Pillar 1: Get Informed
Universal, Equitable Care for Knee Osteoarthritis? Sorry - not in Canada.
In a perfect world, all of our Knee Osteoarthritis care would be paid for by our BC Provincial Health Care System. But none of us need to be told we don’t live in a perfect world when it comes to Canada’s healthcare systems.
For the most part, only doctor and hospital services are covered by our universal healthcare system (this is set out in the Canada Health Act of many years ago). Most of us realize that this leaves our system with very little focus on the conservative aspects of care - for example, physiotherapy is in most cases not covered by provincial health systems. Using the Knee OA Treatment Pyramid, we can see how this affects the care you have access to for Knee Osteoarthritis in BC. Most of the help you would get from health professionals for the aspects of management in the lower half of the pyramid are not funded by our health systems. Ironically and somewhat tradgically, the lower half of the triangle is where you can make the most difference in progression of the disease.
The Knee OA Treatment Pyramid and Healthcare Access
Let’s briefly return to the Knee OA Treatment Pyramid. I love the Knee OA Treatment Pyramid as it helps us visually understand what we should be doing with your Knee OA and when. You can quickly see what kind of treatment you should be getting just by knowing the severity of your Knee OA. But it is not just useful for treatment understanding. It also help us understand what is funded and what is not by our healthcare system.
As can be seen, the top half of the treatment triangle represents specialist services, or surgical / injection procedures. Most of these are covered by our universal health care system. These are the most drastic measures required for those with more severe knee osteoarthritis.
The bottom half of the triangle represents conservative care - or non-surgical / injection techniques. These are the services that your physiotherapist and family doctor are best suited to provide to you. Only the prescription medications from your family doctor are covered by the provincial health care system.
In the end, what this means is that for some of the most important aspects of especially early knee OA care - education, exercise, weight loss, lifestyle changes, and bracing / walking aids - you are largely on your own.
The irony here is obvious and frustrating both for patients and healthcare professionals - the stage of knee osteoarthritis where we can make the most long term difference, and the stage at which the majority of those with knee OA exist, is the precisely the point at which our systems provide the least funding. I suppose this is not unique in our systems and experts in many other fields experience the same sense of irony.
This gap in our funding system is one reason we have developed this program for our community. At the very least, we can help with the bottom half of the Knee OA treatment pyramid for free through this website. You can use this course to get loads of good information presented in the context of our community.
Ideally though, you’d be combining some in-person physiotherapy care with this course to help sort through how the information and suggestions might particularly apply to you, and to try out some various treatments. Despite the lack of government fundings, many will have other sources of funding besides government systems to fund this coordinated in-person care and we would suggest you take advantage of these.
Possible Sources of Funding for Conservative Knee OA Care
Although you can get musch from this course, our recommendation is that you get assessed by a physiotherapist for personalized recommendations,. exercise, and treatment suitable to your unique presentation. Many of you reading this will have resources for that. After decades of managing our rehabilitation services, we can help you examine what resources you might have through a helpful resource evaluation as a part of your assessment.
Some possible sources of funding include:
Extended Health Benefits
you may have an extended benefit plan that you have purchased independently or is sponsored by your employer. These plans will typically cover part or all of your costs for physiotherapy assessment and follow-up sessions and medical equipment you might need such as braces, orthotics, or walking aids.
WorkSafe BC or ICBC
If you’re knee osteoarthritis has developed out of an accepted knee injury claim with WorkSafe BC or ICBC, there may be coverage for your treatment and medical equipment. Check with these organizations for coverage of physiotherapy and other benefits.
Department of Veteran’s Affairs or Department of National Defence
First Nation’s Health Authority
BC Ministry of Social Development and Poverty Reduction
Private Payment