The Managed Competition Act is basically a national managed care system in which the patient chooses from a menu of health plans. The choices of health care packages are intended to stimulate competition among care-givers and force more cost-effective health care.
The health plans theoretically stress preventative medicine. Under the act, an MD "gatekeeper" would have to approve chiropractic treatment for a patient. Chiropractic care is not specifically covered. According to the language of the act, "It would be up to the health plan to determine when chiropractors were the most effective and efficient provider for certain diagnoses."
The bill calls for an ominous entity dubbed the "National Health Board" to determine the specific benefits of each package on the health care menu. There is no word yet on the board members, but it is probably safe to assume that the board would not be replete with chiropractors.
Craig R. Benton, D.C. of Lampasas, Texas first brought this bill to our attention. Dr. Benton, who was active in the lobbying efforts to get DCs commissioned as officers in the military, was quick to write Rep. Andrews to express concern over the status of chiropractic in his national health plan.
Dr. Benton informed the congressman of the many state workers' compensation studies that are showing chiropractic substantially more cost-effective than medical care, and that chiropractic gets injured workers back on the job sooner. Dr. Benton stressed to the congressman that a gatekeeper program would "virtually shut out" chiropractic. Referencing the 1990 antitrust victory for chiropractic against the AMA, Dr. Benton said: "Despite a permanent injunction by the courts, these violations continue today. You cannot place medical doctors in charge of chiropractic care -- it just doesn't work."
In his letter to Rep. Andrews, Dr. Benton equates the chiropractic profession with a large corporation, citing the billions in revenues generated by chiropractors, chiropractic suppliers, and the chiropractic colleges; the 175,000-200,000 individuals employed in chiropractic offices; and the millions loaned to chiropractic students. Chiropractic, as he reminds Rep. Andrews, supports a large tax base.
Dr. Benton's letter was cogent and compelling, and we applaud his efforts.
If you would like to write Rep. Andrews regarding the Managed Competition Act, the address is as follows:
The Honorable Michael Andrews
303 Cannon House Office Building
Washington, D.C. 20515
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