Socialized Chinese medicine in British Columbia?

By Jean-Paul Thuot RAc

It has been about a year since the British Columbia government started covering acupuncture under its provincial health insurance. This coverage has been extremely limited, offered only to those households whose combined yearly income equals $28,000 or less, and only for ten visits (combined with other “alternative” therapies such as chiropractic, physiotherapy and massage), and paying out what some would call a paltry $23 per treatment.

It was estimated at the time that the cost to the province for this coverage would be in the $2-3 million range based on an average usage of five visits per person taking advantage of the coverage. Compare that to the total annual health care budget of close to $15 BILLION!

Realistically, however, the $23 creates little incentive either for the potential user or the acupuncturist to get on board. For the practitioner there are two choices: the “opt in” option, which means that the acupuncturist can not charge more than the $23 per visit or the “opt out” option, which allows the practitioner to charge their regular fee and have the subsidy from the government be just that—a subsidy to the patient. When you consider that $45 is the low end of the scale per treatment (my rate), and the average being in the $60-80 range, $23 hardly seems like much of a difference at all for those with already-thin wallets.

A quick poll of Victoria area acupuncturists reveals that no one has really seen much of an increase in business since this coverage began. Many practitioners simply didn't bother to jump through the governmental hoops in order to get on the registry, feeling that it was more trouble than it would be worth. Those that did either find that the subsidy is still too little for people to get treatment or, like myself, they lower their price per treatment for those on assistance such that those people can get the healthcare they need.

The truth is, this small pile of breadcrumbs thrown out to all those professionals in the “alternative medicine” field, and to the public at large who have been calling for greater access to those professionals, is just that: bread crumbs. While the medical establishment continues to soak up the vast majority of the resources from a budget that is already stretched thin, the government is clearly missing one key way to reduce its overall costs. Namely, that healthy people are less of a drain on the system than sick ones.

Old sayings stick with us for the simple reason that they're often very true. Consider the adage “an ounce of prevention is worth a pound of cure.” If the government really wanted to reduce its medical spending, it would actually need to increase its spending in one area—that of preventative medicine. Preventing disease before it gets a hold on the body, easing the pain in a manner free of further side-effects for those already suffering, and helping people take responsibility of their own health (through education, something we alternatives must become very good at to thrive) can only be a boon for the bean counters in the provincial Ministry of Health. It's a shame that there doesn't seem to be a cure for inertia, however, and so far there does not seem to be much support for this line of thinking within the halls of provincial power.

As a health care practitioner I don't care how my patients get better—so long as they do. If chiropractic, massage, acupuncture, herbs or even surgery work, then all power to you! However, it is clear that equal weight needs to be given to each of these modalities within a framework of professional regulation if those who need care can afford to get it. Canadians are often very smug when it comes to their socialized medicine, especially when looking at the horror that is the medical insurance culture seen south of our border. I have never understood that smugness; to me our medical care, when you can get it, is extremely good. It's the “getting ” part that is so terrible: waiting lists of over a year for necessary tests, MRIs, etc. are the norm.

A man recently died while waiting 34 hours for care at the Health Sciences Centre in what some are now calling the worst emergency room failure in Manitoba's history. Thirty-four hours! How could this have happened? I would posit that it is a clear indication that the medical establishment is far too over-stretched, caring for people who in many cases would never need to be in the ER if they could find and afford care elsewhere.

If some of these patients were able to receive preventative care when their condition was relatively minor, perhaps they would never have ended up in the ER. Fewer people in the ER quite obviously means that those heroic doctors and nurses in the ER could focus their attention and resources on the real emergencies.

Until someone in the government takes real action, and offers real incentive for people to seek out alternative medical care, we will continue to see the degradation of our much-vaunted socialized medicine. People will continue to suffer unnecessarily, and those of us who could help keep our increasingly aged population stay healthy and out of the hospital longer will continue to soldier along in the margins.

Jean-Paul Thuot, RAc is an acupuncturist practicing in Victoria BC. He can be reached at www.stillpoint-clinic.com