Frustrated With Health Care

You know, I really don’t like to beat a dead horse, but I do think that something else needs to be said about the direction our “health care” system is going.  I don’t know, maybe it’s because I’m a chiropractor and I am concerned about how chiropractic services are going to fit into the whole health care picture.  Or, maybe it’s because I see health care continuing along the path of an ever increasing dependence on drugs to cure all our woos. 

It would seem that the push now-a-days is for national health care and what they call “preventative care”; you know, early detection through expensive testing procedures and early intervention through expensive drug regiments.  As previously mentioned, this is sick care and it is LESS cost effective.  Where in this plan is true health care?  Where in this plan do you see chiropractic care fitting in?  As many chiropractors will tell you, it does not!

Back in 1998 chiropractors may have won the battle with the AMA to cease and desist their anti-trust practices, but it would seem that the AMA is getting the final word.  Think about it, what three organizations run the health care industry?  I think you might agree that it is the AMA, the pharmaceutical companies and the health insurance industry.  So, let me ask this, do any of these organizations even consider health care from a wellness point of view?  From a chiropractic point of view?  Not on your life!  It is just not in their best interest!

Medical costs continue to sky rocketed and chiropractic services have been prevented from keeping pace.  Why?  Simple, the allowable fees are also set by the health insurance companies and they do not value chiropractic services.  The result is that with higher overall health care costs the health insurance industry has raised their co-pays, obviously to save money by precluding them from having to deal with what they consider to be nuisance claims; aka, chiropractic services.  One obvious solution is for chiropractors to fight for higher fees, but you know that along with that we would also have to compromise by accepting a cap on care.  OK, great you say, we’ll take $75-$100 per visit with a 12 visit cap.  Then we all know that 12 visits isn’t enough so we’ll just convince our patients to continue care at a cash fee that is much less, right?  Depending on your area getting the full fee might be an unrealistic expectation.  Aaahhhhh, but is it legal to charge less than the established fee schedule?  To answer that let’s take a look at our current model of “national health care”, Medicare.

As a chiropractor in the Medicare system we have three codes that are covered; 98940, 98941, 98942; all chiropractic manipulation codes.  These codes are only covered when there is an active treatment plan with an end result in mind; on going preventative, maintenance care is a non-covered service.  All services, covered or not, are supposed to be properly documented and properly billed.  This means that for all care, covered or not, a claim form must be submitted to Medicare; a special modifier is used to tell Medicare when care is active when it is not.  In either case, your patient is supposed to pay their share, which means that for covered services they pay their co-pay and for non-covered services they are supposed to pay the full fee.  Anything less and you run the risk of having to answer questions of the National Government Services.  It would seem to me that these same rules would apply to any new government plan that comes down the pike.

Now the questions one might have is, why do we need to submit a claim to Medicare for non-covered services?  That’s a good question, but I might speculate that it is because “they” want to keep on eye on us to make sure we are not taking advantage of Medicare patients by convincing them that they require more care than they actually “need”.

The questions abound: Who’s rules are we playing by?  Who says that a patient can’t make their own decisions regarding their need for care?  Since care that is not active is considered a non-covered expense, then why are we bound to the established fee schedule?  Whose to say that we couldn’t give it away for free, and if we did would they still be concerned?

Today while listening to a popular talk show host I was inspired to discuss their comments on my blog, but I wasn’t sure which blog would be most appropriate, this one or my other one, www.HurryUpAndSlowDown.com, which is devoted to the Chiropractic Lifestyle.  I decided to post it on both.

While listening to him speak today his comments were much like those of a chiropractor.  He was saying that our government’s plan to cut costs by pushing preventative health care are misguided efforts that will not save money.  He went on to say that real preventative care is getting regular exercise and watching what you eat.  The government’s thrust and the focus of the medical profession is not prevention care, but rather it is based upon early detection and intervention.  Their goal is to get people into their system of taking drugs as early as possible.  On the contrary, their cost-saving efforts will significantly increase cost simply because of all the expensive tests and early intervention drugs they will dispense.  I wanted so much to call the station just to give him a big thumbs up.  Unfortunately, I did not have the time to hang on the phone; so I did the next best thing, I sent him an email.  Here is what I sent him.

Holy cow!  When I tuned in today you were talking about how preventative care, as the government sees it, is all wrong; that it is NOT about prevention, but rather early detection and treatment.  This is called “sick care”, NOT health care, and this model of care will never save money!  As you so eloquently put it, preventative care is about exercise, and a good diet, which definitely cuts cost.  This is the exact message I have been preaching for the past 20 years.  In fact, when you combine it with a periodic tune-up of your spine and nervous system with a chiropractic adjustment, this is what we call a chiropractic lifestyle.  And, now that the government has gotten themselves involved they are further spending excess money by supporting medicine and big pharmas message that all you need are drugs, a whole bunch of expensive tests, and perhaps a little surgery.  Nothing could be further from the truth.  This is NOT health care and people ARE better off staying as far away from them as possible.  By doing this they will not be required to poison their bodies with expensive drugs, AND they will save lots and lots of money.

Here’s some sick stats: 

            80-90% of all disease is related to lifestyle stress.

            Years ago when the doctors went on strike in Canada, the death rate went down!

            The medical profession kills nearly 100,000 people each year; that’s like 500 fully loaded jumbo jets crashing every year!

A great prescription for preventative care: 

• Take responsibility for your health
• Watch your diet, and most people knows what that means; see item 1.
• Get moving. Exercise is NOT a 4-letter word!
• Get appropriate rest.
• Stop your stinkin’ thinkin’. A negative attitude will kill you and all those you touch
• Get your spine and nervous system checked by a chiropractor.

Think about it; taking responsibility for your health = fewer symptoms = fewer visits to the MD = fewer expensive medical tests = less need to take expensive drugs = a more efficient, cost-effective, productive member of society.

 THIS is the chiropractic lifestyle; THIS is true Health Care!