Insurance Coverage for Complementary and Alternative Medicine

Access, Challenges, and Policy
  • S. Mitchell Weitzman
Part of the Biomedical Ethics Reviews book series (BER)


Overall, few Americans have insurance coverage for complementary and alternative medicine (CAM). Notable health plans that do offer coverage are presented. In order for CAM to achieve coverage levels on a par with conventional treatments, the integration of CAM and conventional medicine is essential.

Challenges that must be overcome to achieve integration include medical-licensing laws that effectively limit the practice of CAM; the viability of CAM fitting into the prevailing reimbursementstructures that are based on identifiable disease states and procedures, not holistic theories and practices; quantifying the cost benefits of CAM; the lack of communication between the CAM and conventional-medical communities; and skepticism manifested by CAM proponents’ charges of economic protectionism on the part of the conventional medical community and counter-charges by the conventional medical community that CAM is quackery. Agreement on whether CAM is quackery or safe and efficacious is, in fact, the most significant barrier to integration and is the overarching issue influencing both healthcare practice and policy in this area.

The extent to which expanded insurance coverage for CAM is good health policy is also discussed. Issues examined include balancing a patient’s right to choose his or her healthcare treatment with the state’s exercise of its police power to protect the public welfare; the ethics of mandating or supporting CAM coverage via increased health premiums, when many subscribers view it as quackery; and whether rationing should be considered if one assumes that expanding coverage for CAM would saturate an already overloaded healthcare system.

A new paradigm of healthcare delivery is urged. This paradigm integrates CAM and conventional medical practice; ensures access to both treatment modalities; contains healthcare costs but balances the benefits and downsides of the fee-for-service and capitated reimbursement systems; and is a holistic, patient-centered approach to health and wellness.


Health Plan Alternative Medicine Conventional Medicine Massage Therapy Utilization Review 
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Notes and References

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    John Weeks cites a report that explored why nutritional counseling plays such a small role in conventional medicine. A finding of that report explained it within the context of insurability. To be insurable, the probability of occurrence must be considerably less than 100% or insurance would make no economic sense. The difficulty in the field of nutrition, which is usually preventive, is that it begins to approach that 100% level. See Weeks, J., 6, quoting Nutrition Education for Physicians: Alternative Roles for Creating and Improved System, March 1993. Ruth A. Bruer, et al. Prepared for the U.S. Department of Health and Human Services.Google Scholar
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Copyright information

© Springer Science+Business Media New York 1998

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  • S. Mitchell Weitzman

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