Alternative Medicine Insurance: What You Need to Know

Alternative Medicine 

Alternative medicine insurance is a necessity to achieve an integrated health care system. Although alternative medicine changes from time to time, coverage for such medications embraces a system where physicians, social workers, counselors, and spiritual counselors can provide quality care. By establishing a carve-in structure, insurance benefits separation is minimized, increasing medical care chances from secondary practitioners. Ross (2013) argues that insurance issues remain the biggest hindrance in quality care as other insurance contractors provide different benefits, meaning that health providers from all practices cannot co-exist. Indeed, for health conditions such as mental illness, insurance coverage for alternative therapies such as chiropractic visits has proven to impact the integration of modern medicine, and traditional methods. If such treatment's prevalence gets the recognition and coverage it deserves, social workers, psychologists, and spiritual councilors can work closely to understand human stressors and mental health. 

Also, insurance could see a reduction in the financial cost of medical health in the country. Indeed, even without acknowledging the urgency for alternative medicine insurance, patients spend approximately $ 30 billion per year accessing alternative care (National Center for Complementary and Integrative Health, 2016). Even with the high expenditure, alternative medicine costs tend to be lower, and so is diagnosis. Therefore, the insurance premiums would also be impacted as focus shifts to preventative and value-based care. Also, since alternative medicine is not as susceptible to technological change as modern treatments, expanding the insurance equation is ideal for catering to cost-effective treatments. Indeed, we must keep in mind that United States health care remains one of the most expensive care systems in the world, with insurance companies having the upper hand in determining premiums. For the uninsured, they rely on alternative medicine to keep up with their medical condition demands. Hence, with the effectiveness of treatments, especially in mental health, declined medical reactions, and positive impact on chronic illnesses, expanding the coverage would be ideal. 

Cost Containment 

The existence of the fee-for-service payment system results in high rates that increase cost and negatively impact efficiency. Such a payment system allows providers to achieve reasonable income at the expense of patients due to the failure of an evidence-based kind of reimbursement. Indeed, providers rely on charging the market with little concerns about the cost, whether individuals, companies, or insurance companies (Karapiperis, 2018, p. 3). They also focus on maximizing income through demand and supply, where units of drugs are produced to benefit from high revenues. The reality is attributed to providers' overcompensation for their services based on the type and number of services offered. In that case, if a patient seeks medical services, they pay for each visit, and each prescription drug a method that fails to focus on the quality of the service but cost maximization. 

Nonetheless, adaptation to a value-based-care that focuses on the quality of care for reimbursements is underway. Karapiperis (2018) argue that, through the system, about 80% of health outcomes that drive high costs through unnecessary testing are minimized. Indeed, the U.S. Department of Health and Human Services (HHS) continues to push for the transition to value-based payments through Medicare and converting the fee-for-service model to other alternative payment models. By valuing the cost of service based on quality, health providers are held accountable for their patients' costs and service quality. Nonetheless, the providers are also incentivized to shift their focus on evidence-based reimbursements resulting in better-coordinated quality care that patients can understand and, at the same time, reduce costs for unnecessary hospitalizations. 

As patients, we have an opportunity to reduce costs through preventative care. These include staying true to necessary checkups such as dental cleanings, screening, or physical visits. For a population susceptible to chronic illnesses, adhering to nutritional foods could see the ailments' management. In so doing, we minimize the rate of emergency care that tends to be mainly expensive for uninsured persons. We must focus on reducing the number of unnecessary hospitalizations and physician costs by taking better care of ourselves. James (2013) argues that the most expensive cities in America have more hospitalizations with physicians requesting costly tests and procedures. Through preventative measures, Medicare will not have to pay for tests that do not benefit patients. 

Prescription Medications 

For cost reduction and effectiveness, there is a need to limit the prices of drugs in the market. Every year, patients are at risk of facing medication price hikes that adversely impact affordability. In 2018, the Kaiser Family Foundation poll revealed that 24% of respondents had family members not filing their prescription drugs or cutting pills in half due to affordability (Twomey, 2019). As drug manufacturers continue to enjoy a monopoly, they set prices too high for profitability purposes. If the amount is not directed to research, hiking costs for marketing and profitability reasons adversely impact a patient's health. In instances that manufacturers account for the medications' value, they do not make the findings public, which does not encourage accountability. If we intend to lower healthcare costs, there must plans and reforms to reduce the amount spent acquiring drugs, which in reality should be going down other than up. 

Improving Quality 

One of the most common medical errors includes adverse drug events (ADE) that negatively impact patients. When practitioners prescribe drugs that turn out to have unintended consequences, they are exposed to hospitalization and sometimes death risks. Still, some ADE's remain undetectable for years, which leads to bodily harm and withdrawals. Niki et al. (2020) assert that annually, there are approximately 5% cases of ADE for hospitals where reporting is mandatory. Therefore, in institutions where reporting is not a requirement, the cases are unreported, which means more exposure to harm. In instances where the drugs take time to detect, such as Rofecoxib, the damage could be already done. 

Still, wrongful diagnosis results in incorrect irreversible treatments that could prove fatal. Errors in the diagnosis tests lead to misdiagnosis, which indicates that patients access medication for the wrong ailments. Since such mistakes can happen even when conducting tests with care, non-intentional errors mostly go unpunished. For example, a skilled doctor using a piece of faulty equipment unknowingly could misdiagnose a patient, but that does not equate to ignorance. Niki et al. (2020) agree that what makes misdiagnosis fatal is because it majorly occurs for severe diseases, including myocardial infarction, spinal epidural abscess, and pulmonary embolism, which makes it the 3 rd cause of death after heart disease and cancer. Also, not all misdiagnosis results in lawsuits since the law provisions protect practitioners in instances where they were not ignorant or without a patient-doctor relationship. 

Ethical Healthcare System 

In a world where lack of access to medical health is a matter of life and death, healthcare should be an obligation to provide medical services for every individual. The right to health protects the vulnerable in society and the marginalized to live a life of dignity and optimal good health. As we spearhead global human rights quests, we must uphold article 12 of the constitution, which outlines that citizens must have access to health within their jurisdiction. Nonetheless, the USA has one of the most expensive healthcare systems in the world and continues to lose patients annually due to affordability and accessibility issues. Gerisch (2013) outlines that approximately 18,000 Americans die annually due to high insurance costs that render accessibility to health impossible. We focus on a health insurance system that exposes uninsured citizens to unmeasurable risks and death in such a system. Through obligation, we embark on a journey to preventative cure before health conditions worsen. Although we have made progress through the affordable care act (ACA), we still lag from becoming the world's best healthcare systems such as Canada or Japan. 

Access to Healthcare Coverage 

There should be an insurance approach, such as consideration of Health Reimbursement Arrangements (RFA), that gives employees flexibility in determining benefits. Employer-sponsored insurance (ESHI) limits choices for insurance coverage and promotes inequity. Under ESHI, high-income earners receive considerably higher benefits than low-income earners, including part-time workers and freelancers, who are not offered varying health benefits. Nonetheless, through the RFA, the underprivileged not covered by their employers are provided the opportunity to access insurance coverage through association health plans that are more flexible. In that case, the disadvantage of ESHI that prevents employees from knowing the actual cost of healthcare and, at the same time, limits the options to seek better, affordable coverage. However, the U.S. Department of Health (2013) outlines that RFA seeks to transform insurance into consumer-driven care where clients can pay premiums on affordability. In so doing, barriers to competition are eliminated, allowing various companies to cater to demand. Accounting for consumer preferences is vital in achieving universal care. 

Healthcare Disparities 

Racial and ethnic disparities are prevalent in healthcare provision and access. For minority groups, the issue of discrimination goes far deeper to influence essential services such as unequal health. Such is attributed to factors that include geographical disparities, low income, and stereotypical perceptions. Despite the efforts to diversify health, when minority groups make up most of the underprivileged, it translates to inadequate insurance coverage that affects access care. Indeed, 34% of Hispanics are uninsured compared to 13% among Whites (CDC, 2013). With high costs, people shun away from seeking treatment. Still, the practitioner's bias influences the willingness to seek care when in need. 

Also, the underrepresentation of minority groups in the healthcare workforce presents a significant hindrance to diversity. When patients cannot identify with the care providers, it affects willingness to express themselves and adversely affects cultural competency. Lack of cultural competency results in a workforce that is not well equipped with the skills, attitudes, knowledge, and behavior necessary to handle patients from various cultural backgrounds. For instance, an all-white medical caregivers’ employee might overcompensate and end up saying the wrong things to a black or Hispanic patient. Without a sizable proportion of minority practitioners, there is a higher likelihood of a language barrier, especially between immigrant patients. 

Disparities matter because they negatively impact health care accessibility for minority groups, which results in high mortality rates. Without preventative care, diseases have a high likelihood of progressing to fatal illnesses that lead to death. According to the CDC (2013), close to 50% of minority groups do not get annual screening required to test for cancer. Also, numerous CDC reports indicate that blacks and Hispanics have a higher mortality rate than whites caused by chronic illnesses such as diabetes. Ideally, the lack of cultural competency impacts practitioners' understanding of the patient's willingness to accept treatments or adhere to medications. For example, varying backgrounds are guided and bound by different cultural beliefs, which would require comprehension other than reprimanding. If clients feel they are treated from a place of prejudice other than open-mindedness, willingness to seek, health is affected. Hence, health disparities impact results in the misappropriate burden of preventable diseases compared to non-minorities, and the healthcare system is mandated to do better. 

References 

CDC Health Disparities and Inequalities Report — the United States, 2013. Morbidity and Mortality Weekly Report. Supplement /. 62 / No. 3 

Gerisch, M. (2013). Health Care as a Human Right. The State of Healthcare in the United States. Vol. 43, 3: 

Stern, R. G. (2014). Stern but Illuminating Words on Imaging: An Internist Replies Reply.  AMERICAN JOURNAL OF MEDICINE ,  127 (4), E9-E10. 

Karapiperis, D. (2018). A Brief Exploration of Rising Health Care Costs. CIPR Newsletter. https://www.naic.org/cipr_newsletter_archive/vol25_health_costs.pdf 

National Center for Complementary and Integrative Health. (2016). Americans Spend $30 Billion a Year Out-of-Pocket on Complementary Health Approaches. https://www.nccih.nih.gov/research/research-results/americans-spend-30-billion-a-year-outofpocket-on-complementary-health-approaches 

Carver, N., Gupta, V., & Hipskind, J. E. (2020). Medical Error. In  StatPearls . StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430763/ 

Ross, C. L. (2009). Article Commentary: Integral Healthcare: The Benefits and Challenges of Integrating Complementary and Alternative Medicine with a Conventional Healthcare Practice.  Integrative Medicine Insights ,  4 , IMI-S2239. 

Twomey. M. (2019). Center for American Progress. Comprehensive Reform to Lower Prescription Drug Prices.https://www.americanprogress.org/issues/healthcare/news/2019/01/29/465621/comprehensive-reform-lower-prescription-drug-prices/ 

U.S. Department of Health and Human Services. U.S. Department of Treasury. U.S. Department of Labor. (2017) Reforming America’s health care system through choice and competition. https://www.hhs.gov/sites/default/files/Reforming-Americas-Healthcare-System-Through-Choice-and-Competition.pdf