How Badly Do You Want to Live?

Courtesy of Gabriel over at Ace's we have an atrocious story of the "wonders" of socialized medicine coming out of the UK.

{...}Mrs O'Boyle, 64, had been receiving state-funded treatment - including chemotherapy - for colon cancer.

But when she took cetuximab, a drug which promised to extend her life but is not available on the NHS, her health trust made her start paying for her care.

{...}Mrs O'Boyle, an NHS occupational therapist, is believed to be the first person to die after being denied free care because of 'co-payment', where a patient tops up treatment by paying privately for extra drugs.

Co-payment was blocked last year by Health Secretary Alan Johnson because he claimed it would create a two-tier Health Service.

{...}Mrs O'Boyle was operated on in January last year for colon cancer and the doctors found it had spread to her stomach lining.

The former NHS assistant occupational therapist, who has three sons, twins Gerald and Anthony, 37, and Mark, 33, as well as grandchildren Luke, four, Finn, three, Jemima, two and Darcey, two, then had six weeks of chemotherapy.

She continued with this until September last year when she and her husband were told the devastating news there was little more doctors could do.

However, her consultant recommended-Cetuximab, which could extend her life. But it is available on the NHS only in Scotland, not in England and Wales.

It is one of many medicines the National Institute for Health and Clinical Excellence denies to some patients because of cost.

Mrs O'Boyle's decision to take it meant she and her husband had to spend £11,000 over two months for care from Southend University Hospital NHS Foundation Trust. {...}

Nice, huh? A lifetime of taxes to pay for a health care system that actually employed this woman and her husband, only to be betrayed in the end because she was willing to pay out of pocket for a few more months on this Earth. She wasn't looking for a cure. She knew that was beyond her. She was simply looking for a palliative treatment which could extend her life a bit. Just a bit.

She was asked, "How badly do you want to live?" And she replied that she wanted just a few more months with her family. She paid the price for a drug that wasn't available under universal healthcare, and she did it gladly, only to be smacked with a frozen mackerel in the end. Her actions would create a "two tier" health care system, and that, apparently, cannot be allowed, because that would mean she wasn't receiving lowest common denominator health care, like everyone else does with the NHS, and the NHS cannot stand that. She thought she had the right to choose what her healthcare was worth to her, and that she wasn't going to be penalized for her decision. One would suspect, with universal healthcare, that that would be a reasonable assumption. Unfortunately, it wasn't.

And yet this atrocious system is what some people would have us install here in the US. This is what some people want because their health insurance premiums are too high, and they would prefer not to have to pay them, but would rather let the government run things. It's tidier in theory, but absolutely disgusting in practice.

Again, how badly do you want to live?

Governments with nationalized healthcare systems don't want to give their citizens a choice. Patients are blackmailed, ultimately, into going with the lowest common denominator treatment if the the choice is between that or nothing at all because they don't have spare millions on hand to pay for private care.

I know I harp on rather a lot about my cancer experience, but I don't think I've ever mentioned what Dr. Academic told me one time, about what my treatment would have been if I lived in Italy. During the course of the staging controversy, we were told by my original oncologist that I would have to undergo three treatments of chemotherapy, instead of the six I'd been told originally. The reason for this was that a new study had come out, advocating three treatments for women with my stage of ovarian cancer, instead of six, because they hadn't been able to find any added benefit, when contrasted with the risks, to the extra three treatments. However, when I was transferred over to Dr. Academic, he said, if I had to have treatment (which he wasn't sure about at that point in time because of the evidence he had in front of him) I would have to have the dreaded six treatments, because he didn't think the study the original oncologist had quoted was a very good study on the whole---and he would know, as he was on the board of the organization which published the study. He said that the group members had been polled and over ninety percent of them hadn't thought it a good study, either---and weren't going to use it as a treatment recommendation. He said that the reason for this disconnect was that to make the study's results all the more powerful, they had let in to the statistical pool ovarian cancer diagnoses from places like Italy and Japan, for example, and Dr. Academic scoffed at their inclusion. He said their participation had ruined the study---because they hadn't followed the protocol precisely, as in, the surgeries hadn't been completed in the proscribed manner and as a result, had skewed the results. He said, after he'd dropped this bomb, that if I'd been living in Italy, with my cancer, all they would have done was the surgery. After all, that meant I would have a 70% survival rate for five years, which is nothing to sneeze at, particularly if you look at the statistics for things like pancreatic cancer, which has a 2% survival rate. But with a round of "precaution" chemo, just to make sure everything was cleaned out, my five year survival rate was boosted to 93%.

Which would you rather have?

Pretty easy choice, isn't it, even with the knowledge that you'd have to go through the extended hell that is chemo to get those extra percentage points.

The reason for this move by the Italians, Dr. Academic explained, was that the national healthcare system had deemed the chemo was too expensive in light of the "limited" benefit it brought about in cases like mine. That's what we're talking about in terms of nationalized healthcare systems. A world where twenty-three whole survival percentage points are a benefit that's not worth the costs incurred. Quite frankly, this is the difference between recurring and not---and if ovarian cancer recurs, well, that's what the cause of death will be. It's sad, but it's true. So the goal, for women like me, is to make sure at the start that we have the best chances possible NOT to recur. That means a standardized protocol of precaution chemo. This is the standard of care here in the US. But not in Italy. How many Italian women, who were diagnosed with my stage of ovarian cancer, have recurred, and received, ultimately, a death sentence, because their government was too cheap to give them precautionary treatment in the first place?

Your life in a nationalized health care system has a fixed price attached to it, and if your cost of treatment exceeds that fixed price you're out of luck. Which, if you ask me, is the equivalent of a state-run eugenics program.

Posted by Kathy at June 2, 2008 10:57 AM | TrackBack