State officials have offered a lung cancer patient the option of having the Oregon Health Plan, set up in 1994 to ration health care, pay for an assisted suicide but not for the chemotherapy prescribed by her physician.
The story appears to be a happy ending for Barbara Wagner, who has been notified by a drug manufacturer that it will provide the expensive medication, estimated to cost $4,000 a month, for the first year and then allow her to apply for further treatment, according to a report in the Eugene Register-Guard.
But the word from the state was coverage for palliative care, which would include the state’s assisted suicide program, would be allowed but not coverage for the cancer treatment drugs.
“To say to someone, we’ll pay for you to die, but not pay for you to live, it’s cruel,” Wagner told the newspaper. “I get angry. Who do they think they are?”
She said she was devastated when the state health program refused coverage for Tarceva, the drug her doctor ordered for treatment of her lung cancer.
The refusal came in an unsigned letter from LIPA, the company that runs the state program in that part of Oregon.
“We had no intent to upset her, but we do need to point out the options available to her under the Oregon Health Plan,” Dr. John Sattenspiel, senior medical director for LIPA, told the newspaper.
“I understand the way it was interpreted. I’m not sure how we can lift that. The reality is, at some level (doctor-assisted suicide) could be considered as a palliative or comfort care measure.”
The 64-year-old Wagner lives in a low-income apartment in Springfield with her dog, the newspaper said.
State officials say the Oregon Health Plan prioritizes treatments, with diagnoses and ailments deemed the most important, such as pregnancy, childbirth and preventive care for children at the top of the list. Other treatments rank below, officials said.
“We can’t cover everything for everyone,” Dr. Walter Shaffer, a spokesman for the state Division of Medical Assistance Programs, told the paper. “Taxpayer dollars are limited for publicly funded programs. We try to come up with policies that provide the most good for the most people.”
He said many cancer treatments are a high priority, but others reflect the “desire on the part of the framers of this list to not cover treatments that are futile.”
Wagner, however, is ending up with the treatment needed when her lung cancer, in remission for two years, returned.
She reported a representative for the pharmaceutical company called and notified her the drug would be provided for at least the first year.
“We have been warning for years that this was a possibility in Oregon,” said the “Bioethics Pundit” on the Bioethics blog. “Medicaid is rationed, meaning that some treatments are not covered. But assisted suicide is always covered.“
“This isn’t the first time this has happened either,” the blogger wrote. “A few years ago a patient who needed a double organ transplant was denied the treatment but would have been eligible for state-financed assisted suicide. But not to worry. Just keep repeating the mantra: There are no abuses with Oregon’s assisted suicide law. There are no abuses. There are no abuses!