Respond to this Article April 2002

Sins of Commission

Insurance coverage is every acupuncturist, hypnotist, and chiropractor's dream.

By Christina Larson

The National Center for Complementary and Alternative Medicine at NIH is just one way that alternative medicine enthusiasts are using the federal government to gain respect and funding. Another card they've been happy to play recently is that old Washington stand-by: the commission.

In March 2000, after intense lobbying from Sen. Tom Harkin (D-Iowa), a complimentary and alternative medicine (CAM) convert who swears bee pollen cured his allergies, President Bill Clinton created the White House Commission on Complementary and Alternative Medicine Policy. From the start, it was clear this wouldn't be the most rigorously objective group: The 20-member commission was stacked with alt-medicine proponents, from "Tom's of Maine" co-founder Tom Chapell to Wayne Jonas, who ran the government's first CAM office, to James Gordon, author of Manifesto For A New Medicine.

Sure enough, the commission's report, delivered to HHS Secretary Tommy Thompson last month, resembles a detailed CAM wish-list. Its recommendations range from calling for CAM proponents to hold seats on important policy boards to requiring mandatory training in CAM reference materials for public librarians.

By far, the most consequential recommendation is that federal health plans, including Medicare and Medicaid, begin to cover CAM treatments. Insurance coverage has become the brass ring of the alternative medicine movement, whose advocates believe demand for their services would skyrocket if more private or federal insurers were willing to foot the bill.

Of course, at a time when soaring costs have already forced Medicare to cut doctors' payments for routine treatments---and, subsequently, many physicians have dumped their Medicare patients---and the powerful seniors' lobby continues its push for prescription drug benefits, it's more likely that the commission's report will gather dust than support. According to one Medicare official, a treatment like acuncupture---even if research were to show it cured migraines---wouldn't be "high on their totem pole" of concerns.

Yet CAM supporters trumpet the simple fact that a presidential commission has recommended coverage as a major victory. It's a useful bragging point in their ongoing and increasingly successful efforts to entice private insurers to cover CAM. For instance, Aetna and Kaiser Permanente already cover some acupuncture and chiropractic procedures; Oxford Health Plans refers patients to a network of naturopaths, massage therapists, and yoga instructors; and Blue Cross Blue Shield's HMO Illinois allows clients to designate chiropractors as their primary care physicians.

Last year, consumers spent nearly $32 billion on CAM services and products, according to American Specialty Health Plans CEO and co-founder George DeVries, who also served on the White House commission. There's a hefty sum at stake in the battle over who picks up the tab in the future.

If your rates go up in the near future because your employer picks up a new insurance rider to cover chiropractic treatment for asthma or arthritis, you may have this White House commission to thank.

Read the companion article, Science Fiction

Christina Larson is the associate publisher of The Washington Monthly.


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