Amputee advocates in B.C. say prosthetic limbs lack adequate health coverage

Amputee advocates in B.C. are shining a spotlight on what they say are the prohibitive costs of getting a prosthetic limb covered in the health care system.

Emery Vanderburgh, a student at the University of Victoria, co-founded the advocacy group Ampuseek because of the struggle she faced getting funding for a prosthetic leg after she lost it to cancer when she was 17.

"When I first lost my leg, I had this idea that Canada's healthcare system would give me the technology I needed to best support my needs since we have free healthcare," she said.

"What I found going through the process was a lot of inconsistency with funding, a lot of incoherence, and a lot of confusion. Once I was fitted with my device, I discovered that the technology is over 20 years and the legs are extremely expensive."

Coverage up to 'basic functionality'

Prosthetic limb coverage differs province to province.

B.C.'s Ministry of Health said its provincial health care plan does covers prosthetic limbs, but Vanderburgh pointed out that coverage is only up to "basic functionality."

The Fair PharmaCare program reviews applications for prosthetic devices and makes a decision about how much of the cost it will cover. The applicant has to make up the remaining costs.

Vanderburgh says it was only through charitable organizations like the War Amps that she was able to get her leg adequately covered.

Even then, her $30,000 leg doesn't allow her to do many activities like walking up and down stairs normally.

"For me, I have to walk up one step at a time," she explained.

Vanderburgh says she has applied for funding for a more high-tech limb, but she has been denied four times.

"The frustration kind of mounted so I wanted to share [my story]," she said.

'Star Wars syndrome'

Vanderburgh's story is not atypical, says Annelise Petlock, the advocacy program manager at War Amps Canada.

"War Amps does what we can," she said.

"But we really need to make sure that government agencies and insurance agencies cover the cost of appropriate prosthetic care, because we're a charity supported by the public. Our own funds can only go so far."

Petlock says amputees in Canada often can't access the prosthetic limb they need for two main reasons: one, the erroneous belief prosthetic technology is more advanced than it is, and two, the costs of prosthetics are underestimated.

Public and policy decision-makers think artificial limbs are better able to replicate function than they actually are because of inaccurate media representations of prosthetics, Petlock says.

"We often talk about the Star Wars syndrome," she said, referring to the film's lead character, Luke Skywalker, replacing his hand with an identically functioning one.

"What people don't realize is that even the most advanced artificial limbs — the ones that are $75,000 to $100,000 — only replicate some of the function that you lost with the loss of your human knee or the loss of your leg."

What does get covered under provincial health care — under the rubric of "basic functionality" — doesn't come close to replicating basic functionality of a human limb, she said.

"You're looking at something like a door-hinge for a knee, for example," she said. ​

Vanderburgh concurs.

"You hear about all this amazing technology and what's possible with a prosthetic device, but after going through the process, you realize that you're not able to get access to the amazing technology that might exist."

Prohibitive costs

The other major issue is the prohibitive cost of artificial limb technology.

Some devices can cost up to $100,000 or more and need to be replaced every few years. And since amputation is not common, companies can't benefit from mass production to lower costs.

However, Petlock argues it's more cost-effective to match an amputee up with higher-functioning prosthetic device because it will save other healthcare costs like massage therapy, pain medication, or rehabilitation.

In addition, because amputation is relatively rare, she argues it wouldn't be a huge burden on the health care system.

The Ministry of Health declined to comment further on the future of prosthetic funding because it is currently in a "care-taker operation" due to the election.

With files from CBC's On The Island