Before we begin this column, I need to define some words I want us all to comprehend.
- Hoax -- "intent to deceive"
- Deceive -- "intent to mislead"
- Lie -- "false statement deliberately meant to deceive"
In early October 1995, the House Ways and Means Committee decided on the future role of the chiropractic profession in Medicare. In recent years, the ACA political action committee has spent millions of hard earned dollars trying to improve chiropractic's role in Medicare. How much the ICA spent is unknown to me, but it is nothing compared to the ACA efforts.
However, the ICA can boast of chiropractic's largest college being located in Cobb County, Georgia and the president of that college is a well known ICA operative. So, what ICA lacks in funding, in theory at least, it makes up with personal diplomacy by Dr. Sid Williams. The Republican leader of the House of Representatives, Newt Gingrich, represents Cobb County, Georgia. Mr. Gingrich was recently photographed with Dr. Sid Williams, and they were projected to be friends.
So we have a hot issue: Medicare and chiropractic influence and money poised to finally do something for the chiropractic patient for the first time in over 20 years. The Ways and Means committee voted on the chiropractic amendment offered by Rep. Crain (R -- Illinois) and do any of you want to guess what the outcome was?
Okay, let's review the results of all the chiropractic dollars spent and the big time Georgia influence:
- The need to take x-rays remains -- UNCHANGED.
- The basis of care is the "subluxation demonstrated to exist on x-ray" -- UNCHANGED.
- X-rays taken by a DC are not reimbursable -- UNCHANGED.
- No clinical examination is reimbursable -- UNCHANGED.
- No cognitive skills are reimbursable -- UNCHANGED.
- You can't detect a subluxation by clinical methods - only x-ray! -- UNCHANGED.
Conclusion: Nothing but the A2000 will be recognized for reimbursement.
Well, didn't we gain anything? Yes we did, according to the ACA. We now can be defined as physicians. What this does is anyone's guess. The spin doctors tell us it's fantastic and will open all kinds of doors. Pardon me if I hold my applause until I see the great opportunities this achieves for chiropractic. As a person from Missouri (the "Show Me" state) would say, "Seeing is believing."
I now ask the practicing DC, can we afford all this political success for another 100 years? Isn't it time to stop the hoax that says we had a victory in Ways and Means? Why are we being purposely mislead? Who are our national leaders deceiving and why are they trying to make fools of the practicing DC who pays the dues to the national associations? What are the colleges going to do with graduates who can't find a level playing field to compete with the allopaths? Between the severe reduction of chiropractic utilization under managed care and the latest Medicare hoax, what can our new DCs look forward to? Isn't is time for the college presidents to be honest with their students?
The obvious next question is, what do we do now?
- Stop wasting money with phony political action.
- Select several members of Congress who really believe in the patient's right to choose his own type of care and only support these representatives and not waste money on the others who give us lip service.
- Let's identify the senators and representatives who will champion chiropractic on the basis of fairness and consistency with the American way of life.
- No more deceiving the practicing DC. Both national associations need to tell us the whole truth and nothing else.
- The ACA and the ICA should stop "one upping" each other. That's exactly what Nero did while Rome burned. Give truth a chance. Lay off the lies.
- Chiropractic is more important than any association. We who practice know the joy that comes to us when we help the body's inherent recuperative ability. We experience the appreciation of our patients on a daily basis. Chiropractic, the science/art/philosophy, is too important to go the way of the dinosaurs. However, we will disappear if we don't prioritize our mission. No more ACA versus ICA. No more playing "big shot" if you can't deliver. If the college presidents fail to realize today's market place, then the college trustees ought to speak up.
- We need a summit of ACA, ICA, COSCA, FCER, CCE, college presidents, NCMIC, and state association lawyers to come together and formulate solutions for the immediate needs of the chiropractic profession. Our survival depends on real world solutions. We need pragmatic, honest people to prioritize our needs for the next 6-10 years. There will be no long range planning if the immediate needs are not attended to.
Am I bullish on chiropractic? Yes, for the science/art/philosophy, but I'm skeptical about our level of organizational maturity. When the day comes that ICA can commend ACA and vice versa and not condemn each other, then I believe organized chiropractic can be proclaimed a mature profession and not until that time.
If our future is to be secured it will take state associations to do their job and not blame the nationals for their own apathy and ineptness. We all know there are some state associations doing a tremendous job. It is now time for the states to assert themselves with both national associations.
Merit alone doesn't get the job done. Rep. Gingrich met with the AMA and announced via the media that he supports their needs. When will Newt acknowledge the needs of the chiropractic patient and our professional existence? Will hell have to freeze? Let's stop giving dollars to those who profess one thing and then vote differently. Does Newt know that a chiropractic college resides within his district?
We need some political victories in Washington, D.C., and not alibis. Yes, I am mindful of the military commissioning bill and the first federal research grant to chiropractic, but that is not worth the millions of dollars in PAC money. Too much for too little return!
Arnold Cianciulli, DC, MS
Bayonne, New Jersey
