Washington, D.C. -- On Saturday, October 16, 1993, representatives of the National Chiropractic Health Care Advisory Committee (NCHCAC) met with President Clinton's health care reform czar Ira Magaziner to discuss changes in the health care reform package that would further protect the rights of patients to seek and receive chiropractic care.
The meeting was originally planned to have participation from the full membership of the NCHCAC. Unfortunately, inclement weather forced the closure of Washington National Airport, stranding committee members in Detroit, Atlanta, Newark, and New York.
Realizing that the administration is in the final days of preparation of the Health Care Security Act of 1993, it became critical that the concerns of the profession and our patients be expressed to the highest level members of the administration. Led by Mrs. Penny Heard, widow of the late Dr. Stan Heard, the committee was able to address the issue of nondiscriminatory language in the drafts previously available, and to offer language to assure the public's freedom of choice in their health care decisions.
The area of the president's plan that has presented the greatest concern is this statement: "The benefit package does not require a health plan to reimburse any particular provider, type or category of provider." The statement leaves the issue of chiropractic inclusion in the basic benefit package at the complete and total discretion of any given health plan.
The NCHCAC committee sought to have this offending sentence struck from the document. Being unable to accomplish this goal, the committee requested that language be put forward to address the fears that have been expressed by chiropractic patients around the country. The recommended statement as proposed reads as follows: "If such professional services are provided by more than one licensed health care provider, then each health plan shall provide freedom of choice to access these professionals."
This proposed clause was discussed with Mr. Magaziner and forwarded for consideration to the legislative staff.
The effect of the additional language is to assure that accountable health plans under the president's system will provide patients with the opportunity to seek covered services from the provider of their choice. The committee sought the inclusion of this language as a means of aligning the functional aspects of the basic benefits' package with the ethical foundation upon which the president based his plan.
The committee was also able to provide Mr. Magaziner with a copy of a recent report funded by the Ontario Ministry of Health in Canada. The project, published as The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain, was conducted under the direction of University of Ottawa professor of health economics Dr. Pran Manga (please see "Manga Report from Canada Extols Benefits of Chiropractic" in the Oct. 8 issue).
The conclusions of the Manga report are of tremendous significance to the Clinton staff as the Ottawa economists determined that the shift of the management of low back pain from the medical community to the chiropractic community would result in the savings of billions of dollars annually in Canada. When the same cost model is extrapolated to the United States, the potential savings in health care are multiplied 10-20 times.
It was the feeling of the committee participants that Mr. Magaziner appreciated the role that chiropractic could play in contributing to the success of the president's reform.
The profession owes a debt of thanks to Mrs. Penny Heard for continuing the lobbying that her husband Stan initiated earlier in the year. While these efforts cost Stan his life, Penny has not turned her back on the issue but rather has made it her goal to see Stan's wishes implemented through her efforts and the committee's.
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