On the east end of my not-so-prosperous neighbourhood, and, on occasion the green line, I notice an increasing number of amputees — usually with one or both legs removed at or below the knee.
Curious as to why they all were wheelchair-bound, I did some research and discovered that they probably can’t afford anything better.
In some Canadian provinces, Ontario being one of them, about 70 per cent of healthcare funding comes from our taxes and the remaining 30 percent is paid for by you and I directly — or through private medical insurance. If there’s no free lunch there’s no free healthcare, either. The 30 per cent that we passy for ourselves includes most dental, hearing and vision care, prescription medication, certain vaccinations, or a ride in an ambulance. While these holes in the system are known to most Canadians, they’d probably assume that a prosthetic limb required after an amputation would be covered. Sadly, they’d assume wrongly. Fact is, the Canada Health Act doesn’t cover prosthetic limbs.
Provincial programs to fund prosthetic limbs are complex to navigate and may even be deceptive. According to CBC, Ontario’s Assistive Devices Program (ADP) claims to cover 75 per cent of the cost of artificial limbs but the coverage is capped. ADP’s approved prices were last reviewed in 2012; advocacy groups claim that even back then, prices were severely out of date.
Nineteen-year-old Emilio Dutra-Lidington lost his right leg to the propeller of a boat on Lac Pemichangan two hours north of Ottawa. Following multiple surgeries, the time came for a prosthetic leg – the quoted price was $91,577. Emilio’s family learned that the leg had to be replaced every three to five years for common technology and every six to seven for higher technology. The life-time cost of the prosthetic leg might run into the hundreds of thousands of dollars. How much would Ontario contribute? A sum of $6,792. Help for Emilio came from a crowd-funding campaign launched by his parents in June 2019; within four months it amassed $130,000.
Ontarian Patty De Guia lost her leg to cancer a few years ago. Global News reported that while in hospital, her chemotherapy meds were covered; but once home, her lower-dose chemo pens ($4,000 each) were only partially covered by her private insurance. With her finances already depleted by out of pocket expenses for at home chemo, she couldn’t afford the $50,000 prosthetic leg her doctor recommended. She opted for a $10,000 “loaner,” $2,500 up front and a promise to return the leg once she got something better. After nine years, De Guia’s neighbours set up a GoFundMe page to help her buy a suitable prosthetic which cost almost $90,000.
In Quebec, the Régime d’Assurance Maladie du Québec (RAMQ) decided that Hugues Leblanc’s two hand prostheses, a complete bio-mechanical hand valued at about $35,000 and a forceps worth about $25,000, would be 100 per cent covered – a wonderful outcome that might not have happened if the Journal de Montreal hadn’t covered Leblanc’s tragic story and if his deputy, Pascal Berubé, and heavy hitter Danielle McCann, Minister of Health, hadn’t intervened.
A study published in 2017, based on 2012-16 data shows that 6,000 Canadians underwent lower limb amputations each year. In addition, there were perhaps 1,500 upper limb amputations in the same period. Unfortunately, some of these amputees might stumble into a Kafkaesque perfect storm that begins with an illness or accident followed by amputation, then expensive prescription meds – not covered – and a hugely expensive prosthetic limb – not covered – loss of earnings, perhaps even loss of one’s employment during months of rehabilitation. The amputee may end up bankrupt or deeply in debt and perhaps severely depressed with limited access and horrendous wait times to psychological services.
Surely in Canada we can do better? I mean, how can Canada make amputee Terry Fox a national hero while nickel-and-diming its everyday amputees? It just seems so un-Canadian, hypocritical even. What to do? Canada could revise its Health Care Act to include prosthetic limbs and other assistive devices, and provinces could cap costs rather than coverage. The provinces could get together to create a national purchasing agency for prosthetics, or prescription meds like the one in the UK, to bulk buy and drive down costs. A “Canadians with Disabilities Act” similar to the United States’ “Americans with Disabilities Act” (ADA) might help.
Learning more about this risk that might come knocking at your door is important. We all need to know and make some noise about it, which is what I’m trying to do.
Graphic by @sundaeghost