In the proposal for the state budget for 2025 The current government proposes to scrap a 50-year-old reimbursement scheme for chiropractor patients. An arrangement the Labor Party was the initiator of and was approved in 1974.
Since then, chiropractors have been an increasingly integrated player in the first-line service, and for good reason. The chiropractors have proven that they are a cost-effective alternative for a large and expensive patient group.
Over 30 percent of all those who are too ill to go to work in Norway today, are at home due to musculoskeletal disorders. This costs society NOK 165 billion annually.
With the state budget that the government is now proposing, both the number of sick leave and the costs will increase drastically. Each year, 1.4 million Norwegians are affected by musculoskeletal disorders. The waiting time for treatment in the public sector is estimated at 8–12 weeks, which worsens the situation.
Anders Danielsen Lie wrote in Aftenposten on 26 September that the GPs benefit from 100 per cent sick leave, rather than having the debate with the patient about whether to work or have a graded sick leave.
They are pressed for time and do not engage in active treatment. And as Lie writes, the GP will ironically lose money by spending time on these discussions. This type of discussion will go beyond the patient/doctor relationship and a pressured GP will not be able to bring himself to put aside business concerns.
The government will save NOK 140 million in the short term, but will incur far greater costs in the long term.
Today, one third of the patients who visit an already pressured GP scheme have so-called “subjective health problems”. These are ailments that cannot be measured with blood tests or taken pictures of. This applies to everything from headaches, dizziness, fatigue, shoulder pain, stiff neck, back pain – the list is long.
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In addition to the fact that there is no time, or profit, for a GP to have the discussion with the patients, Lie further writes that many GPs do not know what the patients actually do at work. It is therefore difficult to understand how the patient’s ailments affect the ability to work.
The chiropractors have both the time and expertise to treat these patients with an active approach and follow-up. They work with employers to ensure graded sick leave and arrangements. It keeps more patients in work.
The chiropractors have proven that they are an important part of the first-line service, with low referrals to the specialist health service and less use of sick leave than the GPs.
The chiropractors also less frequently refer this patient group to diagnostic imaging and the specialist health service. Today, Norwegian chiropractors treat one third of these patients without waiting time. This corresponds to the number of patients who are treated by physiotherapists with public operating subsidies and waiting time.
The chiropractors thus significantly relieve the public health system. Nevertheless, the government wants to discontinue the reimbursement scheme for chiropractic treatment.
Although it is well documented that quick access to treatment reduces long-term sickness absence, the government will now send even more patients into an overburdened public system.
The result is longer waiting times, more sick calls and, in the worst case, transfer of patients to the specialist health service. It is 60–70 times more expensive than treatment in primary care.
Patients choose a chiropractor, even if it involves a higher deductible.
The healthcare system is under pressure from all sides, and the government is cutting where it shouldn’t. By removing the reimbursement scheme for the largest patient group, they save NOK 140 million in the short term, but add up to far greater costs in the long term.
Chiropractors call in sick shorter than GPs and treat patients more effectively than physiotherapists. Patients choose a chiropractor, even if it involves a higher deductible. Because it helps them to avoid health care queues, sick leave and to stay at work instead.
The government will now force this group of patients to pay even more or wait longer for treatment.
The chiropractors have proven that they are an important part of the first-line service, with low referrals to the specialist health service and less use of sick leave than the GPs.
Removing the reimbursement scheme is therefore a step in the wrong direction. Nor does it save society from costs – quite the opposite.
Read also: The system is already failing back patients, now it seems the government is failing them even more