May 2009

Chiropractic delisted in Alberta

Many Canadians will no longer have access to publicly subsidized chiropractic care after the Alberta government dropped chiropractic services from its provincial health plan. Alberta is one of seven provinces, including Ontario and Quebec, which have eliminated chiropractic from their health plans.

The decision to eliminate, or "delist" chiropractic was part of a massive cost cutting effort and was promoted as a way to save approximately $53 million in its 2009 budget. It ignored arguments by the Alberta College and Association of Chiropractors (ACAC) that chiropractic care could actually relieve pressure on the increasingly strained medical system and save money in the long term. The ACAC is a government agency that regulates the chiropractic profession in Alberta under the Health Professions Act.

Despite the claims of cost-cutting motives, the Alberta Health Services increased coverage for cancer therapy drugs and the initiation of the Alberta Rare Diseases Drug Program, and increased funding to support physician compensation, on-call programs, office computerization, primary care and Academic Alternate Relationship Plans, and to boost the number of medical residents and increase their compensation. The increases give Alberta physicians the highest overall compensation program in Canada.

After the delisting was made public, Clark Mills, DC, president of the ACAC said, "We are confident Albertans will always value chiropractic treatment. Chiropractic, as a regulated health profession, remains a strong and valued health care service available to Albertans."

Dr. Mills added: "In facing a global recession, the government had to make some difficult choices -- we understand the decision to delist chiropractic was solely budget driven. Our patients and our profession have appreciated the nominal funding for chiropractic services provided to date. The chiropractic profession looks forward to continuing a strong relationship with the government to help serve the health care needs of Albertans ... Chiropractic still retains the strongest clinical and cost-effective outcomes with the Workman's Compensation Board (WCB) and we anticipate a similar outcome in the insurance industry with MVA injuries... Chiropractic remains an integral player in supporting Albertans' health and wellness needs."

Not all Canadians were as sanguine about the delisting decision. Responses posted to several Canadian newspaper websites reflected widespread anger at dropping chiropractic care from the plan.

"Our government is truly pathetic by de-listing Chiropractic care," said one reader of the Edmonton Journal (www.edmontonjournal.com). "How are low income people and families supposed to get the care they need?"

Another reader, identified as Ron in Lethbridge, noted: "I am stunned at the delisting of chiropractic services! Although I am no longer working, my ... career lasted much longer due to chiropractic care after I was injured, in the Army, in 1971. I now have two chronic spinal conditions which require an adjustment at least every two months. I am on a fixed income of less than $1,200.00 per month. Adjustments were costing me $23.00 per visit. Now I shudder to think what the cost will be; I suspect nearly $50.00 per visit. Perhaps our Premier can return some of the ... pay increase our legislators voted themselves and therefore share in the current difficult financial times that the rest of us must endure."

Identical sentiments were echoed by "Trudy," who wrote: "To no longer pay for chiropractic care is absolutely ridiculous. These people who made this decision have obviously no clue as to the miracles performed by chiropractors. My entire family has visited them since my mother had a car accident around 1945. She would not have had the relief she got if not for them, as well when I was 18 a medical doctor suggested I needed a back operation to correct my problems. I am thankful today that I didn't listen and instead went to the chiropractor. Some 35+ years later I am fine and no operation. Also while I worked for a chiropractor we had a baby of 9 months brought in who was unable to basically do anything and the parents had been told by the medical profession they could do nothing for him, that he would just die. That baby after one month of treatments was crawling and never looked back. I think both professions have a place and need to be covered. Our medical profession will now be even more overwhelmed and people will not be able to get the care they need."

Many other messages included personal stories of positive results gained through chiropractic, similar to this one. "Jonas" wrote: "I was suffering blackouts from severe migraines -- losing my class 1 license, not able to function from day-to-day, in complete and utter PAIN for 10 years. Then I saw a chiropractor every week for 6 months and I am no longer suffering."

Much of the anger was directed toward the Conservative Party now in office in Alberta. Comments such as "Let's vote this bunch of bums out next election and try Liberals. Never to vote Conservative again, bunch of Bozos," and "Dumb moves by dumb people in this budget. Last time I ever vote for the Progressive Conservatives. They really didn't do their homework and as a long time Tory supporter, let me say goodbye to this dictatorial party and hello to the Liberals of Alberta," and "I hope to transfer my pain in the back to the Conservatives in the next election. Anybody with me?"

A few doctors saw a silver lining around this dark cloud. One Ontario doctor noted that when his province delisted chiropractic care, "It immediately empowered people to become more active in their own health."

Terry A. Rondberg, DC, founder and CEO of the World Chiropractic Alliance said that while the decision to delist chiropractic was a serious error in judgment and would hurt both the public and the chiropractic profession, he hoped the situation would spur more doctors to break their dependence on third-party payers.

"This might be the perfect time to consider a partial or total cash practice," Dr. Rondberg suggested. "Governments throughout the globe are becoming more and more aligned with the medical and drug industries and are taking actions to eliminate alternatives to the allopathic model. We can't expect them, or insurance companies, to make it easy for us to supplant the billion-dollar sickness industry. To do that, we have to embrace our identity as a non-medical wellness approach and educate our patients about true health care."