How Obamacare Will Impact Integrative Healthcare

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I have to admit that I was taking a wait-and-see attitude, but this recent NPR post really gave me hope.

It seems that in beginning to make some much-needed changes to the way we Americans receive our healthcare (including making care available to millions who have, for way too long now, gone uninsured and cut off from the system), those shaping the new system have had the foresight to realize that integrative healthcare is GOOD healthcare.  And, in recognizing this, provisions have been made to make sure that “Alternative” (how I hate that term) methods of treatment will be both available and covered in the new scheme of things.

Because this information is both much-needed and somewhat hard to come by, I am posting the whole thing here.  Those who want to read the original, however, should simply click here and trail off to the NPR site.

Here’s the National Public Radio/PBS Newshour report:

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How The Health Reform Law Will Impact Alternative Medicine Access

July 29, 2013

The Affordable Care Act says that insurance companies “shall not discriminate” against any state-licensed health provider, which could lead to better coverage of chiropractic, homeopathic and naturopathic care. Photo by Joe Raedle/Getty Images.

Jane Guiltinan said the husbands are usually the stubborn ones.

When her regular patients, often married women, bring their spouses to the Bastyr Center for Natural Health to try her approach to care, the men are often skeptical of the treatment plan — a mix of herbal remedies, lifestyle changes and sometimes, conventional medicine.

After 31 years of practice, Guiltinan, a naturopathic physician, said it is not uncommon for health providers without the usual nurse or doctor background to confront patients’ doubts. “I think it’s a matter of education and cultural change,” she said.

As for the husbands — they often come around, Guiltinan said, but only after they see that her treatments solve their problems.

Complementary and alternative medicine — a term that encompasses meditation, acupuncture, chiropractic care and homeopathic treatment, among other things — has become increasingly popular. About four in 10 adults (and one in nine children) in the U.S. are using some form of alternative medicine, according to the National Institutes of Health.

And with the implementation of the Affordable Care Act, the field could make even more headway in the mainstream health care system. That is, unless the fine print — in state legislation and insurance plans — falls short because of unclear language and insufficient oversight.

One clause of the health law in particular — Section 2706 — is widely discussed in the alternative medicine community because it requires that insurance companies “shall not discriminate” against any health provider with a state-recognized license. That means a licensed chiropractor treating a patient for back pain, for instance, must be reimbursed the same as medical doctors. In addition, nods to alternative medicine are threaded through other parts of the law in sections on wellness, prevention and research.

“It’s time that our health care system takes an integrative approach … whether conventional or alternative,” said Sen. Tom Harkin, D-Iowa, who authored the anti-discrimination provision, in an e-mail. “Patients want good outcomes with good value, and complementary and alternative therapies can provide both.”

The federal government has, in recent years, tapped providers like Guiltinan, who is also the dean at the Bastyr University College of Naturopathic Medicine, to help advise the federal government and implement legislation that could affect the way they are paid and their disciplines are incorporated into the health care continuum. In 2012, Guiltinan, based in Kenmore, Wash., was appointed to the advisory council of the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health.

Proving that alternative medicine has real, measurable benefits has been key to increasing its role in the system, said John Weeks, editor of the Integrator Blog, an online publication for the alternative medicine community. The Patient-Centered Outcomes Research Institute, created by the health law, is funding studies on alternative medicine treatments to determine their effectiveness.

Weeks said both lawmakers and the general public will soon have access to that research, including the amount of money saved by integrating other forms of medicine into the current health system.

But the challenges of introducing alternative care don’t stop with science.

Because under the health care law each state defines its essential benefits plan — what is covered by insurance — somewhat differently, the language concerning alternative medicine has to be very specific in terms of who gets paid and for what kinds of treatment, said Deborah Senn, the former insurance commissioner in Washington and an advocate for alternative medicine coverage.

She pointed out that California excluded coverage for chiropractic care in its essential benefits plan, requiring patients to pay out of pocket for their treatment. Senn thinks the move was most likely an oversight and an unfavorable one for the profession. Four other states — Colorado, Hawaii, Oregon and Utah — ruled the same way in the past year.

“That’s just an outright violation of the law,” she said, referring to the ACA clause.

Colorado and Oregon are in the process of changing that ruling to allow chiropractic care to be covered, according to researchers at Academic Consortium for Complementary and Alternative Health Care.

Some states, like Washington, are ahead of the rest of the country in embracing alternative practitioners. The Bastyr University system, where Guiltinan works, treats 35,000 patients a year with naturopathic medicine. Sixty percent of the patients billed insurance companies for coverage.

Guiltinan said a change in the system is not only a boon for alternative medicine doctors, but helps families of all income levels access care normally limited to out-of-pocket payment. That’s why some alternative medicine aficianados like Rohit Kumar are hoping the law will increase the ability of his family — and the larger community – to obtain this kind of care.

Kumar, a 26-year-old business owner in Los Angeles, said his parents and brothers have always used herbs and certain foods when they get sick, and regularly see a local naturopath and herbalist. He’s only used antibiotics once, he says, when he caught dengue fever on a trip to India.

While the Kumar family pays for any treatments they need with cash — the only payment both alternative providers accept — they also pay for a high-deductible health plan every month to cover emergencies, like when his brother recently broke his arm falling off a bike.

Paying for a conventional health care plan and maintaining their philosophy of wellness is not cheap.

“We pay a ridiculous amount of money every month,” Kumar said of the high-deductible insurance. “And none of it goes toward any type of medicine we believe in.”

Even so, he said the family will continue to practice a lifestyle that values wellness achieved without a prescription — a philosophy that Guiltinan also adopted in her practice.

As a young medical technician in a San Francisco hospital, she decided that the traditional medical system was geared more toward managing diseases and symptoms rather than prevention. Naturopathic medicine, on the other hand, seemed to fit her idea of how a doctor could address the root cause of illness.

“The body has an innate ability for healing, but we get in its way,” Guiltinan said. “Health is more than the absence of disease.”

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Quick Irate Comment

1 Comment

Again?

How many of these articles are there going to have to be before there is some change to the way that we think about and practice medicine.

At least this time the drug in question, a heart medication called Natrecor, wasn’t found to be harmful, merely ineffective.  Which, in these days of deadly drugs, is beginning to seem like a blessing.

Take a moment, read this article in The New York Times.  It should alarm you.  It should make you mad.  It should make you want to do something so that this stops.

The most alarming part of the article for me is one simple little sentence:  “The drug, nesiritide, brand name Natrecor, was approved after small studies in carefully selected patients.”  Small studies with carefully selected subjects yield untrustworthy results.  Unsafe results.  Our lives are at stake and yet our government pays more attention to the demands of the pharmaceutical companies than to our needs as patients and as citizens.

When the drug was tested in a large unbiased study, the results were different.  The story states:  “Once again, small studies give us the wrong answers,” said Dr. Robert M. Califf, a Duke cardiologist who directed the large study.

Even the allopathic doctors are aware with the flaws in our medical studies.  Small studies give us the wrong answers.  They give us the answers that the drug companies have purchased in setting up the studies.  And they give us ineffective and unsafe drugs.
This needs to stop.

Obamacare: Should We Beware?

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Since then-candidate Obama began promising us all “Change we can believe in” and, as part of that picture, universal healthcare, I have been wondering what that healthcare would mean to those millions of us who routinely choose the “alternative” route to healing.

And, as a quick aside, let me say that I have always resented the use of that word “alternative” when applied to homeopathy, acupuncture and other forms of treatment that do not march in lockstep with the allopathic concept of medicine.  Just by allowing the use of the term alternative, we allow for all other forms of medical philosophy and practice to be marginalized.  To be defined in terms of the allopathic “norm.”  And, as there is nothing “normal” about allopathic medicine, save the fact that it is culturally dominant, I reject the term alternative and will do what I can to stamp out its current usage.  Therefore, in all future postings, I will use the word “holistic” in its place.  Because one of the major differences between homeopathic and allopathic medicine is this concept of holism.  Homeopathic treatments are holistic in the sense that they are “whole being” treatments.  Allopathic practitioners work from the equally jovial and nonsensical notion that they can treat one or two aspects of the being in something of a vacuum–that they can treat one part of the body without impacting the whole.  (For an example of this sort of thinking, slam your finger in a car door and see how you feel–does that fact that only that small part of your body is wounded impact the rest of your being as well or not?  Do you feel the pain only in that finger or throughout your arm, you body?  Does it affect your mood as well? )

Okay, this brings us to  Executive Order 13544, an order that was signed by our President this last summer and an order that gives new powers both to the dreaded FDA and to the Department of Health and Human Services.  These two departments have now, in compliance with the United Nations’ Codex Alimentarius, been given the power to decide which vitamins and supplements and which forms of alternative–there’s that word again!–are safe and efficacious and which should be removed from the marketplace.  In the name of “our own good”, a government agency that have itself proven to be both ineffective and unsafe is now deciding what is safe and effective FOR US.  (The benign-sounding purpose of the Codex is to give the entire planet access to untainted food, water and medicine.  All well and good.  However, the way it is being enacted in the United States is neither well nor good, as we shall see.)

I have issues with this:

First, I have an issue with anything that gives the FDA more power.  Most especially since they are the body that brought us poisoned eggs, and who made us fear salads, as they are filled with foodstuffs–from lettuce to spinach to tomatoes to spring onions–that have, in recent times, been found to contain harmful toxins.  Now, no doubt, any spokesman for the FDA would portray them as well-meaning and overburdened.  This may be true, but the fact that they already seem to have more “on their plates”  (forgive the pun) than they can handle means to me that they don’t need any new tasks.  Indeed, since they are so overburdened with their well-doing, I suggest we give them all a nice, long vacation and set up a new system that safeguards us from the true threats of tainted foodstuffs and from medication (you see the ads for them day and night on TV) whose side-effects include “coma”, “death” and other startling developments.  In other words, if we are going to sign onto the Codex initiative, let’s actually do what it is supposed to do.

Second, I am wary of this whole process because the panel that is being assembled to judge the quick and the dead in the natural health community is comprised of only allopaths, of proponents of standard Western medicine.  Natural, holistic or “alternative” medical practitioners and providers are not being given a voice.  In a nation in which we lag behind that entire planet with it comes to healthcare, especially natural and holistic healthcare (homeopathy, for instance, is considered a form of standard medicine across Europe, Africa and most of Asia and South America), we are being asked to allow a panel of doctors whose training includes precious little in terms of nutrition, much less homeopathy and acupuncture, to judge the efficacy of something  that they do not understand and have been trained to reject?  Excuse me, but after thirty years of studying, teaching and writing about homeopathy, I think I know a bit more about it than a doctor who still uses the word homeopathy interchangeably with “herbal” or “holistic”.  Note that, while the official government site tells us that the panel will be fair, balanced and diverse, it has yet to prove to be any of those.

Further, I have an issue with the fact that the homeopaths, et al, are not being given a voice because it would not be deemed acceptable in any arena save healthcare.  You could never, for instance, have a panel on “Faith in America” and have only Christians or only Jews on the panel.  And you could never have any political panel the contained only Democrats.  In all other aspects of life and the debate of what is or is not appropriate a mix of voices and viewpoints is called for.  Certainly it is called for here.  And yet, the FDA, the HHC and the precious panel of “experts” are being given the reigns and they may soon make decisions that millions of us will regret.

Do you want to consider a world in which, when you go to your health food store to buy a vitamin or a supplement, you can only buy the chemical equivalent of one because the FDA has found that the natural supplement is not standardized enough–because it is natural?  Do you want to be denied not only the right to buy homeopathic remedies (now over-the-counter medications) or to see a homeopathic physician because the FDA has determined that homeopathy is unsafe or unscientific?  Is it right that those who know the least about a philosophy and practice should have the right to deny it to those who freely choose it and find it both safe and effective?

And, again, do we want the FDA of all agencies, to have the right to judge whether or not anything is safe and effective?  They have proven themselves to be incompetent when it comes to guaranteeing the safety of our food.  Now are we going to let them determine the safety of alternative medicine as well–medicines that have not been shown in any way dangerous or threatening to the commonweal?  It seems to me that giving the FDA more power to determine what is and is not safe to consume is as smart a move as giving the family dog the keys to the car.

I, for one, not only want the right to choose for myself what medicine I will use and what medicine I will not (Hint:  it advertises on TV that its side-effects include coma and death) and, further, I want the medicine that I choose to be fully covered by the insurance that Obamacare will force me to buy.

I believe that Candidate Obama had a vision of a great nation.  But I also believe that that vision has not come to pass.  He has forced through his healthcare plan in a way that will force me to buy health insurance, but will not in any way inhibit the insurer from charging me whatever he wants to, given my age and health.  And now, with the signing of Executive Order 13544, Obama goes a step further and seeks potentially (and please note the word “potentially”–I do not wear a tinfoil hat or typically have paranoid delusions, I am merely noting a potential turn of events) to sweep away a system of health and healing that actually works, that benefits millions of Americans.

This is surely the time to make some noise.  To call our Congressman and Senators’ offices.  To contact the media, to write letters.  To dance the blogger’s dance on the internet.  It is also a very good time for those who don’t understand the principles of holistic healthcare–specifically homeopathy (I am biased, I admit it)–to educate themselves and decide for themselves whether or not we as a nation can afford to hand this all away.  The British have recently been faced with the same question.  In the end, after much debate (they actually allowed all voices to be heard), they decided–homeopathy remains a part of the British health system and is fully covered by national healthcare.  We need to make the same wise decisions here and make them quickly, before it is too late.