Complementary and Preventive Medicine: Healthcare & American Public Policy, Part 5

Part 1: Economics
Part 2: Campaign Finance & Elections
Part 3: Education
Part 4: Food

On March 23, 2010, you may have seen many Facebook profiles switch over to the picture on the right. This is a picture of President Obama signing the Patient Protection and Affordable Care Act into law. Most of the people of these Facebook profiles who displayed this picture would be supporters of the movement to improve healthcare in the United States. In fact, the bill that President Obama signed into law was intended to do just that.

Truth be told, I haven’t read the entire bill, but neither did some members of Congress. While you can never ‘absolutely’ trust Wikipedia, it is still good for gaining an overview. In skimming over the Wikipedia article for this bill, we learn a number of things that this bill has done that could be perceived as steps in the right direction for American Healthcare:

• Medicaid eligibility is expanded to include all individuals and families with incomes up to 133% of the poverty level.
• Improved benefits for Medicare prescription drug coverage are to be implemented.
• Changes are enacted which allow a restructuring of Medicare reimbursement from “fee-for-service” to “bundled payments.”
• Low income persons and families above the Medicaid level and up to 400% of the poverty level will receive subsidies on a sliding scale if they choose to purchase insurance via an exchange (persons at 150% of the poverty level would be subsidized such that their premium cost would be of 2% of income or $50 a month for a family of 4).
• Additional support is provided for medical research and the National Institutes of Health.
• The law will introduce minimum standards for health insurance policies and remove all annual and lifetime coverage caps.
• The law mandates that some health care insurance benefits will be “essential” coverage for which there will be no co-pays.

These are only some of the things that the bill changes with regard to healthcare law, not to say that this isn’t already a huge number of changes all by themselves. Michael Moore did a documentary on healthcare in the United States a few years back. The movie was called Sicko. While some of the things that Moore is lambasting have changed as a result of this legislation, I’m pretty sure that this bill doesn’t address all of the concerns that Moore raised in his movie.

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The one thing I would have liked to have seen more of in the bill that President Obama signed into law over a year ago, is more Complementary and Alternative Medicine (CAM). Being a certified practitioner in what could be classified as CAM, I’ve seen the benefits of this important part of healthcare. And the modality that I am trained in is not nearly as much of a household name as say, chiropractic, homeopathy, or Traditional Chinese Medicine (which includes Acupuncture). In 2002, 36% of adults said that they had used some form of CAM in the last 12 months. In 2007, that number rose to 38.3%.  That’s nearly 4 in 10 Americans who use CAM. [All of these statistics are from the National Center for Complimentary and Alternative Medicine, which is one of the many centers that make up the National Institute of Health (a government agency).]

For comparison’s sake, in 2006, 54% of Canadians reported having used CAM within the last 12 months, which was up 4% (from 50%) in 1997 (statistics from the Fraser Institute). In looking closer at the profiles of Canada’s health and America’s health as rated by the World Health Organization (WHO), I wasn’t completely surprised to find differences. There was one major statistic that stood out to me: obesity. Some argue as to whether or not obesity is a disease or a lifestyle, but as it stands, Medicare calls obesity a disease. In the WHO health profiles of Canada and the US, Canada’s obesity percentage is significantly lower than the US. The percentage of adults 20+ years of age, in 2008, that were classified as obese by the WHO: 24. 6% (male) and 23.9% (female). Holding all variables the same (20+, 2008), but for Americans: 30.2% (male) and 33.2% (female). I’m not necessarily trying to say that Canadians are healthier because they are more likely to use CAM, but the correlation does seem to be there. Of course, to truly measure this, we’d need to do a study of health measures (before and after) of CAM users (and non-CAM users).

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I’ve given you some statistics about CAM, but haven’t yet explained it completely:

NCCAM defines CAM as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. Conventional medicine (also called Western or allopathic medicine) is medicine as practiced by holders of M.D. (medical doctor) and D.O. (doctor of osteopathic medicine;) degrees and by allied health professionals, such as physical therapists, psychologists, and registered nurses. The boundaries between CAM and conventional medicine are not absolute, and specific CAM practices may, over time, become widely accepted.

There’s one other bit of information that I want to cite from a report on a study conducted in 2007:

This report demonstrates that there is significant underuse of effective preventive care in the United States, resulting in lost lives, unnecessary poor health, and inefficient use of health care dollars. All of the services examined in this report are extremely cost effective: they all provide an excellent return on investment. It is a national imperative to make these and other cost-effective preventive services affordable and accessible for all Americans. [emphasis added]

Much has been written in the past few months about America’s “debt crisis.” As of 2008, the healthcare costs in the US significantly exceed those of other countries relative to their Gross Domestic Product (GDP) [the healthcare costs in the US are nearly 16% of the total GDP, which is nearly 5% more than the “second place” country, Switzerland. For comparison’s sake, Canada is at 10%.] It takes a bit of foresight, but as the study above describes, it is imperative that the US (and other countries) significantly incorporate the effective use of preventive care into healthcare. Moreover, I think the diligent use of CAM (in conjunction with conventional medicine), paired with the idea of preventive care would dramatically reduce healthcare costs (for the government) and for its citizens.