Public Service Health Care Plan should cover Acupuncture by an Acupuncturist not just MDs!

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The Public Service Health Care Plan (PSHCP) is one of the largest private health care plans in Canada, providing benefits to over 600,000 Plan members and their dependants. The PSHCP is sponsored by the Government of Canada, and its members include public servants and other employees of the federal public administration, parliamentarians, federal judges, and pensioners receiving an ongoing pension benefit based on service in one of these capacities. Members of the Canadian Forces and Royal Canadian Mounted Police may also join the Plan so they can obtain coverage for their eligible dependants.

The purpose of the PSHCP is to reimburse Plan participants for the reasonable and customary costs they have incurred for eligible services and products as described in the Plan Document after they have taken advantage of benefits provided by their provincial or territorial health insurance plan. The Plan also provides coverage to members who reside outside of Canada for basic health care services equivalent, as much as possible, to the services covered by provincial and territorial health care plans. 

The PSHCP offers extended health coverage for:

  • Chiropractic (by a Chiropractor)
  • Massage therapy (by a Massage Therapist)
  • Naturopathy (by a Naturopathic Doctor)
  • Osteopathy (by an Osteopath)
  • Physiotherapy (by a Physiotherapist)

And yet the PSHCP only covers Acupuncture delivered by a Medical Doctor! 

Acupuncture is a health profession that is regulated across the five most populous provinces in Canada; BC, AB, ON, QB and Newfoundland which covers 87% of the population of Canada. Acupuncture qualifies for GST exemption and is authorized for the medical expenses tax credit according to Canada Revenue Agency. Yet, as of 2020 the Public Services Health Care Plan (PSHCP) continues to limit the access to acupuncture services only provided by Medical Doctors.

87% of Canadians have access to acupuncture from a regulated Acupuncturist who has received a minimum of 3 years (1900 hours) of post-secondary training, passed national board examinations, and has a minimum of $1,000,000 in liability insurance. Acupuncture is regulated in five provinces, compared to Massage Therapy which is only regulated in four provinces, and Osteopathy which isn't regulated in any provinces! Naturopathy is also regulated in five provinces. Acupuncture is being held to a different standard and is being discriminated against!

Medical Doctors receive on average between 200 and 300 hours of training in acupuncture. The McMaster University: Contemporary Medical Acupuncture Program delivers 126 contact hours, with the remaining 174 hours coming from self-directed home study. Acupuncture schools across Canada generally require a minimum of 450 to 500 patient contact hours with an emphasis on needling and patient safety as part of their 1900 hours of training. In terms of offering the most effective form of acupuncture treatment for federal employees, it would be in their best interest to have the option of coverage for acupuncture from a regulated acupuncturist.

Acupuncture by a registered acupuncturist is an option offered to most Canadians who are on extended health benefits plans including but not limited to Sun Life, Manulife, Great West Life and Blue Cross. Acupuncture by a registered acupuncturist is also covered by the vast majority of auto insurance companies for their injured clients, especially in regulated provinces such as British Columbia and Quebec. Analysis of the long term statistical data from Quebec’s provincial auto insurance corporation SAAQ, demonstrates that the cost of providing Acupuncture is about equivalent to providing Chiropractic and is actually less than providing physiotherapy.. 

Research into acupuncture as a medical treatment has grown exponentially in the past 20 years, increasing at twice the rate of research into conventional biomedicine. Over this period, there have been over 13,000 studies conducted in 60 countries, including hundreds of meta-analyses summarizing the results of thousands of human and animal studies. A wide-variety of clinical areas have been studied, including pain management, cancer, pregnancy, stroke, mood disorders, sleep disorders and inflammation, to name a few.

The Acupuncture Evidence Project reviewed the effectiveness of acupuncture for 122 treatments over 14 clinical areas. They found some evidence of effect for 117 conditions. “Our study found evidence for the effectiveness of acupuncture for 117 conditions, with stronger evidence for acupuncture’s effectiveness for some conditions than others. Acupuncture is considered safe in the hands of a well-trained practitioner and has been found to be cost-effective for some conditions. The quality and quantity of research into acupuncture’s effectiveness is increasing.” Acupuncture Evidence Project, p55.

While acupuncture enjoys high-level clinical evidence for dozens of conditions, translating trial research into official medical guidelines can take time. However, a recent review examined clinical guideline recommendations from around the world made by a variety of groups including government health institutions, national guidelines, and medical specialty groups. Over a 27-year period, they found 2189 positive recommendations for acupuncture for 204 health problems, mainly in guidelines published in North America, Europe and Australasia.

These official recommendations indicate that acupuncture’s evidence is now acknowledged by medical experts and that acupuncture is no longer ‘alternative.’ Indeed, this new data illustrates that acupuncture is one of the most widely recommended treatments in modern medicine. Of these, 1486 were related to 107 pain indications and 703 were related to 97 non-pain indications. These recommendations were made by a wide range of groups, such as government health institutions, national guideline, and medical specialty groups. The recommendations came from around the world but were especially abundant in North America, Europe, and Australasia.

With such high use of medical treatments that are more likely to harm than help, it becomes self evident that in many clinical situations, patients would be best served to start with safer treatments, such as acupuncture, when indicated. While harms from appropriately administered treatments are not entirely without risk, harms and deaths from medical error are rampant. According to a recent review published in the British Medical Journal, medical error is the 3rd most common cause of death in the U.S., with a quarter of a million deaths in 2013 alone. 

It is in the interest of federal employees and their employers to be able to access a safe and effective treatment option for their health concerns, administered by a proficiently trained and regulated acupuncturist. Limiting access to acupuncture provided only by Medical Doctors seriously limits access to this form of care and perpetuates decades long discrimination against a legitimate form of health care that is regulated across Canada and available to 87% of Canadians!

Sincerely, 

BC Association of TCM & Acupuncture Practitioners (ATCMA)