WASHINGTON — Acupuncturists, dietary supplement makers and other alternative health practitioners, some of whose treatments are considered unproven by the medical establishment, would be brought more squarely into the mainstream of American medicine under the health legislation now before the Senate.
The legislation would allow doctors to incorporate alternative health providers in some treatment plans. It also includes language that some people believe could require insurance companies to expand their coverage for alternative therapies, on which Americans now spend $34 billion a year.
Insurers and some scientific watchdogs say the measure would undermine one of the central principles of the health reform: that the system cut costs by eliminating medical treatments that aren’t proved effective.
“These provisions are anti-science and anti-consumer,” said Dr. Steven Novella, a professor of neurology at the Yale School of Medicine who is mobilizing opposition to the Senate bill.
The leading champion of these measures is Sen. Tom Harkin, D-Iowa, chairman of the Senate Health Committee, who credits bee pollen pills with curing his seasonal allergies. He is also the leading recipient in Congress of campaign donations from chiropractors and dietary supplement-makers.
Harkin’s staff says that he supports health care that has shown itself to be effective.
“Sen. Harkin has done everything he can to ensure that supports for proven preventive practices, be they traditional or complementary, are included in this bill,” said Bergen Kenny, referring to a version of the legislation that cleared Harkin’s committee over the summer.
The provision that has provoked the most concern among insurance companies and doctors says that insurers “shall not discriminate” against any health care provider who is licensed by the state.
Insurance industry officials say it could mean that if they cover a physician’s treatments for back pain, for example, that they must also cover treatment by any other state-licensed health provider or risk a legal challenge.
California licenses acupuncturists, chiropractors and naturopaths, who use supplements, nutrition, medicinal plants, exercise and other techniques to promote health. Illinois licenses massage therapists, acupuncturists and chiropractors. Florida licenses acupuncturists and massage therapists, and it has licensed naturopaths in the past.
Many states require insurers to cover alternative therapies but the rules vary. For example, 12 states mandate coverage of acupuncture treatments. Every state but four mandates coverage for chiropractors.
Insurers dislike the Senate provisions. “Requiring health plans to provide access to unproven therapies would increase costs and reduce the quality and safety of patient care,” said Robert Zirkelbach, spokesman for the health insurers trade association in Washington, America’s Health Insurance Plans.
The Senate bill also would create a pilot program in 10 low-income communities to draw up “wellness” plans for people at risk for preventable conditions, such as obesity. The plans may include nutritional counseling and stress management counseling, as well as dietary supplements.
Makers of supplements, which unlike pharmaceuticals are not subject to federal drug-testing standards before they are marketed, pushed for the pilot program. The inclusion would enhance the credibility of supplements and, manufacturers say, introduce them to lower-income consumers.
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