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Independent Practitioners under Medicare:
A Report to Congress (1968)
In December 1968, the Department of Health, Education, and Welfare (HEW)
issued a report recommending that chiropractic coverage not be added to
Medicare. The report concluded:
Chiropractic theory and practice are not based
upon the body of knowledge related to health, disease, and health care
that has been widely accepted by the scientific community. Moreover, irrespective
of its theory, the scope and quality of chiropractic education do not prepare
the practitioner to make an adequate diagnosis and provide adequate treatment.
Therefore, it is recommended that chiropractic service not be covered in
the Medicare program.
The HEW report -- called "Independent Practitioners under Medicare"
-- contained over 300 pages and covered several professions. In May 1969,
chiropractic organizations responded with a "White Paper" charging
that the report was "biased," "wholly unreliable," and
"totally unworthy of consideration." HEW then published a response
showing why the chiropractic response was invalid.
Taken together, these documents lay bare the pathetic state of chiropractic
education anf practice during the 1960s and 1970s, as well as the refusal
of the leading chiropractic organizations to admit that there was anything
wrong. Despite this negative report, Congress added limited coverage of
chiropractic services under Medicare beginning in 1973. Since that time,
although Medicare has paid billions of dollars to cover chiropractic services,
no government agency or major media outlet has described what the money
has been paid for.
HEW Report
- Cover Letter from HEW Secretary Wilbur J. Cohen
- Recommendations
- Chapter I. Dimensions, Methodology, and Background
of the Study
- Charge from Congress
- Interpretation of Charge
- Methodology of Study
- Concept of Coverage for Independent Practitioners
- Present Medicare Coverage
- Chapter II. Issues Involved in Consideration of
Changes in Coverage
- Health and Safety of Beneficiaries
- Effects of Change in Coverage
- Patient Entrance into Health Care System
- Needs of Medicare Beneficiaries
- Quality of Care
- Impact on Medicare Program
- Impact on Total Health Care System
- Chapter III. Reports on Professions Studied
- Physical Therapy
- Occupational Therapy
- Speech Pathology and Audiology
- Clinical Psychology
- Social Work
- Corrective Therapy
- Optometry
- Naturopathy
- Chiropractic
- Present Medicare Coverage, Requested Change in
Coverage, Professional Associations
- Utilization of Chiropractic Services
- Concept and Philosophy
- Subluxation
- Services of Chiropractors, Scope of Practice
- Approach to Diagnosis and Treatment
- Manpower
- Quality:Indicators, Description of Chiropractic
Schools
- Evaluation of Chiropractic Education
- Chiropractic Research
- Summary: Chiropractic Education and Research
- Current Status of Chiropractic
- Special Studies of Chiropractic
- Positions on Chiropractic
- State Licensure of Chiropractors
- Conclusions and Recommendations
- Chapter IV. Conclusions Underlying the Recommendations
- Physician Referral
- Patient Care Plan
- The Organized Setting
- Appendix A. Ad Hoc Consultant Group & Expert
Review Panel on Chiropractic & Naturopathy
- Appendix B. Statements by Professional Associations
- American Physical Therapy Association
- American Occupational Therapy Association
- American Speech and Hearing Association
- American Psychological Association
- National Association of Social Workers
- American Corrective Therapy Association
- American Optometric Association
- National Association of Naturopathic Physicians
- International Chiropractors Association
- American Chiropractic Association
- Appendix C. Additional Materials on Chiropractic
- Selected Data on Schools of Chiropractic
- Chiropractic Textbooks Cited
Chiropractic's White Paper" (1969)
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This page was revised on March 19, 2000.