ICA SUBMITS EXTENSIVE DOCUMENTATION ON CHIROPRACTIC TO WHITE HOUSE COMMISSION ON COMPLEMENTARY AND ALTERNATIVE "MEDICAL" POLICY
Responding to an invitation and request for input from the White House Commission on Complementary and Alternative Medical Policy (WHCCAMP) in January, 2001, the International Chiropractors Association (ICA) submitted an extensive paper on the science and practice of chiropractic in the United States to the White House Commission for consideration at their Washington, D.C. meeting of February 22-23, 2001. This paper outlined in detail the unique elements of chiropractic philosophy, science and practice and provided extensive documentation regarding chiropractic terminology and definitions, education, licensure, and practice standards. Special emphasis was placed on helping the Commissioners understand the separate and distinct, non-medical nature of chiropractic science and practice and the historic struggle experienced by the chiropractic profession to establish itself as a permanent element in the national health care system.
In a written statement to the Commission, Mr. Ronald M. Hendrickson, ICA's Executive Director and representative at the February 22-23rd meeting stated: "It is our hope that the chiropractic experience will help other non-medical approaches to health address the powerful inertia and inherent conservatism of the medical establishment and understand the anti-competitive history that establishment has displayed in seeking to keep chiropractic in the background. In the end, the public is entitled to federal policies that facilitate the exploration of alternatives."
The purpose of this White House Commission is to explore possible avenues of federal health policy, not to deal individually or collectively with the merits of alternative or complementary approaches to health and health care. To that end, the ICA offered a series of policy recommendations, based on the chiropractic experience, aimed at securing the public interest through fairness and balance, and maximum consumer choice in federal health policy.
In its paper on chiropractic, ICA told the Commissioners:
We believe that the contents of this paper address in a systematic and well-referenced manner the questions set forth by the Commission to guide the discussion on this important series of public policy issues. One important question, however, will be the subject of debate and discussion for the next century. That question, as posed by the Commission in its call for information, states:
What policy recommendations would you like to make to assure the quality of CAM (complementary and alternative medicine) practices and products whether they are provided by a practitioner or used as self care?
The International Chiropractors Association (ICA) would, on the basis of the experience of the chiropractic profession, offer the following points:
The research and exploration of alternative and complementary procedures, at appropriate objective standards, must be a priority for all emerging approaches to health care. The funding of such research should, however, be a high public policy priority. Traditional, entrenched interests have, in the case of chiropractic, argued against the inclusion of chiropractic care in public health programs because of insufficient research data. At the same time, for anti-competitive reasons, those same interests lobbied aggressively to prevent public funding for chiropractic research. Other sciences and health procedures should have the benefit of objective, timely and publicly funded research to explore their full potential and to identify their limitations.
Every consumer is entitled to full and honest information about any new health procedure. Clarity and accuracy in describing new technologies and health procedures is essential for the protection of the public and the honest evaluation of such procedures in the outcomes process. Public guidelines regarding disclosure and the making of health care effectiveness claims should be a high priority, especially in cases where practitioners of emerging procedures may not be certified or licensed in the civil regulatory process.
Public information agencies at the federal and state level should be mobilized to serve as responsible, objective information resources for consumers of health care choices. The utilization of the Internet and other public health information and outreach systems for purposes of informing citizens on new health research findings, choices and concerns would certainly be in the best interests of all parties, provider and consumer alike.
Standard trial and pilot study procedures should be developed to study and, if results are positive, integrate new technologies and procedures into federal health care programs such as Medicare, Medicaid, Federal Employee Health Benefits Programs, veterans care and other health care funding and delivery programs.
Guidelines for the incorporation of emerging health procedures and technologies into private health insurance should be developed on a national level.
These key points would help to provide a climate of objective and timely evaluation of health procedures to the maximum benefit of the consumer and those public and private systems of health care funding and administration that are and will continue to be under severe financial pressure to provide the highest quality care at the lowest possible price. The present system is heavily weighted towards hospital and institutional based, orthodox medical care, anchored in surgery and drug therapy, and increasingly radical, end-stage interventions. This system must be altered to remove the inertia and, too often, sheer prejudice and medical bias that has obstructed the exploration of alternatives. The ultimate issue is quality of life. In the decisions that consumers may make, the widest possible range of choices is the best guarantee of optimal care.
Throughout the two-day meeting, the importance of language was noted by speaker after speaker. Representatives from diverse organizations spoke about the need to understand that most "alternative and complementary" approaches to health care were, in fact, non-medical. They noted that they were convinced that the term "medical policy" in the name of the Commission, would circumscribe and define the discussion in a very limited direction, potentially undermining the effectiveness of the Commission. ICA expressed a similar concern over the use of the term "medical" as an umbrella term for all possible approaches to health care since it clearly refers to allopathic science. That term is not broad enough, and, in many cases such as chiropractic, was simply incorrect. The full text of ICA's paper is available on the Association's website at www.chiropractic.org.
The White House Commission on Complementary and Alternative Medicine Policy was established by Executive Order 13147 on March 7, 2000, to develop a set of legislative and administrative policy recommendations that will maximize the benefits of complementary and alternative medicine (CAM) practices and products for the general public. The Commission has been charged to submit a report to the President and Congress by March, 2002.
ICA has enjoyed an extensive and on-going dialogue with the Commission staff and will be submitting additional materials and policy advice as the Commission works to explore other specific dimensions and elements of alternative and complementary health policy.
