Cancer patients lose EI during treatment

A Vancouver cancer patient whose employment insurance is about to run out is criticizing a gap in federal coverage for working people who get sick.

"you pay into [ei] and you expect it to be there when you really need it the most," said Carlo Pellizzari, 26.

Pellizzari works in retail sales and is being treated for his second bout with a rare, serious form of blood cancer called paid large cell lymphoma.

During both treatment periods, he was able to get AR for 15 weeks, the maximum allowed for sickness coverage. He said after that he was left with no income for several months while off work trying to recover from aggressive chemotherapy.

"the fatigue is pretty bad," said Pellizzari. "during the treatments I was very sick." "Different vomiting every half hour or every hour after."

During his first cancer battle in 2008, Pellizzari said he was off work from March until October. When he applied for AR, he was very ill, so he didn't pay much attention to the limits on sickness benefits - until he was notified his checks were going to stop.

"It's pretty unfair to anybody in this situation," said Pellizzari, "you pay into it every paycheque - and then to be told you only qualify for 15 weeks." "It's tough to take when you're looking at being off for six months or a year."

Pellizzari, seen here with his girlfriend, is an avid photographer who has been working full time in retail sales for years. CBC

Pellizzari is now trying to recover from a second round of chemotherapy and a stem cell transplant. His hematologist wrote a letter to the federal government on April 8, indicating he needed to be off work for three to six months.

However, Pellizzari said his EI coverage is set to run out early - again - in May.

"It's back to zero income, for however much longer I am off," said Pellizzari, who is now living with his parents. "I can 't imagine the stress I' d be under if I had a mortgage and family at this point."

Medical professionals told CBC News the federal government has left a big crack in the system, which thousands of patients fall into each year.

Workers with no extended benefit plans can turn to EI for 15 weeks. After that, their illness has to be "serious and prolonged" to qualify for PPC disability coverage. Medical professionals say in cases they have seen, patients have to be sick for at least a year before they can get that coverage.

That means there is an eight-month gap during which sick workers can't get any help from Ottawa.

"I will never get used to sitting beside someone newly diagnosed with cancer and telling them that they will only get ar sick benefits for 15 weeks," said Beverley Biggs, a Vancouver social worker who helps cancer patients. "people are shocked and feel betrayed by the canadian government."

Pellizzari thinks it is unfair that self-employed workers like him can get only 15 weeks of EI for sickness, while unemployed, healthy workers get up to 50 weeks of coverage. CBC

Biggs said she has seen numerous patients in dire financial straits, including family breadwinners stricken with cancer, who paid into EI for years.

"There is nothing else for them intended to apply for regular income assistance [welfare] except, which for a single person [in B.C.]" "is only $606 per month," she said.

Pellizzari believes because he has assets and assistance from his parents, he couldn't even qualify for welfare.

"You'd have to transfer vehicles out of your name and that kind of stuff." "I m just not willing to do that," he said.

Pellizzari said he finds it frustrating and ironic that healthy workers who are unemployed can get AR for up to 50 weeks. He believes if he were willing to cheat - and ask his employ to lay off him - he would easily get more coverage.

"I m not dishonest." "I d rather be making nothing than cheating the system," said Pellizzari. "the honest person basically gets screwed."

In 2010, 61,393 workers collected sickness benefits, while more than 10 times that many — 683,815 - collected regular AES.

Human Resources and Skills Development Canada told CBC News the average worker on sickness benefits collects for 9.4 weeks. However, 31.4 per cent claimed the maximum 15 weeks in 2008/09 - a figure that suggests thousands would collect for longer if they could.

Dr. John Shepherd, director of the Leukemia/Bone Marrow Transplant Program of B.C., estimated 20 per cent of his patients have no extended coverage from their employers.

"We have patients who will say, 'I' ve got to get out of here as soon as possible because I have got to pay my bills'-and that is a significant concern for us," said Shepherd.

Dr. John Shepherd, director of the Leukemia/Bone Marrow Transplant Program of B.C., wants the federal government to look at extending EI benefits to cover cancer patients until they are well enough to go back to work. CBC

He said advances in medicine mean more seriously ill patients do recover enough to return to work, instead of going on long term CPP disability. He said he would like to see the federal government catch up to that reality.

"The individual who we fully expect is going to recover - and is going to be able to go back to the workforce - is the individual who currently does have the problem," he said.

"There needs to be an ability for those people to be able to deal with their disease and the treatment of their disease without having to worry about facing an undue financial penalty because of it."

The Canadian Breast Cancer Network (CBCN) surveyed 446 breast cancer survivors about the impact their disease and treatment had on their personal finance. Last year, it reported 80 per cent of respondents experienced an economic impact, often with "devastating long-term financial consequences."

The group is lobbying Ottawa to increase EI sickness benefits to a maximum 40 weeks.

"CBCN's report found that there was an average gap of 23 weeks between the end of EI sickness benefits and the end of treatment based on an average treatment time of 38 weeks," the group wrote in a submission on the 2011 federal budget.

"As a result of the financial strain, 21 per cent of respondents returned to work before they were fully able... women who struggled in their jobs due to fatigue and side-effects from treatment."

CBC News asked the three major federal parties for their position on this.

Conservative Party spokesperson Ryan Sparrow indicated it would not make changes because every Ars extension costs money and this would be a "significant cost."

An email from the Liberals read, "we are in favour of a complete review of EI benefits, including special benefits like sickness benefits." The NDP indicated it would extend sickness benefits to a maximum 52 weeks.

"It's got to be addressed," said Pellizzari. "It doesn't have to be just cancer patients, or I mean it could be anybody in any kind of medical situation where you can't work."

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Asking kidney patients give up on a free lifeline to

But the law has unintended consequences, kidney experts say. It should be in the middle ages and to keep young people alive and productive. Instead, many of the patients who take advantage of the law are old and other medical problems, often as a replacement for their failed kidneys by dialysis suffer but not for long, because you kill other chronic diseases have life.

Specialists urge kidney doctors more with older people to be frank, others have serious medical conditions, to the patient say that although they have dialysis, they want can decline such treatment and instead give a hospice. In the end, it is always the patient choice.

An idea that is of leading specialists, each change doctors refer to give themselves up the decision on dialysis. Instead of, say, that a patient is deprived of dialysis or not to start agreement say these specialists, that the patient has selected "medical management without dialysis."

"This is the preferred term," said Nancy Armistead, executive Director of the mid-Atlantic renal Coalition, a Medicare contractor that collects data and patient complaints.

The phrase, she says, "acknowledges that death is imminent", but it also sends an important message: "we are not only send people home to die." "We provide palliative care."

A Committee formulated before recently guidelines for use of the Club doctors renal decision if dialysis is appropriate. It contains, the doctors themselves should questions before the treatment proposed. One is the "surprise" question: I would be surprised if this patient dead within a year?

But, turning it over to the Chairman of the Committee, Dr. Alvin H. Moss, a nephrologist and ethics at West Virginia University, which is the task ahead as an ocean liner said.

"Clearly, if the program was initiated in the 1970s, the hope and the expectation was that this program otherwise return would, that healthy people in the society could be back, so that they are working and productive,", said Dr. Manjula Kurella Tamura, Kidney specialist at Stanford. But, she added, "Dialysis at the end of life is a different kind of treatment."

Dialysis is difficult, especially for the old and the sick. Most of the nation spend 400,000 dialysis patients travel many hours, three days a week, connected to a state machine and additional time back and forth to the hospital.

You have to limit salt and fluids, and the procedure is so stressful that some patients for the rest of the day resting. Although dialysis symptoms as fluid accumulation in the legs or lungs can alleviate, can it to dizziness, weakness, carry cramps in the leg, nausea and other problems. Complications such as blood infections or clogged blood vessels, where the dialysis needles are placed, are common, surgery or hospital is often required. Ultimately, as a patient is not ready to go with him in five at.

It can still hard to say no.

An 84-year-old man in a hospital in Elkins, WV, running from West Virginia University handled has been advised against dialysis. He has high blood pressure and severe congestive heart failure, a condition so fatal as terminal cancer. Make his heart problems hard to breathe it for him, and he is often in the hospital. In a telephone interview, the man said he saw suffering friends in dialysis patients and always thought that he would reject it. But he is always ready to start in any case. The man, whose Name to protect of his privacy will be held back, says, that he changed his mind after he "SA and thought over how well live."

"What choice you really have?" he asked.

As Congress the right numbers for kidney patients in October 1972 founded on dialysis and transplantation were new procedures which were not covered by the health insurance companies. There were terrible stories - rich people have dialysis and lived while poor people died. In Seattle a Committee art dialysis by vote over, that it could get. A man who was a family support took, for example, the priority of a single woman.

It was also expected at this time that less than 40 patients per million would have to dialysis, and most of the patients would be healthy - with the exception of their failed kidneys - and under the age of 54.

Now more than 400 people per million start dialysis every year. More than a third of the patients are are 65 or older, and about 42 percent of the cost. People over 75 are the fastest growing group of dialysis patients. And the most older patients have other serious diseases such as diabetes, heart failure, stroke, and even advanced dementia. Do have a third of them four or more chronic diseases.

The federal program, said Dr. Peter S. Aronson, Professor of Nephrology at the Yale University School of medicine "is incorrectly applied so emblematic of good intentions."

"The question," said Dr. Aronson, "is, how it back to choose."

Recent studies have found that dialysis for many older persons with other severe chronic diseases will extend not life. A study found that the procedure of main effect, increase the chances that such patients in the hospital instead of at home die.

Now, costs are float - the nation an estimated $40 billion to 50 billion dollars cost end-stage renal disease this year. And doctors recommend dialysis of earlier studies although later found that an early start gives no added benefit.

Nevertheless, Mrs. Armistead said if select patents "medical management" are ready, often fighting members of the family with the decision.

It can be difficult, to make some patients understand the severity of the disease or its decisions, Barbara Weaner said a nurse practitioner at the West Virginia University, who works with dialysis patients.

"We live in a country where there are a lot of choice, where people tend to fear will die and palliative treatment is not always recognized as a good alternative," said Mrs weaner.

Their show their patients in the Hospital of Elkins. Those, the old and very sick often are to have them can the choice - "medical management" without dialysis or they have dialysis may fail to improve their lives. But for many, the choice is not acceptable.

A patient, whose Name is to be retained, 78-year-old woman was not a good candidate for dialysis, their doctors said. It has complications from diabetes, high blood pressure, heart valve problem and severe coronary heart disease. Their medical problems were so serious that dialysis was probably lead to a series of medical interventions - to extend their life hospitalizations, drugs and doctor visits - but not necessarily would. And her doctors told her that.

But she insisted on dialysis, has to say, "some life better than no life." In the seven months it is, has hospitalized she was four times, including twice for heart surgery patients.

"I go to dialysis, because I want to live," she said in a telephone interview. "I want dialysis."

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