WINNIPEG – The Manitoba government has implemented a new funding formula that will see subsidies for chiropractic services cut by $4.8 million. This is part of the province’s efforts to get back more than $250 million from health care alone.
Beginning June 1st, chiropractors will bill the province $8.20 per patient visit, down from $12.30, but that amount will rise to $10 on April 1, 2018.
The Manitoba Chiropractors’ Association (MCA) informed its members last week of the cuts, which will see provincial funding capped at a maximum of seven visits annually instead of 12.
Studies by the association show 75 per cent of patients are treated in seven visits or less, meaning the funding cut from 12 visits to seven likely won’t be an issue for many patients.
Health Minister Kelvin Goertzen’s office has declined to comment on the decision, citing Manitoba’s Election Financing Act, which restricts what government officials can and can’t say during a byelection period.
In a statement, the MCA expressed “disappointment” over the government’s decision to cut funding saying it potentially puts the most vulnerable patients – seniors, and low-income, working Manitobans – at a disadvantage by reducing access to care.
“Without question, this change will reduce the access of Manitobans seeking chiropractic care each year,” said Dr. Perry Taylor, president of the MCA.
Despite the cuts, however, the MCA still views the government’s decision to continue funding chiropractic care as an “opportunity for the province to further engage the profession in its fight to cut ER wait times and lessen the opioid crisis.”
“Chiropractors are leaders in drug-free, non-surgical management of back pain who treat over 170,000 Manitobans a year,” Taylor said. “Providing quality care in our clinics keeps back pain patients out of ER’s and away from opioids – a trend that should be encouraged to help ease the burden on taxpayers and Manitoba families.”
There are currently more than 280 chiropractors working in Manitoba.
In March, the provincial government indicated it might cut chiropractic funding in an attempt to tackle a massive budget deficit.
In 2016, the government spent almost $12 million on the service as part of a five-year funding agreement signed by the former NDP government and set to last until March 31, 2020.
Manitoba is curently the only province in Canada that offers broad coverage for chiropractic patients.
Dr. Greg Stewart, a spokesperson for the MCA, says this decision “flies in the face of the national opioid strategy.”
“Although we have the provincial government signing on to the federal government’s national opioid strategy about improving access to nonpharmacological care, at the same time within months of each other, they decrease access for the same nonpharmacological care. It’s hard to understand,” Stewart notes.
Last November, the federal government issued a “Joint Statement of Action to Address the Opioid Crisis.” In it are commitments from the various provincial governments – including Manitoba – as well as other organizations to help address the opioid crisis.
The medical community also recently issued new guidelines for the treatment and management of low-back pain, citing non-pharmacological interventions as the first line of treatment for acute and chronic low back pain. New opioid prescribing guidelines were also recently issued by the Canadian Medical Association, urging doctors to avoid prescribing opioids as first line of treatment for patients with chronic, non-cancer pain.
“If you want to deal with the opioid crisis, you want to decrease or remove access barriers not increase them,” Stewart pointed out.
“Last year, 19 million prescriptions were written in Canada for opioids. Things are going in the wrong direction and unless we improve access for non-pharmacological interventions, this opioid crisis has no end in sight.”
Stewarts expects the board of the MCA to continue to develop strategies to improve communications with the provincial government to look at issues of “mutual concern” including the opioid crisis.
“Hopefully the disconnect between (resolving the opioid problem and increasing barriers to nonpharmacological care) can be evaluated… If they are serious about the opioid crisis there’s going to have to be a systemic change at the budgetary level for interventions that substitutes for drugs in this province,” Stewart said.
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