Position Paper #11
– Insurance
Until the mid-seventies, insurance was never an important issue among straight chiropractors. First, there were relatively few insurance plans that covered chiropractic and second, the straight chiropractic community had yet to clearly define itself by its objective. While insurance inclusion of chiropractic has begun to wane there are still many chiropractors who participate in insurance programs, and enough who identify as straight chiropractors, that the issue needs to be addressed.
The objective of the straight chiropractor is to correct vertebral subluxations because they are in and of themselves a detriment to the full expression of the innate intelligence of the body. Chiropractic care with this objective in mind, is necessary for every member of the human race for a lifetime, regardless of the presence or the absence of medical conditions. The issue of insurance impacts upon the practice of chiropractic economically as well as philosophically. The primary thrust of most national and state organizations is to maintain or improve the ability of the chiropractor to be reimbursed by third party pay. It can very effectively be argued that the medicalization of chiropractic, particularly its educational program during the past 30 years and much of it against the will of the majority of the profession, has been for the ultimate purpose of improving the chiropractors position in insurance and government reimbursement. Because that agenda has not been altered and because so many chiropractors who purport to practice straight chiropractic participate in insurance, it is important that the non-therapeutic straight chiropractor have a position or this issue. The following are reasons for the objective straight chiropractic position:
- Insurance in its current form is designed for the treatment of medical conditions. If chiropractic is included in an insurance program, it is because the third party payer implicitly or actively maintains that the vertebral subluxation is a medical condition or is the cause of a medical condition. Both of these presumptions are incompatible to the objective straight chiropractor. Insurance could cover maintenance chiropractic care. In which case it would be acceptable. However, that would probably defeat the true purpose of insurance which is to cover people for disaster-type medical conditions.
- For a chiropractor to participate and be paid through an insurance plan, he/she must diagnose or imply that there is an effort being made to alleviate a medical condition. While conditions may alleviate under chiropractic care, that is not the objective of the straight chiropractor. Expanding the definition of diagnosis to include vertebral subluxation has the effect of making the subluxation a medical entity and drawing chiropractic further into the medical model, the exact opposite desire of the objective straight chiropractor. The accepted definition of diagnosis with regard to health problems invariably relates to medical conditions and is recognized as such by insurance companies. How the chiropractor wants to define diagnosis is not the issue. How the insurance industry defines it and the public understands it is the issue. (For further clarification see F.A.C.E. Position Paper on Diagnosis)
- Insurance is not intended to cover lifetime maintenance care for the continued monitoring and necessary correction of vertebral subluxations. The objective straight chiropractor accepts members with the understanding that lifetime maintenance care is the intended approach. Participating in insurance programs with this type of care is not only not acceptable to the insurance company, it undermines the practice member’s understanding and acceptance of that care.
For these reasons third party pay is not consistent with the practice of objective straight chiropractic.