Ontario health minister has strange concept of fairness

NationalPost.com – FullComment/Canada
Mar 14, 2011.   Matt Gurney

When Torontonian Jill Anzarut, then 34, felt something in her breast, it never occurred to her that it might be cancer. “I had thought a tumour would feel like a wad of gum under my skin,” she said. When she mentioned it to her doctor at a checkup several months later, an ultrasound was ordered. Worried by the results, the doctor sent her to Princess Margaret Hospital’s Gattuso Rapid Diagnostic Centre for a biopsy. Two days later, Ms. Anzarut was diagnosed with an aggressive form of breast cancer.

Worse, the cancer has a high likelihood of reoccurring if not treated with the drug Herceptin, which can cut the chance of cancer returning in half. But Ontario only provides the drug to those whose tumours have grown to be larger than one centimetre in diameter. Ms. Anzarut, by catching her cancer early, disqualified herself from the best possible treatment. Her appeal for an exemption was rejected on Thursday.

Early cancer detection thus places Ontario breast cancer victims like Ms. Anzarut in a Catch-22. Immediate, aggressive treatment will hopefully kill the cancer for now; letting the tumour grow would make her qualify for Herceptin and thus reduce her chances of second bout with the disease, if the delay isn’t fatal.

The tumour was removed in January and Ms. Anzarut is currently undergoing an aggressive course of chemotherapy. If she is to be treated with Herceptin, the treatment will need to begin in eight weeks. Her appeal to the exceptional access program was rejected on the grounds that her cancer was too small to qualify -a strange conclusion, given that her acceptance of that fact is what prompted her appeal.

Ms. Anzarut has not been shy. She has spoken of her plight in newspapers, on radio and television, and through social media, where a campaign to bombard Ontario Health Minister Deb Matthews with letters continues. Some good may come of that, as Cancer Care Ontario is reviewing their policies on the drug, which could stand to help the 100 or so women a year who face this situation.

Clearly feeling the pressure, Ms. Matthews correctly stated that it was inappropriate for her to involve herself in the exceptional access review, but then oddly seemed to lash out at Ms. Anzarut’s contact with the media: “We cannot have a health system where the stories that land on the front page of the paper determine our health-care policy. It would be unfair to those who do not get their stories on the front page if we were to give priority to those who do.”

The issue Ms. Matthews has either missed or ignored is that the case is worth the media’s attention because it speaks to problems in the Ontario health-care system that could affect any citizen of that province. Even from a perspective of cold economics, the hefty cost of a course of Herceptin — up to $50,000 — is worth it if removes the need for future operations and chemotherapy.

Morally and fiscally, the healthcare system is offside with reality, and that explains the public interest Ms. Matthews would so quickly dismiss. The Minister is better off pointing to the limits of her office than she is brushing off strong interest in a young mother’s reasonable request for potentially life-saving drugs.

Especially since Herceptin is already given to women in Ms. Anzarut’s situation in other Canadian provinces. If Ms. Anzarut lived in British Columbia or Alberta, for example, she would have no need to battle an inflexible health-care bureaucracy.

Universality and equal access to treatment is a fundamental element of Canadian public health-care delivery, as Ms. Matthews alluded to in her own remarks concerning the media and fairness.

That Ms. Anzarut would be better off if she lived in a province other than the one Ms. Matthews represents is something the Minister may wish to consider before further comment about how fair Ontario is to its citizens fighting for their lives.

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