Chiropractic community must be a bigger voice in health-care reform talks

The Health Council of Canada (HCC) has released its latest report on a decade of health-care reform in Canada. The results, according to the agency, are disappointing.

The report, issued Sept. 19, found that, with some exceptions, health-care reforms in Canada have not kept up with the evolving needs of Canadians.

“Progress on wait times for key procedures has stalled. Primary
health-care services lag behind other countries. Home care services do
not adequately meet seniors’ needs. Prescription drug costs remain
beyond the means of many Canadians,” the report said. Despite the
increase in life expectancy, chronic conditions among Canadians also
rose to 31 per cent in 2010.

The HCC was created in 2003 to
monitor and report on the progress of health-care reform in Canada,
embodied in the 2004 10-Year Plan to Strengthen Health Care.

According
to the report, Canada is among the highest spenders in the world when
it comes to health care, spending more than $200 billion in 2012 – and
yet, the state of health care in this country does not reflect this high
spending. We are closer to the bottom in comparison to higher-income
countries when it comes to quality of care.

Clearly, 10 years is a
long enough time for us to realize something isn’t working with the
health-care reform the government has planned and undertaken – and
effective and meaningful changes need to happen.

By the looks of
it, money isn’t the problem, as Canada has increased its total health
expenditure from $124 billion in 2003 to $207 billion in 2012. Exploring
where the money is spent may provide a little enlightenment, however.

The
HCC report provides some perspective. “Canada’s allocation of
health-care dollars changed very little during the past decade. The
proportion of total Canadian health expenditures directed to hospitals,
drugs and physicians – the three largest areas of health-care spending –
remained remarkably unchanged over this period.”

During the same
10-year period, the Netherlands, which also implemented dramatic
reforms to its health-care system, strategically adjusted its spending
mix, reduced the proportion of its expenditures on hospitals and drugs
and increased investment in long-term care, according to the report. As a
result, the Netherlands became a top-performing health system.

Another
interesting finding from the HCC report is the fact that despite
Canada’s high spending on physician salaries, it has the lowest number
of physicians per capita.

There is clearly a void in our primary
care system that has not been effectively filled by physicians today and
is contributing to the unsatisfactory performance of our overall
health-care system.

With a void, comes an opportunity as well. Up
to 80 per cent of the Canadian population are affected by some form of
musculoskeletal conditions. Imagine the burden it would take off our
health-care system, if patients could go directly to a health-care
provider who can actually help relieve their condition, instead of being
passed around from specialist to specialist, waiting months to get an
appointment or a diagnostic procedure, only to be disappointed in the
end.

As Dr. Jay Robinson, president of the British Columbia
Chiropractic Association, puts it, “Canada's chiropractors are the only
doctor-level primary care provider who can adequately diagnose and treat
these patients (with musculoskeletal conditions). Furthermore, the
analysis shows that when patients are seen by a chiropractor the number
of unnecessary referrals to specialists is reduced dramatically.
Chiropractic treatment is saving our government health-care system a
great deal of time and money.”

The chiropractic associations and
colleges across Canada have done a great job in raising the profile of
the profession among the health-care community and the general public.

But
the work must continue. As long as chiropractic treatment remains
outside the realm of the provincial social health-care system, public
access to much-needed neuromusculoskeletal expertise is limited to those
with extended health-care benefits from their employers and a few who
have the extra cash to pay for chiropractic treatment.

The HCC
report is calling for pan-Canadian collaboration among health-care
stakeholders across Canada to develop meaningful strategies to turn the
health-care system around. Perhaps, this is a foot in the door for
chiropractic to be heard in this important dialogue.

The
chiropractic community definitely has the expertise and the evidence to
back up its claim for recognition. Now it needs to just get in there and
play with the big kids.

Mari-Len De Guzman is the editor of Canadian Chiropractor magazine. You can contact her at mdeguzman@annexweb.com.