by John Weeks
Interviewer: Tell me, candidate, as the next President of the United States, do you believe that an integrative health approach, which focuses clinically on education, prevention and empowerment, should play an important role in shaping the Nation’s healthcare reform?
I take it as an assumption among integrative medicine and natural healthcare practitioners that they agree on one strongly held, if ill-formed, policy notion: Health care would be better with more of what we do. Most assert that their type of care would ultimately cost less, too.
Naturally then, any true healthcare reform would include more of them, and be organized around their whole person, patient-centered healing principles. I’ve operated with a notion like this for 25 years.
A few weeks back I decided to take a little tour of candidate websites to see if anything related to integrative practice showed up. It was a walk in the desert. Nothing. Not "integrative medicine." Not "complementary health care" or "alternative medicine." No mention of the distinctly licensed disciplines. Nothing from Clinton, who filmed a supportive cameo at the Donna Karan Urban Zen event in New York last year. Nothing from the candidate who co-chaired the Congressional CAM Caucus in 2000, Kucinich. Nothing from Obama, the man whose message is all about healing. Nothing on the Republican side from major candidates.
Amidst all the jostling and positioning on healthcare reform, I couldn’t find a word that directly included any of the disciplines associated with the natural and integrative health care fields.
This discovery from an albeit non-scientific and incomplete survey (correct me if I have missed something) was hardly surprising. The current health system reform energy is mostly about who pays. One sees scant attention to what is being purchased. Why then would a new paradigm of care be under discussion?
Yet this non-recognition comes despite ample, if cynical, reasons why a presidential candidate would benefit from announcing support of integrative care. A recent poll by CodeBlueNow! of Iowa voters on various health reform topics included a single question on whether all licensed practitioners – "such as naturopathic physicians, acupuncturists and chiropractors" - should be covered. 68% said yes. This is a real number, and from the red state of Iowa.
The self-interested reasons for a candidate to take a stand on integrative practice do not end here. Taken as a whole, the licensed complementary healthcare fields number some 350,000: 70,000 chiropractors, 25,000 acupuncture and Oriental medicine practitioners, 4,500 naturopathic physicians, 1500 direct-entry (homebirth) midwives and 250,000 massage therapists. Add to this number the 3500 holistic nurses, a very loose estimate of 15,000 "integrative medical doctors" and who knows how many million devotees of their natural products. The numbers are significant.
Why hasn’t any candidate – or at least a campaign strategist – developed a strategy to go after this group and the millions of patients and clients they serve?
An answer came indirectly to me through a notice in early January that broke the candidate silence on anything connected to non-conventional health care. The American Chiropractic Association sent an e-bulletin alerting members that John Edwards and Hillary Clinton had published statements backing chiropractic care.
So why does chiropractic receive attention when the rest of the field does not appear to? The obvious reason is that chiropractic is a player. In fact, chiropractic is the only practitioner component of the integrated care universe which has the two necessary elements of participation: an ongoing, active lobbying presence in Washington, D.C. and a political action committee making the candidate contributions to back up the lobbying.
So why is integrative medicine missing from the health reform debate? Well, I would say it is mainly because as individual entities we are mostly too small, or ill-organized or unsophisticated. And as a combined entity – despite the potential suggested by those numbers above and the consumer drift toward natural health services - we do not have enough connectivity and considered direction to actually be considered a "movement."
Bottom line, we aren’t seeing ourselves in the health reform debate because we aren’t yet showing up. The good news is that the next move is ours.
Candidate (answering): Yes, we have an emerging force of practitioners in our healthcare system which is truly dedicated to empowering people to take care of themselves. They are dedicated to working in collaboration, to helping their patients make the changes they need, to keeping people healthy. They represent health promotion and disease prevention at the clinical level, modeling the best sort of primary care. As president, I will invest in these approaches to leverage change.