An Integrative Care Submission to the Obama-Daschle Team: The Daphne White Group in the Beltway

Summary: On December 8, 2008, the Integrator posted an invitation from Daphne White to join a Health Care Community Discussion which she planned to host the next week. Such discussions were urged by Tom Daschle, head of Obama's transition team for health care. These discussion were created as a means of moving grassroots ideas into the dialogue. White, a former journalist and health care organizer, has a passion for integrative medicine as well as a therapeutic touch practice. The subject for her group was the role of integrative practices in health reform. Here is the submission that came from that December 16th discussion.

Daphne White, CHTP: convenor of a Healthcare Community Discussion

The Integrator posted a notice in an action bulletin on December 8, 2008 which included news that Daphne White, CHTP, a former journalist and not-for-profit organizer, was planning to hold a Healthcare Community Discussion. Scores of such meetings were held around the country to gather ideas from the grassroots to inform former US Senator Tom Daschle and the rest of Obama's healthcare transition team. Roughly 15 individuals attended the meeting at White's house. White, who is an integrative care activist and a Certified Healing Touch Practitioner, focused the meeting on the role of integative care in reform.

Here is White's report, as sent to the Obama team.

Recommendations to the Obama Health Transition Team

From a Healthcare Community Discussion Hosted by Daphne White, CHTP

(Report prepared by White)

We recognize that the current system of Western medicine has tremendous value and is the system of choice for acute, emergency and critical care.  We also recognize the need for prevention and health maintenance – including health care education and tools for self-care -- so that Americans can remain healthy and minimize their use of this crucially important yet very costly medical care system.

Tom Daschle: heading up the Obama healthcare transition team

In order to create a truly cost-effective health care system, we need to create a new paradigm that actively promotes health and wellness, rather than simply managing diseases.   

We must identify and incorporate holistic health care systems (including energy medicine, acupuncture, homeopathy, and others) that actively balance and strengthen patients’ immune and nervous systems, making them more resistant to disease … rather than continuing to rely solely on a “sick care” system whose strength is managing disease symptoms after they are entrenched enough in the body to register on an X-ray or an MRI.  A collaboration between Western medicine and holistic health care systems would achieve optimal results and potentially huge cost-savings.

In order to radically shift the outcomes of our health care system, we must recognize that:

·         “Health” is more than the absence of disease.

·         “Health care” is not “disease management.”

·         “Prevention” is more proactive than screening and early diagnosis of a forthcoming disease.  Preventing disease requires building a strong immune system and nervous system, so that the body itself has the strength to withstand infections and disease. 

·         There is more than one kind of valid health care system, especially when it comes to well-care and prevention. 

·         Western medicine has become the most technologically-advanced and expensive form of health care in the world, but it is not the system best-suited for prevention. 

In order to radically shift the outcomes of our health care system, we must recognize that:

·         Holistic health care systems are better suited for prevention and well-care than the Western medical model.  Holistic systems include the Chinese system of acupuncture and herbs; the Ayurvedic system; homeopathy; Healing Touch and other forms of energy medicine; and others.

·         Holistic modalities are often better-suited for treating chronic conditions (diabetes, chronic fatigue, fibromyalgia, back pain, and others) that are resistant to allopathic treatments.

·         Western medicine is best when used as a medicine of critical care, when all other methods of prevention and well-care have failed.

·         It would be cost-effective to use the strengths of each health care system, rather than referring all patients and all diseases for allopathic care.

Some differences between Western medicine and holistic health care:

·         Holistic health care focuses on the whole person, rather than on the symptom or syndrome afflicting the person. 

·         Holistic practitioners focus on healing the underlying causes of illness and disease, rather than fixing the superficial symptoms of the disease.

·         Holistic practitioners recognize that “curing” and “healing” are not the same thing.   “Curing” is part of the sick care system in which the focus is upon cutting out or eradicating the disease; “healing” recognizes an individual can become “whole” or “healed,” regardless of where they are within the health or disease continuum.  (Thus, “healing” can happen even as a person is preparing to die.)

·         Holistic practitioners insist that their patients work in partnership with them:  they do not undertake to “fix” or “cure” the patient.  Patients must be willing to make life-style changes in order to heal:  it is not enough for them to just take pills, tests or undergo procedures.   When patients “buy in” to the treatment plan, they are more likely to heal at the most basic level.

·         Holistic health care practitioners strive to mediate emotional and psychological trauma out of the patient’s system whenever possible.  This is important because even life-saving medical interventions (such as surgery or chemotherapy) may increase physical and emotional trauma.

POLICY RECOMMENDATIONS:

·         Since there are a number of valid health care systems (Ayurvedic, Chinese, energy medicine, etc.), the Obama health plan should recognize all delivery systems based on outcomes.

·         Government and government-regulated insurance reimbursement programs must fully cover licensed and/or certified holistic practitioners (such as acupuncturists, homeopaths, chiropractors, herbalists, energy therapists, manual therapists, and others), and allow hospitals and clinics to have full access to their services and treatments.  This is already being done in Europe and Britain, where health care costs are lower and outcomes are generally better.

·         Patients should have a choice of primary care practitioners:  MDs should not be the gate-keepers between patients and holistic practitioners.   Most MDs have not been sufficiently trained in holistic modalities and often don’t know what patients or conditions might respond best to which holistic therapies. 

·         An Integrative Medicine Advisory Panel should be created to advise legislators and policy-makers on ways to bring holistic and integrative health care practices into the health care reform plan.  Such a panel should draw on the expertise of such organizations as the American Holistic Medical Association, the American Holistic Nurses’ Association, the Preventive Medicine Research Institute (Dr. Dean Ornish), the Osher Institute at the Harvard Medical School (Dr. David Eisenberg), the Osher Center for Integrative Medicine (University of California in San Francisco), the Duke Integrative Medicine Center, The Arizona Center for Integrative Medicine at the University of Arizona (Dr. Andrew Weil), the Scripps Center for Integrative Medicine (San Diego), Healing Touch International, and other similar organizations.

·         The National Center for Complementary and Alternative Medicine (NCCAM) should develop protocols that measure the outcomes and costs of allopathic treatments for specific diseases, compared to holistic treatments for the same diseases. 

·         NCCAM should be required to develop outcome-based research protocols that are consistent with holistic health care.  Holistic practitioners treat individuals, not diseases:  as such, they don’t treat every patient the same way.  Randomized, controlled clinical trials are not the best way to test the way these multidimensional modalities and practitioners work:  they are reductionist in nature, and exclude a lot of what makes these practitioners and their treatments effective.   

·         As this research becomes available, Americans should be educated about the different health care systems, and the strengths of each one. 

COST SAVINGS

·         Encouraging a diversity of health care options, especially those that are holistic and preventative in nature, would dramatically lower the cost of health care coverage and result in a far healthier population. 

·         The new health care plan should not award financial incentives for the use of unnecessary and invasive medical procedures.  Rather, the plan should provide incentives for those health care systems that keep their clients healthy and that minimize the use of expensive medical tests and procedures.

·         Health care costs should be “captitated:” health care providers should receive a set amount of money per patient, with the goal of keeping the patient healthy.  This system works in Europe, where physicians receive bonuses for keeping their clients well, not for performing extra procedures.

We must move away from our current, expensive system of disease management and toward a system of primary and holistic care.  This is much more cost-effective and leads to a healthier population.  The new health care plan should not simply continue to funnel billions of dollars into a high-overhead, for-profit health care industry that is clearly broken.