Political Scapegoat

What is going on in California? The gubernatorial recall election and candidates have all the makings of a farce. Instead of addressing the serious fiscal issues, most of the 135 candidates seem intent on exploiting their 15 minutes of fame. And because of this entertainment aspect, this is not just local or state news—this is national exposure.

Why should California chiropractors be concerned about the state of affairs? The serious candidates can decide that California’s ailing workers’ compensation (WC) system is the perfect platform on which to get elected. According to an August 17, 2003, front-page Los Angeles Times article, “Chiropractic Claims Pain California Employers,” California Senator Jackie Speier (D-Hillsborough) is one lawmaker who has proposed legislation requiring “an independent medical review panel, insurance company, or self-insured employer to approve anything beyond 15 [chiropractic] visits for each work-related injury.”

How can medical doctors, insurance companies, and employers decide on chiropractic care and treatment treatment for patients? All of the parties above have a financial motive for reducing chiropractic care. I do not see how this is an objective health care review panel.

John Garamendi, California state insurance commissioner, also approves of gatekeepers for extended treatment. “By almost any measure California’s system is dysfunctional,” Garamendi says. Chiropractic has become a scapegoat due to the sharp increase in costs for chiropractic care. The article also states, “Chiropractic care is one of the costliest and fastest-growing components of California’s [WC] system, part of an explosion in medical costs that has thrown the employer-paid insurance program into turmoil.”

And how will this affect the rest of the chiropractors practicing in the United States? Chiropractic has always been a favorite target for the medical and pharmaceutical communities and lawmakers. Bad publicity is never good for a profession that has been fighting slings against its reputation since its inception. The LA Times article mentioned a WC case in which Monterey Mushrooms in Watsonville, Calif, was awarded $1.7 million from husband and wife chiropractors in Monterey, Calif, because of more than 700 fraudulent claims billed between 1997 and 1999. Another negative incident mentioned was about an advertisement that Speier used at a WC hearing this year. The ad, which ran in the Journal of the California Chiropractic Association, included copy such as, “Double or triple [your] income from the high-profit work comp market” and “[The WC system] is the only golden goose that is really still laying the golden eggs.” Speier says, “The workers’ compensation system is the equivalent of a blank check.”

Kenneth Martin, DC, Chiropractic Products editorial advisory board member, says, ”Unfortunately, because of the [WC] system’s generosity, there are many who take advantage, which is why the WC costs has skyrocketed in the past 7 years. A recent study by the California Workers’ Compensation Institute (an insurance company organization) produced a report that claimed that DCs have increased [WC] use and payments by 42% in the past 5 years. Armed with this report, the legislature has targeted chiropractic. Chiropractors are the number one providers in nonsurgical, drugless health care, and it makes sense that there is an increase in visits to DCs by injured workers. But what the study doesn’t show is that there is a corresponding decrease in medical care. In addition, payments to chiropractors are less than 1% of the total payments made to providers in the WC system.”

In the August 23, 2003, LA Times Letter to the Times section, the three letters printed were all in support of chiropractic. One reader wrote, “Your article diverts attention from [the cause of the problem] and unfairly places the blame on a convenient target.” The support of chiropractic patients who are rid of dis-ease can always be counted on.

Miwon Seo
mseo@medpubs.com