Guest Opinion Commentary by Dr. J.C. Smith, M.A., D.C.
Just as the 1964 Civil Rights legislation guaranteed that Rosa Parks would no longer have to sit in the back of the bus, the controversial Patient Protection and Affordable Care Act, euphemistically known as Obamacare, will guarantee your right as a patient to have a freedom of choice where you sit in the medical bus.
Chiropractic care has been welcomed by both patients and insurers in this era of evidence-based healthcare that has repeatedly shown the safety, popularity, as well as the clinical-effectiveness of this brand of “hands-on” spine care.
It will also save a lot of money. Musculoskeletal disorders alone currently affect 44.6 million Americans and cost our society an estimated $267.2 billion every year.
Since the early 1990s, research showed that the medical treatments for low back pain were expensive and inappropriate for the majority of cases. In fact, the Dartmouth Institute of Health Policy suggested 30-40% of spinal fusion surgeries were unnecessary.
Moreover, a prominent orthopedist admitted that back surgery “has been accused of leaving more tragic human wreckage in its wake than any other operation in history.” A notable medical journalist minced no words when he recently stated, “Spinal medicine [drugs, shots, surgery] in the US is a poster child for inefficient spine care.”
Today research studies cannot be clearer that chiropractic care stands at the top of spinal treatments as Anthony Rosner, PhD, testified before The Institute of Medicine: “Today, we can argue that chiropractic care, at least for back pain, appears to have vaulted from last to first place as a treatment option.”
After decades of unwarranted medical defamation, this change in attitude highlights decades of controversial medical spine treatments consisting of narcotic drugs, epidural steroid injections, and spine fusion surgery that have all come under increasing criticism.
Despite this evidence-based research that shows chiropractic’s superiority for the majority of back pain cases, long-established medical associations that have dominated this market still resist the inclusion of chiropractic care.
However, this impediment may prove to be inconsequential considering Section 2706 of Obamacare, the so-called provider “Non-Discrimination in Health Care” clause that will apply to all insurance programs.
Section 2706 is healthcare reform’s most significant inclusiveness measure for chiropractors, naturopaths, acupuncturists, massage therapists, and licensed midwives, potentially opening consumer choice to millions of Americans.
Fundamentally, Section 2706 prevents plans from arbitrarily excluding the participation and coverage of categories of non-MD providers in their health plans when this participation is within their scope of practice and licensure.
What can we conclude now about the role of chiropractic in Obamacare? Certainly the evidence-based cost-effectiveness trend will continue to support the inclusion of chiropractic care and Section 2706 will protect chiropractors and their patients from unwieldy restrictions as we’ve seen in the past.
1. Bigos et al. US Dept. of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Clinical Practice Guideline, Number 14: Acute Low Back Problems in Adults AHCPR Publication No. 95-0642, (December 1994)
2. “New Study Demonstrates A Three-Fold Increase N Life-Threatening Complications With Complex Surgery,” The BACKLETTER, 25/6 (June 2010):66
3. Elliott Fisher, MD, on the CBS Evening News, “Attacking Rising Health Costs,” June 9, 2006.
4. G Waddell and OB Allan, “A Historical Perspective On Low Back Pain And Disability, “Acta Orthop Scand 60 (suppl 234), (1989)
5. The BACKPage editorial vol. 27, No. 11, November 2012.
6. Testimony before The Institute of Medicine: Committee on Use of CAM by the American Public on Feb. 27, 2003.
7. Michael Kranish, “Senators Seek Coverage For Alternative Therapies,” Boston Globe, July 24, 2009
8. Letter to the Honorable Kathleen Sebelius from Keith Overland, DC, President of the American Chiropractic Association, October 19, 2012