Ask Dr. Scott: Changing attitudes, better healthcare
Q: With all the health-care reform going on today, what specific local and national health-care changes do you suggest?
A: I believe that everyone now agrees that a major priority in the United States is to reduce health care costs, ensure quality health care, and to make it available to all who need it. Contributing to these efforts is chiropractic care, and it is included in the new federal healthcare plans.
Unfortunately, those of us in chiropractic often see circumstances in which chiropractic care is limited in third-party payer contracts, such as health maintenance organizations (HMO) and preferred provider insurance (PPI) contracts. An excellent example of how this wastes money and does not provide ideal health care is evidenced in a recent case I treated.
A 10-year-old boy, whose father is unemployed because of disability from a work-related accident, was injured while playing soccer and developed low back and neck pain. He was taken to the insurance company’s designated Personal Injury medical doctor, who initially treated him with muscle relaxants and pain medication. When that did not relieve the condition, the father asked to take the child to a chiropractor. The insurance company refused this type of care, and the child was referred to an orthopedic surgeon who examined and x-rayed him. When the back pain was unrelenting to continued medication, a CT scan and ultimately a bone scan were ordered; these examinations proved negative. Finally the child was referred to a neurologist who examined him and continued the same treatment. When there was still no response to treatment, a magnetic resonance image (MRI) was recommended. Before having that procedure done, the father again requested the primary doctor to recommend chiropractic care. She was in agreement with this; however, the insurance company would not pay for chiropractic care. Although he had to pay for my treatment out of his own pocket, the father chose to bring the child to me because continued medical care over a three-month period had produced no improvement. I examined the child and treated him on four occasions. After the first treatment he obtained relief from his unrelenting pain, and the condition was completely resolved in four treatments; the total cost was $239. It seems almost criminal that this unemployed man had to pay this himself when the insurance company paid $2,875.50 to the medical profession for examination and treatment that were ineffective. If the father had not intervened, there would have been another major medical bill for the MRI.
Few people realize the enormous costs for medical spine procedures (not including hospital cost): (Smith et al., 2013)
Lumbar fusion with hardware can cost as high as $169,000
Lumbar laminectomy: $82,614
Lumbar discectomy: $39,836
Cervical laminectomy: $60,304
Cervical fusion with hardware: $112,480
Lumbar MRI: $2,000
Epidural steroid injections: $2-3,000
(Add to this final cost the horrifying recent cases of the tainted steroid spinal injections, the news story first having broken as an outbreak of spinal meningitis in October and in late December (2012) as an infestation of black mold in patients given injections to alleviate spinal pain. With this modality routinely used as a medical option in the management of spinal pain, we faced at least 39 deaths and 555 cases of back infection and/or meningitis, excruciating pain and abscesses across a multiplicity of states. On top of this comes the report that, in one hospital, the use of amphotericin to treat such infections has led to kidney damage in several patients.)
There are “simpler methods” that are highly effective for back pain, namely chiropractic care as many studies have indicated. If it were not for the medical war to eliminate and defame chiropractic care, the utilization of this effective, time-proven method would certainly help to decrease the costs and usage of back surgery.
When only 6% of chiropractors have hospital privileges, it is obvious the integration of American medicine has not yet begun. If our public schools only had 6% black students, the government would send in the federal troops to force integration. But when public hospitals do the same, there is too much prejudice, too much power, and too much money at stake to desegregate hospitals and to give patients a freedom of choice in their own healthcare matters. The medical industrial complex still will not tolerate chiropractic competition.
Many studies have been done comparing the effectiveness and cost of chiropractic treatment for conditions such as this child had. (The National Institute for Clinical Excellence, 2009; The Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders, 2008; Guideline on Back Pain: American College of Physiciansm 2007; RAND Corporation Report, 1992) Research results have consistently shown chiropractic to be more effective in returning people to work more quickly and at a lower cost.
Considering the $200 billion dollars spent annually on spinal care alone (not to mention billions more for the many musculoskeletal pain-conditions that go with this problem), the potential savings to our economy might be enormous. (Guyer, 2008) Musculoskeletal pain is the single largest cause of disability in the United States today. (Null, 2010) Indeed, the substitution of chiropractic care for medical care in this epidemic of back pain is the most overlooked potential savings in healthcare reform today. (Rosner, 2012)
For this reason chiropractic is included in the national health care plan, is included in Medicare and many other insurance plans, and is the third-largest physician-level health profession in the world.
by Dr. Scott Cuthbert
Dr. Scott Cuthbert is the chief clinician at the Chiropractic Health Center in Pueblo, Colorado, as well as the author of two textbooks (released January 15th, 2013) and over 50 peer-reviewed research articles. PuebloChiropracticCenter.com.
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