Cancer
When votes are more important than people.
Turn away
If you could, get me a drink
Of water 'cause my lips are chapped and faded
Call my Aunt Marie
Help her gather all my things
And bury me in all my favourite colours
My sisters and my brothers, still
I will not kiss you
'Cause the hardest part of this is leaving you
I remember the first time I heard that song, also the first time I’d heard the band. Mid afternoon at the Big Day Out, I guess twenty years ago.
Often at a rock concert the intricacies of a piece of music are lost in the roar of grinding rhythm section imploring the crowd into motion, lyrics and melody lost for all but the songs most well known to us, the ones we can hear - even when we can’t.
Although it was the first time I’d heard it every word was clear and rang out, I was as enthralled as all the little emo kids around me half my age. The song is called Cancer, by a band called My Chemical Romance, and I’ve been a big fan, probably one of their older ones, ever since.
Most of us know someone who has lost their life to cancer, perhaps a family member or a friend. A grandparent lost too soon, like my grandad who I would’ve loved to get to know, or the tragedy of a child sized coffin. The loss of a spouse you were going to grow old with, or the reality of our own end.
Diagnosis and Miracle Drugs.
It looms over us all in terms of our mortality. Yes there is progress, when I was a kid it seemed a diagnosis meant someone would go soon with little if anything to be done. Now we’re much better at screening, catching things early, survival rates much improved through early diagnosis and treatment.
Yet even those scientific advances, momentous as they have been, have their limits. Once a cancer has reached a certain stage, spread to other organs, or is a certain type with low success rates for treatment - that’s it. Then you’re into the territory of experimental techniques, anything that might give hope.
That was until recently, until the arrival of new miracle drugs that could take what would’ve been a hopeless situation and extend life, not by weeks or months, but by years. Previously untreatable tumours stopped, or even shrunk. The only downside being the six figure price tag to buy another year of life.
Which made it a pretty compelling case for a politician to come along and promise to pay for that life giving treatment. Sign me up, don’t even tell me what your other policies are - I’m in.
Our biggest killer.
Despite these medical advances, getting our bums, boobs, and bits checked, better knowledge of what to eat and breathe, Cancer still takes an awful lot of us. The following statistics are from Te Whatu Ora:
“For the total population, the leading causes of death in 2021 were cancer, ischaemic heart diseases and cerebrovascular diseases (with 110.8, 42.9 and 19.2 deaths per 100,000 population respectively)”
Which sounds pretty bad, until you read the statistics for Māori:
“For Māori, the leading causes of death in 2021 were cancer, ischaemic heart diseases and chronic lower respiratory diseases (with 166.2, 72.0 and 35.5 deaths per 100,000 Māori population respectively)”
This is a bit off topic for today, but does anyone want to make a case for “we’re all the same” and “there’s no inequality in Aotearoa” off the back of those statistics? They are shameful for our country. I find them incredibly sad, they also make be bloody furious.
Promises Broken.
As we know National promised at the last election that they’d fund 13 cancer drugs, which were already funded in Australia.
This to be paid for by things such as rolling back Labour’s free prescriptions. Christopher Luxon committed to ring fencing $280m, over four years, to pay for them. As he looked into the camera with great feeling saying that “we have a 15% higher mortality rate from Cancer than Australia.”
It’s a great pitch and will have been symphonious to the ears of those desperate to access such medication. Plus of course we have to beat the Aussies - right?
Which left the minor issue that with our Pharmac model politicians aren’t supposed to get involved in funding decisions. They provide the money, but the health experts decide where to spend it. The last thing we need is political parties choosing medications based on what might appeal to the electorate they’re targeting.
In any case, as we know, National simply reneged on the promise, placing it into the too hard basket based on the complexities of Pharmac - which they knew about the whole time. Still it sounds better than the real reason which is that the money was prioritised for tax cuts.
That doesn’t sound flash at all, because the logical conclusion of that is that some people are going to die in this country for tax cuts.
Let the finger pointing commence.
The principal players, not to be confused with principled ones, have differing views on who is to blame and how to extricate themselves from this.
The Health Minister, Dr Reti, who is probably not enjoying the fact that as a Doctor he’s now mostly associated with hindering efforts to discourage smoking, wants to stick to the plan come hell or high-water. “We are committed to delivering the cancer treatments as we described them,” he said on Tuesday.
Appearing before Parliament's health committee Reti said, “We've been working hard to progress our commitment. We will have more to say on this soon. But we do acknowledge that we could have communicated this better.”
“However, its absence from the Budget is not due to us backing away from this commitment. Instead, it's a sign of our commitment to getting it right.”
So Reti wants to stick with the plan, despite former chair of Pharmac, Steve Maharey, telling RNZ last week that some drugs on the list were no longer current, while others had previously been declined by Pharmac.
Labour’s Ayesha Verrall said of Reti, “He's prioritising saving his skin politically over doing what's right for patients and getting modern medicines.”
Oncologist Chris Jackson told the committee that those 13 drugs were put on the list three years ago and treatments have moved on. That a new list would be “meaningfully different”, and would prevent a significant number of people, such as those with blood cancer, missing out. That if the government persisted, better drugs would miss out and drug companies would be able to charge “top dollar” for the named drugs.
Jackson said, “A better way out of this would be for National to say we promise everyone who had a drug on the list they will get the same or better which would give the experts a chance to come up with a newer list.”
Nicola Willis was a little less sincere than Reti, if you can imagine that, saying “We make a very clear assurance that we will be making an announcement that will ensure some of those medicines are funded this year.”
When Newshub picked Willis up on the word “some”, she responded, “That was just a use of a word. We will be funding the 13 medicines.” Yeah Nah. I’m pretty sure you don’t say “some”, in these circumstances, unless that’s exactly what you mean.
Unfortunately for both Reti and Willis Associate Health Minister David Seymour didn’t get the memo. Heck the cancer drugs weren’t his election promise, perhaps this was a chance for a little mischief? Seymour said, “At this point, as far as I am aware, the minister who is responsible, which is me, is wholly committed to the neutrality of Pharmac's decision making.”
When asked if he could commit to delivering the cancer drugs Seymour said, “I can't make that commitment.”
The Reality
Yesterday I shared this fabulous work from Sharon Murdoch, she tweeted it with these words:
“For Marama Davidson, and all the other people in Aotearoa facing up to a cancer diagnosis. (‘Hope is the thing with feathers’ comes from an Emily Dickinson poem)
My #cartoon today #Aotearoa #Cancer”
Reader Brian commented with the following:
Of the 13 Cancer Drugs that National promised and have now backtracked on none are for Breast Cancer and none are for Prostate Cancer - the 2 cancers that kill most women and men in Aotearoa.
Five of those drugs are officially redundant and the latest best drugs for Bowel Cancer and Melanoma aren't on the list. What a shit show of lies and deceit.
Oh yeah they've been contacted by many cancer experts and oncologists etc wanting to advise on Cancer drugs but guess what - they don't listen to experts.
In other news Landlords are doing pretty well so Hurrah all round.
Then Brian told us more:
Kahu (name changed), who's in my wife Lynne's ward room - she's hopefully ok - relatively, is a 40 year old father of five and has been told he has stomach cancer. He has been waiting for days to be advised if he can eat. He's starving but can't eat coz he is due a scan.
He is worried out of his mind what stage he has - he's not been told. He's been waiting all day for a CT Scan - hasn't happened yet. Luckily ( ? ) he has strong faith and remains positive in the face of absolute horror. It's really fucking sad that votes are more important than people.
Exchanging messages with Brian he said, “If it is this bad now how much worse can it get in 2+ years of this fucking cruel government?”
He told me, “My wife has had to go back in for recurring pain after an operation 5 weeks ago. She’s ok but they can’t seem to come up with a solution. Kahu on the other hand has been desperate to find out more and how bad his cancer is. It will happen in time I guess but he’s going through hell. Everything is so slow mostly I guess due to staff and equipment shortages.”
Then ended by saying, “When you come across someone like Kahu it highlights the personal horror for cancer sufferers.”
I cannot even begin to understand how those families with a loved one battling cancer are feeling having thought the government was going to step up and pay for the treatment they need to stay alive.
I’d like to think that Luxon, Willis, and Reti are simply inept and have been incapable of delivering what should have been their top priority in terms of urgency. Yet there is a part of me that is too cynical for that who wonders whether, said explicitly or not, they knew they were making promises that they could not or would not deliver as people believed.
It’s an awful thought that they would raise the hopes of those in desperate need of help just to get their votes. Sadly though it seems the most believable explanation.
I think I should add a warning to this song as it could be upsetting for some. A good song, but a hard listen.
Once again, I see some important analysis from Nick that I've not seen elsewhere. It tells me something about what the future of media may look like in this country.
Just over five years ago I accompanied my father to an appointment at a private oncology clinic. Genetic testing suggested his lung wall was amenable to the new generation of immunotherapy treatments. But these were not funded publicly. I had no idea there was such a thing as private oncology. It was plush, quite, comfortable. The numbers quoted were eye-watering, but Mum and Dad had been careful and mostly fretted about it diminishing the inheritance they were insistent on leaving to their kids. Unfortunately for Dad a conflating health condition intervened and he died only a few weeks later without starting treatment. But this "top tier" system has very much been on my mind. What fraction of our population can afford the treatment each one of us deserves?
It may be my age but cancer seems to everywhere in my circle, it is not shared out fairly and despite huge progress with medicine etc the outcomes are equally unfair. Election promises are made to be broken, just hope that they will be forgotten over the three years. Being paranoid I want to join some dots. Brooke Vampire stating human life was over valued in the worst days of Covid, and Tama Potaka stating that it is just too expensive to save some endangered species. Watch this ‘Coalition without empathy’ decide it is too expensive to save some lives - particularly lives of folk who aren’t much use economically…