Testimony before the U.S. Senate
S. Hrg. 103-146
ALTERNATIVE MEDICINE
HEARING
BEFORE A
SUBCOMMITTEE
OF THE
COMMITTEE ON APPROPRIATIONS
UNITED STATES SENATE
ONE HUNDRED THIRD CONGRESS
COMMITTEE ON APPROPRIATIONS
UNITED STATES SENATE
ONE HUNDRED THIRD CONGRESS
FIRST SESSION
_________________
SPECIAL HEARING
_________________
Printed for the use of the Committee on Appropriation
_________________
SPECIAL HEARING
_________________
Printed for the use of the Committee on Appropriation
STATEMENT OF HARVEY KALTSAS, D.A., PRESIDENT OF THE AMERICAN
ASSOCIATION OF ACUPUNCTURE AND ORIENTAL MEDICINE
Senator Harkin. And Dr.
Harvey Kaltsas, President of the American Association of Acupuncture and
Oriental Medicine. Again, Dr. Kaltsas, I have your statement. It will be made a
part of the record.
Please
proceed.
Dr. Kaltsas. Thank you, Senator. Mr.
Chairman, today I will highlight some of the dramatic cost savings already
brought about by acupuncture, a 5,000-year old healing system of traditional
Chinese medicine that includes the use of heat therapy, massage, herbs, diet,
lifestyle, and exercise counseling.
The AAAOM
requests continued support for research by NIH's Office of Alternative Medicine
into this discipline. We specifically ask that the OAM include the participation
of certified acupuncturists, who are the real experts in this field, in its
research plans. We also ask for Senate support of bills now being introduced in
the House which will cover acupuncture under Federal health insurance.
Derek Bok,
former president of Harvard
University, once said, "If
you think education is expensive, try ignorance." Well, unfortunately, the
Federal Government is relatively uneducated about acupuncture, and its
ignorance about what acupuncture can do is costing the Federal Government a
great deal of money. For example, HCFA has recently ruled — well, 20 years ago
ruled — that acupuncture is experimental, despite voluminous research on
acupuncture's safety and effectiveness. HCFA has not reversed its ruling and,
as a result...
Senator Harkin. Is that
ruling still in existence?
Dr. Kaltsas. It is still in existence.
And acupuncture is not included under Medicare part-B.
Senator Harkin. Is that
FDA?
Dr. Kaltsas. No; that is HCFA, Health
Care Financing Administration.
Senator Harkin. HCFA?
Dr. Kaltsas. It was actually a rule
promulgated in 1984 under a former administration. Starting with California and Nevada,
23 States, and the District of Columbia now
license acupuncturists. Most recently is Iowa.
On May 18, 1993, the Governor of Iowa signed into effect an acupuncture bill.
The health
care consumers in Iowa called our national
organization and requested that we not involve ourselves in any way in their
legislative process. They did not want the legislators in Iowa
to think that it was acupuncturists pushing to get licensed. They wanted the
legislators in Iowa to know that it was
consumers who wanted the service available to them. So we completely stayed out
of it, and the law passed in Iowa.
The same
thing happened 2 months ago in Louisiana where
10,000 consumers who were tired of driving to Texas
for acupuncture treatments petitioned their legislature. Unfortunately, the
bill failed in Louisiana, but it is being
reintroduced.
Now, every
year the public demands that acupuncture be included under Medicare and other
Federal programs, but in response, many legislators wonder, 'With a deficit
this big, how can we possibly include another group of health care providers
under Medicare?" Actually, the legislators should be asking, "Where
can we replace high-cost, high-technology care with low-cost acupuncture?"
We have to
ask, "Why do the patients fight to get acupuncture included?" It
takes a lot to get legislatures to approve groups of practitioners. The main
reason is that patients do not really want health care insurance. They do not
really even want health care. They want health. And, for many patients,
acupuncture is their only way to regain their health.
A study in Florida showed that 96 percent of all acupuncture
patients have already been to the medical doctors for care and could not find
relief, and they came to acupuncture as a last resort. And 80 percent of those
very difficult patients got well.
How can
acupuncture save the Federal Government money in this country? Let us look at
China as an example for a moment. I know China has human rights abuses and it
is not the ideal political system, but when it comes to health care, we have
something to learn from them. America spends $3,200 per year per person on
health care. China spends $71 per person per year; $3,200 versus $71. We have
something to learn from them.
How do they
get their health care costs so low? They use two basic capitalist principles.
They increase the supply of health care providers. They legalized 500,000
Doctors of Acupuncture who work hand-in-glove with the medical doctors. There
is no competition, no hierarchical structure. The medical doctors and the
acupuncturists work hand-in-hand together, and they both educate their patients
on how to stay well. The focus of health care in China is not treating illness,
it is promoting health. And until we start doing that in this country, we are
going to keep on with an $800 billion a year health care bill.
I think 80
percent of all the health care expenditures in China are spent on pregnant
women and children in the first 5 years of life. Senator Dodd is always quoting
that 75 percent or so of our health care expenditures are on patients in the
last 6 months of life in our country. So we have got to shift the focus to
prevention.
One way
China reduces demand is by having widespread public health education campaigns
and by encouraging the use of low-cost acupuncture therapies. One thing we
desperately need in this country is a national cancer registry so that all
cases of cancer are registered, like they are in China. In China, the
Government knows how many cases of a particular type of cancer are in a
particular region. They look to see if there is a lead smelter in that region
spewing lead downwind, and they close it down and clean up the area so people
do not get cancer from the lead that is being spewed out. We do not have
statistics like that in our country, but we should and we should put the
mechanization to collect them in place.
Most
Chinese families practice some very simple acupuncture, massage, and dietary
therapies at home as a way of preventing illness. For example, there is an
acupuncture point right here, between your thumb and index finger. If you rub
it, it is good for preventing constipation and good for preventing and treating
headaches. How many Americans know about this point? Very, very few. But the
Asian Americans know about this in our own country. And the Federal Government
spends less for the care of Asian Americans than for any other ethnic group in
the country. We have something to learn from our own Asian Americans, and from our
own Federal statistics.
Senator Harkin. Are you
saying in America we spend less for the Asian American community on health care
than any other sector?
Dr. Kaltsas. Yes; that is right. Those
are from Federal census statistics. Every day, American acupuncturists are
educating American patients with this basic preventive Chinese wisdom. And what
else are we trying to do to bring the health care costs from $3,200 down to
$71?
Acupuncture
is now used on 90 percent of all drug-related felons going through Miami drug
court. Hugh Rodham is the Public Defender of Dade County and he refers all of
his drug-related cases to the Miami drug court where they are given a choice of
receiving acupuncture; 90 percent of the felons elect to attend acupuncture
sessions. The cost for 1 full year of treatment is only $750 per patient, and
criminal recidivism among those who select acupuncture is now less than 7
percent. Normally, 50, 60 percent of people who have been through the criminal
justice system get rearrested. The cost to process one case is over $3,000. The
cost for the acupuncture is only $750.
New York
City saves millions of dollars each year with acupuncture drug detox programs
which dramatically reduce the time newborns must be sheltered while their
mothers recover from crack-cocaine addiction. It is very expensive to keep
newborn babies in hospitals instead of in their mothers' arms. Acupuncture puts
the mothers back into their proper role of mothering by get- ting them off the
crack-cocaine addiction.
Our own Veterans
Administration researchers found that 61 percent of stroke patients with
paralysis showed significant improvement following acupuncture. Our VA did the
landmark studies of all the world acupuncture community by doing CAT scans of
stroke patients' brains, finding out what part of the brain was damaged and
then doing acupuncture with laser devices on those parts of the scalp.
In
Czechoslovakia, they are doing the same type of work on brain-damaged babies
and they do not have to institutionalize their children who have brain damage.
Not keeping a child in a hospital saves millions of dollars for the countries
of Czechoslovakia and Hungary. And I would like this to be instituted in our
country. The laser device they use — you can get it from "Sharper Image."
You know, it is the type they use to highlight things during speeches on the
wall. It costs $150. This is very inexpensive technology.
AIDS is
another example where acupuncture is saving money. Yearly treatment with
acupuncture in San Francisco Department of Health clinics costs less than
$3,400 per patient, and that figure includes herbs, weekly consultations and
acupuncture treatments, lab work, and all administrative overhead. Clinical
research that was just presented last weekend at a nationwide conference out in
San Francisco shows that low-cost acupuncture and herbs are even more effective
than treating AIDS with conventional, expensive Western therapies.
Acupuncture
is very helpful in treating chronic pain syndromes. The FDA reports that acupuncture
is used by doctors in 90 percent of German pain clinics; that the French
National Health Plan covers acupuncture. The American Chiropractic,
Osteopathic, and Veterinary Associations have all endorsed acupuncture as an
effective therapy for the treatment of pain. Even Henry Kissinger’s dog has
been for acupuncture.
The
conference report accompanying the National Institutes of Health Revitalization
Act urges the Office of Alternative Medicine to coordinate research with other
countries, foster training in alternative medicine, and disseminate its
research findings. The AAAOM strongly supports the directive Congress has given
OAM. China's Minister of Health, who is the brother-in-law of one of our AAAOM
members, has assured our organization of full Chinese cooperation with United
States research efforts. Other countries have made similar offers.
AAAOM
requests that Congress fund the Office of Alternative Medicine to conduct
domestic research staffed by State-licensed acupuncturists and to compile and
translate acupuncture research done in Asia and Europe. It costs a lot less to
translate than it does to conduct a new study. AAAOM also requests that the
Senate pass a companion bill to parity legislation similar to legislation that
was introduced in 1989 by Senator Barbara Mikulski.
The new
legislation is being introduced in the House by Congressman Maurice Hinchey,
and it guarantees that Federal workers have the right to choose a certified
acupuncturist when receiving acupuncture care. Presently, the Federal Employees
Health Benefits Plan covers acupuncture, but many of the policies only do so
when it is provided by a medical doctor and you cannot go for acupuncture to
somebody who is not certified in the discipline. We do not think this is fair.
The savings
in drug detox costs alone for Federal workers could be substantial — 15 percent
of all the American population is affected by chemical dependency. It is a very
substantial cost to our society. And our profession is the only one that offers
training in the prevention of chemical dependency and the treatment of chemical
dependency. Medical schools only provide 2 hours of training in chemical
dependency treatment and prevention — 2 hours in a whole course of medical
school education. We offer 120 hours, leading to certification as certified
addiction professionals. We want to teach the MD's how to approach their
patients so they can prevent addiction and treat it when it develops.
We further
request that the Senate pass companion legislation to a new House bill which
includes acupuncture and acupuncturists under Medicare part-B. Blue Cross &
Blue Shield of Maine estimated that covering acupuncture with their own
policies, provided by licensed acupuncturists, costs less than $1 per member
per month.
To reiterate,
"If you think education is expensive, try ignorance." As a society,
we are now being presented with the bill for our ignorance of how to care for
ourselves. We should learn from the example of Asian Americans and no longer
dismiss their priceless medical heritage as experimental.
Senator Harkin. Very good.
Dr. Kaltsas. Thank you very much.
[The
statement follows:] PREPARED
STATEMENT
Statement
of Dr. Harvey Kaltsas
Mr.
Chairman and members of the Committee, I am Dr. Harvey Kaltsas, a Doctor of
Acupuncture and the President of the American Association of Acupuncture and
Oriental Medicine (AAAOM) which represents America's 7,000 state licensed
acupuncturists. During this proceeding, I will illustrate some of the dramatic
cost-savings already brought about by our profession, which has gained
popularity in the USA only since President Nixon's visit to China in 1971. I
will also request Senate support for research at NIH's Office of Alternative
Medicine (0AM) into this discipline. I specifically request that OAM include
the participation of state licensed acupuncturist in its research plan. I also
ask for Senate support for bills now being introduced in the House which will
cover acupuncture under federal health insurance.
I would
like to start with a quote from Derek Bok, former President of Harvard
University, "If you think education is expensive, try ignorance." The
federal government is relatively uneducated about acupuncture, and that
ignorance is costing plenty.
Acupuncture
is the most commonly known therapy within the 5,000 year old healing system of
Traditional Chinese Medicine (TCM), a system which also includes the use of
heat therapy, massage, herbs, and dietary, lifestyle, and exercise counseling.
When I speak about acupuncture hereafter I am referring to the entire system of
Traditional Chinese Medicine. The practitioners of Traditional Chinese Medicine
understood the circulation of blood 2,000 years before William Harvey
articulated the concept in the West. And one thousand years "before
Richard Williamson pioneered a modem glucose level test, Chinese doctors had
discovered another method for detecting sugar they had patients pass urine on a
wide, flat brick to see if ants gathered to collect the sugar. As far back as
752 A.D., pork pancreas was recommended as treatment for this disease, an
approach similar to modern treatment by insulin."[1]
Yet this
5,000 year old system of healing has been ruled experimental by the Health Care
Financing Administration (HCFA), which has ignored voluminous research on
acupuncture s safety and effectiveness and has excluded acupuncture coverage
under Medicare. This is most inconsistent, because Medicaid pays for
acupuncture in states such as New York and California; the Federal Employees
Health benefits Plan covers acupuncture; millions of federal dollars are being
spent on acupuncture drug detoxification programs, and Master's degree level
programs in acupuncture are funded by the J.S. Department of Education, with
over 500 new graduates each year.
We suspect
HCFA is using the experimental label on acupuncture as a cost-containment
measure. HCFA should reverse its acupuncture ruling immediately. By demanding
acupuncture coverage, HCFA is inflating costs instead of containing them.
Ironically, the same research that shows that acupuncture is safe also shows
that it is quite dramatically cost-effective.
The Office
of Alternative Medicine (OAM) has an opportunity to save the federal
government, literally billons of dollars by identifying specific safe and
effective acupuncture treatments for specific ailments. This will remove the
unjustified blanket label of "experimental" that has been placed over
all acupuncture treatment during the past twenty years. But first OAM must
reach out for the expertise of the acupuncture community, both domestically and
worldwide.
Thus far,
the OAM has relied primarily upon the expertise of MDs in approaching
acupuncture. This is a serious mistake because practitioners of Traditional
Chinese Medicine, with years of schooling are the real experts in this field,
not MDs, most of whom do not have the time to explore this discipline
adequately.
AAAOM strongly urges OAM to include state licensed acupuncturists
on any future acupuncture research projects. Moreover, AAAOM urges that OAM
follow up on offers from China, Taiwan, Japan, Russia and Europe to share its
research. Translation is much faster and inexpensive than conducting new
studies. OAM's recommendations can then spur the integration of acupuncture
into other federal programs. Every year lost adds to needless human suffering
and to the billions in wasted federal funds.
ACUPUNCTURE IN THE UNITED STATES
Over the
past twenty years, since President Nixon's visit to China, some 6 percent or 15
million Americans have been treated with acupuncture.[2]
This low-cost, benign therapeutic system is especially helpful for children,
the elderly, the chemically dependent, and those whose immune systems are
compromised. Acupuncture often precludes the need for chemical pain killers,
cortisone, and surgery, all of which carry serious side effects.
Starting
with California in 1976, twenty-three states and the District of Columbia now
license, certify, or register acupuncturists. Most recent of these is Iowa,
where on May 6, 1993 the Governor signed legislation which for the first time
in Iowa allowed non-MD's to practice. Since so few MD’s practice acupuncture,
it had been virtually unavailable in Iowa heretofore. Not one acupuncturist or
one penny of practitioner support was involved in passing the Iowa law. This
was 100 percent the effort of health care consumers in Iowa.
Why are
these citizens demanding that acupuncture care be made available to them? Eric
Hoffer, LBJ's favorite philosopher, once said, "You can never get enough
of what you don't really want to make you happy." The simple truth is that
Americans do not really want health care insurance. They do not really even
want health care. They want health. And that's what acupuncture offers — a way
for many to regain health who could not do so otherwise.
A 1987
Florida study revealed that 96 percent of Florida acupuncture patients had
already been unsuccessfully treated with conventional western medical care and
then turned to a acupuncture as a last resort. Fully 80 percent of these
difficult patients reported satisfactory results from acupuncture.[3]
Our patients are living proof that acupuncture has a unique contribution to
make to America's health care system. What we offer is clearly not a
replication of services.
Every year
acupuncture gains in popularity. More than 82 private insurance carriers[4]
now cover acupuncture, and there has been growing public demand to include
acupuncture under Medicare and other federal programs. In response, many
legislators are asking "With the deficit this big, how can we possibly
mandate coverage for another group of health care providers?"
Actually,
legislators should be posing a more appropriate question, "What could the
federal government save by including acupuncture in the American health care
system?"
THE CHINESE EXAMPLE
Let us look
at China for a moment. I expect that some don't want to hear about China
because of its human rights abuses, and others don't like the fact that it is a
communist country. But the simple truth is that China spends $71 per person on
health care per year, whereas America spends $3,200.[5]
Granted the American population is healthier as a whole, but not by much. What
accounts for this astounding discrepancy in health care costs per person?
China has
observed two time-honored capitalistic principles to lower its costs, increase
supply and reduce demand. First, China greatly increased its supply of medical
providers in 1949 by giving equal legal and social status to an army of 500,000
doctors of acupuncture and Traditional Chinese Medicine who offer low-cost,
low-tech care.
Second,
China has reduced demand by improving food supplies, implementing massive
public sanitation projects and widespread public preventive health education
campaigns, and encouraging the use of low-cost acupuncture therapies. China's
preventive measures are low-cost and low-tech. They combine western medical
knowledge and practical measures we should have long ago implemented in our
country (such as a national cancer registry) with Traditional Chinese Medical
wisdom. Actually, acupuncture is not so much a disease treatment system as it
is a health promotion system.
As a
result, most Chinese families understand prevention and practice some very
simple therapies at home. For example, there are over a thousand acupuncture
points on the body that can be useful in reinforcing health. Most people in
China know at least some of these points and massage them if a problem is
developing.
I'd like
everyone here to spread their thumb and index finger of your left hand. Now
please take your right thumb and press on the webbed area between your left
thumb and forefinger until you feel a tender spot. You've just located a point,
Hoku. When used regularly, it is often helpful in treating headaches,
constipation, and a number of other ailments. Does it cost anything to rub it?
Of course not. How many Americans know about this point? Very, very few.
Similarly,
very few Americans understand that drinking cold liquids on a regular basis can
disturb the digestive function, thereby weakening the immune and circulatory
systems. Americans drink ice water with meals. Chinese drink hot tea. Do
Chinese know something we don't? Until very recently, western medicine did not
acknowledge the role of diet in creating or preventing disease, something understood
for centuries in China. Now this is common knowledge in the West. American
acupuncturists are working every day to educate our patients with similar
valuable knowledge.
What other
steps are acupuncturists taking to bring that $3,200 figure closer to $71?
ACUPUNCTURE IN THE TREATMENT OF CHEMICAL
DEPENDENCY
The
experience of the Miami Drug Court shows that acupuncture is a safe,
inexpensive way to help most felons succeed at treatment and avoid continued
addiction, probable re-arrest, and possible death. In fact, acupuncture is
considered "State-of-the-Art Treatment" in the domain of chemical
dependency.[6]
The State of Oregon concurred by mandating that "synthetic opiates [i.e.
Methadone] shall be used only when . . . detoxification with acupuncture and
counseling have proven ineffective or upon the written request of a physician .
. . showing medical need. ..."[7]
Why?
Because acupuncture works, and it is very inexpensive. Eighty percent of
arrestees, nationwide test positive for drugs. Hugh Rodham, Public Defender for
Dade County, Florida, [and brother of Hillary Clinton] now refers all of his
drug abusing clients for acupuncture through the Miami Drug Courts.[8]
Acupuncture provides the physical support which keeps felons enrolled in the
treatment and counseling process, dramatically relieving the biochemical stress
of withdrawal and rapidly accelerating physiological recovery.
In two full
years of operation, 4,296 felony drug possession arrestees entered the Miami
program. The 1,600 graduates have a 3 percent re-arrest rate. The 1,153
individuals still in the program have a 7 percent re-arrest rate. Cost is only
$750 per client for a full year of acupuncture treatment.[9]
What would it cost not to treat these patients with acupuncture? On a more
positive note, imagine the savings if our national recidivism rate were only 3
percent. The City of New York also saves millions of dollars each year with
acupuncture detox programs that dramatically reduce the time the City must
house newborns while the mothers recover from crack cocaine addiction.[10]
Without acupuncture, what would the expense to society be? Bullock and Culliton
noted that in a six month alcoholism treatment study, compliance and retention
increased from 5 percent of the patient population without acupuncture to 35
percent with acupuncture.[11]
Sir Jay
Holder, Director of the 250 bed Village Addiction Treatment Center in Miami and
the first American ever to be awarded the Albert Schweitzer Prize in medicine,
conducted the first true placebo study of acupuncture in the treatment of
chemical dependency. Dr. Holder concluded that "patients who complete at
least ten days of auricular [ear acupuncture] therapy and do not receive
intercurrent medications would be ten times more likely [96 percent] to
complete a thirty day residential program than they would without auricular
therapy."[12]
In the
realm of addictionology, these figures compare with Michael Jordan's
performance in basketball.
The real
key to resolving the problem of chemical dependency, which afflicts 15 percent
of the population, is education — starting with health care professionals, who
in turn should educate their patients on the nature, prevention, and treatment
of drug addiction. However, acupuncture is presently America's only primary
care profession which offers significant, comprehensive training leading to
certification as a Certified Addiction Professional. Medical schools generally
only teach two to three hours on the treatment of chemical dependency during
the entire education of an MD. In fact, the western medical tradition is itself
drug dependent and continually sends out a strong pro-drug message with every
prescription written. Acupuncture does just the opposite.
In what
other areas could our federal government save money by supporting the expanded
use of acupuncture in the U.S.?
STROKE, PARALYSIS, AND BRAIN DAMAGED BABIES
The
Veterans Administration, in association with the Boston University School of
Medicine, has conducted landmark research with the use of acupuncture to treat
paralysis caused from stroke. Federal researchers found that "61 percent
of the stroke patients with paralysis showed significant improvement following
acupuncture", and are now able to predict with 95 percent accuracy which
stroke patients are likely to benefit from acupuncture." Once again,
acupuncture proves to be safe and cost-effective.[13]
Dr.
Margaret Naeser, one of the stroke study researchers, also reports the
following on the use of acupuncture for the treatment of brain damaged babies
in Czechoslovakia and Hungary: "The acupuncture is begun within the first
10 days post- birth, or within the first year, post-birth. Dr. Michaela
Lidicka, from Czechoslovakia, has data which shows the brain-damaged babies who
begin treatment with acupuncture within the first year of life, do not have to
be institutionalized for care. Their records are complete up to 5 years, so
far. This represents a great cost saving for medical care in their countries.
Their results are better for babies born with brain damage due to lack of
oxygen at birth, than for babies born with brain damaged due to genetic defect.
The reputation of acupuncture in treating babies with brain damage has spread
in Prague and Budapest, and as a result, most babies born with brain damage are
now routinely referred to these acupuncturists for treatment ... as soon as
possible, post-birth."[14]
AIDS
Acupuncture
has proven to be a low-cost, benign complement to conventional medicine in the
treatment of AIDS. At the First International Conference of HIV, AIDS, and
CHINESE MEDICINE held in San Francisco June 18-20, 1993, research was presented
attesting to acupuncture's popularity and effectiveness at treating AIDS
related diseases. Acupuncture is especially effective for managing such AIDS
symptoms as diarrhea, fatigue, hepatitis, irritable bowel syndrome, joint pain,
night sweats, and peripheral neuropathy.
In patients
receiving acupuncture treatment, CD4 cells, which indicate the strength of the
immune system, showed a decline of only 4 percent after 2.5 years compared to
18 percent and 49 percent in non-acupuncture groups. A sizeable number of
patients remained asymptomatic. In one study of 201 HIV patients, those using
only acupuncture and herbs did better than those using a combination of Chinese
medicine and western medications.
In 1992,
the American College of Traditional Chinese Medicine (ACTCM) in San Francisco
received a first of its kind contract from the Department of Public Health to
provide acupuncture care. Even with such an expensive disease as AIDS, the
yearly cost for weekly treatment in this public clinic setting runs less than
$3,400 per patient, and that figure includes herbal care, consultations, lab
work, and administrative overhead. Once again, education is an essential part
of managing this disease in the ACTCM program, which has a four month waiting
list for entry.[15]
Sir Jay
Holder considers acupuncture and Chinese herbs to be the most promising and
cost-effective treatment for AIDS yet discovered. Dr. Holder asserts
"There are very few things that can support the immune system as quickly,
as effectively, and as inexpensively as acupuncture and traditional Chinese
medicine."[16]
This is not
to suggest that acupuncture is a substitute for all other conventional
therapies. But when these treatments are coordinated, acupuncture provides a
safe and gentle support system for patients too weak to withstand the side
effects of pharmaceuticals or surgery.
CANCER
It is often
said that there are tremendous medical discoveries awaiting humanity within the
flora and fauna of the Amazon rain forests, and that we must save them to
preserve their treasures for posterity. Within the world of acupuncture and TCM
[Traditional Chinese Medicine], many such treasures have already been found and
developed. Over 5,000 herbs and 25,000 herbal formulae are now commonly used in
TCM.
In China,
herbs help significantly in the management of cancer when used as an adjunct to
surgery, chemotherapy, and radiation. The Journal of the American Medical
Association, 1/27/84, reported that life expectancy doubled for patients with
rapidly advancing cancers when Chinese herbs [which cost pennies a day], were
added to the treatment plan. JAMA noted that in general "patients who
received Fu-Zheng [herbal] therapy survived longer and tolerated their
treatment better than those patients who were treated by western medicine
alone. ... In addition, the five year survival rate was twice as high among
patients with nasopharangeal cancer . . . (53 percent v. 24 percent)."[17]
Another
article in JAMA, 11/10/89, noted acupuncture's success treating nausea for
chemotherapy.
PAIN
Acupuncture
is perhaps best known for its ability to manage chronic pain syndromes. In one
study of over 20,000 patients at UCLA, acupuncture reduced both the frequency
and the severity of muscle tension headaches and migraines.[18]
Other studies document acupuncture's marked ability to reduce neck and back
pain, with 58 percent of the treatment groups maintaining improvement after 40
weeks.[19]
The
American Chiropractic, Osteopathic, and Veterinary Associations have all
endorsed acupuncture as an effective therapy. Even Henry Kissinger's dog has
been treated with acupuncture![20]
And the
AMA, while citing its shortcomings, acknowledges that "Acupuncture ... is
considered particularly effective in the treatment of migraine and tension
headaches, but it is often used in the treatment of visceral pain as seen with
cholelithiasis, appendicitis, gastritis, renal colic and peptic ulcer. . .
."[21]
A 1991
study from the FDA's Office of Science and Technology reports that acupuncture
is used by doctors in 90 percent of German pain clinics and is covered under
the French national health plan.[22]
This study goes on to quote R.H. Bannerman, a Programme Manager of the World
Health Organization: ". . . the sheer weight of evidence demands that
acupuncture must be taken seriously as a clinical procedure of considerable
value."[23]
REQUESTS FOR CONGRESSIONAL SUPPORT
Acupuncture
represents the greatest unexplored treasure trove of medical information on the
planet today, and China has freely offered us the benefits of literally
millennia of research. One of our members, Cecilia Chang, is sister-in-law to
the Minister of Health for all China, and he has assured full Chinese
cooperation with almost any U.S. research effort. The Taiwanese, Japanese and
Europeans have made similar offers. AAAOM requests that Congress fund the
Office of Alternative Medicine to support domestic acupuncture research and to
compile and translate acupuncture research done in Asia and Europe.
We remind
the Subcommittee that the Act reauthorizing the NIH Office of Alternative
Medicine specifies that "[t]he purpose of the Office is to facilitate the
evaluation of alternative medical treatment modalities, including acupuncture
and Oriental medicine. . . . P.L. 103-43, Section 404E.
In the
Conference Report accompanying the NIH Revitalization Act, H.R. Conf. Rep. No.
100, 103d Cong., 1st Sess., p. 117, the Conferees urged the OAM to accomplish
the following:
(1) formulate a plan for future research
activities at NIH;
(2) provide fellows authorized under
this legislation the
opportunity to engage in program
and policy analysis, as
well as perform clinical research;
(3) coordinate research efforts with
those of other countries;
(4) develop databases which would
support both research and
information transfer functions;
(5) foster training in the area of
alternative medicine; and
(6) disseminate its research findings through
conferences and other forms of professional communication.
AAAOM
strongly supports the directives that Congress has given to OAM. We
specifically ask that 0AM include the meaningful participation of state
licensed acupuncturists, as research fellows, in the development,
implementation, and evaluation of OAM's research plan to investigate
acupuncture. We ask that as part of its research plan, OAM consult with
representatives of HCFA to establish reasonable scientific criteria to remove
the twenty year old "experimental" status of acupuncture.
AAAOM also
requests that the Senate pass a companion bill to parity legislation being
introduced by Congressman Maurice Hinchey which guarantees freedom of choice of
health care providers for federal workers insured by the Federal Employees
Health Benefits Program.
Some FEHBP
policies presently cover acupuncture, but only when performed by an MD. The
Hinchey legislation would leave insurance companies with the right to choose
whether or not to cover acupuncture. But if they choose to cover acupuncture,
then they must pay for the service when provided by a state certified,
licensed, or registered acupuncturist. This sounds silly, but some FEHBP
policies only cover acupuncture when performed by an MD, and not many MDs are
well-trained in acupuncture. Savings in drug detox costs alone for federal
employees could be substantial.
When
similar parity legislation was reviewed by the State of Maine, its Mandated
Benefits Advisory Commission concluded that "[s]ince the proposed mandate
applies only to policies which already cover acupuncture, the financial impact
would be minimal.”[24]
The Maine study also explored the economic impact of requiring insurance
policies to cover acupuncture and include acupuncturists as providers:
"Blue Cross and Blue Shield estimate that addition of licensed
acupuncturists as providers would add less than $1 per member per month to pure
premium if coverage of the service were mandated."[25]
As a
result, BC/BS of Maine has chosen to provide acupuncture coverage for all State
of Maine employees and school teachers. With this in mind, AAAOM requests that
the Senate pass a companion bill to one being introduced by Congressman Hinchey
which would include acupuncture and acupuncturists under Medicare Part B.
CONCLUSION
To
reiterate, "If you think education is expensive, try ignorance." As a
society, we are now being presented with the bill for our ignorance of how to
care for ourselves. We must increase the supply of those who would teach us how
to live in harmony with life. By so doing, we can reduce the demand for
expensive health care services.
U.S. Government
research shows that Asian-Americans spend less federal health care dollars per
person than any other ethnic group. We should learn from their example and not
dismiss their medical heritage as "experimental." Frankly, we can no
longer afford to do so.
[1]
Keli
Tomoshaitis, Herbal Crossroads, May, 1993, K'an Herb Co., Soquel, CA.
[2]
Time/CNN
poll Oct. 23, 1991 by Yankelovich Clancy Shulman.
[3]
Dr.
Christine R. Geiser, University of South Florida Anthropology Ph.d thesis,
November 8, 1989, Tampa, FL
[4]
See
Exhibit A, list compiled by AAAOM of insurance companies which have
paid for
acupuncture.
[5]
Chinese expenditures on health care
computed as 5 percent of $1.7 trillion GNP divided by 1.2 billion population.
U.S. figure computed by dividing $800 billion expenditure by 250 million
population.
[6]
"Third
National Conference on Drugs and Crime" booklet, 1/31-2/3/93, Na-
tional
Consortium of TASC Programs, 4444 North Capitol Street, N.W. Suite 642,
Washington, D.C. 20001.
[7]
Oregon Legislative Assembly, 1991
Regular Session, House Bill 2580.
[8]
Personal
interview with Hugh Rodham, 4/29/93; interview in the St. Petersburg Times, "The Good Points of Acupuncture,"
May 16, 1993, Page 2F.
[9] See
Exhibit B, Summary of report from the Metropolitan Dade County, Office of
Rehabilitation Services, Diversion and Treatment Program.
[10] See
Exhibit C, "Acupuncture As a Treatment for Drug Dependent Mothers,"
Testimony
presented by Michael Smith, MD to the NY City Council 4/11/88.
[11]
"Acupuncture treatment of alcoholic recidivism; a pilot study" by
Bullock, Culliton, et al., Alcoholism — NY, June 1987; reprinted in Lancet,
1989.
[12] See
Exhibit D, Sir Jay M. Holder, DC, MD, Robert Duncan, Ph.D, et al. "A
New
Auricular Therapy Formula to Increase Retention of the Chemical Dependent
in
Residential Treatment" by Research study funded by the State of Florida,
Department of Health and Rehabilitative Services.
[13]
See
Exhibit E, letter from Margaret A. Naeser, Ph.D. to AAAOM, September
9, 1991.
[14]
See
Exhibit E, op. cit.
[15]
See
Exhibit F, Report from Howard Moffett, on ACTCM HIV Clinic Program.
[16]
Personal interview, June 16, 1993.
[18]
Millman,
B. "Acupuncture: Context and Critique," American Review of Medicine 28 (1977): 223-36.
[19] See
Exhibit H, Coan, Wong, et al., "The Acupuncture Treatment of Neck
Pain, Am. Journal of Chinese Medicine, Vol.
EX, No. 4, pp. 326-332".
[20] Personal
interview with Allen Schoen, D.V.M.
[21] See
Exhibit I, AMA Resolution 126 (A-81).
[22] See
Exhibit J, C.D. Lytle, Research Biophysicist, Health Sciences Branch, FDA,
Division of Life Sciences, Office of Science and Technology, CDRH, "A
Review of Acupuncture and Acupuncture Needles in the U.S.," 1991.
[23] See
Exhibit J, C.D. Lytle, op. cit.
[24]
See
Exhibit K, State of Maine Mandated Benefits Advisory Commission, "Reports
on Acupuncture," 1992.
[25]
See Exhibit K, State of Maine, op. cit.
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