John Weeks June 2013 Integrator Round-up covering the topics of Integratve Healthcare Policy

Commentary on non-discrimination in health care (Section 2706) urges exploration of “big honking lawsuit”

Major successful popular movements in the US often have lawsuits attached. This column here at Huffington Post suggests that implementing non-discrimination may require a major social movement legal case like Silkwood, Roe v. Wade or Brown v. the Board of Education. The non-discrimination in healthcare law in the Affordable Care Act, Section 2706, promoted by US Senator Tom Harkin and his fellow integrative health supporters, will come into effect on January 1, 2014. Yet those close to 2706 will know that Harkin’s intent is hardly a blip on the radar of most states, health systems, insurers and other agencies. Doors remain slammed shut. And those close to a similar law passed in Washington State know that what anchored citizen rights was a brutal series of lawsuits that then insurance commissioner Deborah Senn and the citizens of the State of Washington finally won in the Ninth Circuit Court of Appeals. 

Comment: I wrote the article. Many thought it about time. Others felt I was jumping the gun. It’s elicited a good deal of response on the Huffington Post site. The American Chiropractic Association, American Association of Naturopathic Physicians and Integrative Healthcare Policy Consortium each sent the link to their Boards or members. Some suggested I take a lead in organizing. That won’t be me. Clearly, however, a chord was struck. There are good reasons for the third branch of government. This may be one. Meantime, an interesting posting on 2706 by Integrator columnist Taylor Walsh is here: The Disruptive, Productive Paths of Patient Choice.

 

Congressional supporters of licensed midwives and naturopathic doctors introduce legislation 

On May 12, 2013, Congresswoman Chellie Pingree of Maine re-introduced the Access to Certified Professional Midwives Act, H.R. 1976. The MAMA Campaign, a consortium of supporters of this bill to back certified professional midwives (CPMs) as covered providers in Medicaid, announced the other seven co-sponsors: Michael Michaud (ME), Keith Ellison (MN), Lucille Roybal-Allard (CA), Raul Grijalva (AZ), Eleanor Holmes-Norton (DC), William Keating (MA), and Jim Moran (PA).

Meantime, Holmes-Norton and US Senator Barbara Mikulski (D-MD) introduced the first Congressional legislation with “naturopathic” in the title, according to this column by Jud Richland, MPH, CEO of the American Association of Naturopathic Physicians (AANP). Mikulski’s version, S.135, is a gambit to create visibility for the profession. It calls for the creation of Naturopathic Week for October 7-13, 2013. Those signing on will be agreeing to this assertion: “… Whereas naturopathic medicine reduces health care costs because of its focus on patient-centered care, the prevention of chronic illnesses, and early intervention in the treatment of chronic illnesses …”

Comment: Here’s hoping the Republican fears about how their agenda is limiting their ability to be re-elected will allow some to step across the aisle, finally, to express their support for access to Certified Professional Midwives. The midwives didn’t have any Rs last session, forced by leadership to support nothing from Ds related to healthcare. The shocking reality in the AANP’s move is that this profession managed to pass through the prior decade without introducing anything with their profession’s name in it. S.135 is classic use of a symbolic act: a door-opener for corralling support for more substantive issues down the road.

 

Interview with chiropractic lobbyist John Falardeau provides look behind the curtain

A substantial interview of John Falardeau, the chief lobbyist for the American Chiropractic Association, provides a look behind the scenes at policy developments for the most significant Beltway player associated with the integrative health and medicine fields. The interview, by seasoned journalist and Cleveland College of Chiropractic professor Daniel Redwood, DC, is in Redwoods informative Healthy Insights publication. One subject regards both the importance and limitations of evidence in making a political case. In other areas, Falardeau is hopeful that Section 2706, the non-discrimination in health care section of the affordable care act (referenced above), will force significant openness to inclusion of chiropractors. Falardeau also believes that a bill to allow doctors of chiropractic to be commissioned in the US Public Health Services has a good chance to pass in this Congress.

One fascinating note touched upon in the interview is that the Congressional Budget Office will not take into account potential cost offsets when it evaluates the financial impact, say, of including chiropractors throughout the military. Says Falardeau: “So if the bill calls for having doctors of chiropractic in 120 more facilities in the VA, the only thing they do is take what the average doctor of chiropractic makes in the VA, and multiply it by 120. The current cost-estimation arm of the U.S. Congress is flawed. The back surgeries that are saved if more veterans go to doctors of chiropractic are not considered in CBO computations.”

Comment: That the CBO does not look at cost-offsets in the present context of massive health-related budget deficits is about as smart as entering a fight for one’s life while being willfully blindfolded. It’s not the first time. After all, when Congress established an institute devoted to comparative effectiveness research, the Patient Centered Outcomes Research institute, regular medicine banned the new agency from comparing costs. Both restrictions make one wonder if something very expensive is being protected.