Subj: lifechiro V1 #19 Date: Wed, Jul 8, 1998 12:42 PM EDT From: lifechiro@list.lifewest.edu X-From: lifechiro@list.lifewest.edu (lifechiro) Reply-to: lifechiro@list.lifewest.edu To: lifechiro@list.lifewest.edu lifechiro Wed, 8 Jul 1998 Volume 1 : Number 19 In this issue: The Latest Stuff from Gerry- June 30. 1998 -Forwarded ---------------------------------------------------------------------- Date: Wed, 08 Jul 1998 09:42:50 -0700 From: George Muntean To: lifechiro@list.lifewest.edu Subject: The Latest Stuff from Gerry- June 30. 1998 -Forwarded Message-ID: Date: Tue, 07 Jul 1998 16:34:50 -0700 From: Tanisha Key To: GMUNTEAN@lifewest.edu Subject: The Latest Stuff from Gerry- June 30. 1998 Mime-Version: 1.0 Content-Type: text/plain Content-Disposition: inline * *Welcome to Summer 1998! It's official. Summer has arrived! For the West Coast, it is more or less on paper. Across the country, it has arrived with a variety of faces and personalities. We hope that none of the adverse weather or the fires have affected any of you too badly. My big decision for the season was to get this issue of TLS to you on July 1 or to enjoy the lead up to the 4th. You lost!! To make up for being a week late with this issue, we have some great information for you! *Notice TLS has been declared, by me, to be a Viagra-free-zone. No references, information, articles or jokes pertaining thereto will be presented as of this date. *9th Circuit Court of Appeals Rules in Favor of Washington State "Every Category of Provider Law" On June 18, 1998, the 9th Circuit Court of Appeals ruled 3-0 to reinstate the Every Category of Provider legislation that went into effect on January 1, 1996. The measure had been put in limbo based on a decision of the Distrct Court of Western Washington. The 9th Circuit decision was lauded by Washington State Insurance Commissioner, Deborah Senn, who commented, "This is a victory for consumers and for consumer choice in health care." The Washington State Chiropractic Association, in a release on June 19 expressed their enthusiasm for the decision by noting, "We are pleased to announce the complete and total victory for patient choice and access." According to the WSCA and their president, Dr. Joyce Middendorf of Port Orchard, "The Every Category of Provider Law requires that all health insurance carriers provide access to every category of health care provider. If the condition is covered by the plan, and treating the condition is within the scope of practice for the category of licensed health care provider, then that category of provider must be included in the plan." Commissioner Senn expressed the impact of the law to be "basically that Washington's health carriers have to provide consumers access to all kinds of health care providers licensed or certified by the state." The big dog of carriers in Washington, Group Health commented, "We were against it being rolled out as a mandate, but we put compliance measures in place. We had heard loud and clear that people do want access." Following the law being struck down by U.S. District Judge, Franklin Burgess, the supporters of the concept undertook to pass a ballot measure in the general election last fall. The initiative backers, lead by Dr. David Butters of Seattle, were unsuccessful in passing the measure, but they were successful in keeping the spirit of the Every Category law before the public. In addition a serious and committed coalition of consumers and providers was put together by Butters and colleagues in Washington. The ability to be a force in future legislation and regulatory battles is unquestioned. Congratulations to everyone involved. *West Virginia Limits Who May Provide Spinal Manipulation The West Virginia measure to limit who may perform spinal manipulation was passed by the legislature last March. The essential language of the bill reads "No person may perform or authorize a spinal manipulation without having received a minimum of 400 hours of classroom instruction in spinal manipulation and 800 hours of supervised clinical training at a facility where spinal manipulation is a primary method of treatment." The measure also contained language relating to the ability of the DC to serve as an expert witness, the protection that a chiropractic IME may only be provided by a DC and authority to utilize diagnostic procedures taught in chiropractic college. *The Managed Care Experiment Approaches New Phase In an ominous announcement on June 16, 1998, Watson Wyatt Worldwide, a major multinational consulting firm, warned, "We simply can't discount the cost anymore. We simply can't get people out of the hospital any faster unless we put them on roller skates," remarked Randall Abbott of Watson Wyatt. Those sentiments were supported by other WW conclusions that included, "The managed care revolution has ensured that healthcare costs have barely budged for several years, but analysts say that consumers should get ready for that to change in 1999." "One of two things is going to happen--employees are going to have to pay more or their benefits are going to have to change." Increases predicted by WW include 12-15% for traditional indemnity plans, 7-11% for point-of-service plans and 5-7% for HMO plans. The WW crystal ball gazers have come up with an odd conclusion as to what is driving the increases...not that the system is untenable, not that the public doesn't want it, rather that the population is aging, demanding more health care, more technology and, as a result, generating more cost. For people who make their living at watching the horizon, this seems to be a little bit of a late call of a very obvious reality. *Women's Health Advocate's "Report on Alternative Medicine" The above publication offers a discussion about chiropractic care for the female health care consumer. Aside from the traditional background on DD and done-by-hand, etc., there are a number of notable quotes. "When should you consider going to see a chiropractor? Here's what one chiropractor says, 'If all you want is pain relief, quite frankly Darvon works faster than anything I can do' says Gerard Clum, D.C. who serves on the board of directors of the International Chiropractors Association and is president of Life Chiropractic College West in San Lorenzo, CA." "But you can take Darvon until the end of time and it's not going to correct a structural fault in the spine or skeleton. If you really want to eliminate the problem and reduce the likelihood of returning, then chiropractic can help. The patients I encounter are concerned about the negative effects of drugs. They want a more natural approach to their health care." The article also quoted Jerry McAndrews, D.C. speaking on behalf of the ACA. He related his experience with patients with low back problems. They gave me the final quote in the deal "For my nickel, the literature indicates that a chiropractor should be where you begin the treatment of spinal problems." For the record, I said "care," not treatment!! *The Landmark Report We featured the report of Landmark Healthcare, Inc. "Report on Public Perceptions of Alternative care in TLS on February 15, 1998. After reviewing the full report, there are a few gems with relating once again. Consider: "Chiropractic is also one of the most used types of alternative care. A total of 16% (nearly one out of six adults) and a similar proportion of household members (15%) have had chiropractic care or treatment in the past year." "About one out of every five adults who are 55-64 years of age have had chiropractic. Furthermore, about one out of every four adults with an annual income of $61,000-$80,000 uses chiropractic." "Similarly, virtually everyone treated by a chiropractor is satisfied with their care: three-fourths (73%) are "very satisfied" and 23% are "somewhat satisfied". *Occupational Outlook Handbook, 1998-1999 Hot off the press from an agent of the gubment of the United States of Uhmerica comes the latest version of the Occupational Outlooks Handbook. This publication is available from the U.S. Government Printing Office (they don't go by the colloquial "gubment"), Superintendent of Documents, Mail Stop SSOP, Washington, D.C. ISBN 0-16-049357-9. "Chiropractors...Significant points...Employment of chiropractors is expected to increase rapidly and job prospects should be good. Chiropractic treatment of back, neck, extremities, and other joint damage has become more accepted as a result of recent research and changing attitudes. In chiropractic, as in other types of independent practice, earnings are relatively low in the beginning, and increase as the practice grows." *"How the medical industry traps you" The above is not the view of some wide-eyed chiropractor or a disgruntled patient. It is the title of a recent article in The Gazette of Cedar Rapids, Iowa (June 23, 1998, page 6A) written by the former Associated Director of University of Iowa Hospitals and Clinics, Donald Van Hulzen. With respect to medical expenditures, Mr. Van Hulzen wrote, "They are far too large, getting more so every year, and they fall far short of helping us reach desirable public health goals. Large expenditures are made with almost no hope of real benefit while working poor families suffer from lack of basic services." *Pharmacogenomics The dawn of a new discipline and another word your spell checker won't recognize! Reported by the Associated Press under the byline of Lauran Neergaard is an article dealing with a new approach to pharmacology and appropriate selection--even from a medics point of view! "Medicines are sold based on studies in which they prove an effect on the average disease sufferer, not every individual. So there's little way to tell who is wasting time and money on treatment that will fail or to predict who's at risk for side effects." The AP quoted the chief science officer for SmithKline Beecham, in reference to the application of pharmaceuticals, to say "It's a crapshoot." The objective is pharmacogenomics is to develop simple tests to tell before a patient takes a drug if it will help them or harm them. Tests have been developed to detect certain patients with Alzhemier's who demonstrate a certain gene subtype who will not benefit from certain drugs. A similar development is expected for women who take birth control pills and demonstrate a genetic variant relative to blood clotting. These women are particularly prone to birth control related clots and their impact. Don't expect these developments to be heralded by drug manufacturers. Every such finding cuts the market for a given drug and, therefore, profits thereto related. On the other hand, they are going against mom and apple pie to argue against the developments. *Healthcare Decisions Based on Data The June 17 edition of the Fort Lauderdale Sun Sentinnel brought us an interesting article about the science behind certain health care decisions. This one focused on Caesarean sections in Florida and, in particular, South Florida. The feds have a goal to have a national C-section rate of about 15%. Florida has made some progress over recent times, dropping their rate from 28% to 22.7%. But in recent years, the data indicate that the trend has stagnated. In certain areas of Florida, the rates of C-section exceeds 41%! The reason offered for the significant difference, even compared to Florida as a whole is the time available for natural deliveries. The assertion was made that the South Florida delivery rooms are so busy, they just can't handle Mother Nature's time table. The Sun Sentinnel reported some other components of the out-of-whack numbers, these included: obstetrician habits, patient preferences, busy delivery rooms and financial incentives for docs and hospitals. Bottomline, if you want a natural childbirth, you better get out of the Southern Florida and head to the Redneck Riviera in the panhandle! *Up To 600,000 Unnecessary Coronary By-Pass Surgeries Perfomed Annually in the U.S. Reuters reported, on June 18, on a recent New England Journal of Medicine article that found "More than a quarter of the Americans who have heart attacks each year are subjected to expensive, risky and ultimately unnecessary procedures to reopen their clogged arteries." "They said that based on the new findings, about 400,000-600,000 Americans each year could easily avoid coronary angiography....The procedure costs $20,000 to $25,000 per patient." Reuters went on to add a comment from unidentified expert who stated, "heart surgery was a big industry and it was unlikely that hospitals would want to switch to cheaper, less invasive methods--even if they worked better." Read that again-even if they worked better. And you wonder why chiropractic care has problems making in roads when we know it to be less invasive, more efficient and works better at less cost, we simply don't understand the deal!! Lest you think this is revolutionary information that just hasn't gotten out yet, this is the fourth study of its kind with the same result. In certain types of heart attacks, "aggressive treatment does not save lives and may, in fact, carry greater risks." *Insurers Warming Up to Alternative Care From the Miami Herald comes a story dated June 15 reflecting on the change in attitude among the nation's insurers toward alternative care. The Herald reported on input from Coopers and Lybrand that indicated "about 50 health maintenance organizations now cover alternative services, up from 20 four years ago." California appears to be leading the change of thinking on the part of the HMOs: "About 23 California HMOs, including Prudential and United Healthcare, have purchased alternative care coverage at a cost ranging from $2.50 to $9.00 per member per month, depending on the company's size and the type of coverage." *Osteopaths Meet in Chicago The American Osteopathic Association House of Delegates will be meeting in Chicago later in the month. That doesn't seem to be earth-shattering news, but what they plan to discuss might be of more than passing interest on the part of Joe or Mary Chiropractor. The DO crowd plans to debate a ban on all alcohol and tobacco advertising, a subject our national associations have been too slow and too silent upon. In addition, in their June 26 press release, the AOA indicated they will be considering "Medical decisions being made only by those with a valid medical license." Hmmm, do your antenna go up with such language? I am not interested in practicing medicine, but I would bet that their concept is that health care equals medical care; therefore, any health care decision belongs with someone holding a "medical license." The descendants of Andrew Taylor Still are also interested in licensing telemedicine throughout the country and to "advocate narrowly drafted Medicare Evaluation and Management (E and M) guidelines for physicians regarding health care fraud..." Just something else to pay attention to!!! *Humana Sued Under Racketeering Laws In 1989, Humana Incorporated was sued in Nevada under the Racketeer Influenced and Corrupt Organizations Act. The basis of the suit was that consumers had entered a contract to pay 20 percent of the cost of services under certain insurance contracts. Humana then entered secret negotiations with providers and hospitals for reduced fees, but the reduction was applied 100% to the Humana expense and was not conveyed to the consumers. Consider the following scenario, a procedure is billed to a consumer by a hospital for $1,000, the consumer pays 20% or $200, but Humana had negotiated to pay $500 for the procedure. The consumer paid $200 so Humana was left to pay $300 or 30% rather than 80%. A federal judge ruled the action could not be brought under RICO. The 9th Circuit Court of Appeals overturned that decision and said yes it could be brought under RICO. Humana subsequently sought to have the U.S. Supreme Court decide the matter. They agreed to do so. The case is known as Humana, Inc v. Forsyth 97-303. *You Thought You've Heard It All? A 38 year-old physical therapist has filed suit in Florida alleging personal injury of the whiplash nature. Not too out of the ordinary you say. Consider the nature of the "moving vehicle" involved. Seems the PT was about to be married and was enticed to participate in that time-honored tradition of the Bachelor Party at an establishment known as the Diamond Dolls Club. According to the traumatized therapist, a person known as Miss Tawny Peaks did with malicious intent and forethought "jump up and slammed her breasts into my head and just about knocked me out." The PT compared the brazen attack as follows: "It was like two cement blocks hit me." Ms. Peaks was not quoted in the article, but she was described by the Media News Group and the Alameda Newspaper Group as having "prodigious breasts" estimated by the authorities to measure 60HH. The suit is seeking $15,000 in damages. When asked about his bride-to-be's view of the matter the victim related, "My wife understood completely, she has a good sense of humor, thank goodness." *Last Chance...