©  Copyright 2002 Rogers Media. The following article first appeared in the February 2002 edition of BENEFITS CANADA magazine.

The Canadian Medical Association (CMA) says insurers, and to some extent banks and employers, are requesting more and more medical information on patients. While the president of the Ottawa-based CMA says he understands "insurance companies' desire to weed out false claims," Henry Haddad adds that "the patient's file often contains a lot of info which is of a personal nature and it is not at all relevant to the evaluation of an insurance or disability claim."

Haddad says an example of the danger in revealing too much of a patient's medical history can be found in the U.S. He says there have been cases where employees in the States have been terminated because it was found they had hemochromatosis or iron overload. The condition can lead to cirrhosis of the liver, cancer of the liver or the employee may require a transplant. "Employers decide these people may be costly later," he says.

Physicians also worry that patients will become distrustful and tightlipped about their health information, which will make diagnosing them much more difficult.

Typically, insurance companies will only request a summary of the pertinent information from a patient's file. Laura Mensch, assistant vice-president, group products at Liberty Health in Markham, Ont., says requesting entire medical files "is not a routine practice of ours at all."

But Wendy Hope, vice-president of external affairs with the Canadian Life and Health Insurance Association in Toronto, says in a more complicated case, insurers do have to request complete medical files from physicians. Hope adds that such instances usually involve patients who are being treated by a psychiatrist or psychologist. "Those are the kinds of cases that tend to be more complicated and not easily diagnosed." Non-physical ailments are also the fastest rising category of disability claims.

Haddad says, in future, he would like all information requested to be obtained with the consent of the patient and without coercion. "Insurers should ask for specific information and provide the extent, duration and the purpose [of its use]. I think it's really very important to protect patients' information and use just what's needed to settle the claim."

Employees are increasingly responsible for making investment decisions for their defined contribution (DC) retirement plans, according to the results of a Watson Wyatt survey released in January.

The survey found more than two-thirds of Canadian employers with DC plans allow employees to make all their own investment decisions. Yet only a quarter of the country's firms offer any financial counselling to help members make investment decisions.

"In one type [of DC plan], employers do not give employees a choice of investment vehicles. In that case, there's less education necessary," says David Burke, national practice director of Watson Wyatt's retirement division in Montreal.

However, Burke says that the study shows the majority of DC plan sponsors do give contributors a choice. "Clearly, there's a fiduciary responsibility there. If you're going to give a choice of funds, it behooves the employer to provide the employee with some reasonable ability to make those choices. But the reality is, only 25% of companies that offer DC plans provide some sort of financial counselling."

Watson Wyatt's survey looked at data on plan provisions for over 600 employers across Canada. According to the study, 77% of DC plan sponsors allow employees to change their investment choices at any time. Information was collected on salaried and non-union employees, representing a broad cross-section of industry, geographic location and size.

--Jim MacDonald with files from Doug Watt, advisor.ca

The Wellness Councils of Canada, a national not-for-profit organization, has given the Town of Richmond Hill in Ontario its first Well Workplace Award.

According to Joan Wade, manager of employee benefits and occupational health and safety and wellness for Richmond Hill, the Town's wellness program is unique for several reasons. "We take a look at the full spectrum of wellness--from needs assessment right through to evaluating measurable outcomes and benefits to the organization." Wade adds that the Town's program had full support from senior management.

Since the wellness program was implemented in 1998, the organization has seen a drop in absenteeism rates. The decrease has averaged three-quarters of a day per employee each year. This has translated into a net savings of $68,000 a year, says Wade. The Town has also seen a drop in its long-term disability (LTD) cases. Before 1998, it averaged three approved LTD cases per year. Between 1998 and 2000, there had been only one approved claim.

Wade says a health risk assessment review of employees identified a need for gastrointestinal, asthma and migraine education. The organization provided employees with awareness sessions and management programs and the result was a reduced use of drugs for those three conditions.

The Town has also tried to ensure that its wellness programs are relevant to as many employees as possible. It has held health fairs and allergy clinics and offered free memberships to community centres in Richmond Hill or subsidized memberships to other clubs. Employees also have access to a host of other health programs such as stress management, heart health, diabetes, nutrition and weight management.

According to the Buffett Taylor National Wellness Survey Report 2000, only 17.5% of organizations in Canada offer comprehensive programs.

The Workplace Safety & Insurance Board (WSIB) launched a $3.4-million campaign, "Safety Starts With You," in Toronto last month to promote its message of keeping workplaces safe.

The WSIB says in 2000, it approved 294,703 claims in Ontario, including 104,154 involving injuries severe enough to require time off work. WSIB benefits costs in 2000 totaled more than $2.5 billion. The average lost-time injury costs Ontario employers about $59,000. The Board says if a business operates on a 6% profit margin, it would take almost $1 million in sales to make up for that.

The WSIB reports that at least one worker died each week in 2000 as a result of a traumatic injury. On average, during each working day in 2000, there were 72 injuries sustained through falls, 31 people were injured due to machine hazards and three amputations occurred.

The Bourse de Montréal introduced a new market model for trading options in Canada last month, based on a central, anonymous, electronic order book using a strict price/time algorithm for order matching. The Bourse says this will mean client orders will have the same status as professional orders in the central order book.

The new model is designed to provide easier access, fewer barriers to entry and competition, and will contribute to a more liquid market with improved pricing for investors. The Bourse says it is now North America's first traditional derivatives exchange to be fully automated. It moved from a floor-based, specialist-trading environment to an electronic market trading platform early this year.

The Romanow Commission has released its final report on the future of healthcare in Canada.

For Commissioner Romanow's recommendations, click here.

Click here for Senator Michael Kirby's report, "The Health of Canadians – The Federal Role: Recommendations for Reform."