Medicare, Alternative Medicine, and Quality of Senior Health Care

In 1992, a Congressional mandate established the Office of Alternative Medicine, a small

office in the National Institutes of Health. They were tasked with reviewing the wide range

of alternative treatments, methods, and practices outside mainstream Western Medicine. Some of these are Acupuncture, Biofeedback, Chiropractic, Naturopathy, and Homeopathy. Until recently, alternative medical treatments and practices have not been reimbursed by medical insurance companies, or used in hospitals.

In a report on recent research, John A. Astin, "Why Patients Use Alternative

Medicine,"(Journal American Medical Association 279(19), May 20, 1998, pp. 1548-1553),

reported on the characteristics of people who use these forms of treatment. He reported that

First, individuals with college or graduate degrees were found to be more likely to use

alternative medicine than those with high school education or less. Second, individuals

reporting serious health problems were more likely to use alternative medicine than

healthier individuals. Furthermore, the majority of individuals who used alternative

medicine did so largely because they viewed these practices as being compatible with their

own values, beliefs, and philosophy toward life and health.

"Some health plans and employers have begun to voluntarily cover different types of

alternative medicine. In January 1997, Oxford Health Plans became the first major health

care plan in this country to offer comprehensive coverage for a range of alternative care

services, including acupuncture, chiropractic, naturopathy, and other specialties (e.g.,

nutrition, yoga, massage therapy). Policy holders, if they choose to pay an additional three

percent premium, are reimbursed for these alternative services. Unlike other health plans

that offer some coverage for alternative medicine, Oxford does not require a referral by a

patient's primary care physician (PCP) to use these services." AARP,Alternative Medicine: An

Overview Fact Sheet, Craig Caplan, AARP Public Policy Institute.

Still, Medicare does not recognize nor reimburse for expenses which are incurred in

Alternative Medicine Health Care. With over 9% of the workforce currently unemployed, with

the increase in health care costs escalating, and with the dubious effects of this current

Administration's proposed Health Plan, including rising copay percentages in Medicare, many

will be uninsured or underinsured and need these alternative methods.

Alternative medicine may reduce primary health care costs and provide more effective care;

it is difficult to generalize about the usefulness and effectiveness of alternative medicine

as a whole. While acceptance of an alternative approach has grown in parts of the medical

community, diehard skeptics will still abound. More research will make acceptance easier for

insurers, providers, employers, and others to evaluate which treatments effectively

complement traditional medicine. Hopefully, this Administration has allocated new funds for

this research.