|
Few parties need to be convinced of the value of physio. Most benefits plans cover
treatment of up to $500 to $1,000 per year, recognizing that treatment saves health
dollars in the long run and can have an immediate impact on productivity. At least
one insurance carrier, Sun Life, doesn't even require a doctor's note for treatment
anymore.
The Ontario Medical Association (OMA) and the Ministry of Long Term Care in Ontario
are two exceptions, though. They don't even regard physio as a medically necessary
service. The two groups recently teamed up to reduce healthcare costs. When all was
said and done, the OMA and the Ministry chopped $50 million out of the Ontario
Hospital Insurance Plan's (OHIP) budget, with little regard for patient care or the
impact that their measures would have on employer benefits plans.
The savings effort was really a delisting bonanza. It identified services--notably
physio--that it deemed to be not medically necessary, out of date or no longer
needed. How any group of healthcare experts could come to this conclusion for
physio defies common sense. So does not inviting employers to the table to discuss
the issue.
To give the province its due, OHIP will still cover some physio treatment--but only
if it takes place in what are known as Schedule Five physiotherapy clinics or
outpatient clinics that are overseen by a physician. The problem is, these
resources are tremendously limited with waiting lists up to six months long. In
fact, there has been a licensing freeze on Schedule Five clinics--meaning no new
clinics have been approved--since 1967.
The delisting move is another example of employers not having a say in an important
healthcare matter that directly affects them. Yet, once again, they are left
picking up the tab as the government bails out. This time it is for a legitimate
treatment that is not about to decrease in terms of plan members' usage just
because OHIP won't pay for it or acknowledge its necessity.
Physio tends to be a low-cost item on benefits plans--taking up about 1% to 2% of
total group health costs. But now it could more than double to 5%, say healthcare
consultants. They add delisting is a sign of things to come.
The delisting of physio is short-sighted for many reasons. It could lead to more
hospital and doctor visits and increased use of drugs, which, of course, employers
will be expected to pay for. As well, employers may face pressure to hike their
coverage for physio.
Take hip and knee replacements, for example. Lorelli says the physio required after
these surgeries can total about $2,000 to $3,000. Many employees will look to their
plan to pick up this expense or opt not to pay out of their own pockets and endure
a longer recovery time.
The most disturbing aspect of this physio fiasco is the fact that the exercise
helped finance a raise for the province's doctors. This isn't just about shifting
cost from one silo to another. It is another example of doctors protecting their
own turf and preventing other healthcare professionals from having a voice in the
transformation of our system and, better still, playing a more active role as
healthcare providers.
Ontario's move to delist physio is potentially dangerous because it could result in
other provinces following suit. It is time to take up the fight and mobilize a
lobby group.
Let governments and doctors know, loud and clear, that organizations want a say in
healthcare decisions that directly impact their plans, and they want to see other
professionals, such as nurses, pharmacists and physiotherapists--who have helped
their plans save money--included in the debate. BC
|
News
News
