Memorandum
To: ACA Members, House of Delegates, Board of
Governors and Other Interested Parties
From: Garrett Cuneo
Re: ACA EVP Weekly Report
Date: November 11, 2003
This week’s report includes the following items:
1. WNBC-TV IN NEW YORK AIRS CONTROVERSIAL SEGMENT ON CHIROPRACTIC NECK MANIPULATION; SEGMENT SET FOR SYNDICATION
2. PRESIDENTIAL CANDIDATE DEAN MODIFIES STATEMENT ON CHIROPRACTIC; OTHER DEMOCRATIC CANDIDATES WEIGH-IN
3. MASTERS CIRCLE PROGRAM PROVIDES STRONG SUPPORT FOR NCLAF
4. NATIONAL BOARD STEPS UP TO THE PLATE AGAIN
5. A MOMENT OF SILENCE FOR DR ED SAUNDERS
6. HELPFUL INFORMATION AVAILABLE TO MEMBERS RE: BLUE CROSS BLUE SHIELD FEDERAL EMPLOYEE PROGRAM
7. HOUSE-SENATE MEDICARE CONFERENCE CONTINUES
8. BE SURE TO BUY YOUR PAGE BOY BOOKHOLDER
9. CAN’T ACCESS THESE LINKS?
1. WNBC-TV IN NEW YORK AIRS CONTROVERSIAL SEGMENT ON CHIROPRACTIC NECK MANIPULATION; SEGMENT SET FOR SYNDICATION
The ACA has been communicating with Dr. David Marks, medical reporter for WNBC-TV in New York, for several weeks regarding a controversial news segment that the stations aired late last week. The segment examined the purported link between chiropractic neck manipulation and stroke. ACA staff and ACA President Dr. Donald Krippendorf held discussions with Dr. Marks to offer the facts regarding the extremely low risks associated with neck manipulation. While the piece that aired was not particularly favorable, Dr. Marks did highlight ACA’s assertion that a May 2003 study in the journal Neurology was “fraught with design flaws.” As soon as ACA learned that the news segment was set to air, ACA immediately distributed a memo to the chiropractic state associations, chiropractic colleges, ACA’s House of Delegates and the chiropractic media, along with a packet of “talking points” on the stroke issue and other backup information. The piece is now set to be syndicated nationally, so ACA is offering the chiropractic profession the following tools to combat any local negativity: Talking points on the issue of chiropractic cervical manipulation, informed consent and the low risk of treatment:
http://www.acatoday.com/pdf/informed_consent_bullets.pdf.
A document by William J. Lauretti, DC, titled “What are the Risks of Chiropractic Neck Adjustments,” that will provide even more background on this issue:
http://www.acatoday.com/pdf/chiro-risks.pdf. ACA’s response to the study that was published in the May 13, 2003 issue of the journal Neurology.
http://www.acatoday.com/media/releases/051203.shtml.
2. PRESIDENTIAL CANDIDATE DEAN MODIFIES STATEMENT ON CHIROPRACTIC; OTHER DEMOCRATIC CANDIDATES WEIGH-IN
A couple of weeks ago the ACA was asked by the Howard Dean campaign to set up a meeting at the Iowa Chiropractic Society offices, and to include those individuals whom we thought should be there, including the leadership of the Iowa Association. The purpose of the meeting was to discuss with Dean the concerns of the chiropractic profession. At the request of the Dean campaign, we had worked with them earlier in preparing a statement on chiropractic. The Dean campaign then posted the statement on their Web site.
While the statement was better than any we had ever received from a presidential candidate, we felt it still did not go as far as it should have. Additionally, doctors from Vermont continued to have serious problems with the candidate because of the actions he took while Governor of Vermont. These doctors made their feelings known directly to us and through the ACA list serve.
The meeting’s participants included: F. Dow Bates, DC, ACA Iowa delegate; Maurice Cyr, DC, ACA Vermont delegate; Charles Foster, DC, immediate past president, Vermont Chiropractic Association and ACA member; Ken Storjohann, DC, ICS president; Rodney Langel, DC, ICS president-elect; Larry Phipps, DC, ICS legislative co-chair; Gene Handley, PhD, ICS executive director; and Jon Hymes, ACA vice president for government relations. Providing additional outreach was Keith Overland, DC, ACA Connecticut delegate, who serves as a health care policy adviser to the Lieberman campaign.
The meeting, which lasted 90 minutes, went very well. The Democratic presidential candidate agreed to revise his statement on chiropractic, including a section dealing with gatekeepers; attempted to clarify the positions he had taken in the past; and noted that his son is receiving chiropractic care. Here is a link to the full statement:
http://www.deanforamerica.com/site/PageServer?
pagename=policy_statement_health_chiropracticcare.
In the afternoon, Mr. Hymes traveled with Dr. Bates to the Iowa headquarters of presidential hopefuls Dick Gephardt and John Kerry, where they gained immediate access to the state campaign directors for both campaigns. It wasn't long afterward that these candidates issued strong statements. (Just as a side note, it is clear that Dr. Bates is a player in Iowa politics, particularly on the Democratic side. He was known by the major Iowa players in most of the presidential camps.) We also received a statement from Senator Joe Lieberman. Dr. Keith Overland, who has been working with that campaign, secured the position paper.
Copies of the statements from Dean, Gephardt, Lieberman and Kerry can be found on ACA’s Web site at:
http://www.acatoday.com/government/other/candidates_endorse.shtml.
So just why does Howard Dean, a medical doctor with a poor track record on chiropractic as Governor of Vermont, spend 90 minutes with representatives of the profession and present a positive statement? Why did the other candidates -- not known to be strong advocates of the profession (although not adversaries) -- present such positive comments? (In the 2000 campaign it took months to get statements out of the Bush and Gore campaigns, and neither statement was terrific. Here is one view…
The Iowa primary is the first presidential primary of the season. It has for years had the reputation of making or breaking presidential candidates. The media and political pundits, as well as major contributors, watch this race closely as a gauge of the success of a candidate. It’s not the only presidential primary, but it is given importance far beyond its size or population. Iowa is also a state that has a prominent chiropractic college. It has a strong chiropractic state association and the largest population of chiropractors per capita of any state. I once saw a figure that indicated that 30% of Medicare recipients seek chiropractic -- the highest percentage ever. It is also the state in which Tom Harkin is a Senator. Two years ago the profession raised a substantial amount of money for his reelection when he ran against a medical doctor. The ACA- PAC participated in this effort. Additionally, we made an independent expenditure, purchasing radio time during the critical month of October. 1,200 30-second radio spots spoke favorably of Harkin and noted the source as ACA. In the state next door to Iowa -- South Dakota -- we also made an independent expenditure, purchasing 2,400 radio spots of 30 seconds each. In that state, our candidate won by fewer than 500 votes. We were active in a number of other races as well.
None of these facts are lost on the political types. Earlier this year, ACA’s PAC began to explore the possibility of getting involved in the Iowa primary. While not endorsing a particular candidate, we began to look closely at Howard Dean as someone to be concerned about. We let out our concerns about him be known within the right circles, and presented the idea of becoming involved. The polls in Iowa make this race too close to call. The result was predictable.
I am sure we can come up with a number of other reasons why the candidates released positive statements, and why the accessibility of the candidates to our members is greater today than ever before. We have grown as a profession and there is a certain amount of respect that comes with that. But it’s also nice to have political clout. None of this puts more money in your pocket or provides more patients, but it sure makes it easier the next time we lobby a legislator or work with the media.
I don't believe it is the intent of the ACA to come out and endorse a presidential candidate, particularly at this stage. We do plan to inform the doctors in Iowa and New Hampshire (and probably other states as well) of the positions taken by the candidates so they can make up their own minds.
3. MASTERS CIRCLE PROGRAM PROVIDES STRONG SUPPORT FOR NCLAF
In an earlier report I had noted the offer by Drs. Markson, Hoffman and Perman to promote the NCLAF at the Masters Circle Super Conference held in Las Vegas last weekend. Over 2000 doctors and CAs were in attendance. The promotion began on Thursday afternoon, when Dr. Hoffman showed the “Simple Justice” video and made a dramatic plea regarding the importance of the lawsuits and the need for each doctor to show "advanced citizenry" by contributing to the NCLAF. Drs. Daryl Wills, George McClelland, Don Krippendorf, James Edwards, Cynthia Vaughn and Mario Spoto, along with Bobbie Wills and I, were in the audience to collect contributions. We did fairly well, collecting one contribution of $1,500 and over 10 monthly contributors. But the next day was when it all really clicked. Dr. Hoffman stepped up the encouragement to contribute, with Drs. Edwards and Vaughn aggressively manning the NCLAF booth collecting funds. At the end of the weekend, 105 doctors had either submitted checks or became monthly contributors, with over 85 people pledging $100 per month for a total annual income of over $110,000.. It was an outstanding effort, second only to the successes at Parker Las Vegas.
4. NATIONAL BOARD STEPS UP TO THE PLATE AGAIN
The National Board of Chiropractic Examiners once again has shown its support for the profession by agreeing to contribute $75,000 to the National Chiropractic Legal Action Fund (NCLAF). This brings NBCE’s total contribution to $275,000, making them the highest NCLAF contributor next to NCMIC, which has contributed $410,000.
5. MOMENT OF SILENCE FOR DR. ED SAUNDERS
I regret to report the passing of Dr. Ed Saunders of Lanark Village, FL. Dr. Saunders has been a long time contributor to the success of this profession. He was one of the original founders of the National Board of Chiropractic Examiners. He was an active member of the Florida Chiropractic Association, holding numerous positions, including president. Nationally, he was an active
member of the ACA. He served on ACA’s Board of Governors, was Chairman Emeritus of the ACA Legislative Committee and was selected in 1984 as ACA’s Doctor of the Year.
6. HELPFUL INFORMATION AVAILABLE TO MEMBERS RE: BLUE CROSS BLUE SHIELD FEDERAL EMPLOYEE PROGRAM
ACA has released a new “talking point” on the chiropractic coverage provided by the Federal Employee Program (FEP), which should answer most of your questions relating to the coverage. The talking point clarifies both the manipulation coverage under the Basic Option of the plan, as well as the physical therapy coverage available under both options of the FEP plan. The talking point can be found on the ACA Web site at:
http://www.acatoday.com/insurance/managed_care/coverage_clarification.shtml.
This talking point would be most helpful to the chiropractic office staff responsible for submitting insurance claims. If you have any questions on the coverage, or if you continue to receive denials for PT claims, please contact the ACA at 800-986-4636.
7. HOUSE-SENATE MEDICARE CONFERENCE CONTINUES
On October 30, CMS announced the possibility of a 4.5% cut in the Medicare physician fee schedule beginning on January 1, 2004, if Congress did not once again act to correct an anticipated funding shortfall in the Medicare program. Earlier this year, some in Congress thought this problem had been corrected when $54 billion over 10 years was included in the omnibus spending bill approved in February specifically to prevent a physician payment cut and to provide a 1.2% increase for 2003. But even while individual payments declined in
2002, the volume of Medicare physician services increased, prompting another cut for next year.
We joined with a number of other groups in responding to CMS' announcement by urging members of Congress to consider this issue as part of the Medicare modernization bill now being finalized by a House-Senate conference committee. Accordingly, in addition to supporting inclusion of the Senate-passed Medicare Chiropractic Demonstration Project (Section 440 of S. 1) in the final version of the Medicare legislation, the ACA has taken a stand in support of a provision to restore the full 4.5% cut in next year's fee schedule. On October 31, Senate Finance Committee Chairman Charles Grassley (R-IA), the sponsor of the chiropractic demonstration project and a senior conferee, announced a tentative agreement within the conference to provide sufficient funding to ensure that the physician fees under Medicare will not be cut in 2004. Final approval of the physician fee schedule adjustment and the chiropractic demo remains contingent upon the resolution of the broader policy differences still separating House and Senate negotiators working to agree on and pass a final Medicare overhaul bill.
There is a lot of political maneuvering going on between the conferees, which has been interpreted in some circles as the preparation for a breakdown of talks overall. The conferees still have three major and three mid-level issues to decide. The big issues include the cost-containment provision, the House-passed competition provision and whether to allow U.S. residents to purchase lower-cost, prescription drugs from Canada and other nations. The lower-level issues include how to change the current system Medicare uses to reimburse doctors who administer drugs in their offices, whether to implement a competitive bidding system for durable medical equipment and whether to limit physicians' ability to invest in specialty hospitals. Notwithstanding these problems, Senate Majority Leader Bill Frist (R-TN) says that Medicare negotiations are "progressing well" and that he expects an agreement on a final bill by Nov. 21.
8. BE SURE TO BUY YOUR PAGE BOY BOOKHOLDER
The Page Boy Bookholder makes reading easy for all ages. It's aid without strain, and an easy, affordable solution to poor posture. It allows your patients to sit in a balanced position and to stand texts upright and closer to eye level. The wide swinging arms hold magazines, large and small books, computer manuals, newspapers and cookbooks.
ACA Member Price: For a pack of 5 Page Boy Bookholders: $28.50
Non-Member Price: For a pack of 5 Page Boy Bookholders: $33.50
SAVE $$$!!! If you buy a pack of 10…
ACA Member Price: $46.00 ($4.60 each)
Non-Member Price: $56.00 ($5.60 each)
Help the ACA promote good posture. To order the Page Boy Bookholder, call 800/368-3083 or go to
www.shopaca.com. Order Item #PBBH-1. (Be sure to mention this email when ordering.)
9. CAN’T ACCESS THESE LINKS?
Some of you have been unable to download my PDF links. To view these file types,
you need Adobe's Acrobat Reader. This is a free utility available at www.adobe.com. If you need further assistance
viewing anything referred to in this report, please e-mail me at gcuneo@amerchiro.org.
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