Gerard Clum, DC, president of the Association of Chiropractic Colleges (ACC) and Life College of Chiropractic West (LCCW) represented the ICA; Jerome McAndrews, DC, ACA vice president of professional affairs, voiced the ACA's concerns.
Drs. Clum and McAndrews were among 40 health professionals hoping to get their message across to Rep. Stark and the subcommittee members. Chiropractic's message was clear: inclusion in the core or minimum benefits package of the national health care plan.
Other groups bending congressional ears were the AMA, the American Optometric Association, the American Podiatric Medical Association, the American Heart Association, the American Physical Therapy Association, and the AIDS Action Council. Many of the witnesses' testimonies contained the same message -- preventative care now will save health care dollars later.
The testimonies of Drs. Clum and McAndrews focused on the widespread utilization, preventative nature, and cost effectiveness of chiropractic.
Emphasizing these factors, Dr. McAndrews said, "First, millions of Americans currently use chiropractic services. Second, chiropractic is high quality, low cost care that saves millions of health care dollars. And third, DCs provide important primary health care services which are key to health promotion and disease prevention."
Dr. Clum asserted chiropractic's strong points: "We in the chiropractic profession are content to compete on the basis of clinical outcomes because we are confident that chiropractic services are not only cost effective, but highly valid, as an overwhelming body of clinical data supports. ... Prevention is the new frontier of health care. ... It is our belief that a new class of prevention benefits and services needs to be invented and incorporated into the practices of all health care professionals."
Just some of the points covered by the testimonies of Dr. McAndrews and Clum:
- Chiropractic is the second largest primary health care profession in the U.S., as well as the fastest growing primary care profession in the world.
- Chiropractic care is in demand. Dr. Clum noted that over 30 million consumers will seek chiropractic treatment this year. Dr. McAndrews stated that in 1990, chiropractors treated approximately 19 million patients, and annually they treat about 7.5 percent of the entire U.S. population.
- The British Medical Journal study of chiropractic and the RAND report stress the effectiveness of chiropractic care.
- The rigorous chiropractic college curriculum insures thorough primary-care training.
Additionally, it was stressed that Medicare is an ineffective model on which to base the national health care plan, because of its inherent restrictions on chiropractic care. Dr. McAndrews pointed out that when Medicare was enacted in the early 1970s, the AMA's boycott of chiropractic was at its height. "It is a clear vestige of a time when organized medicine was bent on destroying this profession and monopolizing health care," said Dr. McAndrews. He related how the chiropractic profession spent 15 years and $5 million to bring the AMA's boycott to an end.
Dr. Clum decried the current situation in health care, which he said was in crisis. "The key issue in this discussion is the growing cost of health services and the alarming realization that even though we spend one-tenth of our entire GNP on health services, tens of millions of our citizens are left uninsured and without proper care." Dr. Clum pointed to the misappropriation of modern health care: "Our national research priorities are based on finding increasingly dramatic cures ... whether surgical, or technological, to intervene and save every life."
In the summation of his testimony Dr. Clum said: "Until we change our thinking and alter our focus to deal with prevention, health maintenance, health education, patient responsibility, early detection, conservative care alternatives, and other first line issues, making this kind of approach our primary care focus, nothing can or will change.
"From the perspective of the chiropractic profession, spending more and more money in an endless pursuit of dramatic intervention at a stage in the patient's health in which the maximum amount of scarce resources will be required to obtain a favorable outcome, at the expense of prevention, education and factors such as this, is not always in the public interest, either economically or in terms of health policy."
Among Dr. McAndrews closing comments were these statements: "To place medical gatekeepers between us, our patients, and prospective patients is not to place the fox in charge of the henhouse but to invite the fox to devour the hen. We look to Congress to help break the log jam, to break the monopoly, to establish true competition in the health care marketplace, to make sure that effective care finds its way into the system and ineffective care is shown the exit. All providers must meet the test. We believe we have done so. We are prepared to assist in the process and not to act as spoilers as health care reform unfolds."
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