Wednesday, December 9, 2009

Alternative medicine could go mainstream

Alternative medicine practitioners might hit the jackpot, if a provision in the Senate bill were to advance into the final legislation. This represents another battle in the long war between traditional medical practitioners and alternative health providers.

Under the Senate bill, a team of health professionals, which can collaborate on patient care, may include “physicians and other professionals, such as a nurse care coordinator, nutritionist, social worker, behavioral health professional, or any professionals deemed appropriate by the State.” This provision would allow doctors to include alternative medical providers in treatment plans.

In fact, some believe that the bill would require insurers to provide coverage for alternative therapies, which might include such things as chiropractic care and massage therapy. The basis for this view is another Senate bill provision which states that a health insurer ”shall not discriminate with respect to participation under the plan or coverage against any health care provider who is acting within the scope of that provider’s license or certification under applicable State law.”

According to the Chicago Tribune, the nondiscrimination provision can is subject to varying interpretations. It cites insurance industry officials who say that the provision might mean that if they cover a physician's treatments for back pain, for example, they must also cover treatment by any other state-licensed health provider, or face a possible legal challenge. The Tribune points out, for instance, that in Illinois, massage therapists, chiropractors, and acupuncturists are state-licensed but exactly who is covered varies by state. Under current law, most states require chiropractic coverage but far fewer mandate coverage for acupuncture treatments.

Even without mandatory insurance coverage, alternative medicine is already quite popular. Americans spend nearly $34 billion annually on alternative medical treatments, amounting to more than 11 percent of total out-of-pocket medical expenditures. Nearly 40 percent of Americans already use alternative medical treatments so what’s the fuss?

There’s plenty wrong with this alternative medicine provision, according to doctors’ groups and health insurers. As quoted in the Los Angeles Times, "these provisions are anti-science and anti-consumer," says Dr. Steven Novella, a professor of neurology at Yale School of Medicine, who is organizing opposition to the Senate bill. Further, a coalition of 19 doctors’ groups wrote to Senate Majority Leader Harry Reid (D-NV) to protest the nondiscrimination provision, claiming it "would create patient confusion over greatly differing levels of education, skills and training among healthcare professionals."

Health insurers also oppose the provision. The Los Angeles Times reports that Robert Zirkelbach, a spokesman for America's Health Insurance Plans, believes that "requiring health plans to provide access to unproven therapies would increase costs and reduce the quality and safety of patient care.”

So, which side is correct? Should alternative medicine be covered by insurance, just like other medical treatment? These are just a few of the questions to ponder as you prepare for the holidays or search for your snow shovels and cold weather gear in anticipation of bad weather ahead.

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