Autism decision shows mental health funding discrepancies

When the Supreme Court of Canada ruled last fall that our provincial government is not required to pay for the autism treatment known as Lovaas or Applied Behavioural Analysis (ABA), it sparked a frenzy of protest.

Advocacy groups, parents and the general public raised their voices against what they saw as a discriminatory system and many were surprised to learn that the government does not have to cover all treatments that are considered medically necessary.

In fact, the court said that our health system does not promise any Canadian will receive funding for all medically required treatment, but only funding for "core services". All non-core services are left to each province's individual discretion and then to the pocketbooks of the citizens.

What we have in Canada is a partial health plan and universal health care doesn't really mean what it implies. Health care providers have always known this.

Although there is still some debate over whether the ABA intensive autism therapy is medically necessary, advocates and medical professionals agree that evidence shows its results are promising and at the very least warrant more research.

In my opinion, this is the kind of research the government should be funding in order to determine the exact value of the treatment. We rely far too heavily on the private sector for health research. There are some treatments and conditions that are unlikely to attract private sector funding.

However, the real debate here rests not in whether the treatment is valuable or even necessary, but simply in the fact that it is not considered 'core' and therefore is at the discretion of the provinces to fund or not. With a per person price tag of $60,000 per year, it's not surprising that governments want to avoid paying if they can legally do so.

Unfortunately, there has been no public debate on what constitutes core services. Many currently funded services and treatments would likely not withstand close scrutiny as core services.

Also, many expensive treatments designed to prolong the life of people who are terminally ill are covered while children are being denied treatments like ABA that are less costly considering the years of life affected.

This looks like another example of stigmatization of mental illness, the same factor that results in psychiatric patients always getting the crummiest, most run down wing of the General Hospital or the mentally ill homeless people failing to elicit the philanthropic zeal of a natural disaster. Why is it that people left homeless as the result of fire or tsunami get help from all quarters, while we can't provide basic housing for those who are homeless as a result of various conditions and circumstances just as truly beyond their control?

 

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