After weeks of bad news, things turned Barbara Wagner’s way this week.
Last month her lung cancer, in remission for about two years, was back. After her oncologist prescribed a cancer drug that could slow the cancer growth and extend her life, Wagner was notified that the Oregon Health Plan wouldn’t cover it.
It would cover comfort and care, including, if she chose, doctor-assisted suicide.
Then on Monday a representative of the pharmaceutical company Genentech called Wagner and offered the medicine for free.
Wagner said she didn’t know whether to laugh or cry, so she did both.
Treatment of advanced cancer meant to prolong life, or change the course of this disease, is not covered by the Oregon Health Plan, said the unsigned letter Wagner received from LIPA, the Eugene company that administers the plan in Lane County.
The Oregon Health Plan started out rationing health care in 1994.
Conditions such as pregnancy, childbirth and preventive care for children lead the list. At the bottom are uncovered procedures such as cosmetic surgery.
“We can’t cover everything for everyone,” said Dr. Walter Shaffer, medical director of the state Division of Medical Assistance Programs, which administers the Oregon Health Plan.
“Taxpayer dollars are limited for publicly funded programs. We try to come up with polices that provide the most good for the most people. Most cancer treatments are high priority on the list,” Shaffer said.
Wagner said she was devastated when she found out the plan doesn’t cover Tarceva.
“I think it’s messed up,” Wagner said, bursting into tears.
“The letter said doctor-assisted suicide would be covered. To say to someone, `we’ll pay for you to die, but not pay for you to live,’ it’s cruel,” she said. “I get angry. Who do they think they are?”
Dr. John Sattenspiel, senior medical director for LIPA, said that at some level doctor-assisted suicide could be considered as a palliative or comfort care measure. “We had no intent to upset her, but we do need to point out the options available to her under the Oregon Health Plan,” he said.
More. As I’ve noted previously, there really is no such thing as universal healthcare. No government funded program, no matter how lavish, is going to pay for every treatment that could potentially save someone’s life. In fact, if recent experience in Massachusets is any indication, mandating universal health care won’t even ensure that everyone has health insurance, let alone that they receive needed care.
Whether cases like this would end up being repeated on a grand scale is, of course, speculative. But it’s not out of the question, either. Medicare already has long term unfunded liabilities of more than $65 trillion, and the more the government is forced to engage in health care rationing for seniors, the more attractive government funded assisted suicide will appear, at least to some. This, in my view, is not the only reason to be wary of an increased government role in paying for health care. But it’s not an insignificant one.
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