Rebuilding Our Healthcare System: A Better Solution - Part II

Rebuilding Our Healthcare System: A Better Solution – Part II


Idaho is a state of great beauty that has huge natural resources and plenty of clean air and water (except during our fire season.) What we don’t have is a way to help 20% of Idaho’s citizens get access to adequate healthcare services and incentives to keep themselves healthy once they are well.

For those of you who don’t know how many people 20% works out to, it nearly 400,000 of our citizens. Many of these Idahoans are plagued with chronic diseases, and they are treated by allopathic doctors with allopathic drugs that address the symptoms they exhibit but do not address the root cause of their illness. Until we teach people how to get well and stay well, we will not be able to begin solving our healthcare problem.

One of the reasons we believe that the use of integrative medicine can turn a plague of untreated chronic illnesses to a plethora of healthy citizens is that alternative and complementary medicine practitioners have been taught to help their patients learn how to eat and exercise properly. Most regular MDs only get 19 hours of instruction in nutrition, which is why when you go to the doctor and complain about a problem it is seldom that you hear your doctor tell you that you need to change your diet.

The other problem is when they do tell you to change your diet, it is usually not very beneficial to the patient. After extensive study, we believe that nutrition is the basis of most metabolic related illnesses. In other words, “you are what you eat.” Many of these illnesses can be corrected by changing your lifestyle, not only with your diet but also with your pattern of exercise. We have for too long been expecting a pill to solve all of our problems. It is now time to grab the medical establishment by their stethoscopes and spin them around to find a real solution instead of just making the drug companies wealthy by popping pills.

What makes us crazy is that we have about 36,000 state employees with great health coverage but no real way to incentivize them to get well or stay healthy. Wouldn’t it be prudent to make sure they didn’t smoke, were not overweight, and didn’t drink excessively? Some people would say that is intrusive, but we think if you’re getting insurance on the taxpayers’ nickel, these are questions that should be asked and policies that should be enforced to keep healthcare costs down.

In other words, if you want to play you have to pay. The state pays hundreds of millions of dollars a year of taxpayer money to make sure that state employees have quality healthcare coverage. Why is it that no one seems to care about getting them healthy and keeping them that way? When you compare what is happening in the private healthcare market, 70% of corporations have instituted wellness programs to reduce their premium costs and reduce employees’ sick days. They are rewarded if they quit smoking or achieve weight goals with lower insurance premiums and are charged more for their health insurance if they do not achieve set goals. We need to change the system to encourage people to get healthy and stay healthy. The implementation of wellness programs will help fix part of the problem by inhibiting these chronic diseases from developing.

Corporations have found that chronic disease prevention is cost-effective because nearly half (47%) of Americans have at least one risk factor for heart disease or stroke and over half of the U.S. population have already been diagnosed with a chronic disease. Naturopathic strategies using individualized healthy lifestyle recommendations, nutrition, and dietary supplements resulted in reducing 10-year cardiovascular event risk by one-third. The benefit for moderate to high-level risk patients was even greater. Just look at the cost savings for Naturopathic treatment of patients at high cardiovascular risk, which showed a societal cost savings of $1,138 per participant and a reduction in employer costs of $1,187.[1]

In a survey comparing the frequency of doctor visits, patients of Naturopathic doctors had fewer conventional doctor visits (four fewer over a year) and lost 55 fewer hours at work over the year compared to an enhanced conventional care control group.

Study after study found major cost savings with the use of naturopathic care. An internal study by Blue Cross Blue Shield concluded that naturopathic physician-managed chronic disease programs lowered the costs of chronic and stress-related illness by up to 40% and lowered costs of specialist utilization by 30%.[2] In a University of Washington study, it was found that in Washington State, naturopathic care cost insurers $9 per enrollee versus $686 for those who received conventional care.[3] If given a choice, more people would choose complementary or alternative medicine then conventional medicine simply because it is less invasive and, in most cases, treatment does not involve prescription drugs.

The health care system in the U.S. is currently in crisis, but there is a workforce of nearly one million skilled and licensed complementary, alternative, and integrative health and medicine practitioners reducing costs and improving patient’s lives every day. These practitioners are leading the shift away from disease-focused care toward health-oriented care. By giving people access to these providers as an option for every patient through every health insurance product in every state—as was stipulated in Section 2706 of the Affordable Care Act—we will be able to attain both short and long-term positive impacts on both the health and the economy of the United States. http://www.ihpc.org/wp-content/uploads/section-2706-faq.pdf

It is critical that every patient have the ability to choose what type of health care they believe is the best for them, and this non-discrimination policy must be included in any new health care legislation if we ever intend to control healthcare costs and get better results from our providers.

One only has to take a look at the State of Washington where Complementary and Alternative Medicine (CAM) health care providers of every discipline have been a mandated part of the healthcare system for 20 years. The data shows that patients who see CAM providers have lower prescription drug costs, hospitalization costs, and total costs despite starting out in poorer health and incurring the additional cost of the CAM provider’s services. If CAM were not beneficial, why would people spend $33 billion each year out of pocket for its services?

Analysis of data from the four largest insurers in the state of Washington over the first decade of this law to include (CAM) as part of all insurers’ policies provides an excellent case study of what any state or the nation could expect if CAM practitioners were more broadly covered by insurance.[4] CAM users had lower average expenditures than nonusers ($3,797 versus $4,153 annually).[5] The largest difference was seen in the patients with the heaviest disease burdens; the sickest CAM users averaged $1,420 less annually than nonusers, a difference that is both statistically significant and highly meaningful to insurers. Patients who saw a naturopathic doctor, acupuncturist, and chiropractor or massage therapist through their insurance benefits had lower inpatient expenditures: $765 versus $1,178 for enrollees not working with CAM providers. Overall, lack of use of CAM providers cost insurers $355 more per enrollee per year or $3.2 million across the State.[6]

In 2011, the Haig Report showed that 90% of VHA facilities offer CAM services in some form.[7] This is a testament to its value while formal studies of the cost-effectiveness are currently going on. In 2002, the VHA considered chiropractic care a CAM modality but have since re-classified it as a mainstream practice.

Our health care system is currently geared to allopathic doctors, the over-prescription of drugs, unnecessary surgeries, and non-transparent costs for medical procedures. It is currently the norm for doctors to get 20 minutes or less to visit with each patient along with long wait times to see specialists. It’s time to change the system.

Be sure to watch for Part III of this article.

 


[1] A naturopathic approach to the prevention of cardiovascular disease: cost-effectiveness analysis of a pragmatic multi-worksite randomized clinical trial. J Occup Environ Med. 2014 Feb;56(2):171-6. doi: 10.1097/JOM.0000000000000066

[2] Phase I Final Report: Alternative Healthcare Project: King County Medical Blue Shield; 1995

[3] The effect of mandating complementary and alternative medicine services on insurance benefits in Washington State. J Altern Complement Med. 2004 Dec;10(6):1001-8.

[4] CNM Outcomes: A Systematic Review 1990-2008. Women’s Health Issues, 22(1), e73-381. Doi: 10.1016/j.whi.2011.06.005.

[5] Comparison of Health Care Expenditures Among Insured Users and Nonusers of Complementary and Alternative Medicine in Washington State: A Cost Minimization Analysis. JACM. Volume 16, Number 4, 2010, pp. 411–417.

[6] Insurance Coverage and Subsequent Utilization of Complementary and Alternative Medicine Providers. Journal of Managed Care. July 2006.

[7] Complementary and Alternative Medicine Survey. Healthcare Analysis & Information Group (HAIG), Department of Veterans Affairs; Veterans Health Administration. http://shfwire.com/files/pdfs/2011CAM_FinalReport.pdf

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