The rise of health care’s ‘three amigos’
Demand for massage, physio and chiropractic treatments pushing up benefit costs
Parents are taking their babies to chiropractors to cure colic and ear infections. Teens and young women are having “spa days.” Young adults are taking antidepressants for anxiety.
According to a study of claims and costs commissioned by Green Shield Canada, a rise in what it calls the “three amigos” of massage, physio and chiropractic treatments is changing how the drug and health benefits pie is being dished out.
Where it was once 70 per cent on drugs and 30 on benefits, it is now 60-40.
Coming at a time when more drugs are available to manage chronic illness — but at a higher price — the new balance raises questions about finding the money to pay for them.
The fourth annual report by Green Shield, a non-profit and the fourthlargest Canadian insurer of these benefits, shows how age and stage influences demand.
Use of paramedical services, the so-called laying on of hands, is starting at younger ages.
Parents are taking their babies under the age of 1 to chiropractors based on the Internet-based wisdom that moving their baby’s back and spine will lessen colic and ear infections.
Massages have become a lifestyle rather than health choice. Some children under the age of 10 are getting them. Massage allowances are mostly used by girls and women.
Women at all ages use benefits at a much higher rate than men, with one exception, which is 10 years old and under. In this age group, boys tend to need speech therapy more than girls.
Mental-health claims for drugs and therapy that treat depression and anxiety are starting at everyounger ages.
David Willows, vice-president of strategic market solutions at Green Shield, said spas were once considered something for the wealthy. The rest of us might manage a massage once in a while as a special treat. Not so now. “Just look around your neighbourhood,” Willows said. “Ten to 15 years ago, you couldn’t find a spa; now there’s one on every corner.”
“We can’t afford it all.” DAVID WILLOWS GREEN SHIELD
With all the money being spent on soft benefits, the challenge will be finding the money to pay for new drugs, Willows said.
He cited breakthroughs in the treatment of rheumatoid arthritis, a crippling, painful disease, as an example.
“These drugs are incredible,” he said. “They can send you from bed back to work. The catch is they cost $15,000 to $30,000 a year. Most of us would struggle to pay that, which is the purpose of insurance.”
But like defined-benefit pension plans, these programs were introduced after the Second World War. When it comes time for an annual review, many firms top up the existing pot rather than stepping back to see whether the package should be fundamentally changed.
“The big picture is that we’re spending a lot of money on glasses and massages, but are struggling (to find money for) things like diabetes, hypertension and high cholesterol,” Willows said. “Isn’t this what insurance is supposed to be for, the catastrophic stuff?”
The goal, he noted, shouldn’t be to eliminate allowances for massages and eyeglasses, but to find a way to restore the balance. “We can’t afford it all.” Ross Cristiano, who heads the Toronto health and benefits team for HR consultant Towers Watson, agreed payments for soft benefits are rising, but these paramedical costs are about 10 per cent of all spending.
He agreed that high-cost drugs, which account for 20 per cent of all spending, are getting pricier and there’s going to be a reckoning.
“If you look at high-cost drugs over the last four years, the cost of providing them has increased by about 60 per cent,” he said.
“Given that a lot more of these drugs are hitting the market, that’s probably going to increase.” Adam Mayers writes about investing and personal finance on Tuesdays and Thursdays. Reach him at amayers@thestar.ca.