Testimony of Jerome F. McAndrews, D.C., chairman of the ACA task force on managed care on "Health insurance options: state mandates on health benefits" before the subcommittee on Health Ways & Means Committee U.S. House of Representatives
Article Abstract:
The role of overseeing health insurance regulations has traditionally belonged to the states. It is the role of the state to regulate and license health care providers, oversee insurance benefit programs, and regulate the insurance industry. There are three types of state insurance laws: those that mandate the coverage of certain kinds of services; those that require that certain groups receive coverage (such as newborns); and those that require that services by certain types of providers be covered, such as podiatrists, optometrists, and chiropractors. This last type of law allows the patient the freedom to choose his provider. Forty-five states have permitted insurance coverage for chiropractic services. These laws expand patient access to health care; often these laws are the only guarantee that any services will be available to people in medically underserved rural and urban areas. If a patient has insurance coverage for treatment of a back problem, treatment must be paid for, whether it is given by an orthopedic surgeon or a chiropractor. The increases in health care costs are enormous; contributing factors include new technology and an older population. Chiropractic is a conservative cost-effective method of treatment. Recently, various studies have shown the benefits and cost effectiveness of chiropractic treatment. In the past, the federal government has preempted state health insurance laws without providing alternative federal provisions, which resulted in fewer consumer options. The federal government should recognize the states' laws; if this recognition does not occur, then federal legislation should enact its own laws to reflect the wishes of the states. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Chiropractic
Subject: Health
ISSN: 0744-9984
Year: 1991
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ACA testifies on state mandated benefits issue
Article Abstract:
A congressional hearing on July 29, 1991 focused on state mandated benefits. The federal government may preempt a state mandated benefit or a federal minimum benefits package may be substituted for one already in place in the state. The state mandated benefit is a law requiring coverage of a specified health care service, such as child care or acupuncture. If treatment of a specific disorder is included as a mandated service, then any appropriately licensed provider should be permitted to compete to provide treatment for the patient. State mandated benefit laws increase access to care by broadening the pool of providers from which the patient may choose. The American Chiropractic Association supports the need to assist the uninsured or under-insured and acknowledges that the increase in health care costs is unacceptable. It is not clear why competition, which reduces costs and improves quality in all other areas of the economy, is not present, or does not work, in the area of health care. The American Chiropractic Association believes this is due to the cartel approach maintained by the controlling structure of health care; elements outside this structure are not easily allowed to compete. Through mandated benefits, 45 states permit competition and protect against discrimination among health care providers. Recent evidence has shown that chiropractic care is more successful and more cost effective in treating low-back pain than medical treatment. Chiropractors are licensed providers of health care and should be covered by insurers. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Chiropractic
Subject: Health
ISSN: 0744-9984
Year: 1991
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Minimum benefits laws: escape from mandated benefits - unequal access for all
Article Abstract:
The major problems confronting the chiropractic profession are discussed by the American Chiropractic Association in a three-part series. The first part focused on how the federal pre-exemption, managed care and minimum benefit laws reduce the gains achieved by the chiropractic profession under the previous legal conditions. The attitudes of labor, business and government tend to affect the health-care debate in a way that does not favor the chiropractic profession. The second part of the series examined how businesses avoid regulation by the state by adopting the managed-care system. In the third part of the series, the effects of the minimum benefit laws are discussed. The minimum benefit laws, if enacted, would have unfavorable effects on insurance equality, or the even distribution of health coverage. These laws may also provide an opportunity for chiropractic care services to be included into the minimum benefits legislative structure. In the marketing of chiropractic services, the cost-effectiveness of chiropractic care should be emphasized. Specifically, chiropractic care centers around prevention of disability and subsequent reduction in health care expenses. The possible actions that could be taken by the chiropractic profession to deal with these problems will be evaluated in the future. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Chiropractic
Subject: Health
ISSN: 0744-9984
Year: 1991
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