It is all about change – and maybe not necessarily paying someone to do something or administer something.
In relation to the health funds in Australia; for most of the past 35 years I have worked there as an acupuncturist. Initially no ‘health’ funds gave refunds and CAM workers were quite happy doing what we did, and had no trouble getting business, as when the orthodox medicos had no/limited answers, CAM practitioners were there always to help – as the safety net.
In relation to the health fund refunds in Australia – it is a pitiful return for those who think they are ‘covered’. In the past 20 or so years since its inception, the amount refunded has stayed constant, (around the upper limit of $200/$250 per person per therapy category refunded on sessions, a year) whereas cost of living has moved substantially so what was essentially half the consultation fee is now a fifth, with an upper limit that does not reflect the times.
Also often funds have combined groups of care that used to be separate – eg chiro and acup – meaning far less is being offered. By now it seems not so much to provide assistance for CAM users, but to look inclusive – until it is needed. Those who can’t afford health fund coverage may take the basic – if they take any, but opt out of ‘extras’ cover for this reason.
What NZ does offer is ACC co-payments here – and many are far better covered with this scheme for CAM as acupuncture and chiropractic. Perhaps as the CAM providers are acknowledged and are paid for injury and accident services there could be a similar scheme for chronic health issues? Diabetes and cancer are definitely lifestyle diseases that could do with some CAM assistance.
As a public funder of health care across the board, I may take a very different view than most, as I would want to know the effectiveness of providing ‘health care’ (or more realistically supporting an industry of illness management) when so many of the public seem intent on continuing creating their problems.
Brian Cox, the Otago University Hugh Adam Cancer Epidemiology Unit director, said New Zealand’s position on the (cancer) league tables was a major concern. “There’s not sufficient focus on prevention. I think we can do a lot better than that.” The Cancer Control Council, which advised the minister, did not have a current action plan, he said. http://www.stuff.co.nz/national/health/4591266/NZ-fourth-in-world-in-rate-of-cancer With lifestyle issues being mentioned wherever a searcher looks:
Why not change those lifestyle factors so less funds are needed to be spent on it? Those who fund their own cancer survival may be less likely to revert to the person they were prior to healing (changing) themselves. I am not aware of there having been any research on this, as the group of people who self heal seem to be missed in any research I have found to date – has anyone seen any?
As a funder of cancer treatment, I imagine I would have an area of concern. Someone else in another government department would have another. The lack of the ‘big picture’ is the concern I have as a funder – where is all the money that has been thrown at this ‘scary monster’ gone? Who is responsible for getting best value for money? Is the word of the medicos enough?
A small issue in amongst the entirety of the poisoning of our environment, but why allow the sale of products like aspartame in them? Why allow the drugs for smoking, and alcohol to be sold in food shops? Why allow food that contains carcinogenic substances to be on the shelves at all?
If we are to label all sensible healthy interventions – including medication, exercise regimes, prayer, hands on healing, and better food choices – as ‘CAM’ then the whole issue we are currently debating is to buy into the idea of pharmaceutical answers for all self created problems.
I feel the elephant in this question is whether orthodox oncology is even useful. Keeps people in jobs, granted. Has anyone done an accountability project? Where would the money be if a ‘cure’ was found that did not need patenting? Which drug company would forgo their profits for humanity – and my budget as a national funder? http://www.moneytrendsresearch.com/scientists-cure-cancer-but-no-one-takes-notice/ Much like my post on hemp oil. (The raw ingredients are burnt regularly by the paddock full).
Has there been research to see if modern oncology is actually helping?
To keep someone alive, not necessarily well, or to give them a few more months, when there has been no study that I can find to chart what would happen with status quo as a control, and an all out attempt to undo the reasons for the cancer (using an individualised CAM process), and the standard ‘attack’ orthodox medicine is seen as unquestionably? To mess up the quality of life in what time the person has left?
As a funder I would want to know this – more than what ‘evidence’ there was to stop CAM providers in case their treatments messed with the orthodox versions. The lack of ‘cure’ – but talk of ‘5 year survival’ for all the money spent would worry me enormously.
Western Orthodox Medicine with drug therapies is not winning that ‘war’. Medications/’therapies used, rather than insisting on lifestyle changes, (causative factors) mean that patients are happily eating and living as they were – essentially what has created their health issues and doing almost no exercise – and still are given treatment.
Whilst the following report was for the USA and is a few years old – it can only reflect what is happening to the population in NZ. http://aspe.hhs.gov/health/reports/physicalactivity/
Where is the research to say oncology funding is money well spent, especially when not supported with life adjustments? In Cuba in the 1990’s the oil was turned off. People got on their bikes and cycled or walked everywhere. They had to grow their own food. Organically – as there were no chemicals available.
Besides this, a public health system had been in place that allowed clinics next door – so people were already well serviced. They lost weight (supposedly 20 lb/9 kg each on average) and no doubt had less lifestyle disease. http://www.amazon.com/review/R39919QJ8KK6G1/ref=cm_cr_pr_viewpnt#R39919QJ8KK6G1
Western lifestyle is not a health promoter. Sedentary living is not healthy. No costly ways to improve fitness/reduce weight are needed. How simple is it to get on a bike? http://www.cyclehelmets.org/1015.html
Why are the supermarkets allowed to sell the liquor, cigarettes, ‘soft drinks’ and all the non nutritive ingredients that go to make up what is a blow out in health and cancer funding? http://www.helpguide.org/life/healthy_diet_cancer_prevention.htm
Here I have given on article for aspartame – an increasingly prevalent compound in the new version of ‘normal’ – ‘diet’ foods and drinks. Look to the conclusion.
Who will fund a reasonable RCT on the role of the modern diet – that deviates so much from even thirty years ago?
Given the displacement of drinking water to the ‘cola’ style drinks, and the space their sale takes up in the average supermarket/retail food area, looking to just the one ingredient by itself (aspartame) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1964906/
The very problematic issue of each potentially ‘bad’ chemical (not naturally found in plant based foods) interacting with all others, and all other healthy lifestyle destroyers.
What we can deduce, is that something is creating the wave of obesity (mentioned in earlier posts – and the increasing rates of cancer and the likelihood of most getting one form of it prior to death.
As many have mentioned, we have an aging population, and as things are not looking to get better – I as a funder would be putting a ‘line in the sand’ and asking for accountability from both the conventional and the CAM providers – but also from the patients.
- Is there to be responsibility placed on the role of the patient, just as there is supposed to be for the safety of any CAM supplement or CAM practitioner?
As a public health funder, I would want to get some assurance from those helped that they would be mending their ways.
- Why did the primary rogue cells happen? (Why was cancer there?)
- ‘Whose life is it anyway?’ may well be my new catch cry. By not respecting what a gift they were getting – a second chance at life, through whatever funded services they are getting may mean they do not get another ‘go around’ with more funded services.
- At what point is cause and effect, which most parents use to raise children to abide by, going to be in force?
This is not so much an issue when utilising the various CAM traditions (especially when self funded) – as Coulter & Khorsan (2012) have pointed out
‘Where in biomedicine the intent of the provider is to cure the patient, in CAM the intent is to assist the patient to heal themselves.’
The patient, if funding themselves, would be far less likely to pick and choose what they did; they would be far more likely to pay attention and follow directions to optimal healing.
As mentioned by others, the issue for funders – whether private or public – is value for money.
What is being offered and does it deliver?
Whilst we are wondering where the ‘evidence’ is – the people who are flocking to the CAM practitioners are not doing so, as they are gullible so much as, as they are paying usually full fee they are going with what gives them benefit.
What benefit is given may be argued. As the Crystal article stated, ‘of CAM users, 71% felt these therapies had given them some benefit and, of those, 32% thought they had been extremely helpful’.
People who use these services are usually 100% out of pocket and do so as they feel benefit.
As Coulter & Khorsan (2012) state ‘In the U.S., integration of CAM and biomedicine (traditional medicine as practiced in Western cultures) is being led by patients as they combine both approaches to treatment [i.e.., they typically seek out a biomedical provider before or concurrent to seeking CAM care (Barnes, Powell-Griner, McFann, & Nahin, 2004; Eisenberg et al., 2001; Ni, Simile, & Hardy, 2002)] on a daily basis to address their health and mental health needs (Astin, 1998; Eisenberg et al., 1998).
In 2003 a national survey of 1,007 hospitals in the U.S. documented patient demand was the most significant factor (83%) for incorporating CAM/IM (Larson, 2005)’.
As a funder, I feel I would want to know what benefit there was to having very expensive and distressing orthodox treatment given, whilst the person was still doing what they were to give them the cancer. What return for the public investment? Is it a right to use oncology, or any health care offered and not take on board the private changes needed to assist optimal health return?
- Chrystal K, Allan S, Forgeson G, Isaacs R, (2003). The use of complementary/alternative medicine by cancer patients in a New Zealand regional cancer treatment centre. The New Zealand Medical Journal. 2003 Jan 24 ;116(1168):U296. URL: http://www.ncbi.nlm.nih.gov/pubmed/12601420
- Coulter, Ian D, and Raheleh Khorsan, (2012) in Outcomes Measurement in the Human Services: Cross-Cutting Issues and Methods, Second Edition, Washington D.C.: National Association of Social Workers Press, 2012, ed Jennifer Magnabosco and Ron Manderscheid (Eds)
(all referenced 21/3/12)