December 2004


  • Medicare Pilot Project Expands Coverage for Chiropractic Care
  • FDA Incapable of Protecting Americans
  • Business Publication Picks Up on Chiropractic Cost Savings
  • Lack of Sleep Can Make You Fatter
  • British Study Touts Benefits of Chiropractic
  • Antidepressant Use Rising Among Kids

Medicare Pilot Project Expands Coverage for Chiropractic Care

The Dec. 13, 2004 issue of the American Medical News reports that Medicare will be expanding coverage for chiropractic services in a pilot study. The report notes that starting next spring, certain Centers for Medicare & Medicaid Services will begin paying licensed chiropractors for services beyond what was previously termed, “manual manipulation of the spine to correct subluxations”.

The demonstration project was put into effect in a bill that passed last year known as the Medicare Reform Act. Because of this pilot project certain chiropractors in Illinois, Maine, New Mexico and Virginia will be able to provide reimbursable care in areas previously not covered, such as diagnostic services, x-rays and physical therapy.

Dr. Rick Miller, a lobbyist and consultant with the American Chiropractic Association stated that this pilot program will show the benefits of chiropractic care. He noted, “We believe that if you take a cohort of patients that exhibit the same type of symptoms and you look at episodes of care, patient satisfaction will be higher and global costs will be lower for the chiropractic services.”

The timetable for the implementation of this program is in the spring of 2005.


FDA Incapable of Protecting Americans

The above headline comes from numerous publications including the November 18, 2004 edition of the LA Times. This feature article strongly suggests that the FDA as currently configured and run cannot protect the American public from bad medications.

The article notes that the Food and Drug Administration knew before the agency approved Merck & Company's, Vioxx painkiller in 1999 that the drug could have serious adverse effects on the heart. In spite of knowing of problems in advance the article said that the FDA gave its approval without resolving the concerns.

David Graham, a doctor with the FDA's Office of Drug Safety, which monitors drugs already approved for patient use, said that as a result, as many as 139,000 Americans who took the drug for arthritis, back pain and other ailments may have suffered serious side effects. He also noted that from 26,000 to 55,000 people may have died as a result.

In his testimony, Dr. Graham told the US Senate Finance Committee, “Vioxx is a terrible tragedy and a profound regulatory failure." He continued, “I would argue that the FDA, as currently configured, is incapable of protecting America against another Vioxx. We are virtually defenseless."


Business Publication Picks Up on Chiropractic Cost Savings

From the Nov. 22, 2004 Business Wire comes another in the long line of reports on a major study that has now shown that when chiropractic care is included in a health care plan, it reduces the cost of healthcare for those in the plan. The original study, published in the October 11th, 2004 issue of the Archives of Internal Medicine, was a 4 year review comparing more than 700 000 health plan members with an additional chiropractic coverage benefit and 1 million members of the same health plan without the chiropractic benefit.

The results of the study showed that members in the health plan with chiropractic insurance coverage, had lower annual total health care expenditures ($1463 vs. $1671 per member per year) compared with those without chiropractic coverage. The study also noted that having chiropractic coverage was associated with a 1.6% decrease in total annual health care costs at the health plan level.

The study and report also showed benefits in terms of utilization of health care services. For example the study noted that back pain patients with chiropractic coverage, compared with those without coverage, had lower utilization (per 1000 episodes) of plain film x-rays. Additionally, the average cost of a back pain episode in related costs was $289 for those in the plan with chiropractic compared to $399 for those in the plan without chiropractic coverage. The total savings to the health plan was estimated at $208 per member per year.

This latest report in Business Wire shows that the world of big business is attempting to reduce the cost of health care services and have begun to find that including chiropractic may provide a viable solution. The study was conducted by Health Benchmarks, a leading health care outcomes research organization that specializes in integrating complex sources of health care data to provide customized solutions that promote quality and value in health care.

Antonio P. Legorreta, M.D., M.P.H., President and CEO, Health Benchmarks Inc, summed this up by stating, "The results of our study indicate that the addition of chiropractic coverage reduces overall health care expenditures." Dr. R. Douglas Metz, a co-author of the study noted,"Systematic access to managed chiropractic care not only may reduce overall health care costs but also may prove to be clinically beneficial." Dr. Metz went on to say, "these findings impact health care providers and payers."

Drs. Ness and Nisly wrote an accompanying editorial in the same issue of the Archives. In it they stated, “One of the study's greatest strengths clearly lies in the sheer magnitude of the sample investigated, resulting, to my knowledge, in one of the largest analyses ever performed on the economic impact of chiropractic."


Lack of Sleep Can Make You Fatter

From the American College of Physicians, December 7th 2004 issue of the Annals of Internal Medicine comes a study that suggests that there is a correlation between lack of sleep and weight gain. Chief author, Dr. Eve Van Cauter, Professor of Medicine, University of Chicago, states, "If you do not run a sleep debt, you will be able to curb your appetite more easily and maintain or lose weight."

A full article on the original research on the December 2004 FitCommerce.com website notes that sleep deprivation increases levels of a hunger hormone and decreases levels of a hormone that can make you feel full. These 2 factors lead to cravings for sweets, chips, and starchy fare like bread and pasta thus setting up the scenario for weight gain.

According to the National Sleep Foundation, An estimated 63% of American adults do not get the recommended 7 to 9 hours of sleep a night. They report that the average adult gets 6.9 hours of sleep on weeknights and 7.5 hours on weekends, for a daily average of 7 hours. The researchers point out that the decline in time spent sleeping correlates to the rise in obesity in the U.S. Statistics show that less than one-quarter of young American adults sleep eight to nine hours per night -- down from about 41 % in 1960.

The article notes that this scenario sets up a downward cycle. Not having enough sleep leads to weight gain, then weight gain and obesity leads to sleep difficulties that can affect the quality of sleep and therefore cause even more sleep loss and therefore more weight gain.


British Study Touts Benefits of Chiropractic

A study released by the British, “Medical Research Council” (MRC) showed that Chiropractic and exercise was effective for patients suffering from lower back pain. The British study used the term “spinal manipulation”, (more correctly termed “adjustments”), which they noted is the primary form of care performed by Doctors of Chiropractic. The study, published in the November 19, 2004 edition of the British Medical Journal, stated that when combined with an exercise program, these two offer an effective treatment for those suffering from back pain.

The trial study recruited more than 1,300 patients from across the UK, whose back pain had not improved after receiving what they termed the “best care” in general medical practice. These patients were then compared and assessed to judge the effectiveness of three different types of care.

The three types of care were:

    • A class-based physical exercise program.
    • Spinal manipulation
    • A combined package of spinal manipulation followed by a program of exercise

The results showed that to varying degrees all patients in the treatment groups reported improved back function and reduced pain over time. They noted that patients assigned to exercise classes in addition to general practice care reported a small benefit at three months but not at one year. Those assigned to spinal manipulation in addition to general practice care reported a small to moderate benefit at three months and a small, on average, benefit at one year. However, the greatest improvement was found in the patients assigned to combined manipulation and exercise in addition to general practice care.

Antidepressant Use Rising Among Kids

A November 18, 2004 Reuters News story with the above headline starts off by noting that according to a new study doctors are prescribing more antidepressants for children and adolescents although there is little evidence about their safety or efficacy in youngsters.

Dr. Ian Wong of the Centre for Paediatric Pharmacy Research at the University of London was one of several researchers who conducted the study. They compared prescribing trends in Britain, France, Germany, Spain, Canada, the United States, Argentina, Brazil and Mexico by using information from an international database that contains a representative sample of medical practitioners in each country. Dr. Wong noted that Britain had the highest rate of increase with 68 percent while Germany, with 13 percent, had the lowest. He commented, “The number of prescriptions in different countries for children with mental illness is increasing.”

Dr. Wong did note that the rate of increase in England was higher because the number of children that were taking antidepressants was low compared to the United States. “In England, the number of prescriptions per child for that kind of illness is actually 10 times lower than in America. When you have a very low baseline the increase is much quicker,” Dr. Wong said.

The article noted that earlier this year New York Attorney General Eliot Spitzer accused drug manufacturer GlaxoSmithKline Plc in a lawsuit of fraudulently suppressing information about its antidepressant Paxil, which is sold as Seroxat in Europe. The lawsuit claimed that the drug was broadly ineffective in youngsters and could increase the risks of suicidal behavior.

Wong and his colleagues concluded, “We believe the use of psychotropic medications in children is a global public health issue, which should be studied in partnership with pharmaceutical companies, governments and researchers.”


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