Obamacare and Chiropractic: A Chiropractor’s Perspective

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.

Dr. JC Smith, MA, DC, is the author of The Medical War Against Chiropractors. Dr. Jarvis can be reached via e-mail at: jcsmith@smithspinalcare.com.

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

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Comments (23)

I always pay for chiropractic care out of pocket and I’m looking forward to seeing this change. I had a herniated disc several years ago and I’m so glad that I didn’t succumb to back surgery. It took several years to heal but I’ve never looked back. I do have occasions to see a chiropractor when my hip goes off balance. I’m just thankful I can afford to pay for it when it’s necessary. Let’s hope there’s a more enlightened approach in the future of Obamacare that includes chiropractic care for everyone.

Twice in my life, a chiropractor SAVED my life! I’m a staunch fan of chiropractic. The very best chriprators will let the patient know when the best treatment requires a different discipline… which is more than an MD is likely to do, unless they can refer you to another MD.

I am thrilled by the idea that insurance companies may now be required to recognize RESULTS is what validates any kind of healthcare practice, and that RESULTS is what should establish the compensation protocols! May this go far beyond chripractic and extend to the myriad other effective alternative medical disciplines!

I suffer from the same spinal condition as my mother did. She had surgery & never walked without a walker or wheelchair again. My chiropractor keeps me on my feet & walking upright. I couldn’t do my job as a contractor without him.

bravo. its about time the pain and suffering and
expense of all peoples are reduced with alternative care that works.with chiropractic nobody diesor ispermanently injured.modern medicine has killed millions, not to mention all the drug addicts it has hascreated. modern medicine has
done wonders on the emergency room cases but otherwise is a disgrace.

As a patient of one amazing chiropractor and a former patient of a neurosurgeon and ortho surgeon I am a prime example of how GREAT a good chiropractor can positively affect your health. After having my neck fused (and being told not to let a chiropractor go near my neck) I was rear ended while at a dead stop by a truck going 70 mph There went L5 to S1 and messed up more of my neck. The surgeons only solution was more surgery – no way! I found a fantastic chiropractor who in 3 months got rid of the symptoms of lower back injury and gave me 25 degrees more rotation in my neck. He has taken care of carpal tunnel syndrome and has worked with my dentist on my TMJ. All you MD’s out there – work WITH the chiropractors not against them. There are positives to both professions.

Many years ago, I suffered with a chest pain for several years. I went to an osteopath who laid me on my back and “cracked” my spine. The pain that had worried me for such a long time was gone!

Chiropractic care has been the “backbone” of my health. It has helped me work out of sprained ankles, back pain and even a prolapsed uterus after my last birth.

The AMA and BigPharma are so tied to money, as opposed to patient care, that I would always look for alternative care whenever possible. The dangerous drugs and invasive procedures used by conventional medicine obviously are a worse choice than chiropractic preventive care.

I am 83 years old and not on any AMA/Pharmaceutical poison drugs. I have been in the care of Chiropractors for years and if it was not for their care I would not be walking today. I am against the AMA/Pharmaceutical as they murder thousands each year and all condone by the FDA (murder for corporate profits inc). As a retired Chef I volunteer and teach free cooking classes with the title “How to cook outside the FDA’s poison box.”. My Wife and I both are under the care of a great Chiropractor and wish other would too and not believe the AMA Trained Drug pushing Doctors.

A little difficult to have sympathy due to chiropractors infringing upon fully trained, certified, licensed acupuncturists. There are chiropractors falsely advertising themselves as “acupuncturists” with only 50-100 hours of acupuncture instruction vs the 4600 hours that fully trained acupuncturists do study Oriental Medicine theory/acupuncture, get Nationally certified from the Oriental Medicine governing board and licensed under the Board of Medical Practice. Chiros have been misleading the uninformed public, getting reimbursed by insurance for this, and real acupuncturists in many states cannot get reimbursed, with acupuncturists being the best qualified to offer the service of acupuncture. But, things are changing, though. Acupuncturists are now, much more accepted, by the allopathic medical community than are chiros. The tables are turning.

I am a strong believer in chiropractic and massage therapy

I believe your assessment is accurate from the standpoint that chiropractic may finally get a fair shake with a more level playing field. We chiropractic physicians all too often hear from our patients that they wish they had tried chiropractic care sooner…after they have exhausted treatment options in the medical model of care. I write about the concept of taking responsibility for ones health in my book: Reclaim Your Life; Your Guide To Your Body’s Life Changing Secrets For Renewed Health http://amzn.to/TmPgZW

It’s great to see patient’s respond to care that allows their body to heal itself.

Thanks for the great editorial!

I am a supporter of chiropractic methods of care. If left up to the mainstream health system, I might be walking with two canes. Instead with my faith, and my chiropractors I walk with none.

Supplements should also be included in our healthcare.

We have seen what the cost of an almost monopoly in health care has brought. Will the cost ever slow down? Not if the AMA has anything to do with it. Why should the rest of us see our pay go down, or stay the same, while medical costs continue to rise? This is done in many insidious ways, such as lack of reimbursement for alternative therapies, only the use of drugs, rather than herbs, vitamins, or alternative therapies for the treatment of conditions, and lack of scientific studies that include things other than drugs. Do we want to continue on this ruinous path?

Wonderful article and I am one of those that has turned to alternative health care for my health needs, and has had wonderful results with my health. I use both chiropractic and massage therapy frequently for my arthritis pain and both work well and I take no medication and have not taken any medication in the past thirty years, so I am very pleased to read such a
wonderful article that will help so many and at least give people a choice for their health needs. Thank you, Kathy O’Brien

This is welcome!

I praise the president for his creation of “Obamacare”… to help bring the USA in-line with the rest of the civilized world!
However, if we are forced to be insured, then I want to make sure that I can get the treatment that I want…. which will always start with alternatives.
If alternative treatments are taken off coverage then I guess the insurance is excluding me… so why should I pay for it?!

You can combine standard medical care with spinal manipulation by choosing an osteopathic physician.
D.O.’s (Doctors of Osteopathy) are trained like M.D.’s with the addition of caring for the structure of the body.
Many D.D.’s also incorporate nutrition, detoxification and herbal healing as well.

Don’t wait for a backache to see aD.O. Or a D.C.! Caring for your body’s structure and spine can improve cell signalling and improve and maintain general health. The famous healer Edgar Case recommended regular spinal manipulations.

Probably the only good thing on obamacare.

Alternative medical practice has been coming along better in the last few years. Hopefully the new act will act to further cement the matter in place.

Thank you for this article. I am just getting (re)started in practice after a time away, and I am not finding an overabundance of information on the potential impact that the ACA will likely have on chiropractic. I think in the aggregate it will be a good thing for the profession, but there will no doubt be a shakeout period as the insurance companies begin to realize the game has really changed for good.

thank you for the information. does this mean, medicare and medicaid recipients may look forward to elect accupuncture as a treatment option?

I asked one of my mentors while at a seminar why, after so much research showing the effective of chiropractic care we are still not seeing the implementaion in the VA, or other hospital programs. He stated “follow the money.” In the past, ww were denigrated for being “non scientific”, but now that the science is shown it seems all for naught. Sure, we have our internal problems, but so does medicine. Until politicians are not being influence by lobbyist change will be slow, and the people who will suffer most are those that we profess to help. When I get a referral “as a last resort”, as if what I did was more dangerous, it makes wonder just what are MDs being taught about us and by who.

I had an irregular heart beat. With one Chiropractic adjustment, my heart beat has been regular, which is several years.

Who knows what is about to unfold in 2014 when Obamacare becomes mainstream. Time will answer most of our questions. If it is what we think it is it will effect ALL.

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