The B.C. Nurses Union is investigating how one nurse’s family managed to use $174,000 in massage therapy benefits over the course of a year through the taxpayer-funded extended benefits plan.
This amid a raging controversy triggered by news that public health care employers spent $31 million in nurses’ massage therapy costs in 2017, a 900-per-cent increase from 2008.
Unlike most other public and private employees, nurses do not have a limit on the number of massages they and their family members can get each year and there are no co-pays; massages are 100 per cent employer paid at rates up to $110 per hour.
According to BCNU contract bargaining documents, a disproportionate number of nurses are using most of the massage benefits. Twenty-one per cent ate up 82 per cent of the expenditure on massage therapy. The vast majority — 80 per cent — of union members used less than $1,000 per year in such benefits.
But there are cases of apparent abuse, according to nurses union CEO Umar Sheikh.
In a town hall question and answer teleconference for nurses soon after the tentative contract was reached last month, he told union members that under the system of unlimited massages “abuse is possible.”
He cited the $174,000 case and said at that rate, the nurse and his or her dependents would have had 1.8 massages per day. There is a provision in the nurses union benefits package to curb such egregious spending but the language is vague, with reference to “reasonable and customary limits” on such perks.
Sheikh said there is no proposal to revoke massage therapy for “vulnerable” nurses who need them for medical and preventive purposes, but the proposed review to take place over the next year would consider whether to introduce a cap to curb the exponential growth in costs to publicly funded hospitals and other health care facilities.
Massage therapy is a popular health and wellness treatment approach and many have said it can help nurses reduce stress and its associated symptoms, not to mention relieve muscle and joint pain. B.C. has eight schools for massage therapy training and there are about 400 new registrants each year. In 2015, there were 4,183 active registrants, up from 3,653 just two years earlier.
The Registered Massage Therapists Association of B.C. said the “significant rise” in massage therapy use is attributable to studies showing evidence of benefits, an increase in the public’s interest in non-surgical and drug-free treatments and higher educational standards among therapists.
According to companies that specialize in health benefits, private companies and public employee plans typically have limits on the dollar value or number of massages that are covered per year. A recent survey showed that the upper limit of coverage in the most elite plans is $400 per person. The B.C. Public Service Benefits Guide shows that employees can claim up to $750 a year per person for massage therapy.
Sanofi Canada Healthcare Surveys have shown that massage therapy is one of the fastest growing benefits and that nearly half of those who have extended health care benefits filed at least one claim for massage therapy. The steady growth in the use of employer-sponsored massage therapy has caused much consternation and navel-gazing in the insurance industry. Green Shield Canada, which calls itself Canada’s only national not-for-profit health and dental benefits company, recently posted this commentary: We Spend More on Massage than Mental Health Services…Time For A Change?
Green Shield Canada has initiated a rethink on massage benefits, removing it as a core benefit in its new SMARTspend plans, as they are called, “in order to reinvest significant funds in more serious health challenges.”
Under siege Tuesday from angry nurses who read the first Postmedia story about the tentative contract, Sheikh declined to be interviewed. On social media channels, some nurses were vociferous in their protests over some elements of the agreement, including the plan to consider capping massage benefits.
Nurses are also angry that Sheikh said the average annual wage for nurses is about $45 an hour. For the 36,420 registered nurses in the B.C. Nurses Union, it is currently $42.35, according to a union factsheet. For 9,229 licensed practical nurses, the average in 2018 was $29.42. If nurses approve the tentative agreement by the Jan. 21 deadline, licensed practical nurses’ wages on April 1 would range from $27.87 per hour to $32.46 per hour, depending on job descriptions and experience. Registered nurses and registered psychiatric nurses would be paid anywhere from $34.83 to $55.18 per hour.
While nurses’ benefits are part of their collective agreements, in other health care unions there are joint benefit trusts that are co-managed by union and employer-appointed trustees who get funding from employers that is fixed to a percentage of the payroll.
Roy Thorpe-Dorward, spokesman for the Health Employers Association of B.C., said “no benefit costs are unlimited.”
“Working together, both parties (unions and employers) are motivated to operate efficient and sustainable benefits plans that provide the best possible benefits for employees,” he said, adding that historically health sector agreements have included caps on “paramedical” expenses such as massage therapy.
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