Congress Backs Alternative Medicine Research

Two recent trends signal that the U.S. is becoming more receptive to alternative medicine. The first is the allocation of federal funds for research on alternative therapies. In 1991, Congress created the Office of Alternative Medicine (OAM) as part of the National Institutes of Health (NIH) in Bethesda, Md. The OAM opened in June 1992 with a mandate to research alternative therapies. Sen. Tom Harkin (D, Iowa) has been credited with winning the office's creation. Harkin had suffered from hay fever and was impressed by the effectiveness of bee pollen treatments, a nontraditional remedy, in controlling it.

OAM originally funded more than 40 small research projects to study the efficacy of various therapies in treating specific conditions, such as the effect of a macrobiotic (strictly vegetarian) diet in treating cancer. OAM is currently funding larger research projects on alternative therapies at 10 sites across the nation. At the University of Virginia School of Nursing in Charlottesville, the use of chiropractic treatments, massage and sound therapy are being evaluated in the treatment of chronic pain. At Stanford University in Palo Alto, Calif., traditional Chinese medicine, which incorporates diet, acupuncture and herbal remedies, is being assessed in treating ailments associated with aging. At other sites, music therapy, biofeedback and homeopathy are being studied. The office's budget has grown steadily since its inception. In the 1997 fiscal year, which ended on September 30, 1997, the office was allocated $12 million. Its original budget in the 1992 fiscal year was just $2 million.

The second trend is that a growing number of health insurance companies have begun to reimburse patients who seek alternative treatments. In general, health insurers do not reimburse members for visits to alternative-health practitioners. To control costs, they usually maintain strict rules as to the medical treatments they will and will not cover. While the majority of insurance companies have resisted requests to cover alternative treatments, a small number have responded to consumer demand and extended their coverage.

In January 1997, Norwalk, Conn.-based Oxford Health Plans Inc., one of the nation's largest health maintenance organizations (HMOs, or networks of care providers), became the first HMO to give its members full access to a network of alternative-care providers. The network includes acupuncturists, chiropractors, massage therapists, nutritionists and yoga teachers. Prior to the extension of coverage, Oxford had surveyed its members in New York, New Jersey and Connecticut and found that 33% used some form of alternative care.

The American Western Life Insurance Co., based in Foster City, Calif., offers what is probably the most extensive alternative-health coverage plan in the nation. In 1992, the company began covering acupuncture, biofeedback, homeopathic medicine, massage, hypnotherapy, Ayurvedic medicine, herbal medicine, yoga and chiropractic services for its members.

State legislatures have also shown support for alternative medicine. Several states now mandate that health insurers cover specific therapies in some instances, the most common being chiropractic services. In January 1996, Washington became the first state to require all of its health insurers to reimburse members for visits to any health provider that is licensed by the state. Chiropractors, naturopaths and acupuncturists all fall into that category.

While the Washington law was embraced by alternative-care enthusiasts, some health care professionals complained bitterly that it would force insurance companies to reimburse a host of treatments that may not even be effective. Dr. George Rice, president of the Washington State Medical Association, said, "There's a finite number of dollars. We are not interested in spending a lot of those dollars on things that are unproven."

In 1996, Blue Cross of Washington and Alaska began covering the services of acupuncturists, homeopathic and naturopathic practitioners in three states. Other insurance companies may not cover alternative care automatically but may reimburse members for such treatment if it is recommended by a physician.

A prominent example of broadening coverage for alternative medicine is the fact that about 20 U.S. health insurers, including the Mutual of Omaha Insurance Co., one of the largest, now agree to cover a program developed by Dr. Dean Ornish, a California naturopath, to reverse coronary heart disease. The program combines exercise, a vegetarian diet, support groups, meditation and yoga. The Ornish program costs about $5,000 per person. The average cost of heart bypass surgery, meanwhile, is more than $40,000. The Ornish program aims to help patients to avoid surgery altogether.

Sources

Day, Kathleen. "Finding a Prescription for Economic Pain." Washington Post (January 16, 1997): E1.

Facts On File World News Digest (February 25, 1993). "Alternative Medicine Seen Popular": 122.

Guernsey, Diane. "Alternative Medicine." Town & Country (January 1997): 97.

Herman, Robin. "Therapies Outside the Mainstream." Washington Post (August 1, 1995): 10.

Jaroff, Leon. "Bee Pollen Bureaucracy." New York Times (October 6, 1997): A19.

Kolata, Gina. "In Quests Outside Mainstream, Medical Projects Rewrite Rules." New York Times (June 18, 1996): A1.