California Health Care Reform: Better access to what?

The great health care reform countdown has begun, with nearly every American required to have some level of health insurance by the end of this year. That much we know for certain. What remains to be seen, however, is whether simply adding more people to the insurance pool will translate into better health for policyholders.

Increased access to quality, affordable care – even if compelled by government mandate – has long been a goal of health care reform advocates. But is this what our current system provides?

“We have a disease care system,” not a health care system, says Shannon Brownlee, senior research fellow at the New America Foundation and author of Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer. “And the disease care system… if it really was honest with itself, it doesn’t want you to die and it doesn’t want you to get well. It just wants you to keep coming back for your care of your chronic disease.”

While that’s hardly a rousing recommendation to buy health insurance, it doesn’t mean that quality, affordable care is beyond our collective reach; only that there’s a need for continued reform.

One small component of this reform might be found in a provision in a new law dealing with California’s implementation of its federally mandated health benefit exchange – a virtual marketplace offering qualified individuals a variety of private health insurance options. The provision makes it clear that there’s nothing in the law that prohibits insurers from covering the types of spiritual care services already being covered by a host of other federal and state programs including Medicare, Medicaid, the Federal Employees Health Benefit Program (FEHBP), Tricare, and California’s own Public Employees’ Retirement System (CalPERS). Depending on the program, these services might include treatment provided by religious practitioners and nurses as well as some Native American and holistic healing centers, many of which deal with both the curative and, perhaps more importantly, preventative aspects of health care.

Even before this law was enacted there was nothing in California law prohibiting insurers from covering this kind of care. However, were this language not included, there’s a chance that this fact might be compromised as the legislature works to implement cost control measures and impose medical oversight and/or evidence-based requirements on health plans being offered both in and out of the exchange. Such requirements could temper an insurer’s willingness to cover alternative methods of care that don’t conform cleanly to a medical model.

The challenge now is for insurers to not just be aware of this provision but to take full advantage of it, for their own as well their customers’ benefit.

Dr. Robert Faraci, a surgeon and former chief medical officer of a Colorado-based HMO, makes a strong case for doing just that. In testimony given before the Utah Health System Reform Task Force, he focused on three key reasons:

1) It works. “Our research indicated that people with strong spiritual beliefs often had better medical outcomes than those who did not have such beliefs,” said Dr. Faraci. “Subsequent studies at Duke and Harvard Medical Schools and a comprehensive review by the Mayo Clinic have reinforced these findings.”

2) It’s what people want. According to a study funded by the John Templeton Foundation (Managed Care Outlook, “National Briefs,” January 1, 1999), 55% of Americans said they would choose a health plan that included spiritual and religious healing practices over a plan that did not.

3) It saves money. Where plans that cover spiritual care have been studied, Dr. Faraci noted that those utilizing spiritual care experienced much lower utilization than those who did not receive similar benefits.

Although adding spiritual care services to an insurer’s list of covered benefits will not, in and of itself, turn our current “disease care system” into a bona fide health care system, it is a step in the right direction – a step that the public desires, that could save money, and that could have a very real impact on the health of our state and our nation.

Eric Nelson is the legislative spokesperson for Christian Science in Northern California. His articles on the link between consciousness and health appear regularly in a number of local, regional, and national online publications.

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