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Acupuncture as part of mainstream health care in the USA by 2014?

As some of you may know, America recently passed an item of legislature heralding a new era in health care. Called the Affordable Health Care Act, this legislation is intended to provide Americans with affordable health care commencing in 2014.

As with many types of legislation, the devil is in the detail, and the actual nature of provision is currently being determined. This means that a range of heath care treatments, therapies and modalities are being considered to see whether they provide real and cost-effective benefits to the patient, health care insurers and the government.

>The American Association of Acupuncture and Oriental Medicine (AAAOM) has submitted a position paper to the USA’s Department of Health and Human Services, arguing that acupuncture should be designated as an ‘Essential Health Benefit’ for the following reasons:

• Acupuncture is safely and effectively practiced nationally by state licensed and regulated health care professionals who are trained in institutions whose accreditation is recognized by the U.S. Department of Education;
• Acupuncture is a proven, cost-effective and comparatively-effective medical treatment for commonly occurring illnesses as enumerated by the World Health Organization (WHO) and the National Institutes of Health (NIH);
• Acupuncture is an important aspect of integrative medical care whereby thousands of trained licensed acupuncturists and physicians are practicing acupuncture in clinics, hospitals, universities, veterans’ care facilities, and military establishments;
• Acupuncture reimbursement for treatment by licensed acupuncturists and physicians is available through federal, state, and private third party payers;
• Acupuncture, a medically-effective service, has an unparalleled safety record with far fewer side effects than conventional therapies such as prescription drugs and surgery as well as consistent meaningful improvement outcomes;
• Acupuncture is sought after by the public as there is an established need for increased patient access to care;
• Acupuncture meets the EHB criteria and services, and at minimum, serves five of the EHB categories of care.

The full paper can be read here.

What’s interesting about all this is that it reflects a similar situation in Europe, where countries are reviewing the provision of conventional treatments in hospital and other mainstream medical settings, and considering the cost effectiveness of complementary and alternative therapies. It seems that across the western world acupuncture is increasingly being considered as a viable element of a more flexible, preventative, and integrated approach to health care.

Whether or not the AAAOM is successful remains to be seen. Having not long returned from a trip to the USA, I was struck by the number of drug advertisements on TV and the almost equally prominent advertisements by lawyers promising to sue the pants off the drug companies for the serious side effects of drugs. Given the cost of TV advertisements its hardly surprising that there were no advertisements by acupuncturists. I got the impression that Americans could only be bamboozled into thinking that there is no alternative to drugs, while having fear struck into their hearts about the potential side effects. Moreover, while the basics of life are generally much cheaper than here, the cost of medicines in the US seems much higher; one gentleman told me that he regularly drove over the border from Arizona into Mexico to purchase his medications because they were 25% less than in the US.

To get to the point, the pharmacutical companies and lawyers have great influence and will very likely resist the AAAOM’s attempts to gain greater recognition for acupuncture.

Nonetheless, there is significant evidence of a change in attitudes and practices in some very unexpected places. See, for example, references to the use of acupuncture to treat American veterans outlined in the AAAOM’s paper. When the medical division of the American military starts using acupuncture, it really says something.

So, its all to play for in the USA.

January 2012