Stigas suffered a severe spinal cord injury in 2014 after slipping into his bathroom overnight and hitting his throat in the bathtub.
He said he was forced to reuse the urine collection bags needed for his catheters – against medical warnings that reusing them could cause infection and other serious health complications.
“It makes me feel like a second-class citizen,” Stigas told Go Public. “It’s a constant source of stress, I always have to think about where to find money to pay [for] my medical supplies “.
Stigas receives just over $ 1,000 a month from the Ontario Disability Support Program, which is supposed to cover his medical supplies. This funding is about $ 600 less than the amount needed to buy what is medically recommended each month.
Research studies show that approximately 47,000 Canadians with spinal cord injuries rely on catheters as standard medical equipment. However, proponents of her case have been working to make the actual transcript of this statement available online.
In addition to being forced to reuse catheters, patients are also reusing related medical equipment such as the collection bag pictured here. (Derek Hooper / CBC)
Each province and region decides which medical supplies to cover and for how long, leaving many patients without, said Peter Athanasopoulos, director of public policy and government relations for the Spinal Cord Injury Ontario.
“Just imagine that you have to negotiate how many times you will go to the toilet based on the many catheters you have. Imagine you have a urinary tract infection where the solution is to drink a lot of water, but you have to negotiate how many cups you can have because you do not have enough catheters “And you can not afford what you need,” he said.
Roll the dice
Stiga funding covers about a quarter of the cost of catheters needed, not counting the other relevant equipment. Because of this, he said, taking medical risks and shortcuts is the rule. And he is not alone. Go Public interviewed spinal cord injury patients and advocacy groups across the country, who say some catheter users also risk their health for lack of: deliberately dehydrating to keep their bladder full, boiling medical equipment to try to disinfect it or use cheaper, non-lubricating catheters, which research shows doubles the risk of urinary tract infections. Several studies, including one by a team led by Canadian Urology Nurses, show that the safest type of catheter is self-lubricating, which minimizes the risk of infection.
Variation in coverage
The average patient needs four or five of these a day, at a potential cost of $ 2,500 per month for bladder management supplies, according to a 2021 policy paper from the Spinal Cord Injury Ontario. Some patients cover their equipment with extensive health insurance, employee compensation schemes or insurance arrangements. Many others, however, are at the mercy of the provinces in which they live. “It seems completely unbelievable that we all live in Canada and there are different levels of coverage for medical supplies, and it should be the same for everyone. A spinal cord injury is a spinal cord injury … It needs to be more equal,” he said. Στίγκας. Ontario spinal cord injury went from province to province, trying to understand the appropriateness and availability and found that “they are very inconsistent and difficult to identify,” Athanasopoulos said. CLOCKS Has difficulty paying for basic medical supplies:
Toronto man with paraplegia struggles to pay for supplies not covered by health system | Go to Public
A Toronto man who became paralyzed in the fall years ago now finds it difficult to pay for some basic medical supplies because they are not covered by the county health system. Advocates say it is a problem many Canadians face. 2:01
“There really isn’t a pattern of practice across Canada; relevant supplies for everyone [intermittent catheter] users, not just people with spinal cord injuries, “he said, referring to others who need catheters, such as patients with multiple sclerosis or Parkinson’s disease.
Since launching the #peeforfree campaign in 2018, Spinal Cord Injury Ontario has been pushing healthcare authorities for a program that would cover the use of home catheters regardless of income, location or insurance status.
By the way, the province of Stiga, Ontario, is one of the provinces with the least coverage, without special catheterization programs, except for people with very low social welfare incomes.
This is also the case in Manitoba and British Columbia. There is partial coverage in Alberta and New Brunswick that includes income- and prescription-based programs.
Saskatchewan funding, on the other hand, is seen by proponents as the golden rule, based solely on the patient’s needs, where the medical billing provider goes directly to the government and supplies are shipped directly to the patient’s door.
It costs billions
It is not clear what it will cost to fully fund this type of medical supply in the provinces and regions.
Another question is why there is so much inconsistency in funding and patient access across the country.
“The short answer is that we really do not know,” said Kristine Cowley, an associate professor at the University of Manitoba’s Spinal Cord Research Center.
He said catheters are not the only example of basic medical items being excluded from state funding. He mentions insulin, for example, and how type 1 diabetics do not have guaranteed funding for it anywhere in Canada.
Peter Athanasopoulos is from the Spinal Cord Injury Ontario, a defense team working to obtain equal funding for catheters and related supplies regardless of where patients live. (Petros Athanasopoulos)
Athanasopoulos suspects that limiting coverage is a cost-saving effort, but says math does not add up.
A 2013 study funded by Health Canada estimates the annual financial burden of traumatic spinal cord injury, including post-traumatic complications, at $ 2.67 billion.
The study says better management of these complications could reduce costs.
Another study from 2016 shows that a single hospitalization for a urinary tract infection can result in a cost of $ 5,000 to $ 190,000 in the Canadian healthcare system.
“Improved quality of life”
An update to the 2013 Health Canada-funded study is in the works, but no release date has been announced. Athanasopoulos said that in addition to significant savings in the healthcare system, improving access to catheters would also have a social benefit. “After saving resources by going to the hospital, reducing infections, improving the quality of life, the greatest potential for sustainable, lucrative employment, the number of opportunities we give people the opportunity to pee for free is enormous.” Stigas has had temporary cost relief for almost two years. As a temporary solution to staffing issues in the healthcare sector, he was given a “home” catheter during the pandemic, which is more commonly used in hospitals. It is changed every month by a nurse and covered by the healthcare system, but this type of catheter has an even higher risk of infection and can come off or become clogged. Stigas said he would likely return to intermittent catheter use in the coming months, so he wanted Health Canada and the provinces to strengthen and fund medically recommended catheters and related medical supplies – not just for him but for thousands of others. situations. “In the early years when people had spinal cord injuries, they died of kidney failure because they could not properly manage their gut and bladder. So the fact that we still have to fight for this kind of thing in 2022 is completely outrageous.” he said. Go Public asked both the Ontario Ministry of Health and Canada about the health effects and financial difficulties caused by the lack of universal coverage for catheter products for people with spinal cord injuries. The Ontario Department of Health did not address the patients’ concerns, saying only that “Ontario will continue to look at evidence and funding models for other jurisdictions.” Health Canada said “Canada’s health and safety is a top priority for the government”, but said medical devices, including catheters, were the responsibility of the provinces and territories.
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