Letter to Pelosi highlights work of Integrative Practice Advocates

Late Monday night, the Integrated Healthcare Policy Consortium (IHPC) announced that 47 members of the House have signed a letter to Speaker Nancy Pelosi, urging her to:

…ensure that any final legislation…reflects certain patient and provider safeguards that currently exist in state law.  These protections include provisions intended to ensure patient choice of provider and (to) prevent discrimination against entire classes of health providers by health insurance plans.

(The letter is here at IHPC’s web site.)

While this is language anyone might approve, it is notable for the nature of those “entire classes” represented by the IHPC — professions that have been on the outside of the “conventional” care equation, and its financial structure: naturopathic physicians, chiropractic physicians, physician assistants, nurse practitioners, as well as the professionals who are members of the organizations who helped recruit the 47 House members:

  • American Association of Acupuncture and Oriental Medicine (AAAOM)
  • American Association of Marriage and Family Therapists (AAMFT)
  • North American Registry of Midwives (NARM)
  • National Association of Pediatric Nurse Practitioners (NAPNP)
  • Consortium of Academic Centers of Integrative Medicine (CAHCIM)
  • Associated Bodywork and Massage Professionals (ABMP)
  • American Massage Therapy Association (AMTA)
  • American Chiropractic Association (ACA)
  • Bastyr University (a major naturopathic medical school)

Of particular note is the support of CAHCIM.  This is a coalition of the nation’s most influential conventional medical schools that have been the focal points much of the research into complementary and alternative medicine (CAM) that the NIH’s National Center for Complementary and Alternative Medicine (NCCAM) has funded over the last 17 years.  While the results of some of this research has drawn criticism from both conventional medicine and from within the IH&M community itself, NCCAM’s investment – nearly $2 billion, most of that in recent years – reflects the reality of consumer choice in the market.  (A list of CAHCIM’s member institutions is here.)

The IHPC “anti-discrimination” letter also makes the important practical point to the House: that ensuring discrimination protections for practitioners,

“would help encourage the placement and location of a wide range of skilled healthcare professionals in those areas of our nation currently without sufficient numbers of health providers to adequately serve the public.”

Many advocates of integrative practice have long maintained that the growing shortage of primary care physicians could be effectively addressed by assigning primary care tasks to trained, licensed practitioners from those now-excluded “entire classes.”

Advocacy Rising?

The IHPC-organized letter also shines a slightly brighter light on the legislative activities on behalf of the integrative practice community, which has been mostly notable for its low profile during the last year’s health reform conversations.

The IHPC, directed by Janet Kahn, MD from her position as a research professor at the University of Vermont, is one of the few entities that have organized policy needs around an all-inclusive definition of integrative health and medicine that includes the distinctive CAM and holistic practice fields like those listed above.

Another is the Samueli Institute in Alexandria, VA, whose 2008 “Wellness Initiative for the Nation” set out a broad agenda for a national health enterprise that is totally refocused on wellness, prevention and strengthening primary care.   (Two authors of the WIN document later went on to join the Obama administration’s reform team.)  In August, Samueli responded to a request from Congress to provide its recommendations for “bending the cost curve.”   You can download the PDF here.

Both IHPC and Samueli have worked diligently to bring integrative practice language into the House and Senate versions of the enabling legislation.  The subtle language of this letter to Speaker Pelosi reflects the care with which these advances have been made.

The letter’s signers, all Democrats, with his or her state and district:

  • Marion Berry                   Arkansas 1
  • Ann Kirkpatrick              Arizona 1
  • Raul Grijalva                   Arizona 7
  • Adam Schiff                     California 29
  • Jared Polis                       Colorado 2
  • Chris Murphy                  Connecticut 5
  • Kathy Castor                    Florida 11
  • Kendrick Meek                Florida 17
  • Suzanne Kosmas             Florida 24
  • John Barrow,                   Georgia 12
  • Neil Abercrombie            Hawaii 2
  • Mazi Hirono                     Hawaii 2
  • Phil Hare                           Illinois 17
  • Barron Hill                       Indiana 9
  • Bruce Braley                     Iowa 2
  • David Loebsack               Iowa 2
  • Leonard Boswell              Iowa 3
  • John Yarmouth                Kentucky 3
  • Ben Chandler                    Kentucky 6
  • Frank Kratovil                   Maryland 1
  • Chellie Pingree                  Maine 1
  • Michael Michaud              Maine 2
  • Carol Shea-Porter             New Hampshire 1
  • Martin Heinrich                New Mexico 1
  • Harry Teague                     New Mexico 2
  • Steve Israel                         New York 2
  • Michael Arcuri                   New York 24
  • Betty Sutton                       Ohio 13
  • Tim Ryan                            Ohio 17
  • Zak Space                           Ohio 18
  • David Wu                           Oregon 1
  • Earl Blumenauer              Oregon 3
  • Christopher Carney         Pennsylvania 10
  • Kathleen Dahlkemper     Pennsylvania 3
  • Joe Sestak                          Pennsylvania 7
  • Charlie Gonzalez              Texas 20
  • Lloyd Doggett                   Texas 25
  • Gene Green                       Texas 29
  • Rick Boucher                    Virginia 9
  • Donna Christensen          Virgin Is.
  • Peter Welch                       Vermont At-large
  • Tammy Baldwin               Wisconsin 2
  • Ron Kind                           Wisconsin 3
  • Gwen Moore                     Wisconsin 7
  • Steve Kagan                      Wisconsin 8
  • Alan Mollohan                 West VA. 1
  • Nick Rahall                       West VA 3
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