Government Health Care for Everyone: Buyer Beware

[originally published in KCN, February 2010]

As our nation waits on pins and needles for our elected officials to craft a “health-insurance- plan-for-everyone,”  those who are super-excited by this proposition need to understand that it will not be “free.”  We will all directly and indirectly pay for it.  You can be sure of that.  And the scary thing is, we are looking to the federal government to craft this utopian health insurance plan… when their track record in the insurance business is down right lousy.  Can  you say “Medicare?”

I’m concerned that in our over-exuberance to grant everyone  health “insurance,” if we are not careful, we might unknowingly strip ourselves from the very thing we need:  health “care.”

Take, for example, in the late 90’s when Blue Cross of Northern California pitched their health plan to medicare eligible seniors.  They said their plan had “chiropractic services.”  When, in fact, what it had was physical therapists rendering spinal manipulations in lieu of chiropractors.  Talk about misleading.

Or what about the study that was release a dozen years ago, in which Group Health of Washington compared the effectiveness of chiropractic and physical therapy for the treatment of low back pain to a one dollar “educational booklet.”  Guess which one received a glowing report!

My point is, we need to be mindful of what we are signing up for.  Are we truly going to get the health “care” we need and want, or are we going to be  subjected  to misleading promises and unacceptable cost-cutting measures — all in the name of “insuring” everyone?

If we are truly going to “craft” a plan that insures everyone, it is imperative that we turn to treatments that are effective — both in terms of cost and actually working.

In the last half of 2009 three studies have surfaced regarding  chiropractic, for example, that should give anyone drafting a health care reform proposal pause.

Reporting after one year, a Wellmark Blue Cross and Blue Shield physical medicine pilot study found that patients who received chiropractic and other physical medicine procedures were less likely to have surgery and had lower overall total health care costs when compared to similar patients that did not receive such services.

An assistant professor of Harvard Medical School along with a chief physician at Mercer Health and Benefits asked this question:  “Does the availability of chiropractic care improve the value of health benefit plans?”  Their answer:  “When considering effectiveness and cost together, chiropractic physician care for low back and neck pain is highly cost effective, represents a good value in comparison to medical physician care and…. is likely to drive improved cost-effectiveness of US care.”   Would you believe that their findings did not include medication expenses?

Finally, Milliman USA recently released a “previously confidential report” that looked at the financial impact chiropractic care would have on the medical costs for patients with common spinal diagnoses.  Amassing over 2.5 million “member months” of claims data, they found that those seeking chiropractic care had “materially lower health care costs than those who did not…. ten to 23 percent lower costs….”  Extrapolating this data to a member pool of one million, they projected that if six percent of this population shared a common spinal diagnosis and half underwent chiropractic care, a savings of $1.2 million per month would be realized.  That’s over $14 million per year!

So, as our elected leaders scramble to come up with a “plan,” let them hear your voice. Insist on care that will deliver for your hard-earned dollar.  I recommend checking out

You know, I bet we could get the cost of that educational booklet down to near zero if we offered it as an eBook.


Source used for this article:
Blue cross drops chiropractic for seniors in northern california: new medicare regulations seen as culprit.  Dynamic Chiropractic.  17 (5).  1999.
Cherkin, Deyo, Battie, Street, and Barlow.  A comparison of physical therapy, chiropractic manipulation, and provision of an educational booklet for the treatment of patients with low back pain.  New England Journal of Medicine.  339 (15). 1998.
Choudhry and Milstein.  Do chiropractic physician services for treatment of low back and neck pain improve the value of health benefit plans?  An evidence-based assessment of incremental impact on population health and total health care spending.  Mercer Health and Benefits LLC for  the Foundation of Chiropractic Progress.  October 12, 2009.
Crownfield.  Cost-effective care:  the evidence mounts. (MillimanUSA  Report) Dynamic Chiropractic. 27 (19). Sept. 9, 2009.
Crownfield.  How chiropractic helps the insurance industry.  (Mercer Health and Benefits Report).  Dynamic Chiropractic.  27 (25).  December 2, 2009.
Study suggests chiropractic reduces health care costs, need for surgery.  (Wellmark Blue Cross and Blue Shield Physical Medicine Study).  Dynamic Chiropractic.  27 (18).  August 26, 2009.
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