Why is Massage Therapy Not Covered by OHIP?

If you have a heart, lung, kidney, brain or skin condition, we can all be grateful for our inclusive provincially-funded health care. However, if you have a physical impairment, persistent movement (bio-mechanical) pain, perhaps affecting your work, recreation and social life, you must pay out of pocket. Perhaps you have workplace health insurance to cover some of your physical rehabilitation. Needless to say, without inclusion in provincial health insurance, physiotherapy, chiropractic and massage therapy are unavailable to many.

Why does provincial health insurance not cover physical rehabilitation? I asked this of MPP and health critic France Gélinas (front row, right of centre above) when in 2018, I (back row, far left) was one of 24 delegates from the massage therapy profession attending Queen's Park to petition MPPs and Senior Policy Analysts to consider incorporating massage therapy in community health programs. Gélinas responded provincial health insurance was created for medically-necessary procedures.

I respectfully counter this premise with a statement from the Canadian Pain Task Force Report, 2020, "An estimated 7.63 million, or one in four Canadians aged 15 or older, live with chronic pain - a condition that although often invisible, is now understood as a disease in its own right. It is often interwoven with other chronic conditions and can affect people across their lifetime. Chronic pain has significant impacts on physical and mental health, family and community life, society, and the economy, with the total direct and indirect cost of $38.3 to $40.4 billion in 2019." I argue that the intervention of physical impairment and chronic, persistent physical pain is, de facto, medically-necessary.

We can appreciate the high and progressive costs of funding a public health system. Perhaps this idea from Dr. Herbert Emery at the 2012 conference for the International Network for Complementary and Alternative Medicine (IN-CAM) has merit. "In order to include CAM (Complementary or Alternative Medicine) in Medicare, government would need to: a) change the Canada Health Act (CHA) to fund/supplement 70 per cent of service costs instead of supplementing 100 per cent of physician and hospital-only services and 'broaden the basket' of services covered by public health care; or b) keep the CHA as is, but encourage government to spend more on CAM interventions that are needed, evidence-based, offer good value for money spent and require public funding to ensure access."

Emery identified the biggest barrier to public funding for CAM as the ever-rising costs of Medicare. He suggested a health savings account – a pre-set amount of dollars for defined services causing the patient to use services efficiently, improving access for a broader population to CAM services and limiting government expenditure to the defined cap – may be the best funding option for CAM services.

As we confront the complex problems of offering accessible and equitable health care, let's remember physical rehabilitation and function are priorities in feeling and living well.