With the Supreme Court ruling and the election results behind us, the United States seems certain to fully implement a form of socialized medicine known as Obama Care. We join with citizens in the rest of the first world in relinquishing part of our personal responsibility to the federal government. Now, we can make uninformed decisions about our health, consume foods that promote diabetes and even abuse ourselves, knowing that the financial burden of its subsequent treatment will be borne by unseen taxpayers.
Against this backdrop, many chiropractors in the United States have been holding their breath, waiting for the election to be over. Now, they have their hand out, hoping that the takeover of one seventh of our gross national product by the government will result in a “practice stimulus package” of sorts. The expectation of far too many chiropractors is that the payment for patient care that formerly came from private insurance companies will be replaced by checks from the United States Department of Treasury.
And you don’t have to read all 2,000-some pages of the legislation to reach the same conclusion.
Please don’t shoot the messenger!
While not a practicing chiropractor, I’ve got skin in the game. By serving in a supporting role for chiropractors around the world for over three decades, I’ve come to learn that when chiropractors sneeze, Patient Media catches cold. Realize that what follows is intended as merely a gentle reminder for chiropractors who are unwisely betting the future of their practices on the generosity of the federal government. Here are the undeniable facts:
Fact #1 – We’re broke.
In case you didn’t know, the United States government (that's us) is broke. And has been for some time. Not only are we broke, we borrow 30 cents of every dollar that is paid to social security recipients, armed service personnel, TSA airport security employees, IRS agents, food stamp recipients and others who are dependent upon the government for their salary or support. Borrowing money to grant citizens, even desperately deserving citizens, still one more entitlement program is unaffordable and unsustainable.
Fact #2 – We’re in debt.
The sum of $16 trillion and change that the government has borrowed continues to grow. (Our payments merely pay the interest—we're not even touching the principle!) For the first time in history, credit rating agencies have downgraded the credit worthiness of the United States. Our creditors are rightfully nervous. At what point do the Chinese and others who lend us money say “enough is enough” and pull the plug? Or charge credit card level interest rates? Must we continue down the track toward Greek-style riots, strikes and depression-era levels of unemployment? The Federal Reserve cannot continue printing money without eventually producing hyperinflation or triggering some other dire consequence. Or is that the intent?
Fact #3 – Government is inefficient.
The idea of a coordinated, nationwide health care system was sold on the alleged efficiencies that could be produced by eliminating duplicate layers of administration and other non-health care related expenditures. (I think they were envious of the cash flow of premium dollars that they could use for other purposes!) Yet, without exception, every estimate of the likely cost of a new government program hasn't just been wrong, but it's been wrong by orders of magnitude. One can reasonably assume that this will be the case here.
Fact #4 – The law is ambiguous.
I trust you've read the actual legislation that will govern your practice in the years ahead. Even if you haven't, a casual browsing of the “we-have-to-pass-the-bill-to-find-out-what’s-in-the-bill” reveals almost 3,000 occasions in which the phrase “the Secretary shall... or “the Secretary may...” is used. In other words, an unelected political appointee, namely the Secretary of Health and Human Services, has unprecedented power to determine a variety of details that affect both patients and providers. With every four-year presidential election cycle the policies, procedures and exclusions can change. Combine this with the patchwork of state run exchanges and there is potential for all kinds of mischief.
Fact #5 – Chiropractic is nonessential.
The sad truth is that with a growing epidemic of cancer, diabetes and heart disease, the neuromusculoskeletal conditions for which chiropractic is thought to help is small potatoes. The limited resources are more likely to be spent amongst providers who attend to far more serious, life-threatening problems. Naturally, we’d make the case that less expensive chiropractic care could actually serve to help prevent some of these expensive lifestyle-induced conditions. But such an argument would run counter to the prevailing allopathic beliefs of those running the system. The prospects are even worse for the token reference in the law to wellness care. When a “well baby checkup” is merely a pretense to inject toxins into a child’s bloodstream in the hopes of creating artificial immunity, the prospect of chiropractors getting a piece of the wellness mandate seems unlikely.
Fact #6 – Chiropractic is excluded elsewhere.
Other countries that have nationalized their so-called health care system have chosen not to include chiropractic, or if they did (in the case of Ontario and other Canadian provinces) they have since “delisted” chiropractic care as a cost-savings measure. But here’s the point. In those countries that have modeled their health care after the Department of Motor Vehicles, chiropractic is booming. In places like Australia, New Zealand, the United Kingdom, Spain and elsewhere you’ll find huge cash practices in which eager patients search out alternatives to the state-controlled system of seemingly “free” health care.
Fact #7 – You’ll be an indentured servant.
If chiropractic services are included, you better hope that unlike Medicare, you'll be able to opt-out. Because if you think practicing under the jaundiced eye of insurance companies is annoying, wait until your boss is some bureaucrat of the federal government! Bottom line? If chiropractic is included you won’t be practicing chiropractic, but rather a bastardized form of chiropractic medicine or some type of spinal therapy. Whatever it might be, I'm almost certain it won't be what you dreamed of when you entered chiropractic college!
Again, please don't shoot the messenger. I hope I'm wrong. And if you have a more optimistic interpretation of the road ahead, great. But if I were you I'd prepare for the worst. And then be pleasantly surprised should I have it all wrong.
How do you prepare for the worst? Owners of our Converting to Cash program already have a road map. Generally speaking, it means slowly disengaging from insurance reimbursement dependency and becoming more attractive to those who value their health enough to self-pay for the services necessary to recover and maintain it. If you have a couple of workout gyms in your area, a health food store, a Pilates studio and a nearby Wal-Mart selling organic produce, then there are probably enough people in your drawing area to sustain several busy chiropractic practices without government dependency.
Will yours be one of them?