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Help Suzanne Aucoin
Jan. 31, 2007 - National Post
Ontario agrees to pay $52,000 cancer bill
Out-of-country coverage: Woman has been seeking refund since 2005
Natalie Alcoba And Kelly Patrick
National Post
Wednesday, January 31, 2007
A St. Catharines woman has been handed a hard-earned victory after the Ministry of
Health agreed to refund the costs she incurred out of pocket for intravenous cancer
treatment and promised to review its out-of-country health coverage based on
recommendations from the provincial Ombudsman.
Suzanne Aucoin, who was diagnosed with colorectal cancer in 1999, received a
telephone call yesterday afternoon from Deputy Minister of Health Ron Sapsford, who
apologized to her for the obstacles she faced in "resolving this issue".
The Ontario government has agreed to pay her entire medical bill--more than $52,000
that she paid for herself, in part by fundraising -- plus her legal fees, also on the
advice of the Ombudsman.
In a news release yesterday, the ministry said it will take "immediate steps" to provide
doctors with better access to information about the province's out-of-country health
coverage program.
Other elements of its review will address specific deficiencies highlighted by
Ombudsman Andre Marin, such as the need to provide more information about funding
for particular treatments, ensuring that decisions about funding for out-of-country
care are "consistent and based on evidence" and providing more comprehensive
reasons when a request is denied.
"I have to say I'm relieved and I'm thankful that I can close this chapter in this fight,"
Ms. Aucoin, 36, said yesterday in a telephone interview, surrounded by friends and
family who had gathered to celebrate at an Italian restaurant in St. Catharines.
"I'm looking forward to just focusing on my health and not having to worry about
fundraising or about fighting government bureaucracy."
Her battle with Ontario's health-care red tape began in October, 2005, when her
oncologist recommended she begin receiving weekly infusions of Erbitux, a drug that
was approved by Health Canada but not commercially available in this country.
Her doctor applied for out-of-country coverage for the drug but was denied. While
she appealed that decision, she found a private clinic in West Seneca, N.Y., where
Erbitux infusions cost about $4,000 per treatment. She spent $31,065 on two months of
treatment in West Seneca, then was allowed to access the drug at the Hamilton
Health Sciences Centre, where she spent an additional $21,182. Meanwhile, Ms.
Aucoin's Toronto lawyer Brian Cohen discovered that OHIP had paid for 29 other
Erbitux users from Jan. 1, 2004 to February, 2006.
In March of 2006, OHIP reversed its original rejection and agreed to pay for the drug
at a Buffalo, N.Y., hospital, which charged $8,000 per treatment.
In November a Health Services and Appeal Review Board denied her bid to recover the
costs of the infusions she paid for herself, a decision that spurred the ombudsman to
intervene.
In an interview yesterday, Mr. Marin said his investigation found "far too much of a
cloak-and-dagger approach" by the ministry when it came to approving out-of-country
treatment.
"Physicians don't quite know what the rules are, patients don't know what the rules
are, form letters are being used by bureaucrats. There is not the kind of
communication that should occur when someone is dying of cancer," said Mr. Marin,
who may yet address other issues, such as why the government would pay for the
more expensive hospital treatment in Buffalo, but not the cheaper treatment at West
Seneca.
Ms. Aucoin, a former Catholic school chaplain who just came off a grueling seven
weeks of treatment, said she has learned that "you've got to be persistent to get what
you need".
In her telephone conversation with Mr. Sapsford, she reminded the Deputy Minister
that cancer patients still face many other challenges on the road to recovery and that
fighting government bureaucracy should not be one of them.
"It's enough to deal with the diagnosis of cancer."
Ontario agrees to pay $52,000 cancer bill
Out-of-country coverage: Woman has been seeking refund since 2005
Natalie Alcoba And Kelly Patrick
National Post
Wednesday, January 31, 2007
A St. Catharines woman has been handed a hard-earned victory after the Ministry of
Health agreed to refund the costs she incurred out of pocket for intravenous cancer
treatment and promised to review its out-of-country health coverage based on
recommendations from the provincial Ombudsman.
Suzanne Aucoin, who was diagnosed with colorectal cancer in 1999, received a
telephone call yesterday afternoon from Deputy Minister of Health Ron Sapsford, who
apologized to her for the obstacles she faced in "resolving this issue".
The Ontario government has agreed to pay her entire medical bill--more than $52,000
that she paid for herself, in part by fundraising -- plus her legal fees, also on the
advice of the Ombudsman.
In a news release yesterday, the ministry said it will take "immediate steps" to provide
doctors with better access to information about the province's out-of-country health
coverage program.
Other elements of its review will address specific deficiencies highlighted by
Ombudsman Andre Marin, such as the need to provide more information about funding
for particular treatments, ensuring that decisions about funding for out-of-country
care are "consistent and based on evidence" and providing more comprehensive
reasons when a request is denied.
"I have to say I'm relieved and I'm thankful that I can close this chapter in this fight,"
Ms. Aucoin, 36, said yesterday in a telephone interview, surrounded by friends and
family who had gathered to celebrate at an Italian restaurant in St. Catharines.
"I'm looking forward to just focusing on my health and not having to worry about
fundraising or about fighting government bureaucracy."
Her battle with Ontario's health-care red tape began in October, 2005, when her
oncologist recommended she begin receiving weekly infusions of Erbitux, a drug that
was approved by Health Canada but not commercially available in this country.
Her doctor applied for out-of-country coverage for the drug but was denied. While
she appealed that decision, she found a private clinic in West Seneca, N.Y., where
Erbitux infusions cost about $4,000 per treatment. She spent $31,065 on two months of
treatment in West Seneca, then was allowed to access the drug at the Hamilton
Health Sciences Centre, where she spent an additional $21,182. Meanwhile, Ms.
Aucoin's Toronto lawyer Brian Cohen discovered that OHIP had paid for 29 other
Erbitux users from Jan. 1, 2004 to February, 2006.
In March of 2006, OHIP reversed its original rejection and agreed to pay for the drug
at a Buffalo, N.Y., hospital, which charged $8,000 per treatment.
In November a Health Services and Appeal Review Board denied her bid to recover the
costs of the infusions she paid for herself, a decision that spurred the ombudsman to
intervene.
In an interview yesterday, Mr. Marin said his investigation found "far too much of a
cloak-and-dagger approach" by the ministry when it came to approving out-of-country
treatment.
"Physicians don't quite know what the rules are, patients don't know what the rules
are, form letters are being used by bureaucrats. There is not the kind of
communication that should occur when someone is dying of cancer," said Mr. Marin,
who may yet address other issues, such as why the government would pay for the
more expensive hospital treatment in Buffalo, but not the cheaper treatment at West
Seneca.
Ms. Aucoin, a former Catholic school chaplain who just came off a grueling seven
weeks of treatment, said she has learned that "you've got to be persistent to get what
you need".
In her telephone conversation with Mr. Sapsford, she reminded the Deputy Minister
that cancer patients still face many other challenges on the road to recovery and that
fighting government bureaucracy should not be one of them.
"It's enough to deal with the diagnosis of cancer."