Chiropractic and Health Care Reform: An Uncertain Future or an Opportunity?
SOURCE: Dynamic Chiropractic
By Claire Johnson, DC, MSEd and Lori Byrd, MS
The United States is currently experiencing a health care crisis. Much of the current health care system focuses limited resources on the treatment of disease, and very few resources are aimed at primary and secondary prevention.
Although 70 percent of factors influencing health are environmental and behavioral, and only 10 percent of the factors attributed to health are associated with access to health care, the actual reimbursement for health services accounts for 96 percent of the $2.3 trillion spent each year. [1] Thus, we need to take a closer look at health care reform and how doctors of chiropractic will approach this changing landscape.
In March 2010, the Patient Protection and Affordable Care Act was law signed into law. The intention of the act is to put “in place comprehensive health insurance reforms that will hold insurance companies more accountable, lower health care costs, guarantee more health care choices, and enhance the quality of health care for all Americans.” [2] However, it is not exactly clear how this will be done or if the promised goals will be met, especially during this time of reduced funding and economic crises.
Chiropractic is one of the largest complementary and alternative medicine professions, and one of the largest licensed health care professions in the United States. [3-4] It is considered to be a holistic and wellness-oriented profession, traditionally not using drugs or surgery to help patients maintain health. Care typically incorporates wellness, lifestyle and prevention approaches with patient management, and focuses on the body’s natural ability to heal itself. Services provided by doctors of chiropractic have demonstrated high patient satisfaction, cost-effectiveness and parity compared to other types of care for similar conditions.
For these and other reasons, the chiropractic profession has much to offer health care reform. However, for the most part, the profession appears to have been marginalized in the health care reform process up to this point in time. It is important for all stakeholders that the chiropractic perspective be represented and that chiropractic leaders and practitioners be participants in health care reform.
At present, the direction of health care reform is still being determined. The chiropractic profession can become more involved and contribute in a positive way as health care reform moves forward. One way to be more involved is to participate in the American Public Health Association (APHA). In March 2011, the APHA held a midyear meeting to focus on health care reform. More than 600 public health practitioners attended the meeting to learn how the Affordable Care Act will impact public health, wellness and prevention. Attendees participated in workshops and presentations including enlightening discussions of topics like fiscal repercussions, technology, legal challenges, roles of policy-makers, and communication.
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I think the big difference between requiring insurance because of the moral hazard of health care, versus that of burials, soup kitchens, and shelters, is that the consequences of not providing safety nets for health care are much more dire, and to many, ethically unacceptable. In our society, it would be ethically unacceptable to leave a man struck by a car on the side of a road and not provide him medical attention. As unsavory as it would be, a body dumped into the ocean is more acceptable, as is (however wrong some may think it is) letting someone starve, or sleep on the street.