Because they have yet to pass national legislation protecting the chiropractic profession, Japanese DCs are in a similar situation that U.S. DCs faced. We were fortunate enough to be able to pass chiropractic licensure state by state. The DCs in Japan must accomplish this nationally, which has proved to be an extremely difficult task. And in spite of their efforts, Japanese DCs are currently faced with two chiropractic professions.
Growth of Managed Care
Managed care enrollment in the United States is growing at an unprecedented rate. The number of Americans enrolled in preferred provider organizations (PPOs) increased by more than 32 percent in 1993. The number enrolled in health maintenance organizations (HMOs) increased by over 9 percent.
HMOs
1992 -- 38.8 million enrollees
1993 -- 42.3 million enrollees
PPOs
1992 -- 58 million eligible enrollees
1993 -- 76.6 million eligible enrollees
SOURCE: 1. InterStudy
2. American Association of PPOs