Three Tier Universal
Healthcare Proposed, with Chiropractic Only Included in
Tier 2
On
March 2, 2009 an article was published in the Annals of
Internal Medicine, that laid out a detailed plan for
universal healthcare in which chiropractic is only
included on a voluntary basis. The authors of this
article call themselves the "Healthcare Professionals
for Healthcare Reform", and describe themselves as, "a
group of physicians and others interested in health care
reform who, recognizing the urgent need for change,
convened to propose a universal health care plan that
builds on the strengths of the U.S. health care system
and improves on its coverage, efficiency, and capacity
for patient choice."
In their article, they put forth a detailed plan for
universal healthcare delivered in a three tiered system.
(The
article can been seen here.) In this proposed
system there would be three tiers of service offered.
As they describe it, "Tier
1,
the base level, would cover the entire population from
cradle to grave. It would include all medical, surgical,
and psychiatric therapies considered to be life saving,
life-sustaining, or preventive on the basis of the best
evidence (from the medical literature and expert
opinions)."
In their
plan, Tier 2
would, "cover all therapies considered to help with
quality of life, as well as some diagnoses or services
that do not have sufficient evidence for a Tier 1
indication." This Tier would be administered by private
insurance who would be allowed to limit the amount and
type of care, subject to and oversight board. As they
describe it, "Tier 2 plans can be broad (covering most
Tier 2 services) or can be customized for specific
groups, such as a geriatric plan that covers extended
care facilities but not fertility care; a heavy laborer
plan that includes
chiropractic therapy;
or a worker's compensation plan purchased by employers,
employees, or unions." In other words, chiropractic
services are second class in this plan.
The last
tier of care is described as follows. "Tier
3
would apply
to all medical and surgical issues considered luxury or
cosmetic, such as radial keratotomy or botulinum toxin
treatments. Funding for Tier 3 would not be covered
under the EMBRACE system—as in the current system—and
all bills would go to the patient."
They
differentiate the three tiers by saying,
"Pharmaceuticals will have similar tier assignments for
medical coverage: Tier 1 would include formulations and
therapies that treat or prevent serious illnesses and
would mostly be paid for by public funds or be heavily
subsidized. Tier 2 would apply to drugs and therapies
that enhance quality of life and would be covered by
private insurance. Tier 3 would be for luxury items."
From the look of this
proposed system, it seems that chiropractic is given a
back seat, and the same old philosophy of disease
treatment first, will prevail. We need to be wary if we
start to hear our government officials working on
universal healthcare start to use the phrase, "Three
Tier System". If we hear that, we know where it came
from and where that train is going!
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