to the province's physicians, hospitals and associations in October, 2007. The next month, a special website was created. Those who receive denial letters are now provided a special telephone number to call for clarification on why the request was rejected, said Health Ministry spokeswoman Joanne Woodward Fraser.
But all that was too late for Ms. de Vries.
"I feel disappointed that when you're going through something like I did, you had to think about financial issues. It put a tremendous amount of strain on us," she said.
Her husband, Adriaan de Vries, an IT systems engineer, said they had no choice but to go to the U.S. "Nobody was in charge," he said, "and nobody really cared."”
*
LOOK AT THAT: "Nobody was in charge... and nobody really cared" - - - this is exactly what I’ve been writing about for several years now: read Liberal Healthcare Duplicity, An Ontario Overview 2003-2007 .
It's overwhelmigly sad what these Liberals have done to Ontario's health care system: they are more concerned about the health of their medicare-monopoly, than the actual health of individual patients.
*
“The Ontario Health Minister sympathizes with anyone battling an illness, but he stopped short of offering any help to a cancer patient who paid $60,000 in the United States to have a massive tumour removed.
"There are rules that require an individual to apply for approval before receiving treatment out of country," Laurel Ostfield, press secretary to provincial Health Minister George Smitherman, wrote in an e-mail yesterday. "These laws are in place to preserve our public health-care system because if we funded every hope mission that presented itself, the system would be unable to keep up with the demand."
The comments follow a Globe and Mail story about Sylvia de Vries, who despite having an enormous tumour and fluid totalling 18 kilograms, could not obtain timely treatment in Canada. The Windsor, Ont., woman went to Pontiac, Mich., where a surgeon excised the tumour - 35 centimetres at its longest - along with her ovaries, appendix, Fallopian tubes, uterus and cervix. As well, 13 litres of fluid were drained during the October, 2006, operation.
Had she waited two weeks for treatment, Ms. de Vries would have faced potential multiorgan failure, rendering her unstable for surgery, wrote Michael L. Hicks, who performed the operation.
Sylvia de Vries and her husband, Adriaan, of Windsor spent their own money to get her potentially life-saving surgery in the United States for ovarian cancer.
To pay for the $60,000 worth of treatment, Ms. de Vries drained her savings, maxed out her credit cards, took out a line of credit and relied on friends who threw a spaghetti-dinner fundraiser that brought in $11,125.
The Ontario Health Insurance Plan would not pay for her ovarian cancer treatment, because she did not fill out the prior approval form before receiving out-of-country care. OHIP also says no medical documentation was submitted that indicated that a delay in obtaining the service in Ontario would result in death or medically significant, irreversible tissue damage.
Figures obtained yesterday reveal the number of patients approved for out-of-country care has nearly tripled over the past five years.
In fiscal 2002-2003, there were 2,083 patients approved for out-of-country care. Since April, 2007, a total of 6,132 patients have had their treatment approved, according to Health Ministry spokeswoman Joanne Woodward Fraser. (Those numbers do not include the referrals of emergency neurosurgery and cardiac patients sent to the U.S. for care.)
The number of people denied out-of-country treatments has also increased, though not nearly as much. In fiscal 2002-2003, 225 patients were denied funding through the program, compared with fiscal 2007, in which 388 patients have so far been denied.
To have an out-of-country treatment approved, the procedure must not be one performed in Ontario, cannot be experimental and should be deemed medically appropriate. However, patients can have out-of-country treatment funded even if it is available in Ontario so long as there is a delay that would cause irreversible tissue damage or death. Part of the form must be filled out by the patient's physician.
Yesterday, Progressive Conservative health critic Elizabeth Witmer called on the Health Minister to review the case of the ovarian cancer patient.
"They need to look at some of the extenuating circumstances and if it's deemed to be warranted, I think they have to recognize some of the challenges she faced," Ms. Witmer said in an interview. "... They need to very seriously review the situation."
Also yesterday, lawyer Kate Sellar, who represents Ms. de Vries, said the Health Minister's sympathy is not enough.
"Ms. de Vries can show that she meets the medical requirements for treatment in the U.S., but wasn't able to comply with all of OHIP's processes and procedures," Ms. Sellar wrote in an e-mail. "The minister should step in and make sure she doesn't pay for her choices with her life savings."
Ms. de Vries had bounced around the Ontario health-care system before a U.S. physician diagnosed her with ovarian cancer. He operated on her four days later.
"It's ludicrous," Ms. de Vries said yesterday. "Where's the judgment and the integrity in all of this?... I'm disappointed with the bureaucracy of it all.""
*
Here we go again: another Ontario patient, another victim thrown into HSARB, that mysterious government star-chamber of monopoly-medicine, where the failed promises of Liberal medicare are appealed.
The smarmy gall of McGuinty's government to spin that patients – who were unable to obtain treatment in Ontario's Liberal health-care-monopoly - are to blame for not filling out some forms. Where is the part where the Liberal government is held liable and accountable for failing to provide their end of the socialist-medicare bargain? Dalton’s gang is held harmless, while patients in the mythical Liberal health care system suffer!
Once again, where would patients from Ontario go if they couldn’t find treatment in the States? The Dalton McGuinty Liberal health-care monopoly is failing on what should probably be seen as a criminal scale.
Didn’t we just go through almost the same scenario a year ago locally in St. Catharines, with Suzanne Aucoin?
Didn’t Ontario Ombudsman Andre Marin tear a strip off Ontario's Liberal health-care system then?
Didn’t the Liberals pledge to improve things?
Didn’t St. Catharines single-payer-pushing healthcare-monopolist Liberal MPP Jim Bradley...
...{see: Can Jim Bradley explain why he "stood up and said 'I hate doctors'"?
or:
Jim Bradley and the entropy of Ontario's health care
or:
Liberal medicare unbelievably scary}...
...attend Aucoin’s memorial and blab about vague 'inequities in health care' - as if he had nothing to do with what his own Liberals did to Aucoin?! {..talk about Bradley's cognitive dissonance here! Bradley and his Liberals were the problem!}
Don’t the Liberals know that HSARB is a bell-weather for their failing monopoly?
Since Aucoin, have the Liberals improved procedures, access and staffing so that HSARB may become a help, not a hindrance, to those Ontarians who were victimized by the McGuinty's Liberal health-care monopoly, and who were forced to get treatment elsewhere (mostly in the U.S.)?
This is another example of Liberal health care duplicity, where the Liberals are practising two-tier medicine: the patient gets sick in Ontario and is greeted by a health-care waiting list, or, goes to the States and is treated with health-care.
The Liberals, in the meantime, collect the patients' taxes, but fail to provide the supposedly-promised "universal" treatment; and even better: no Liberals are ever held liable for the death and destruction which they create.
What a socialist scam.
************
Lisa Priest previously wrote on Mar.11, 2008, on the same subject, titled “Even huge tumour can’t secure care in Ontario” (Globe and Mail):
“Inside Sylvia de Vries lurked an enormous tumour and fluid totalling 18 kilograms. But not even that massive weight gain and a diagnosis of ovarian cancer could assure her timely treatment in Canada.
Fighting for her life, the Windsor woman headed to the United States. In Pontiac, Mich., a surgeon excised the tumour - 35 centimetres at its longest - along with her ovaries, appendix, fallopian tubes, uterus and cervix. In addition, 13 litres of fluid were drained during that October, 2006, operation.
And there was little time to spare: Had she waited two weeks, she would have faced potential multiorgan failure, rendering her unstable for surgery, according to a letter from Michael L. Hicks, who performed the four-hour operation at St. Joseph Mercy Oakland.
"Based on my exam and experience as a gynecological oncologist, I felt it necessary to perform surgery within two weeks," said the letter written by Dr. Hicks, provided to Ms. de Vries's lawyer, Kate Sellar.
Sylvia de Vries and her husband, Adriaan, of Windsor spent their own money to get her potentially life-saving surgery in the United States for ovarian cancer.
But a devastating cancer diagnosis was only the beginning of Ms. de Vries's troubles.
The Ontario Health Insurance Plan says it won't pay for the $60,000 cancer treatment because Ms. de Vries did not fill out the correct form seeking preapproval for out-of-country care.
As well, it says no medical documentation was submitted that indicated a delay in obtaining the service in Ontario would result in death or medically significant, irreversible tissue damage.
That administrative misstep has left Ms. de Vries, a 51-year-old corporate communications manager, with a staggering cancer bill. She has drained her savings, maxed out her credit cards, taken out a line of credit and relied on friends to hold a spaghetti-dinner fundraiser, which earned $11,125.
"I feel abandoned; I was fighting for my life," Ms. de Vries said. "... I definitely would like to get some money back but more importantly, I would like to see the situation rectified so [other patients] don't go through this."
Ms. de Vries's case raises questions about OHIP's out-of-country health coverage program, which was put under a review more than a year ago after cancer patient Suzanne Aucoin of St. Catharines, Ont., was denied funding for treatment she received in the United States.
Only after ombudsman André Marin intervened was Ms. Aucoin reimbursed $76,018.23 in January, 2007, to cover costs associated with the colorectal cancer drug Erbitux, among other expenses and legal fees. (She has since died.)
At the time, Mr. Marin described the out-of-country approval process as "literally impossible for patients and physicians to understand."
Just two months before Mr. Marin made those comments, Ms. de Vries was trying to get access to that same program.
To have an out-of-country treatment approved, the procedure must not be performed in Ontario, cannot be experimental and should be deemed medically appropriate. However, patients can have out-of-country treatment funded even if it is available in Ontario so long as there is a delay that would cause irreversible tissue damage or death. Part of the form must be filled out by the patient's physician.
Patients denied preapproved, out-of-country treatment can appeal their cases to the Health Services Appeal and Review Board. And that is what OHIP has suggested to Ms. de Vries.
But her lawyer, Ms. Sellar, said such an appeal would be futile: Since Ms. de Vries did not fill out the out-of-country form before receiving treatment in the U.S., she cannot win the appeal.
Health Minister George Smitherman has the discretion to reimburse Ms. de Vries for treatment, if he chooses to do so. Ms. de Vries said she contacted her MPP, Sandra Pupatello, about it. In the end, she was told she had to go through the appeal process.
Bill Hryniuk, a past chairman of the board for the Cancer Advocacy Coalition of Canada, said cases like Ms. de Vries are "happening quite a bit." The problem, Dr. Hryniuk said, is that "no one is in charge. No one is in charge of the case and the patient bounces around. ... It really is a bad system. Really, it's no system."
Even after Ms. de Vries obtained a CT scan in the U.S. that suggested she had ovarian cancer, she still couldn't get treatment in Ontario. She was referred to a gynecologist who would not take her as a patient because she had dismissed his practice partner some years earlier. Another gynecologist said he did not believe she had ovarian cancer. And a general surgeon said she needed a gynecological oncologist.
At that point, in October, 2006, her condition was worsening - so she tapped her savings and went to the U.S.
After the surgery, she tried to get into the cancer system in Windsor, this time for chemotherapy. In November, she was told there was a six-week wait for chemotherapy, and she ended up getting chemo in the U.S. as well.
Ron Foster, vice-president of public affairs and communications for Windsor Regional Hospital, which includes the Windsor Regional Cancer Centre, said such a wait even back in 2006 would have been unusual - that it may have been as long as three weeks. Today, chemotherapy begins within one week of being referred by a doctor, he said.
Several improvements have also been made to the out-of-country process. A bulletin describing the program was mailed to the province's physicians, hospitals and associations in October, 2007. The next month, a special website was created. Those who receive denial letters are now provided a special telephone number to call for clarification on why the request was rejected, said Health Ministry spokeswoman Joanne Woodward Fraser.
But all that was too late for Ms. de Vries.
"I feel disappointed that when you're going through something like I did, you had to think about financial issues. It put a tremendous amount of strain on us," she said.
Her husband, Adriaan de Vries, an IT systems engineer, said they had no choice but to go to the U.S. "Nobody was in charge," he said, "and nobody really cared."”
*
LOOK AT THAT: "Nobody was in charge... and nobody really cared" - - - this is exactly what I’ve been writing about for several years now: read Liberal Healthcare Duplicity, An Ontario Overview 2003-2007 .
It's overwhelmigly sad what these Liberals have done to Ontario's health care system: they are more concerned about the health of their medicare-monopoly, than the actual health of individual patients.
*
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