The response to the challenges that face chiropractic will define the profession in California for years to come

If I had to use one word to describe the 2002 California legislative session, it would have to be challenging. California is on the defensive again because: 1) myopic legislators are considering eliminating chiropractic from Medi-Cal, the state Medicaid agency, to save money; 2) legislation to force managed care contracts to be fair and reasonable is being fought by the unrelenting managed care industry; 3) Senator Jackie Speier (D-San Francisco/San Mateo) has vowed to prevent chiropractors from performing Department of Motor Vehicles physical examinations on truck drivers; and 4) naturopaths are seeking licensure to allow them to become primary care providers. The California Chiropractic Association (CCA) has taken several steps to protect and promote the chiropractic profession from these attacks. However, it is time for all chiropractors to become more involved in the political process to ensure the profession continues to flourish.

Fighting the Good Fight

Proposal to eliminate chiropractic care from the Medi-Cal program. California’s state budget is expected to have a deficit of more than $12 billion next year. CCA has learned that one of the numerous proposals the legislature is considering is to eliminate all services from the Medi-Cal program that are not required by federal law, including chiropractic.

To ensure continued access, the CCA has developed a fact sheet demonstrating that chiropractic care is more cost-effective than traditional medicine and should be expanded under Medi-Cal to maximize savings. This fact sheet is being used in our lobbying effort to educate the legislature on the benefits of chiropractic care.

AB 1600—fair and reasonable managed care contracts. The CCA is working with the California Medical Association to pass legislation to allow all interested parties to sue managed care plans refusing to offer contracts to health care providers that are fair and reasonable. This bill is being fiercely opposed by the managed care industry, which believes that the Department of Managed Health Care should be the only entity allowed to enforce the law.

Physical examinations. Last year, Senator Speier amended a bill to prohibit chiropractors from performing the required physical examination for a truck driver’s license. In response to CCA’s strong opposition, Senator Speier restored chiropractors to the list of health professionals who could give the exams because she wanted other provisions unrelated to chiropractic to pass. However, Senator Speier indicated that she would be introducing a separate bill in 2002 dedicated to eliminating chiropractors from performing these examinations.

Naturopaths seeking licensure in California. Their initial proposal includes performing everything chiropractors do without the education and training. With strong arguments and dedication of a few chiropractors in the state, CCA may be able to fend off these attacks this year. However, this profession will be faced with the same challenges every year until we are able to develop and harness the political power necessary to prevent the opposition from attacking.

Ask Not What Chiropractic Can Do for You

What can you do to make a difference? There are several strategies that any chiropractor can do to effect change:

• Become politically active in your community. People who see a chiropractor regularly or are friends with a chiropractor are much more positive and supportive of the profession. Legislators and other elected officials are no different. Politically active chiropractors help educate legislators about the practice of chiropractic and discuss issues important to the profession. Becoming a member of the legislative committee for the local chamber of commerce will give you exposure to state and local legislators, as well as provide an opportunity to learn about the legislative process.

• Be knowledgable about political issues that impact your practice. The more you know about chiropractic and health care issues in general, the more effective you will be as an advocate on behalf of the profession.

• Get to know elected officials and opinion leaders in your local area. As a constituent in the area, they really do want to know you. Attend local community events and forums and make a point of meeting your local officials and state legislators. Demonstrate your support by volunteering for campaign activities such as precinct walking and telephone banking, or making a contribution.

• Be active in your neighborhood and in family-oriented organizations. Elected officials, public opinion leaders, key staff persons, and their families may attend your church, have children in the same schools, help coach the soccer team, or be involved in local Neighborhood Watch programs.

• Send a letter to the editor of your local newspaper. It is a good forum for spreading the word on chiropractic issues, especially if you demonstrate the impact on a personal level. Elected officials and their staff routinely peruse this section to gauge public opinion.

About the Author

Kristine Shultz is director of governmental affairs for the California Chiropractic Association and is responsible for implementing legislative and political programs. She can be reached at 916-648-2727, ext 130, or via email: kshultz@calchiro.org.