When You Have Nothing Else, Use Fallacy!

Today on Twitter I picked up quite a few new followers. One of them was a Twitter account promoting TwiceRight, a right leaning blog in the USA. Whenever I get emails about new followers, since I don’t have an unmanageably large amount, I tend to check out their recent tweets to see what they have to say. One from this account jumped out at me, linking to a blog post that claimed to “prove” the nonsensical allegation of “death panels” in systems of universal healthcare – specifically in Canada. With great interest I checked out the post.

It was a deceptive and idiotic telling of the rather sad tale of Kent Pankow, an Alberta man who suffers from what sounds like an extremely rare but pernicious form of brain cancer called glioblastoma. My knowledge of brain cancer isn’t particularly extensive, but is slightly enriched by having contributed to fundraising efforts for The James Fund For Neuroblastoma Research, in memory of James Birrell, a child from my former hometown of Peterborough, Ontario. James fought and eventually lost a battle with another form of cancer that is relatively rare, such that drug companies don’t put a lot of research into developing treatments for it. As I understand it brain tumours are difficult to deal with surgically as they spread fast and can be difficult to access.

The post tries to make much hay of the “Alberta Cancer Board”, suggesting, falsely, that “… countries with socialized health care have “boards” for different sectors of disease”. I don’t know what a sector of disease is, but that’s not the important part. I don’t know of any other disease or condition that has a similar management system in Canada, at least. And of course, as I’ve discussed before, Canada doesn’t have “socialized health care”. We have socialized health insurance. Most of our healthcare is delivered by private sector actors – our primary care physicians, our specialists, diagnostic services, etc etc are all private sector actors. The difference between us and the United States is that virtually everyone here has coverage under a universal health insurance plan. Anyhow, back to “boards” In the case of Alberta, the Alberta Cancer Board has been folded back into Alberta Health Services, but I looked at an analogue I was fairly familiar with, Cancer Care Ontario. Who are they? Well, here’s their page, I’ll let them answer. http://www.cancercare.on.ca/about/who/ They note their responsibility it to continuously improve cancer services. Given that cancer is pretty widespread – and is actually just a blanket term for more than 200 different diseases, requires intensive treatment, and has a lot of research ongoing, it makes sense that provinces have agencies that coordinate the management of care and prevention programs.

Similar programs seem to exist in other provinces, including Nova Scotia where I live. They have generally the same mandate – coordinate resources, design and improve standards of care, collate and disperse knowledge to all stakeholders. Nothing about that sounds particularly insidious, despite TwiceRight’s claims. In fact, I’m quite happy that given the toll cancer takes, our healthcare system has created such a mechanism for addressing it more effectively in every possible case. If anyone sees any reason that this is actually a bad thing, I’d love to hear it, but I can’t seem to find anyone besides TwiceRight who does, and their argument is more a case of misrepresentation and insinuation than any sort of representation of facts.

Back to Mr. Pankow. TwiceRight omits the contextual explanation for the man’s plight. They claim – and they word it such that they are making clear they have no facts, “The cost to remove Pankow’s brain tumor was too expensive, they would rather have him be on meds for a couple of weeks and die than get the surgery.” They then assert “it’s not rocket science”. I am in no position to comment on why the surgery wasn’t done in Alberta and why there was the 16 day lag that TwiceRight and other articles refer to. The difference in my case is that I won’t speculate on the reason. The fact that TwiceRight does just shows more of a lack of integrity, but you’ve probably figured that out already. In any case, as a result of this predicament he sought treatment at his own cost at the Mayo Clinic.

The bigger part of the problem involves a drug called Avastin, an incredible anti-cancer drug. I’m familiar with it because it’s the primary reason a very good friend of mine’s mother is alive today. She was diagnosed with colon cancer several years ago and told to expect the worst, until she got into a research trial group and the drug worked its magic. Avastin is approved for treatment of a few different cancers, but in Canada, not for the treatment of brain cancers – yet. In the United States, it is, and it’s part of the protocol that Mayo is coordinating with Mr. Pankow’s doctors in Canada to treat his condition. That’s the terrible, horrible grind that Mr. Pankow finds himself in – Avastin is working, but it’s also costing him $9,000 a month because it’s not approved for his condition and therefore not covered by his insurance. This is one of those terrible bureaucratic nightmares that can crop up in any sort of insurance system. Interestingly, TwiceRight’s blogger contradicts himself here, seeming to assert that Alberta Health is withholding treatment because of cost, but then noting that had he had colon, lung, or breast cancer it would have been paid for… because the approval process for those cancers is complete.

Health Canada is in the approval process, but the wait is surely agonizing. In the meantime Mr. Pankow has a complaint before the Alberta Human Rights Commission regarding what he regards as discrimination. I believe from what I read of the story that he has a good case, and that in the end he should receive a decision in his favour. His lobbying effort is to get an exception to waive the cost of his Avastin therapy until such time as a decision is rendered, and they’re frustrated that the Alberta Government hasn’t done so. I can’t disagree with that position at all, either.

The real problem with this story, or rather, with its use by TwiceRight. It’s basically a sort of straw man against health care reform, and I’ll suggest that it’s disingenuous for at least two reasons. First, look at TwiceRight’s last paragraph. “Which is why we need to address health insurance not health care in this country. (emphasis in original). Well, the only viable health care reform option in the USA right now deals almost exclusively with insurance, not the continued tired drone about “government takeover”. They then descend into the normal canards about portability which have been addressed broadly elsewhere as being likely totally ineffective in dealing with insurance costs and access.

They are correct about how a more liberal response would sound. This tactic of pointing at Canada as a great big straw man for fighting reform is getting worn out, and it’s ridiculous. In fact, that Mr. Pankow lives in Canada and has the ability to at least fight for coverage would seem to put him ahead of the game, in comparison, let’s say, to Ben Martin (http://www.bensfight.org/). Or to the various patients of the disease profiled here: http://www.yasg.com/bios002.html, and their struggles to maintain their insurance coverage and fund their treatment. What if Kent Pankow lived in the US and his relapse was treated as a pre-existing condition, leaving him with basically no recourse whatsoever? A few minutes on Google reveals that glioblastoma multiforme is a tragic disease for many people, regardless of where they live, but to read that second link and see the added stress that battling insurers causes makes you really have to rethink the argument presented.

To sum up, as I’ve gone on long enough, the case of Mr. Pankow highlights my main assertion about the Canadian healthcare system. Like most systems, it’s not perfect, but I don’t think I’d like to trade my coverage here for anything in the USA under its current system. The fact that even those with insurance face difficulties fighting their conditions shows me that universal healthcare has tremendous advantages in so many ways. I wish Mr. Pankow well in his fight, both with cancer and to improve our system, but hope I have been able to make a reasonably compelling case for why the political hay being made of him (or rather, attempting to be made) is just another fine example of the desperation of opponents of the effort to improve healthcare access in the United States – of their willingness to use fallacious arguments and deception to support their claims.

Incidentally, Mr. Pankow has a trust fund for donations to support his care in the interim while his case works itself through the system, with any surplus going to glioblastoma research, and those interested in his case can make donations by following the instructions on the site.

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2 comments so far

  1. Jeremy Hoover on

    Great post. You mentioned what might happen to Mr. Pankow if he was in the US and his condition was treated as “pre-existing.” Suppose he became unemployed due to this illness. He would be without health insurance. He would be able to maintain his previous insurance under COBRA at his own expense (and there is no guarantee his insurer would cover this, either). Barring COBRA, he’d be on his own…no insurer would pick him up.

    I like what you said about straw men. For every strange or ridiculous case in Canada several exist also in the US. There are always going to be gaps in coverage for unintentional (or even intentional) reasons. People need to realize they can’t cherry-pick one case to make a point.

    • Jeremy Hoover on

      I know of one man who has brain cancer in the US. He lost his job and his insurance because he could no longer work. He has insurance through COBRA but is forced to ask for donations to pay for it because he is not working! Further, his insurance does not cover the full cost of his treatment.

      Would I be right to capitalize on his circumstances by going back to Canada and using his one case as a testament to the evils of a private health insurance and care system? Of course not.

      On the death panels, I know recently of one family whose elderly mother passed away. They lost her at home but the EMTs were able to revive her. On the way to the hospital, they lost her again. At the hospital, although she was very nearly gone, they hooked her up to life support so her family could arrive to say their good-byes. After this, the family chose to take her off and she went peacefully away. So much for the death panels.


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