A disconnect in recent years between insurers, patients, providers and other stakeholders has magnified to the extent that it is destabilizing the Ontario auto insurance industry. As we have clearly seen in the recent round of reforms, the current insurance model is a fragile system at best. Although full of excruciatingly detailed checks and balances designed to ensure stakeholders know the rules and work within them, it has its periods of disequilibrium. In this writer’s view, the pendulum has swung far from the centre as symptoms of mismanagement and abuse have compromised the integrity of the system and undermined the confidence of patients.
At points of extreme stress, radical change is warranted to avoid further deterioration. Indeed, with so much change over the years producing so few results, the viability of the entire Ontario auto insurance regime may be at risk. As providers, we must comprehend the nature and implications of the cycles and take every precaution to avoid jeopardizing the system since our livelihoods are dependent on its existence and health. Regulatory institutions exist for a number of reasons. In the case of auto insurance, one reason is to control exorbitant claiming practices. It is imperative that counter measures be injected at critical stages in the cycle to encourage sustainability and equity.
Every five years or so, regulatory changes are enacted to help stabilize the auto insurance industry in order to better serve its true purpose. Some are major transformational regulatory mandates that signal a major shift in direction. Regulation 34/10 and the Central Processing Agency (HCAI) are two such mandates. Through them, the industry has firmly positioned itself to effectively counter the increasing cost momentum and usher a shift back toward sustainability. The Minor Injury Guideline is intended to persuade providers to focus on the core principles of rehabilitation, primarily patient-centred care, something the mainstream model has neglected in recent years.
It is not an easy transition, since the gravy train was near full capacity and roaring full speed ahead. To weather these changes and continue to be a player in the auto insurance industry, providers must align themselves with the new regulation and make a concerted effort to change indulgent claiming practices. As always in periods of transition, it is difficult to make sense of the intended outcome; however, an unwillingness to allow for transformation will inevitably weaken our system franchise. All providers should heed the warning and start thinking about the importance of maintaining sustainability and integrity for the collective whole. Patient-centred care is where it starts.
In understanding the auto insurance industry, we should be more inclined to perceive changes in regulation not as “us versus them” but as “the integrated symbiotic mechanism at work.” At first glance, Reg. 34/10 may seem a strong counter measure on the part of regulators to rein in unconscionable profit-taking behaviour. However, a broader perspective would view it as the initial step in stabilizing the industry, which in time allows free market forces to settle and adjust the current valuation discrepancy. One insurer is already taking the initiative to reduce premiums and the rest might well follow suit shortly.
The new MIG is clear about its intent. Functional restoration is the essence of rehabilitation and is based on the principle of restoring the functionality of the patient as a whole, not treating the patient as a sum of injured parts. This is where providers should begin to implement our tools and resources in establishing a new model of rehabilitation – “conscious rehabilitation” – based on the awareness that the mind and body are intimately connected in the healing process.
The shift in conscious awareness toward a healthy mind and body has been increasingly noticeable in recent years as millions of people turned to yoga, meditation and mindful presence to counter the stresses of life. The fitness training regimen of the past has also undergone a metamorphosis toward functionality instead of brute strength. The clunky weights, pulleys and machines that were once the mainstay of fitness are being pushed aside as the new class of yoga mats, balls, rollers and latex bands are ushered in. Gyms are finding themselves in a scramble to restructure their space and make room for the new players on the scene.
As we embark on this new paradigm, we start by examining the shortcomings of the current rehabilitation model. This need not require that we discard the old system, but instead carefully trim away the needless excess and redefine the synergistic role of each component of therapy in terms of the overall outcome. Essentially, it’s using the components of the old model as a stepping stone toward a more evolved therapeutic approach that incorporates both patient awareness and functionality.
For providers, at least, the secret to success in the age of reform is not a secret at all: play by the rules and make the patient better. In doing so, we are given the rare opportunity to transform an old model and improve best practices.
