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Freedom or Security?

The real interest in unity...The debate over whether to use the term subluxation or joint dysfunction, adjust or manipulate or care instead of treatment pales in comparison to a much larger conflict gathering on the horizon: national health care. More specifically, should chiropractic be included in any type of national health care plan, or should it remain outside whatever Congress and the next president concoct?

I’m guessing that the most recent push for merger talks between the major chiropractic political organizations is actually motivated by the hope that chiropractic will speak with one voice during the ensuing “negotiations” about what role chiropractic might play in such a plan.

If it were only that easy.

Those who distinguish between sick care and health care and see the price tag of symptom-treating escalate with each passing year, know that the current system is unsustainable. My guess is that sooner rather than later taxpayers will be asked to pick up the tab. When they do, will chiropractors get their “fair share” of the trillions that will be spent to treat the symptoms of the public’s ignorance, lack of self-responsibility and poor lifestyle choices?


Those with struggling practices, unable to make a compelling case for patients to pay cash for their care, would find the credibility, validity and economic safety net of inclusion comforting. Yet, those who already chafe at the compromises of working for “the man” in the form of Medicare or the state agency regulating work-related injuries, will campaign vigorously to be excluded. (You want unity? Start by reconciling these opposing perspectives!)

Then there will be the vast majority of chiropractors who see the inevitability of a national health care program and will want to be included IF certain restrictions and assurances are in place that treat chiropractors and their patients respectfully. This is the Trojan Horse strategy, better known as the “Rope-a-Dope” maneuver. What these unsuspecting chiropractors naively forget is that “what the government giveth, the government can taketh away.” And probably will. (Just ask chiropractors in Ontario, Canada.) Because if you think higher co-pays, higher deductibles and visit caps have impacted your practice, wait until even the most meager coverage under a national plan is suddenly jerked out from under you in some money-saving scheme like chiropractic supporter Schwarzenegger pulled in California.

“Yes, but by then I’ll have stashed enough money aside to retire. That’ll be a battle for the next generation of chiropractor to deal with.”

Has it come to that? Every man for himself? If so, then selling out for thirty pieces of silver is a no-brainer. Get while the gitt’ns good!

You don’t have to decide today. Remaining outside the system will offer advantages and disadvantages. Before you choose, find out how chiropractors with cash practices are getting along in the UK, New Zealand, Australia and even those in British Columbia working outside their respective country’s socialized medical system.

Just remember the wisdom of Benjamin Franklin who observed, "Those who would trade freedom for security deserve neither."

Comments (1)

I would have never thought of this being the reason there is a more recent effort to bring nationals together. As one who is playing an integral part in running the Assoc of NJ Chiropractors, I witness many state assoc who are looking to the nationals to support them. Nationals don't have the money, resources or capability of accomplishing this for 50+ assoc.

The more impactful the state assoc becomes, the less relevant nationals appear to local DC's in that state. Having said that, the question needing to be asked is, "if nationals unified tomorrow and we looked one year down the road, what difference might that make for chiropractic?

Why are 65% of DC's not a member of any national organization?

I believe a more impactful model is if both unified nationally, all they should be concerned with are national issues. They should not be spending a dime on building membership. Daryl Wills, DC told me a couple of years ago that ACA spends 13 cents of every dollar attempting to grow membership, and that this remains their most clostly expense.

I believe one answer is to have every state assoc member automatically become a member of the national org and that a percentage of state dues goes to the national to support their efforts.

Now to the points you brought out Bill. I want to know what the position of both nationals are relative to being included in any national health plan. The first reaction of most I believe is that they would want to be included.

I know of no business plan, that includes insurance/manage care, to be sound in growing ones business and making it more profitable.

Although inclusion sounds good at first blush, to me in the long run, it doesn't feel good deep inside. I would assume you to be correct, that whatever the deal for reimbursement/number of visits is in the beginning, in the years to come, the monies paid/visits allowed will become less and less.

I am interested to know how differently the nationals believe on this point and what evidence they have that suggests otherwise.

As a profession, it is paramount that we find ways to help DC's grow and fourish in their practices; one that the DC is confident in building their business around. I believe the "cash patient" not cash practice concept that you so eliquently present is a solid beginning point. Simply stated, your approach in developing the cash patient model impresses the hell out of me.

Sigmund Miller, DC, FICC
Executive Director, ANJC

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From May 16, 2007 9:41 AM

This page contains a single entry from the blog posted on May 16, 2007 9:41 AM.

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