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An Intergral Solution To Resolving
Today’s Health Care “Crisis”
Getting Alternative Medicine Covered by Medical Insurance
Burton Goldberg, Alternative Medicine Magazine
Insurance pays over $100 billion every year for ineffectual or even harmful conventional
medical treatments. It is time to make proven alternative therapies affordable and
available to everyone.
Would you join me in helping to rectify one of the great inequities of our time?
This is the disparity between medical insurance coverage of alternative therapies
compared with conventional treatments.
I receive thousands of e-mails, letters and phone calls every year from people asking
all kinds of questions about alternative medicine. One of the questions I am asked
most frequently does not have anything to do with how to treat any one particular
health condition: it is how to get medical insurance to cover alternative therapies.
Every day I learn about exciting advances in alternative medicine, and hear inspiring
stories of patients who have been cured of diseases conventional medicine calls “incurable.”
But what good are these medical miracles if people do not have the money to pay for
them? Therefore, to make alternative medicine available to more people, I have started
a not-for-profit foundation with the purpose of getting every state in the U.S. to
pass legislation that requires insurance companies to cover alternative treatments
on an equal footing with mainstream medicine.
In general, alternative medicine costs less than conventional treatments. It is more
than ironic that it is more expensive to individuals because they must pay for it
out-of-pocket: It is a tragedy. To see why, we have to look no further than the number
one and two killers in this country: heart disease and cancer.
If you get cancer, your medical insurance or Medicare will pay for tens and hundreds
of thousands of dollars of surgery, radiation and/or chemotherapy–whatever is the
standard of practice for your particular kind of cancer. This in spite of the fact
that after spending more than $2 billion annually for research over the last quarter
century, the medical literature reveals that the incidence and mortality for most
kinds of cancer remains unchanged–or continues to rise.
However, if you want to get treated at an alternative clinic where the success rate
is upwards of ten times higher than conventional treatments–with the subsequent quality
of life also immeasurably better–the cost could run $5,000 per week for a one- or
two-month in-patient program. This is still less than the cost of conventional treatment–for
which hospitalization can cost upwards of $5,000 per day–but again, this would all
have to come out of your pocket. And presently, it might have to occur out of the
U.S., because many therapies that have proven effective abroad are not allowed to
be practiced within our borders.
With heart disease, if you have a blocked artery, you can be one of the half-million
or so people in this country every year who have a bypass operation that costs between
$50,000 and $100,000–and it will cost you little, if anything, because it is probably
covered by your HMO, PPO or Medicare.
However, it is an entirely different story if you want to prevent or reverse coronary
heart disease by going to an alternative physician. He or she would likely prescribe
lifestyle changes, supplements and chelation therapy (see Quick Definition on page
13). A full examination, follow-ups, all lab work and a year’s complete treatment
could cost between $5,000 and $7,500. This is a fraction of what conventional treatment
costs, but again, the chances are that you would be responsible for paying for all
of it. That is, if you are lucky enough to live in one of 11 states in which a doctor
can perform chelation therapy without risk of losing his or her medical license.
Yet, according to the federal government’s General Accounting Office, less than 10%
of bypass operations are necessary; and studies in mainstream medical literature
show no significant difference in the death rates between heart attack victims who
receive bypass surgery and those who do not. Still, approximately $4 billion dollars
is spent on bypass surgery every year.
Here, of course, is where the difficulty lies. The people to whom these billions
of dollars are being paid do not want a change in the status quo.
Those industries and occupations that have the most to lose include insurance carriers.
Insurance companies make their money as a percentage of their gross revenues. From
a business point of view, insurance companies would be most profitable insuring lots
of sick people employing ineffective, expensive medicines.
Also threatened by alternative medical insurance coverage would be dyed-in-the-wool
conventional doctors. There are, unfortunately, a significant portion who don’t want
to go back to school to learn an entirely new medical paradigm, and others who don’t
want to face the fact that in their ignorance or arrogance they have let many of
their patients suffer or die unnecessarily. The public now makes more visits to alternative
practitioners than to primary care conventional doctors, and spends more out-of-pocket
for alternative services than they do for hospitalization services. Without the insurance
“subsidy,” conventional doctors would lose even more of their patients.
Pharmaceutical companies would be the biggest losers. Expensive patented drugs that
only suppress symptoms and have toxic side effects would only be used in the rarest
circumstances in alternative medicine. If there was a major shift in this country
from sick-care to real healthcare, the drug giants would have to do what the tobacco
companies have done to survive: Once it became common knowledge that their main product
was poison, they had to diversify into entirely different businesses.
Quick Definition
Chelation Therapy: The intravenous administration of substances which bind to
heavy metals, toxins and metabolic wastes in the blood stream, allowing them to be
eliminated throughthe digestive tract. Common chelatingagents are DMPS(2-3-dimercapto-1-propane-sulfonate)
to remove mercury and EDTA (ethylenediaminetetraacetic acid) to remove other excess
metals such as calcium, iron, lead, copper and arsenic.
There is formidable opposition, then, to getting alternative medical therapies covered
by insurance–the pharmaceutical and insurance industries are among the very top political
contributors on the national and state levels, with physicians’ trade organizations
major players, also. The monetary stakes are huge: $37 billion dollars are spent
annually on direct medical costs for cancer treatment and an equivalent amount is
spent treating heart disease. Conventional medicine in this country is an industry
with annual revenues of hundreds of billions of dollars.
On the other hand, much of the public–and many doctors–do want more access to alternative
medicine. The following statistics were compiled and documented by health activist
Monica Miller of Healthlobby.com:
• 80% of medical students want training in complementary and alternative therapies
(“CAM”);
• 70% of family physicians want training in CAM;
• 69% of Americans use nonconventional medical therapies;
• 67% of HMOs offer at least one form of CAM care;
• 64% of U.S. medical school offer courses in CAM;
• 60% of physicians have referred patients to CAM practitioners;
• 56% of Americans surveyed believe their health plans should cover alternative therapies;
• 29 health insurers and HMOs already cover some CAM therapies.
So, it is possible to get alternative therapies covered by medical insurance–in fact,
it has been done in one state. In 1993, Washington passed a state law requiring insurance
policies to provide coverage for treatments and services by every category of licensed
health care providers, starting in 1996. Washington currently licenses naturopathic
doctors, acupuncturists, chiropractors, certified dietitians and nutritionists, massage
therapists and midwives. A coalition of insurance providers immediately initiated
a legal challenge to the legislation, but the law was upheld in a ruling earlier
this year by the Washington Supreme Court.
Washington is the exception, however. And before we can get medical coverage for
alternative therapies, we have to make alternative therapies themselves available!
Presently, only eleven states have laws that protect patient access to alternative
therapies from licensed physicians: Alaska, Colorado, Georgia, Massachusetts, New
York, North Carolina, Ohio, Oklahoma, Oregon, Texas and Washington. Further, individual
states vary widely in the licensing of health care practitioners other than M.D.s–providers
such as naturopaths, acupuncturists, homeopaths, etc., must also be recognized and
their services included in insurance coverage. In addition, wording in insurance
law and policies has to be defined by statute, so that, for example, “medical necessity”
is something determined by the physician on a case-by-case basis, instead of by an
insurance underwriter.
There is much work to do, and we are just getting started. To find out how you could
help by volunteering your time or contributing to the foundation, please e-mail me
at foundation@alternativemedicine.com.
Making alternative medicine available for everyone is more than a matter of money–it
is no exaggeration to say that it’s a matter of life and death.
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