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Benefits plans not reflecting health challenges: study

Too much is being spent on glasses, orthodic shoes and chiropractics, not enough on dieticians and nutritionists.


TORONTO — A year-long study of health benefits usage by Green Shield Canada reveals that big dollars are being spent on services that don’t necessarily align with the predominant health challenges facing Canadians.

The comprehensive study includes data related to prescription drugs, eyewear and paramedical services, and shows how benefits programs are being used.

For example, the study showed that Green Shield Canada’s clients spent approximately $144-million on glasses, orthotic shoes, and chiropractic and massage services last year. Yet, only $100,000 (less than 1%) of that amount was spent on dietitians and nutritionists, despite studies showing type-2 diabetes has doubled in Canada since 2000 and eating habits are a significant contributor to the disease.

Most surprising was the rapid increase of paramedical services at younger and younger ages, including chiropractic care for infants and massages for teenagers. The highest expenditure of any service was for massages, which starts with people in their 20s and continues well through their 50s. This trend is seen at a time when chronic disease such as hypertension, high cholesterol and diabetes are increasing, and driving significant costs to the health care system.

Green Shield Canada does not advocate discontinuing coverage for paramedicals, but suggests there is a risk that they are increasing at the expense of other critically important health strategies and treatments.

“What employees and their dependents like and want versus what they may need must be balanced better for the future,” says David Willows, vice president of strategic market solutions, at Green Shield Canada. “The industry and employers need to re-orient how we look at benefits plans given the reality of how they are being perceived and used.”

What the future holds demographically for Canada and its employers is another cautionary tale. The Baby Boomers are aging and costs for treating their health issues – largely associated with chronic disease – are escalating, with fewer people shouldering those costs.

In the 1960s, there were eight working people for every senior. In the coming decades the ratio will fall to only 2:1, raising the question of where the required funding for health care will be secured.

Escalating drug costs are also a major concern. During the study period, the predominant debate was about the ability of Canadian employers to afford escalating benefits costs to cover expensive drugs for conditions such as rheumatoid arthritis and hepatitis C.

“There must be a real discussion about traditional employee benefits plan,” said Willows. “We know people like getting their glasses and massages paid for, but demands for expensive but highly effective drugs and chronic health care are increasing rapidly.”

Green Shield Canada is a Windsor, Ont.-based insurer that specializes in individual and group health and dental plans.

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