A year after President Obama signed the Patient Protection and Affordable Care Act into law, many Americans are still struggling to get their insurance to cover basic medical treatments. A new report by Deloitte and Oxford Economics finds that consumers spent $363 billion dollars more for health-care goods and services in 2009 than official government statistics acknowledged -- a discrepancy of nearly 15%.
These out-of-pocket medical costs include "purchases that are outside of conventional therapies and treatments," as well as other products and services not covered by insurance programs and care for others. The finding joins a growing body of evidence that more Americans are exploring often less expensive alternatives to traditional Western medicine.
A 2007 National Health Interview Survey, which polled Americans about their use of so-called complementary and alternative medicine (CAM), estimated that 3.1 million U.S. adults and 150,000 children had used acupuncture during the previous year. And in the five years leading up to the survey, the use of acupuncture -- the traditional Asian medical technique that involves the insertion of thin needles at skin-level, into key areas of the body -- had increased among U.S. adults by 0.3%, or about 1 million people.
Getting Coverage for Acupuncture
Acupuncture, once considered exotic in the U.S., has been around long enough to become federally regulated. Practitioners must use needles produced and manufactured according to U.S. Food and Drug Administration standards, which require needles to "be sterile, nontoxic, and labeled for single use by qualified practitioners only."
Acupuncture has been used for centuries to treat a wide variety of ailments, including chronic pain, depression, menstrual irregularities, infertility and weight loss. Individual treatments at licensed acupuncturists can cost anywhere from $25 to $65 dollars or more per session.
While most employer-sponsored health plans cover may cover physicals, prescription drugs and mental health, only about half -- according to a 2004 Kaiser Family Foundation survey -- cover acupuncture, chiropractic care and other CAM treatments.
But insurance companies' reluctance to cover licensed acupuncture treatments may be changing. For the ninth straight year, Rep. Maurice Hinchey (D-NY) is introducing legislation that would add acupuncture to the list of services covered by Medicare and Federal Employees Health Benefits Program participants.
"Even though the National Institutes of Health has found acupuncture to be an effective treatment for a range of serious diseases and conditions, 52 million Medicare beneficiaries and federal employees have no guaranteed access to the treatment," Mike Morosi, Hinchey's press secretary, writes in an email. "Congressman Hinchey will soon reintroduce the The Federal Acupuncture Coverage Act, which would ensure that those in need of care aren't forced to choose more expensive, invasive and risky treatments with a long list of side effects simply because acupuncture isn't covered."
Pinpointing the Problems
Colorado lawmakers also are working on a measure that would make it easier for licensed acupuncturists to get insurance reimbursements. Many patients supposedly covered for acupuncture treatments are still turned down by their insurers, says state Sen. Lucía Guzmán, one of the bill's sponsors, who adds that the bill uncovered a disconnect between some carriers and their bureaucracies.
"Some of the insurance companies I spoke to were sort of dumbfounded," she says. "They said 'we cover that.' But then when we got into it, we found that once something gets to the billing department end of it, then it's like, 'no, the reason we didn't pay for that was because that was not a licensed [acupuncturist]...they're not included on this list of licensed persons."
Acupuncture treatments can vary in length, taking anywhere from several weeks to several months. But even insurance companies that cover acupuncture usually limit the number of annual visits their patients can make.
"There are some that give you [a limit of] 20 treatments per year," says Parago Jones, clinic director at the Colorado School of Traditional Chinese Medicine in Denver. "I think they're trying to placate a certain amount of their customers, giving a real basic [acupuncture coverage] -- like giving basic cable TV. It's kind of like, why even have it? I think an insurance carrier that only gives you 20 sessions per year isn't giving you much at all."
Jones recommends that consumers considering acupuncture educate themselves about their local practitioners and the available treatments. He also thinks there's a place in American health care for both Western medicine and legitimate, alternative treatments like acupuncture. "We're in that process of those two worlds slowly merging," he says, "and there's still a lot of trepidation -- at least from the Western side -- about what we do and what we know, and what's the best of this medicine."
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