It’s Summertime, and Healthcare Reform is Not Easy

By Elisa Behnk, AAAOM VP of Communications

Where is AOM in the current round of healthcare reform proposals? What can you do to support AOM now at a critical juncture in healthcare legislation?

President Obama’s pledge to pass healthcare reform legislation this year has lawmakers center-stage on Capitol Hill this summer working furiously to chart a new course for healthcare in America.

While the healthcare reform hearings that commenced just after the President assumed office in January focused on integrated approaches including acupuncture and Oriental medicine (AOM) as key to improving wellness and reducing healthcare costs, the focus is now decidedly on health care economics, primarily government-sponsored insurance plans, and electronic medical records. “Prevention” has become an obligatory closing salvo for any plan, although AOM is nowhere to be found in recent formal discussions. Among the reams of legislative proposals and hours of Congressional hearings and media coverage, a three-minute exchange between President Obama and an inquisitive citizen is the only spotlight AOM has enjoyed in the past month of vigorous national healthcare reform debate.

Across the board, lawmakers are saying that this is a singular moment in history for the health of Americans. Is AOM still on the Congressional radar and a part of the healthcare reform discussion? Since February AAAOM’s lobbyist Sam Brunelli has been representing our interests on Capitol Hill, and we are eager to hear about his progress on our behalf.

In the meantime, we each have a role to play. Have you written to your member of Congress to let him/her know about the value and benefits of AOM? If you are in the clinic phase of your education, have you encouraged your patients to voice their support for increased access to acupuncture through the Federal Acupuncture Coverage Act? Are you actively supporting the lobbying efforts of your professional association by contributing to the Political Action Fund? If you do not act now to support broader access to AOM, you cannot reasonably expect healthcare reform to include AOM.

The Key Players
President Obama has pledged to build a new health system this year with increased benefits (estimated at $1trillion) and a government-sponsored insurance plan that enables consumers to retain their choice of practitioner. The President has proposed paying for his plan by limiting tax deductions for individuals in the top tax brackets, though it is not yet clear how he plans to lower the overall cost of healthcare, currently running $2.3 trillion or more than $7,400 per person per year.

Meanwhile, a group of more than a hundred moderate House Democrats have formed a coalition in Congress aimed at limiting the size and scope of the President’s proposed government-sponsored health insurance program. Their measure seeks to curb a large public entity from undermining the private insurance market.

The medical establishment, under the banner of the American Medical Association (AMA), is opposed to the public health insurance system at the center of the President’s health reform plan. The AMA, with over a quarter-million members, argues that a government-funded system would put private insurers out of business, impacting patients by drastically restricting their choice of health care providers. Fearful of a government-run plan that would underpay for medical services, the AMA maintains its support for the private health insurance system. And, not surprisingly, the insurance industry under the rubric of America's Health Insurance Plans espouses the importance of private health plans.

The public-versus-private insurance debate puts President Obama neatly on the horns of a dilemma: The public adamantly wants movement on health reform, but most Americans don’t believe that government could effectively manage the provision of healthcare services.

While lobbying for government to stay out of the public’s healthcare choices, the GOP has historically partnered with the AMA on permanent legislation against reductions in Medicare reimbursements to physicians. This makes for a strong bond between Republicans lawmakers and the AMA, yet passing such legislation in this Congress would require support from the Democratic majority, thus setting the stage for some deft politicking.

For their part, the American Hospital Association (AHA) voices a commitment to lowering medical costs by reducing complications and improving safety to prevent infections and surgical mishaps. They admonish doctors to save money by using electronic medical records and look to the insurance companies to reinvent the arcane processes that cost inordinate administrative time and staff committed to paperwork, approval for procedures, verifying information, and dealing with denials.

Hospitals report that their highest costs are incurred in the emergency room. Roughly 40% of patients in the ER don’t need emergency treatment, but they either don’t have or don’t want to wait to see a primary care physician, which are in shorter supply these days largely because PCPs are not as well reimbursed for their time as specialists are.

The AHA also argues that doctors order too many diagnostic tests, but they do so with good reason: Physicians are concerned that if they don’t order a test they will miss something and be sued. This brings medical malpractice award caps back onto the table as a cost-reduction tactic.

A Critical Timetable
June was a busy month for healthcare reform. The Democrats introduced a $1trillion Affordable Healthcare Choices Act, the House Republicans proposed a yet un-priced Medical Rights Act, and a splinter group of bipartisan lawmakers calling themselves “The Coalition of the Willing” announced the makings of a reform plan aimed at coming in under $1 trillion.

Meanwhile, the Senate Finance Committee—once deemed the best hope for producing a bill that could draw bipartisan support—has postponed presenting its proposal until after the July 4 Congressional recess.

According to Washington pundits, pushing the Finance Committee proposal to August significantly diminishes the likelihood of healthcare reform legislation in 2009. If pushed back to 2010, a midterm election year, health reform is put at the center of Congressional seat races—already slated for record-high spending by Republicans. A change in Democrats’ majority status, many believe, would neatly nix the probability of health reform in the President’s current term. Lack of traction on this issue would erode public perception of Obama’s capacity to create change—his winning platform in 2008—and undermine his gambit for a second term.

Ultimately, “it might take decades to change to a national culture of wellness, and when we see the doctor and for what purpose,” observed Robert Siegel, host of National Public Radio All Things Considered. The crux of the issue, he noted, rests on the expectations and behavior of patients and health care providers, which effectively brings the discussion back around to prevention.

A focus on the practical means of maintaining health, prevalent in every community and starting at an early age onward, is clearly the key to the success of any health reform policy that aims to be both functional and fiscally sound.

This is perhaps our greatest point of solidarity as AOM students and practitioners. AOM works on many levels to support the immune system and to bring patients to greater awareness of their body’s early-warning signs and symptoms.

The manifold benefits of this approach are tangible to President Obama. We have a truly unique opportunity to leverage this awareness into legislation if we as AOM practitioners do our part. At the risk of repetition, your member of Congress needs: 1) to hear from you and your patients about the practical value of AOM as a means of health promotion and disease prevention, and 2) to hear from us as a profession by way of a concerted national lobbying campaign.

Several AAAOM student chapters are working with Michael Taromina, AAAOM public member and legal advisor, to present local educational events on the value of AOM in healthcare reform. The Qi Unity Report will cover these events. In the meantime, if you are interested in hosting an AOM in Healthcare Reform event in your area, contact ___ at the AAAOM at _______.