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Help Suzanne Aucoin
Nov. 17, 2006 - The St. Catharines Standard
AUCOIN LOSES OHIP BATTLE
By Peter Downs, The St. Catharine's Standard
Local News - Friday, November 17, 2006
"Suzanne's story" Part 12
The decision delivered her no real surprise in its punch.
Suzanne Aucoin has lost her bid to be reimbursed by OHIP for more than
$51,000 she spent on colon cancer drugs in New York state and in Hamilton.
Ontario's Health Services Appeal and Review Board rejected Aucoin's appeal
Thursday afternoon.
Shortly after receiving the panels 16-page written decision, Aucoin resolved
not to waste what strength she has left on anger.
I was kind of half expecting it, she said quietly. I'm tired of being upset
and tired of being sad, so I'm not going to give it any energy.
Its been a trying week for Aucoin, 36, who lives with her parents in Port
Dalhousie.
She learned last Thursday that surgery she hoped to receive to remove
tumours in her liver and lungs isn't possible because more cancerous cells
have been found in her lymph nodes.
Then came word that her push for reimbursement of her medical costs for
life-saving treatment had been turned down.
Its frustrating. Its disappointing and its just another reflection of how
this health-care system doesn't take care of us. Its the health-doesn't-care
system. Its the health-screw-you-care system, she said.
Aucoin diagnosed with terminal colon cancer three years ago was rejected in
October 2005 by OHIP for out-of-country coverage for a colon cancer drug not
available in Ontario.
She decided to pay for the expensive intravenous drug Erbitux out of her own
pocket.
Aucoin arranged to receive weekly treatments with the medication at a
private clinic in West Seneca, N.Y., for about $14,000 US per month.
That price was $10,000 less than OHIP was paying for other Ontario patients
to get Erbitux at Buffalos Roswell Park Cancer Institute.
OHIP subsequently agreed to pay for Aucoin to get the treatment at Roswell
Park at the higher cost beginning last March. Aucoin tried to convince OHIP
to reimburse her for the money she spent on the medication during the months
prior to her approval for out-of-country coverage.
She spent $31,065 for Erbitux at the clinic in West Seneca from October to
December 2005. She paid a further $21,116 for the drug at Hamilton's cancer
centre through a federal special access agreement.
In June, the provinces health insurance program rejected Aucoin's initial
application for reimbursement.
She and lawyer Brian Cohen argued for the decision to be reversed at a
one-day hearing before Ontario's Health Services Appeal and Review Board
Sept. 18 in Toronto.
In its decision Thursday, the tribunal ruled it doesn't have jurisdiction to
cover Aucoin's tab at the West Seneca clinic because it doesn't meet its
definition of a licensed health facility.
The board also concluded OHIP doesn't have jurisdiction to use its
out-of-country fund to reimburse Aucoin the money she spent for Erbitux at
Hamilton's cancer centre because the facility isn't outside the country.
What struck me most were the (boards) unbelievable contortions of logic,
Cohen said.
Aucoin presented the tribunal a letter from her West Seneca oncologist,
indicating he is a licensed physician and his infusion clinic operates in
accordance with all laws in this jurisdiction.
But the tribunal said its bound by legislation that requires the facility
itself not just the physician to be licensed in order to be considered for
out-of-country benefit coverage.
It just doesn't make sense to me because there was no licence the clinic
could get, Cohen said.
He also maintained Aucoin is effectively paying the price for trying to
stretch her limited resources as far as possible. I think most of us would
be pretty horrified that you have someone who's trying to save the ministry
money and she's penalized, he said.
Aucoin said she wont dwell on the panels decision. I refuse to get too
deflated by it, she said. I cant go there again. I'm depleted.
AUCOIN LOSES OHIP BATTLE
By Peter Downs, The St. Catharine's Standard
Local News - Friday, November 17, 2006
"Suzanne's story" Part 12
The decision delivered her no real surprise in its punch.
Suzanne Aucoin has lost her bid to be reimbursed by OHIP for more than
$51,000 she spent on colon cancer drugs in New York state and in Hamilton.
Ontario's Health Services Appeal and Review Board rejected Aucoin's appeal
Thursday afternoon.
Shortly after receiving the panels 16-page written decision, Aucoin resolved
not to waste what strength she has left on anger.
I was kind of half expecting it, she said quietly. I'm tired of being upset
and tired of being sad, so I'm not going to give it any energy.
Its been a trying week for Aucoin, 36, who lives with her parents in Port
Dalhousie.
She learned last Thursday that surgery she hoped to receive to remove
tumours in her liver and lungs isn't possible because more cancerous cells
have been found in her lymph nodes.
Then came word that her push for reimbursement of her medical costs for
life-saving treatment had been turned down.
Its frustrating. Its disappointing and its just another reflection of how
this health-care system doesn't take care of us. Its the health-doesn't-care
system. Its the health-screw-you-care system, she said.
Aucoin diagnosed with terminal colon cancer three years ago was rejected in
October 2005 by OHIP for out-of-country coverage for a colon cancer drug not
available in Ontario.
She decided to pay for the expensive intravenous drug Erbitux out of her own
pocket.
Aucoin arranged to receive weekly treatments with the medication at a
private clinic in West Seneca, N.Y., for about $14,000 US per month.
That price was $10,000 less than OHIP was paying for other Ontario patients
to get Erbitux at Buffalos Roswell Park Cancer Institute.
OHIP subsequently agreed to pay for Aucoin to get the treatment at Roswell
Park at the higher cost beginning last March. Aucoin tried to convince OHIP
to reimburse her for the money she spent on the medication during the months
prior to her approval for out-of-country coverage.
She spent $31,065 for Erbitux at the clinic in West Seneca from October to
December 2005. She paid a further $21,116 for the drug at Hamilton's cancer
centre through a federal special access agreement.
In June, the provinces health insurance program rejected Aucoin's initial
application for reimbursement.
She and lawyer Brian Cohen argued for the decision to be reversed at a
one-day hearing before Ontario's Health Services Appeal and Review Board
Sept. 18 in Toronto.
In its decision Thursday, the tribunal ruled it doesn't have jurisdiction to
cover Aucoin's tab at the West Seneca clinic because it doesn't meet its
definition of a licensed health facility.
The board also concluded OHIP doesn't have jurisdiction to use its
out-of-country fund to reimburse Aucoin the money she spent for Erbitux at
Hamilton's cancer centre because the facility isn't outside the country.
What struck me most were the (boards) unbelievable contortions of logic,
Cohen said.
Aucoin presented the tribunal a letter from her West Seneca oncologist,
indicating he is a licensed physician and his infusion clinic operates in
accordance with all laws in this jurisdiction.
But the tribunal said its bound by legislation that requires the facility
itself not just the physician to be licensed in order to be considered for
out-of-country benefit coverage.
It just doesn't make sense to me because there was no licence the clinic
could get, Cohen said.
He also maintained Aucoin is effectively paying the price for trying to
stretch her limited resources as far as possible. I think most of us would
be pretty horrified that you have someone who's trying to save the ministry
money and she's penalized, he said.
Aucoin said she wont dwell on the panels decision. I refuse to get too
deflated by it, she said. I cant go there again. I'm depleted.