why insurance won't cover alternative medicine

May 17, 2009

As the government eyes healthcare reform to address today’s problems in coverage and expenses, there’s a group of lobbyists representing an unusual set of clients who want their services covered in insurance plans. It seems that acupuncturists, chiropractors, homeopaths and even faith healers want your visits to be covered so they can attract more patients to their alternative practices. Today, if you want to see an alternative medicine practitioner, you have to pay out of your pocket, but if your insurance company will subsidize your visit, odds are you may be more willing to come and see them. Whatever per service revenue they lose in negotiations, they’ll gain in volume. However, their case might be lost before it’s even considered in a Congressional hearing.

mixing herbal medicine

Insurance companies base their coverage on sets of guidelines that are created by physicians and reviewed for anything questionable or objectionable. Before the companies are willing to pick up their part of the tab for a new treatment, they want to know that it works, that it will improve the quality of life and that it makes sense. For them to do anything else is just gambling with their money and hence, they try to rely on evidence-based medicine as much as they possibly can. How can their guidelines track something as obscure as spiritual or holistic health? And why should they cover something that scientists and doctors are sure doesn’t work past the placebo effect? We’re talking about companies that will think twice about giving you a new kidney. Do any of the alternative medicine advocates really think the same companies will want to cover New Age medicine?

The same insurance companies have their own powerful lobbies and armies of political allies who can throw a lot more money and a lot more weight around Washington DC. Currently, alternative medicine proponents have only one serious supporter, Senator Tom Harkin (D-IA). And while they might sway some congressmen and women with a passionate presentation or two, representatives of insurance companies will be ready to line up expert after expert who will truthfully tell them there’s no solid proof that alternative medicine is on par with conventional medical practices and that faith healing is a religious tenet rather than a valid practice that has any place in a hospital. Why then should the government ask insurance companies to cover these ideas? And what politician would want the negative press that would come with advocating something like this?

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  • ColonelFazackerlely

    I am ashamed to admit that, here in the UK, our esteemed national health service has spent money on woo medicine. For example, my wife was rung by a “research midwife” and asked if she wanted acupuncture during childbirth.

    In the US, if you choose to have smoke, mirrors and ritual with your placebo, then can’t you just choose a (more expensive) insurance company?

  • Greg Fish

    In the United States, insurance companies use guidelines for what procedures they have to cover and they base their coverage on the reported efficacy of a treatment in clinical trials.

    There are two major companies which issue these guidelines, Milliman Inc. and McKesson. These companies assemble their exhaustive lists by consulting large groups of physicians and actuaries and there are debates about anything and everything that could possibly be objectionable from both financial and medical standpoints.

    If treatments are not very effective, yet very expensive, insurance companies looking at the guidelines may decide not to cover them and have the patient pay out of his or her pocket to get it if that treatment is so desperately desired. The same would apply with CAM and anything else the guidelines would call smoke and mirrors. You wouldn’t really be able to just go to another insurance company. They would simply refuse to cover your faith healing and homeopathy bills because according to the information they have, it won’t work and they make it clear they don’t cover it because it won’t help you.

    One big misconception people tend to make about medical insurance in the U.S. is that companies will cover anything and everything if you give them enough money. But in reality, there are things they will never cover. Sometimes, even medical procedures of the utmost necessity. The “think twice about giving you a new kidney” quote is not an attempt at being witty. They really do think twice about the benefits of covering organ transplants for some patients.

  • Rip

    “…expert after expert who will truthfully tell them theres no solid proof that alternative medicine is on par with conventional medical practices…”

    Who are these “experts”? These “experts” are allowed to “tell” them there’s no solid proof, as opposed to “proving” there’s no solid proof!! And yet alternative medical practitioners are to “prove” their worth according to the “acceptable conventional medical practices” guidelines! And what if a lot of these benefits of alternative medical therapies are due to the “placebo” effect? Are you kidding me? You are going to dismiss these patients’ benefits because “you” believe it is all in their minds? The mind is as much a part of our beings as the bodies for heaven’s sake!! So because of that their healing/cure isn’t real to you? You can believe it is real to the patient!

    Of course alternative medicine isn’t “on par” with conventional medicine, because conventional medicine only treats symptoms! Alternative deals with causes and heals or cures.

    Let’s look at this from a common sense point of view:

    When was the last time conventional medicine “cured” anything? Polio? Back in the 1950s? Conventional medicine has had well over 50 years to use all the millions and millions of dollars they have received to come up with a cure. ANY cure! Just one in over 50 years. No, what they would rather do is spend that money on new drugs, surgical techniques, and radiation machines!! Outrageous!

    Why is it that when human beings need food, water, and air in order to live, conventional medicine spends little if any time educating patients about these three extremely important things? Hell, they don’t even teach their own students about them for that matter.

    And why is it that conventional medicine focuses virtually, solely, on the big three: burning (chemo and radiation), cutting (surgery), and poisoning (drugs)?!?! I for one, am sick to death of it!

    Who are the REAL drug pushers in the world? Proponents of convetional western medicine, that’s who! These over-the-counter and prescription only tv commercials need to be outlawed! It is absolutely irresponsible and unethical!!!! Trying to encourage people with indigestion problems to take a tablet and continue to eat like a pig!!!

    Conventional medicine is killing people in the US on a daily basis. And they don’t care! There is way too much money to be made from keeping the public sick!

    Insurance companies: Stand up and get a huge clue! Rally together, do your homework, and 1) Start covering alternative medical practices! The information is there! If I can find it, you can too! 2) Demand that conventional medicine show evidence of curing and healing! Demand that they cure before you pay. Let’s see how fast cures begin coming out of the preverbial woodwork then!

  • Jack

    As if recently a freind of mine has gotten cancer. He has been going for radiation treatments. But due to those treatments he gets very sick and sometimes has to stay home from work. He has been taking these meds and steroid shots that calm down the nausea and what not, but now his health insurance company will not cover the cost of the shots and meds, by saying that they are not needed. So now he has to pay like 5000 a month out of pocket for this stuff, is ther any way to get around this were he wont have to pay. is there a article or law in which the insurance company will have to pay? if he shows proof that it is helping him? PLEASE HELP

  • Annoyed

    I just find it ironic that US insurance companies will pay hundreds of thousands of dollars for chemo and conventional medicine, but will deny coverage totaling twelve thousand dollars if the treatment and cure, yes CURE, is provided by means of alternative medicine. It makes no sense. The insurance companies will blindly pay oodles for chemo, without even requiring chemosensitivity testing? And we wonder why our healthcare system is up the creek. Thanks to the lobbyists and big pharma and our profit driven healthcare system, and the US citizen’s laziness as well as the insurance companies’ stupidity, we will continue in this downspiral of increasingly poor health. Alternative medicine doesn’t stand a chance here in the US. It’s not profit driven. We’re all better off moving to Europe where the insurance companies cover alternative medicine. Health is more of a priority there, rather than greed.

  • Greg Fish

    Insurance in the U.S. will pay for chemotherapy because it actually works. If there’s some sort of cure for cancer being offered by alt med practitioners, they have not yet proved it in any way, shape or form. So it actually makes perfect sense that insurance companies won’t cover woo that does nothing for patients with a potentially terminal illness and stick to what is known to be effective against the host of diseases we collectively know as cancer.

    If alt med really found demonstrable ways to cure cancers with simple nutrition or special water, you bet that doctors and pharma companies would be paying billions to get their hands on such simple and inexpensive cures and lower their costs to compete with the current crop of homeopaths and naturists. If alt med can rake in billions of dollars a year, so can they.

    But you see, conventional medical professionals have to prove that treatments work before they can sell them. Snake oil salesmen don’t which is why they get away with selling bogus cures.

  • Deb Swift

    Makes me sick!! Keep pushing those addicting drugs!!!