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.
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."
