Freedom of Choice

Originally Published NO April 2010

Nearly 38% of American adults and 12% of children use some form of complementary and alternative medicine (CAM), according to the latest statistics by the National Center for Complementary and Alternative Medicine. It's good to see, then, that the Patient Protection and Affordable Care Act that President Obama signed into law on March 23 did not leave out this important category of medicine.

Debate had been heated among those concerned over if and how the final law would incorporate CAM-including the use of dietary supplements.

If complementary and alternative medicine had been left out of the law, many fretted that Americans would have been pushed into using conventional pharmaceutical drugs only. As it stands, brand-name pharmaceutical companies stand to benefit greatly from the new law, which is guaranteed to send millions of new insured customers their way.

Initially, some feared that Americans who seek complementary and alternative medicine would have instead been forced to spend their CAM budgets on purchasing drug-only insurance plans they would never use. As Jim Turner and Curt Levey wrote in a Citizens for Health article, "It's as if the government forced you to join and pay for a food shopping club that didn't include natural food stores," if you only eat natural foods.

Instead, the law as it has been signed does include provisions for CAM and dietary supplements. Focusing on prevention, it includes a provision championed by Senator Tom Harkin (D–IA) that would ultimately create "wellness" programs, in which select groups of citizens can participate, designed to educate people about wellness and prevention. Among other things, the programs will provide participants with certain dietary supplements for which the Food and Drug Administration (FDA) has approved health claims. Supplements to be distributed include folic acid, calcium, vitamin D, omega-3, and multivitamins.

Also importantly, another provision prevents insurance companies from discriminating against state-licensed CAM practitioners, such as acupuncturists, chiropractors, and naturopath doctors who prescribe dietary supplements, nutrition approaches, and medicinal plants as part of their remedies.

Keeping CAM providers and dietary supplements in the game not only ensures that there will be at least a little healthy competition in the marketplace by providing alternatives that aren't purely drug-based, it also gives Americans the basic freedom to choose what type of medicine they want.

It's this freedom of choice, however, that scares naysayers. Those who don't believe in complementary and alternative medicine are upset that insurers would be "forced" to cover "unproven, alternative therapies" that don't work, thereby potentially worsening an already inefficient healthcare system. One critic of Senator Harkin's efforts wrote, "[Sen. Harkin] wants to legitimize quackery by including it in any federal plan under the guise of 'preventative care.'"

If Americans are mandated to purchase healthcare insurance, they should have the freedom to purchase the type of healthcare they want. "Every American deserves the right to make their own healthcare choices with their own healthcare dollars," wrote Turner and Levey.

Healthcare reform is a beast, and it will take a decade to see it running smoothly. (Well, as smoothly as healthcare can ever run. As I'm writing this piece, the law is a mere one-day old.) However, as I mentioned above, it's good to know that those who use CAM and dietary supplements should not have their choices taken away.

"The new healthcare law is a starting point for a broader inclusion of CAM within the U.S. healthcare system," says Michael McGuffin, president of the American Herbal Products Association (Silver Spring, MD). "If managed properly, the greater inclusion of alternative practitioners in healthcare should open a pathway for increased acceptance of the dietary supplement products they provide."