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13 · Thursday, November 26, 2009 OAKVILLE BEAVER · www.oakvillebeaver.com When waiting is not an option By Joe Fantauzzi METROLAND MEDIA GROUP DEREK WOOLLAM/SPECIAL TO THE BEAVER ON THE MEND: Jenna Mayer, wearing her brace to reduce curved-spine problems, relaxes at home in Oakville with her parents, Denis Mayer and Kelly Rosettani. After the initial checkup with their family doctor, Jenna Mayer had to wait a month to see a specialist in Toronto. During that time, the family researched Jenna's condition and spoke with other parents. When the family saw the specialist, they learned the curve in Jenna's spine was more severe than originally thought. It was advised that the six-year-old be braced as a way to delay possible invasive surgery. However, she required an MRI. The family was told there was a wait time of between two and six months for an MRI, depending on whether Jenna would be sedated during the procedure, said her mother, Kelly Rosettani. The family agreed to a non-sedated MRI, which would involve a two-month wait. Rosettani said she wanted treatments that could begin for Jenna during the wait, but was told it could not. After doing more research online and speaking with more parents, Rosettani was encouraged to contact Shriners Hospital for Children in Philadelphia. After contacting the American hospital, Rosettani said Jenna was given an appointment within a week. Meanwhile, Rosettani had also researched a medical brace mentioned by a doctor in Toronto. "We were just not comfortable waiting "We were just not comfortable waiting the two to six months." Kelly Rosettani, Jenna Mayer's mother the two to six months." Rosettani said she contacted an orthotist in Virginia who makes a brace for children with curved-spine problems. The family planned to visit the hospital in Philadelphia, and then the orthotist in Virginia. In mid-October, the family travelled to Philadelphia and was offered an MRI opportunity if they could stay for a week. However, because they were due at the Virginia orthotist they couldn't do so. The Shriners hospital in Philadelphia, which provided a prescription for the brace, did not charge the family for seeing Jenna, Rosettani said. The brace, which Rosettani said is not covered by either OHIP or the family's insurance, cost the family about $3,800 US. "We are 100 per cent happy with our decision to go to Philadelphia and Virginia to get Jenna in her brace as quickly as possible, and we have already seen the benefits of doing so," Rosettani said. Jenna has had another X-ray since she began wearing the brace, and the family can already see some correction, Rosettani said. "So for us, it was a great decision. We feel we are already one step ahead." Confused by the system? -- Join the club Continued from page 12 bled in four years. Last year, more than 12,000 applied to OHIP for pre-approval of U.S. procedures, including cancer and cardiac care, up from 5,800 applications in 2005. Patients also go south because they say they want to be assured their Ontario diagnosis was correct. Doctors say they understand why some patients balk at finding an option here. "It's a socialized system and for 97, 98, 99 per cent of people for their regular, everyday little problems, it's reasonably good," says Jeffery Brock, a Montreal emergency physician and cofounder of MedExtra, a Canadian firm that helps patients co-ordinate their care. "You have something that's a little bit more complex, you want a bit higher standard of care, it's really not available." U.S. medical facilities, such as Baltimore's Johns Hopkins Hospital, and the UCLA Health System in Los Angeles, say they are seeing more patients from north of the border with complex problems they cannot have solved at home. "It is growing, mainly in terms of patients that "It's as if they hand a dying cancer patient a Rubik's Cube and they've got to figure it out themselves. It's a real cruel game." Ombudsman André Marin have really highly unique issues, high-complexity cases, and also with people and patients who receive a diagnosis and then would like to make sure it's the correct diagnosis," said Raffaella Molteni of Johns Hopkins. The out-of-country care system last came to wide public attention when an investigation by the Ontario Ombudsman prompted the health ministry to order an independent review two years ago. That three-month appraisal -- led by Mary Catherine Lindberg, a former assistant deputy minister of health -- identified some weaknesses that could undermine the ability of doctors and patients to get needed out-of-country care. Lindberg's 2007 review followed Ombudsman André Marin's investigation into the case of Suzanne Aucoin of St. Catharines. Aucoin, who died in 2007, was denied funding for the chemotherapy drug Erbitux, but was later reimbursed more than $75,000 and given an apology by the province. Marin said the out-of-country system is so confusing, "it's as if they hand a dying cancer patient a Rubik's Cube and they've got to figure it out themselves. It's a real cruel game." The Metroland investigation has also found: · The Health Services Appeal and Review Board -- the independent body set up to hear a wide range of health-related appeals -- does not track or report on how many of the cases it reviews involve OHIP refusals for out-of-country care. It also has not made public an annual report in almost four years. An official of the board says its only legal obligation is to file annually to the ministry, and has done so. There is no indication why the reports have not been issued publicly -- as they were from 2001-06. Patients say they face long waits for appeal hearings before the board when OHIP refuses to pay. The board says the average wait for a hearing is about seven months, then three more months for a decision. By the numbers Out-of-country applications pre-approved by OHIP · 2008-09: 11,775 · 2007-08: 8,885 · 2006-07: 7,021 · 2005-06: 5,549 · 2004-05: 4,533 · 2001-02: 2,110 OHIP Spending on Out-of-country procedures* · 09-10 -- $164.3 million (estimate) · 08-09 -- $127.9 · 07-08 -- $101.4 · 06-07 -- $70.1 · 05-06 -- $56.3 *Pre-approved by OHIP