In politics, it takes blood, sweat, tears, and luck to be successful

I have always lived a charmed life in politics. Even as a college student, I was involved in a number of political campaigns, and I was fortunate to befriend individuals who would later become key staff members for the late President Reagan. As a result of my networking, I was selected as a staff person on the California delegation for the 1968 Republican Convention in Miami, and in 1970, I ran Reagan’s reelection campaign in San Francisco.

Eventually, I served in the Reagan Administrations when he was governor and later as president. I got these positions by working hard, being reliable, and most importantly, being at the right place at the right time. I have known individuals who labored in the vineyards for years and made greater contributions than I, but who never received the accolades or positions I did.

Right Place, Right Time
Being in the right place at the right time can also be attributed to a DC I met at the recent California Chiropractic Association (CCA) convention. David Paris, DC, the president of the CCA North Bay Society, thanked me for the American Chiropractic Association’s (ACA) efforts in getting the chiropractic benefit in the Veterans Affairs (VA) system. Paris, who is being credentialed as the treating doctor in the Redding, Calif VA Hospital, indicated that he had come to the National Chiropractic Legislative Conference (NCLC) in 2001 as the SACA president from Palmer West. He said his experiences during NCLC helped him secure the position at the Redding VA Hospital. Here is a prime example of someone who can show a positive cause-and-effect relationship between their actions.

Unfortunately, in politics, the examples of Paris and myself are few and far between. If you consider that more than 65 years ago, BJ Palmer first proposed to Congress a chiropractic benefit in the VA, this profession labored for years before any legislation passed that positively affected chiropractic.

Ask yourself this question: What legislation was passed in Congress prior to 1996 that positively impacted the profession? From my vantage point, the only legislation of significance was the inclusion of the chiropractic benefit in Medicare, and I do not believe that anyone is very excited about being paid for only correcting a subluxation.

Now, let’s look at what has been accomplished since 1996:
    •    President Clinton signed legislation that included the removal of the x-ray requirement under Medicare.
    •    President Clinton signed legislation that included a provision that allowed a DC to treat members of Congress and the Supreme Court at the Capitol.
    •    President Clinton signed legislation that included a provision making chiropractic a permanent benefit for members of the armed forces. President Bush signed a subsequent bill that accelerated the implementation of this provision.
    •    President Bush signed legislation that included a provision making chiropractic a permanent benefit in the VA.
    •    President Bush signed a bill that included a provision establishing a chiropractic pilot program in the National Health Services Corp. He then signed a related bill last year authorizing an additional $3 million for the program.
    •    President Bush signed the multibillion-dollar Medicare Prescription Drug Bill, which included a provision that established a pilot program under Medicare. This program allows DCs in four sites to treat Medicare patients to the full scope of practice as set forth by their respective states. (What was significant about the passage of the chiropractic benefit in this bill is that it not only provided the profession with the opportunity to show its cost-efficiency using the government’s own protocols, but also showed the level of support for this profession that exists in Congress against some significant opposition.)

Perception Versus Reality
In Washington, perception is as important as reality. The perception that chiropractic and the ACA are a power to be dealt with continues to build momentum. In December, The Washington Times included a story written by an independent analyst who had recently surveyed 77 congressional staff. The survey asked which political organizations had the most effective grassroots efforts, particularly as it related to the then recently passed Medicare legislation.

The ACA was ranked as the 19th most effective organization—ahead of the American Physical Therapy Association, the US Chamber of Commerce, and the Osteopathic Association. Subsequently, the author of the survey was interviewed by a chiropractic publication, and he discussed the criteria used in determining these rankings. From that article, we learned that the analyst began by reviewing more than 1,200 associations. He then narrowed the list to 171 associations, and then scheduled interviews with staff who had worked on key committees in Congress. In the end, the ACA was found to be the 19th most effective organization. The author indicated that the other national chiropractic organizations did not make the first cut of 170 organizations, confirming what I have known for years—the ACA is the most effective national chiropractic organization in the country, bar none.

In Washington, where organizations can go for years without showing any legislative progress, the success of the ACA has been noted and praised. So who is responsible for this success? I believe that the efforts of DCs cannot be underestimated. What we have accomplished over the past 30 years to develop credibility as a profession and as a political force is outstanding.

Future Plans
What about the future, you ask? We do have great momentum, but we also have much work to do. If the 2-year demonstration project of Medicare is as successful as we think it will be, the ACA will push for full implementation for all doctors in the country. Furthermore, we must continue to push the Dept of Defense to ensure that the chiropractic benefit is available to all of our service members by the end of 2005, as required by Congress. The VA program is doing well, but we need to continue to monitor this effort. Just recently, Rep Mike Rogers (R-Ala) introduced legislation (HR 999) that would extend chiropractic health benefits to US military retirees, dependents, and survivors through the TRICARE program. This will not be an easy bill to pass.

I have been fortunate to be at the right place at the right time to see such great success for chiropractic. Join with me in participating in future efforts, because unlike many of your predecessors, you will be able to see success and will help build this profession’s future. CP

Garrett F. Cuneo is the executive vice president of the American Chiropractic Association. His previous positions include executive director of the California Chiropractic Association, director of the Secretary’s Advisory Committee Office of the US Department of Health and Human Services, and executive director of the California Board of Chiropractic Examiners. Cuneo can be reached via e-mail: gcuneo@amerchiro.org.