I just received an email from the California State Oriental Medicine Association asking for practitioner and patient support in getting acupuncture covered as an Essential Health Benefit (EHB) under the President’s Affordable Care Act. This would mandate coverage of acupuncture by all insurances by 2014. This and the other item on the acupuncture associations’ wish list, Medicare coverage, will not happen in this current climate if ever. There’s just too much going on internally with regular medical coverage for lawmakers to even start worrying about including what is not scientifically proven to work. Not that acupuncture doesn’t work, just that the consensus among the experts who provide the advice to the policymakers know it doesn’t work according to the science, strange as that sounds. So until something other than scientific consensus becomes the basis of creating standards of care, acupuncture will not be considered an EHB. But science is only part of why this won’t happen.
With millions uninsured or underinsured, getting basic medical coverage to everyone for regular screenings/preventive visits and medical treatments is the priority for all, including myself. I’m all in for the greater good of all. As an acupunk/herbalist, I know that people have heard of acupuncture and herbs but that for many hearsay is the extent of their knowledge: a friend of a friend told them about it. I would love for this not to be the case which is why I and so many others have opened up CA offices. Knowing that their is still a lot of education and exposure needed for the general public to accept and use acupunture/herbs, I don’t see how that many people will choose to use a punk as their primary medical provider.
Some will say, “Well why don’t you as an acupunk provide some of those basic medical services? You have the training!” In fact I don’t, and neither do many fellow acupunks (an issue with schooling to be explained some other time). In order to serve within the system that politicians and medical advisors are creating for universal health coverage, acupunks have to play by their rules. Their money=their rules (yes I pay taxes but again, I’m all in for the greater good of all). Like I said above, there is no consensus among policymakers that acupuncture works. And until acupunks receive the same basic training as MDs/PAs/NPs with the concomitant repitition necessary to master those basic skills, acupunks won’t be able to play well in the system of evidence-based medicine, regulations, and standards of care that is being set up.
On top of the actual practice of acupuncture under universal coverage acupunks also have to be aware of how to collect on services rendered. Having worked as a medical biller for a diagnostic laboratory, I’m aware of the benefits and pitfalls of the system from a billing POV and I say “skip the insurance!” The headaches and frustrations of trying to collect from Medicare, Medi-Cal, and insurances I believe far outweigh the benefits of having acupuncture covered. Documenting to the level of the standards of care required to show medical necessity as well as to help defend yourself against the eventual malpractice suit takes time which MDs constantly point out would be better used providing care. And in a time when fee schedules are being reduced yearly, Medicare physicians are facing a 27% pay cut, and every dollar has to cover more people and services, what kind of cut of the funds could an acupunk expect? Not enough to deal with all the above.
So in light of the need for each dollar to provide basic care to more patients; many acupunk’s inexperience in working under systems set up for biomedical practice; and the hassle and hustle of trying to get a decent piece of the universal coverage pie, I just don’t see acupuncture being considered an essential health benefit that needs coverage under the Affordable Care Act.
