Question: When is a deal not a deal?
Answer: When you make it with the government.
Many in the Saskatchewan’s Agricultural sector, and beyond, will remember the problematic changes by the New Democratic Party to the Gross Revenue Insurance Plan (GRIP) in 1992. Now, The Saskatchewan Party has created a similar fiasco — with chiropractors.
I hadn’t planned on returning to Canada’s democracy problems so soon. But Saskatchewan's recent Budget holds a precise example of what has been worrying me, and so many other Canadians. (I’m not saying this is only a Saskatchewan problem; it’s just that Saskatchewan’s event is so timely.)
Previously, I discussed the latest report from the Canadian Index of Wellbeing. A central finding in the “Democratic Engagement” report was that Canada is facing “a huge democratic deficit, with trust in Canadian government and public institutions on a steep decline.”
The “steep decline” was pushed ahead by the Saskatchewan government’s decision to limit funding for chiropractic care.
Every three years, the Saskatchewan’s Chiropractors negotiate a contract with the Saskatchewan Health. That was done again, the agreement was ratified by the chiropractors. Their president, Dr. Shane Taylor, of Regina, says the agreement included a 2.5% increase in government payments per patient visit, from $12.50 to about $12.80. (That’s for the first 16 visits; Taylor said 90% of the roughly 125,000 people who see a Chiropractor each year go for 16 visits or less.) Taylor says he went to the Saskatchewan Health and signed the agreement on behalf of the chiropractors earlier this year.
In the budget, the Wall government reneged on the deal, offering only limited chiropractic assistance to people with very low incomes. It’s a case of using a law to over-rule a contract. And it’s quite legal, as unhappy farmers learned in 1992, in relation to GRIP.
The government’s decision has created several problems.
First, this has destroyed the credibility of people negotiating on behalf of the Government. The budget decision screams “bad faith.”
Second, this decision has jeopardized the health of people who are now getting chiropractic care through Saskatchewan Government Insurance (in the case of car accidents) or the Workers’ Compensation Board (for people hurt on the job). Payments to chiropractors from those agencies were based on the government agreement with chiropractors. The questions: can those agencies still pay chiropractors, and how much?
Third, this is a major setback to the direction of 21st century medicine and holistic care. The goal of “Functional Medicine” is not to simply treat injuries and illnesses, but to treat people. And to work largely on “evidenced based care.” Taylor says the evidence shows chiropractors can get people back to work faster, at less cost, and more effectively, than can physicians. But when you have the physician and chiropractor working together, perhaps with other professionals, the progress is even better.
Three questions remain. What can chiropractors do, will they be paid by government-related agencies, and on what other deals will Brad Wall’s government renege?
And behind all that, there is an even more sinister sign. This is the conservative government's first broad step in privatizing health care. The actual process is called "de-listing." It's the government's way of saying, "Remember some of those services we used to cover through medicare; we're not going to cover them any more."
Which means individual citizens are going to have to reach deeper and deeper into their own pockets to meet their health care expenses. For the old, and the chronically ill, this is just the beginning of their nightmare.
This originally appeared as an op-ed column in The Western Producer of March 24, 2010.