The juggernaut of managed health care with its alphabet soup of HMO's and PPO's has successfully steamrolled its way over the allopathic medical profession and now has set its sights on the alternative medical profession, especially acupuncturists and herbalists. In California, where this trend has made a strong start, more than four million subscribers have had acupuncture services added to their insurance policies. Is this trend good for alternative health care practitioners, or will they too become victims of the "mangled care" phenomenon which has left many allopathic physicians and their patients frustrated and dissatisfied with the quality of their health care. Here are some of the most commonly voiced arguments on both sides of the issue.

Pro's
Every day alternative health care practitioners turn away thousands of prospective patients because they cannot afford this form of medicine. These rejected patients include the not only the indigent, but also the elderly living on fixed incomes as well as middle-class patients who are already stretched thin by day-to-day expenses. For many, alternative health care offered on a fee-for-service basis is a luxury. And although many alternative health care practitioners offer their services at a modest fee when compared with the often exorbitant fees charged by allopathic physicians, these modest fees cannot compete with the average co-payment of $5-10 charged by a managed health care provider/participant. If alternative health care practitioners were to join a managed health care network, not only would they be competitive with their allopathic counterparts, but they could offer their services to many patients who cannot presently afford this form of treatment. Theoretically, this would result in a growth and proliferation of alternative medical practices, and the word about the effectiveness of these alternative forms of treatment would spread.

Con's
The chief complaint about managed care is that it is "medicine by bean counter." What this means is that alternative health care practitioners would no longer have the final say in what care should be delivered, or how it should be delivered. Instead that choice would be made by the accountants who monitor the bottom line of the managed health care company. The complaint that allopathic physicians most stridently voice is that they can no longer practice medicine the way they were trained. They have little time to spend with their patients, and their choice of treatment is severely limited. Instead of treatment, much of their time is spent in generating mounds of paperwork. And as for their patients, they complain that their doctor gives them little time, little interest, and little relief from their ailment. As Z'ev Rosenberg, L.Ac., a California practitioner, elegantly sums it up in a letter to the editor in the Spring 1998 issue of the Colorado Acupuncturist,

Medicine …begins with a person finding the resources to heal inside of oneself. Historically medicine works to empower the individual. Later developments in medicine gave the power to the physician, with the patient a passive recipent of treatment. Managed care takes the power from the physician into a corporate, market/profit oriented enterprise. The patient/practitioner exchange has become a merely mercantile one, as profit-motivated corporations make the clinical decisions.

This puts alternative health care practitioners on the horns of a dilemma. They cannot run from this juggernaut which currently has removed the "caring" from health care. But if they opt not to join a managed health care program, they risk being supplanted by allopathic physicians who will begin delivering (albeit poorly) many of the alternative health care specialties, including acupuncture, herbal, and homeopathic medicine. This will be because patients will continue to demand this alternative kind of care and the managed care corporations, ever market-driven, will have their provider-participants offer it. My suggestion is that alternative health care practitioners join with their allopathic colleagues to reform the health care system in this country to return the autonomy of care to the doctor and patient. If alternative health care practitioners and their patients don't act now to bring about needed reform, they will be smashed by the juggernaut of managed health care and this wonderful form of medicine will no longer be alternative, just ineffective.
Copyright 2003 Fred Jennes

Contact Information

Fred Jennes, L.Ac., Dipl.Ac. & C.H.
710 11th Avenue - Suite 106
Greeley, CO    80631
(970) 346-8152 ~ Voice
www.jademtn.net
E-mail us at fjennes@jademtn.net