With Liberty and Necessary Chiropractic for All

The APHA & National Health Care Reform

By Jonathan Todd Egan, DC, MPH, PhD (cand.)

The health care system in the United States is not well. Thousands die every year solely because they lack insurance. Others are underinsured or cannot afford to use the insurance they have. Most bankruptcies in the United States involve health care challenges, and most of those people had health insurance when their health care challenges began. Overall, more than 40 million people are uninsured in this country, even after spending much more per capita on health care than other nations that provide health care for all and often have better health outcomes.

In this broken health care system, expensive and insufficiently evidenced therapies and interventions are used for some patients, while other individuals suffer for lack of preventive or mitigating measures. Overutilization and overmedication are problems, as are access to primary care and misuse of emergency room services (two sides of the very big coin). It's no wonder that most people agree health care reform is sorely needed.

Many chiropractors are concerned about impending changes to the health care system, and wonder how patient access to chiropractic care or reimbursement for services will be affected. Headlines such as "Health Care Reform Is Here," "A Strategy for Health Care Reform," and "Some Things Never Change: Will Health Care Reform Fare Any Better This Time Around?" have appeared recently in this very publication and testify to that concern. Wouldn't it be nice to know that one of the most powerful lobbying organizations on Capitol Hill was advocating for chiropractors? Wouldn't it be even more fascinating to learn that the lobbying organization wasn't a chiropractic organization at all, but was an interdisciplinary organization made up of health care providers from backgrounds as divergent as medicine, statistics, epidemiology and education?

Well, the American Public Health Association (APHA) is just such an organization. The APHA is advocating on behalf of chiropractic access for all Americans under the major health care reforms they advocate. The APHA is the world's oldest and largest association of its kind, is wonderfully interdisciplinary, and officially endorses health care for all and seeks necessary chiropractic care for all.

Necessary chiropractic care for all! Have you ever had a patient who required necessary treatment, but could not afford it? Have you ever had a patient who needed an MRI or other examination but did not have the means? Have you ever had a patient in pain who did not seek an appropriate remedy you could offer because of financial hurdles too great for them to overcome? The APHA has indicated that it supports health care for all, including chiropractic care for all.

In fact, one of the major health care proposals backed by the APHA is H.R. 676, the U.S. National Health Insurance Act, which as of August has 78 co-sponsors in the House of Representatives. This bill is also officially endorsed by the American Medical Student Association, the American Medical Women's Association, the National Medical Association, the American Nurses Association, the National Association of Social Workers, faith organizations such as the General Board on Global Ministries of the United Methodist Church, and civic organizations such as the U.S. Conference of Mayors.

H.R. 676 is based on a proposal published in the Journal of the American Medical Association (JAMA) that supported payment for chiropractors as part of health care access for all. Let me repeat that: An article published in JAMA advocated for payment for necessary chiropractic services for all Americans! This proposal was the basis for similar statements included in H.R. 676.

The exact wording in the proposed bill states: "The program shall pay physicians, dentists, doctors of osteopathy, pharmacists, psychologists, chiropractors, doctors of optometry, nurse practitioners, nurse midwives, physicians' assistants, and other advanced clinicians" and "In GENERAL -- The health care benefits under this Act cover all medically necessary services, including at least the following," with chiropractic on the list along with medical care, mental health, dental care, vision care, podiatry, and hearing care.

The APHA and a host of other well-regarded organizations support H.R. 676, which would cover necessary chiropractic services for all Americans. The APHA is putting its credibility on the line on behalf of the health of all Americans and in support of chiropractic care. If you would like to join us in support, consider joining the Chiropractic Health Care section of the APHA. We look forward to having you with us. To join, visit www.apha.org and click on "Membership" and then "Join." Remember to select "Chiropractic Health Care" as your primary section affiliation.

Clearly, health care reform is coming. Come help shape it! See the value of mainstream public health participation as an investment in the future of your community, an investment in your patients, and an investment in the health of your nation. Join the APHA and help shape the future of health care in the U.S., with liberty and necessary chiropractic care for all.

Dr. Jonathon Egan is a graduate of New York Chiropractic College and current chief of staff of the NYCC Campus Health Center. Formerly a clinician at the VA facility in Rochester, N.Y., he now chairs the Seneca County Board of Health.

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