Visits to Christian Science practitioners aren’t an expensive benefit for plans to cover. In the past three years, the University of Manitoba spent exactly zero dollars on it, according to Dave Muir, director of compensation and benefits. In the past six years, McMaster University in Hamilton, Ont., has seen six claims totalling $1,800 throughout its 11 collective agreements, says Wanda McKenna, assistant vice-president and chief human resources officer. But affordability aside, should benefits plans cover visits to Christian Science practitioners at all?
A relatively new religious movement, Christian Science was founded in New England in the late 19th century. Scientists, as adherents are called, believe prayer, rather than pharmaceuticals or surgery, is the best treatment for diseases and injuries they consider to be illusions. “They’re praying to realize that they’re not actually sick but they’re not necessarily praying to God to heal them,” says Terra Manca, a sociology doctoral candidate at the University of Alberta who has researched Canadian Christian Scientists’ attitudes towards health care.
When Scientists get sick, they may hire a Christian Science practitioner to help them heal through prayer. They may also spend time in faith-based nursing facilities, where Christian Science nurses feed, bathe and pray with patients but administer no mainstream medical care.
There are 29 Christian Scientist practitioners and 10 nurses working in Canada, says Wendy Margolese, the legislative and media representative for Christian Science in Ontario. They charge in the range of $20 to $40 per day, and a 24-hour stay in a Christian Science nursing facility with round-the-clock care costs in the area of $200 to $375, according to Margolese.
No group benefits provider offers Christian Science faith healing in its standard policies, says Joan Weir, director of health and dental policy at the Canadian Life and Health Insurance Association. “Plan sponsors do tend to make all kinds of interesting requests, and it’s up to the insurer to see if they can accommodate it and if it can be built into the pricing. If it could be, then the insurer would do it.”
Users can’t submit fees paid to Christian Science practitioners as a medical expense tax credit because no province or territory authorizes them to practise any form of medicine, the Canada Revenue Agency told Benefits Canada in an email. Accordingly, says Weir, plan members can’t use their health spending accounts for services from Christian Science practitioners but they can use coverage from an insured part of their plan. An exception is a private health services plan that allows 10 per cent of account spending to not be eligible for the medical expense tax credit.
The University of Manitoba added Christian Science practitioner treatments to its benefits plan in April 2002, along with many other paramedical services, says Muir. Earlier that year, the university had polled staff and faculty on available benefits, including paramedicals. The benefits had included unlimited coverage for physiotherapy, chiropractic and podiatry.
“The survey results suggested that people wanted a broader range of services than the limit of three that had existed at the time,” says Muir. As a result, the university introduced a $500 limit that staff can spend on any of 12 paramedical services, including Christian Science practitioners.
Nobody at McMaster can pinpoint when the university introduced Christian Science benefits, says McKenna. But since claims have been so low, the issue isn’t a concern for McMaster, she notes.
Debating the medical benefits
While supporting employee choice and targeting ballooning costs are commendable, what medical evidence exists to support Christian Science health treatments?
“From the perspective of my academic interests, the most I can say on the topic . . . is that there is absolutely no evidence, scientific or otherwise, that Christian Science faith healing provides any medical or health-related benefit or that it is even a verified form of healing,” says Ubaka Ogbogu, an assistant professor of law and pharmacy at the University of Alberta. “But that, of course, does not mean it cannot be offered as an employee benefit for other reasons.”
For one thing, visiting a Christian Science practitioner may trigger the placebo effect, which can produce positive short-term results, says Manca. “Sometimes, short term is really helpful but sometimes it’s coming at financial costs or [causing patients to refuse] treatments that are more effective in the long term.”
In response to the questions about the effectiveness of Christian Science healing, Margolese acknowledges the criticisms but she notes the practice’s long tradition of helping people live healthier lives. “In a highly technological culture where conventional medicine is the norm, many ask why reasonable people would continue to turn to this practice at all.
“Christian Scientists are conscientious, reasonable people on the whole and they aren’t driven by dogmatic religious belief. The real reason for our commitment to spiritual healing is in the actual healing we’ve experienced. We can’t claim to be perfect, and often this spiritual approach to healing is itself a learning process, but what we’ve witnessed and experienced of healing — sometimes of quite serious conditions — in our own lives and families has been significant.”
Not all employees, however, are on board. “I think it’s ridiculous to include any non-scientifically proven procedures in any extended health benefits plan,” says Philippa Carter, a teaching professor in McMaster’s department of religious studies. Since McMaster bills itself as a research-intensive university with a top-notch health sciences faculty, she argues it shouldn’t provide $500 per year for Christian Science healing or any other alternative therapy. That coverage is especially galling, Carter says, since the university only provides $250 every two years for vision care—a quarter of the money they’ll pay for faith healing—and many staff members need glasses to do their jobs.
What about other religions?
Carter also argues that since the plan covers Christian Science therapy, it should also do so for healers from other religions. “If I were Catholic, I might want to offer my priest a fee to pray for healing for my arthritis or to exorcise the demon of depression and cynicism that has possessed me for years, but McMaster and [its insurer] won’t cover any of that, apparently.”
Arguing an employer discriminates against some staff by covering Christian Science therapy but not Catholic exorcisms has a stronger legal case than suggesting coverage should move from faith healing to vision care, says Eric Adams, an associate law professor at the University of Alberta. “Is it discrimination on the employer’s basis not to pay for exorcisms under the guise of medical treatments?” he asks, noting he ultimately thinks an employer would still prevail in a legal case.
“I think the argument would be that the employer is not under a positive obligation to do so. They can choose to extend benefits as they see fit, but I don’t think that obligates them to extend it to all manner of non-medical benefits that might be sheltered under some religious heading.”
No employee has complained about the McMaster benefits plan’s exclusion of faith-based healing practices from other religions, says McKenna. And Carter admits she’d never raise the issue. “I think there are flaws in it, but it’s still a pretty good package compared to what a lot of people have,” she says of the benefits plan.
Risks for plan sponsors
Nevertheless, Adams cautions that employers could face adverse effects if an employee chooses plan-sponsored faith healing instead of mainstream medicine. “Would the estate of that family have a claim in negligence against the employer? Again, that’s pretty speculative, but what about media coverage in that scenario?”
He points to the recent court case and media attention around the 2012 death of Alberta toddler Ezekiel Stephan, whose parents treated his meningitis with hot peppers, onions and horseradish. If “an employer plan led to the prayer treatment of meningitis that resulted in the death of a child, you might imagine it would expose that employer to, if not a legal case, then certainly media scrutiny,” says Adams.
Sara Tatelman is an associate editor at Benefits Canada.
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