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Marchildons Win!

RAMQ approves US surgery

Beryl Wajsman

2 April 2008

At 3 p.m. Tuesday, Kirkland residents Ella and Joe Marchildon received word that the Régie de l'assurance maladie du Québec would fund life-saving cancer surgery for Ella, The Suburban has learned.
$">Events took a dramatic turn in the past week, ever since the Marchildons came back from Washington, DC. Ella had been personally evaluated at the Sugarbaker Clinic for life-saving cancer surgery. The doctors, including world-renowned Dr. Paul Sugarbaker, concluded that she was an excellent candidate for the Sugarbaker procedure. The procedure is successful in 75 percent of cases with a 10-year cancer free span.
$">To review the facts once again, Ella Shepherd Marchildon was operated on in February for a very rare form of cancer. The surgeons at the Royal Victoria Hospital determined that her best chance for survival was to go to the Sugarbaker clinic in Washington and undergo the Sugarbaker procedure that combines surgery with a cutting edge chemotherapy procedure known as IPEC.
$">The estimated cost, including post-op treatment, is estimated now at somewhere in excess of $100,000. The Marchildons applied to RAMQ to cover the costs. RAMQ refused, stating that this surgery was available at four hospitals in Quebec. Joe Marchildon collected letters from three of these hospitals stating that they do not do this procedure. The fourth said that it did it on an experimental basis but did not have the IPEC chemo follow-up. In any case the wait time for the experimental surgery was four to six months. Too late for Ella.
$">Ella's files were sent to Dr. Paul Sugarbaker for personal assessment. He was in touch with Ella's doctors who had performed the initial surgeries here. He sent a letter to RAMQ stating that though the procedure is lengthy and difficult, Ella was an excellent candidate for a successful operation and post-op treatment. He confirmed all this once again in last week's physical exam.
$">All the documentation was then sent to RAMQ with another request for aid. Two weeks ago RAMQ again refused. This time the Régie stated that it had contacted someone at the one hospital that does this procedure experimentally but has no IPEC follow-up. They did not speak to the chief surgeon for this type of operation as he was away. According to RAMQ, the doctor that was spoken to believed the Sugarbaker procedure would not help Ella. This was the basis for RAMQ's last refusal.
$">Events took several dramatic turns upon the Marchildons’ return. The community rallied to help the Marchildons. Please see Kristin Morency’s report on last Friday’s moving midnight fundraiser at the Kirkland Colisee theatres on page 9 of this issue.  And just as dramatic have been the machinations of RAMQ, the involvement of Health Minister Couillard and the intervention of a federal MP.
$">Late last week Francis Scarpaleggia, MP for West Island's Lac St. Louis riding, sent an almost unprecedented letter to Philippe Couillard pleading for compassion for the Marchildons. Sources I spoke with highlighted how rare it was for an elected representative at the federal level to intervene in an area of provincial jurisdiction.
$">Scarpaleggia's letter was personal and heartfelt. He wrote of Ella's “courageous” struggle and reminded Couillard that not only has communal support for Ella and Joe been extraordinary, but that three eminent doctors have recommended the Washington surgery as the only means to save Ella's life. He reminded the Minister that Ella was a mother to five children. Scarpaleggia acknowledged the jurisdictional issue but stated that he was moved to write in his “simple capacity” as an elected official concerned for the welfare of his constituents. He asked that the “technicalities” of jurisdiction be set aside and that Couillard use his “discretionary power” to intervene and reverse RAMQ's decision.
$">Coincidentally, on the same day that Scarpaleggia sent his letter, a RAMQ official contacted Joe and asked him to have Ella seen again by a doctor at one of the hospitals that had already written that it could not do the procedure and that Ella should go to Washington. Joe reminded the officials that they had just returned from Washington. That the window of opportunity was narrow. Dr. Sugarbaker will not operate after April 17. Joe pleaded with the official that time was being wasted and asked if this third go-around was just an empty gesture meant to appease the public and media outcry. But Joe and Ella agreed once again to work by the rules.
$">This past Monday they went to see the doctor RAMQ sent them to. The surgeon confirmed the earlier assessment and said he would immediately inform RAMQ that it should pay for Ella's surgery and that only Washington could help. And at 3 p.m. Tuesday, RAMQ finally said “yes”. 

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