Medicare wasted over half a billion dollars on chiro and osteo nonsense

[Pooka1]

https://www.forbes.com/sites/stevens.../#6f3c8fd37082

Here's a quick way for the U.S. government to save over half a billion dollars. Stop paying for coverage of medical procedures that have little or no evidence to support them.

The Centers for Medicare and Medicaid Services (CMS) now releases annual reports of how much it spends, broken down according to the procedures. Their latest data, for the year 2015, reveals that Medicare spent $564,165,721 on pseudoscientific medical practices.

I'm talking about chiropractic and osteopathic manipulation. These are similar but distinct belief systems, both involving bones, and both with no evidence to back them up. Most people think that chiropractors' spinal "adjustments" can relieve pain from injured or aching backs. It turns out that it's just an elaborate placebo: a back rub at home is likely to work just as well. And that home treatment is probably safer–I'll get to that below.

Osteopathic manipulative therapy (OMT) is another hocus-pocus belief, invented out of whole cloth in the mid-19th century by Andrew Still. He believed that every part of the body was linked by a mysterious "myofascial continuity" and that manipulating it could treat a vast range of aches, pains, and other ailments. Most of this is not true. (There is some evidence that OMT can be beneficial in carefully selected cases of lower back pain, but the CMS codes don't distinguish different uses of OMT.)

[LindaRacine]

https://www.forbes.com/sites/stevens.../#6f3c8fd37082

But, if the people who seek manipulations are able to avoid more expensive treatment, especially surgery, perhaps it's not as worthless as it appears on the surface.

[Pooka1]

But, if the people who seek manipulations are able to avoid more expensive treatment, especially surgery, perhaps it's not as worthless as it appears on the surface.

That's a big "if". Also I think they might be saying is expensive for a placebo and maybe there are cheaper placebo treatments.

[burdle]

But, if the people who seek manipulations are able to avoid more expensive treatment, especially surgery, perhaps it's not as worthless as it appears on the surface.

But there is a great danger that they will be misled by the people offering manipulations and miss the 'window' for a more permanent solution which might be surgery but surgery at the most effective time.


Also while 'treatments' like this are 'legitimised' it gives rise to the more despicable who prey on the vulnerable with treatments that do not work but look inviting to desperate people e.g. Scolismart.

I would like to see all chiros go and we can focus on paying for research for non-surgical treatments that are co-ordinated within the system. We would then get a far better idea of what is effective and what isn't.

[titaniumed]

Rising medical costs are "PURE EVIL"....And Charlie Munger uses the word "VULTURES".

https://finance.yahoo.com/news/charl...191934214.html

Medical costs are the tapeworm of American Competitiveness Warren Buffet
https://finance.yahoo.com/news/buffe...220647855.html

Funny how the whole world is expected to maintain or lower prices on goods, but the medical community gets huge increases for some reason.

A simple example...(I actually have many)
I had a wart last year and visited a dermatologist to see if they could freeze it off. 30 years ago, I had a few frozen off for $25. I figured that $100 would be fair for 2 minutes work....($3000/hr) A 22 year old told me that they needed to re-schedule for a biopsy, I knew that she was trained by her doctor. In the long run, it would have cost $2000 plus, ripping off the insurance company and myself to remove a wart. I walked out, went to Wal-mart and bought a $5 bottle of Compound W. It took around 10 cents worth to remove that wart. This is not new cutting edge scientific technology.

We need something done and we need it done soon.

Money and time go hand in hand.....We could bash or praise Chiro, but there are other areas that are not necessarily the correct answer to our expenditure problem. Epidural shots save money, its been proven, but debatable on its value, and has its complications which can be serious. Chiro and shots buy time, and delay very expensive surgeries like in my case. The interest on a very expensive surgery over 34 years is substantial....and would I have needed revision or revision surgeries since that time?

Do you do 10 cents or $2000 for a wart?

Do you do $2000 worth of Chiro, or $2 million on complicated scoliosis surgeries?

Everybody has a spine problem. Imagine if everyone did surgery. What would that cost?

Ocean therapy is free. (I had excellent results for my lumbar herniation pain doing this) Medicare could save a fortune by flying all of us out to Hawaii. I think this is the answer.....(smiley face)

Ed

[Pooka1]

A simple example...(I actually have many)
I had a wart last year and visited a dermatologist to see if they could freeze it off. 30 years ago, I had a few frozen off for $25. I figured that $100 would be fair for 2 minutes work....($3000/hr) A 22 year old told me that they needed to re-schedule for a biopsy, I knew that she was trained by her doctor. In the long run, it would have cost $2000 plus, ripping off the insurance company and myself to remove a wart. I walked out, went to Wal-mart and bought a $5 bottle of Compound W. It took around 10 cents worth to remove that wart. This is not new cutting edge scientific technology.

That's amazing. It is one reason why i use a nurse practitioner instead or a doctor for my primary care.

Money and time go hand in hand.....We could bash or praise Chiro, but there are other areas that are not necessarily the correct answer to our expenditure problem. Epidural shots save money, its been proven, but debatable on its value, and has its complications which can be serious. Chiro and shots buy time, and delay very expensive surgeries like in my case. The interest on a very expensive surgery over 34 years is substantial....and would I have needed revision or revision surgeries since that time?

Buying time is not always good if it means longer fusions for waiting. That's why I consider a T curve an emergency.

[susancook]

But, if the people who seek manipulations are able to avoid more expensive treatment, especially surgery, perhaps it's not as worthless as it appears on the surface.

There is no evidence based research that shows that chiropractic or osteopathic manipulations prevent scoliosis surgery.
Susan

[titaniumed]

That's amazing. It is one reason why i use a nurse practitioner instead or a doctor for my primary care.

My GP uses a PA....and I go down there and he is pushing to do a Prostate exam... I told him, "I'm no doctor, but its my spine, I have scoliosis". Anyway, a few years had passed after surgery and I went down for "swimmer's ear" (ringing) which cost probably $400, (I do this now myself with hydrogen peroxide for $1.00) After that, he say's "Ed, its time" so, I figured what the heck. I sang the song "Moon River" you know, Chevy Chase from the movie Fletch. I asked him if that has ever happened, he told me no, I was the first.....(Just having some fun)

Second example of being over charged. Is swimmers ear worth $400? No. I had a doc do this in Hawaii and they charged me $90. Is it worth $90 when you can do it for $1.00?

The amount of inflation that's happening now is incredible. Housing is mind blowing.....especially in California.

Reno has also been on fire....$1,000,000 for 20 acres of desert land. Are you kidding me?
https://www.zillow.com/homes/for_sal...92_rect/14_zm/


Ed

[titaniumed]

Buying time is not always good if it means longer fusions for waiting. That's why I consider a T curve an emergency.

The Medicare financials are mainly adults, and scoliosis patients are a few percent of society. Its not us. Its everybody else....Most of the patients at Chiropractic offices are adults. It was a rare exception seeing any kids....

I don't go anymore because Chiro for herniated discs does not work. Been there, done that.

I do get the discount for only having one level left..... The look on their faces when I asked for this discount was PRICELESS!

After I left, I was in my car crying it was that funny.

Ed

[LindaRacine]

There is no evidence based research that shows that chiropractic or osteopathic manipulations prevent scoliosis surgery.
Susan

I agree that there is no scientific proof that chiropractic adjustment or any other non-surgical therapy results in avoiding surgery. However, there are people who feel that they've been able to avoid pain and even surgery by using alternative therapies. We see them in the non-surgical forums here, and I've known more than few. There are many, many people who have no interest in surgery. And, there are people who cannot have surgery for some reason.

While I think it's great to post the results of scientific studies, I don't personally see any benefit in denying a treatment to someone if that someone feels that a treatment helps them. We should never forget that the placebo effect is a very powerful treatment. If insurers are willing to pay for some alternative treatments, so they must think they're somewhat cost effective.

[burdle]

I agree that there is no scientific proof that chiropractic adjustment or any other non-surgical therapy results in avoiding surgery. However, there are people who feel that they've been able to avoid pain and even surgery by using alternative therapies. We see them in the non-surgical forums here, and I've known more than few. There are many, many people who have no interest in surgery. And, there are people who cannot have surgery for some reason.

While I think it's great to post the results of scientific studies, I don't personally see any benefit in denying a treatment to someone if that someone feels that a treatment helps them. We should never forget that the placebo effect is a very powerful treatment. If insurers are willing to pay for some alternative treatments, so they must think they're somewhat cost effective.

The problem is that many insurers will not cover and so patients are left to fund themselves. If they are paying for something then it should be worth the money. I agree with the importance of the placebo effect but we need to be careful to make sure that the vulnerable are not taken advantage of.

I would be happy if chiros said - "we can help you with pain by stretching and massage and advice about how to manage your spine" but I can't accept the ones who claim they can straighten a scoliosis and then produce phoney evidence to back up their claims. and it is the latter which is very prevalent.

It is so easy to qualify as a chiro and masquerade as a proper doctor!

[susancook]

The problem is that many insurers will not cover and so patients are left to fund themselves. If they are paying for something then it should be worth the money. I agree with the importance of the placebo effect but we need to be careful to make sure that the vulnerable are not taken advantage of.

I would be happy if chiros said - "we can help you with pain by stretching and massage and advice about how to manage your spine" but I can't accept the ones who claim they can straighten a scoliosis and then produce phoney evidence to back up their claims. and it is the latter which is very prevalent.

It is so easy to qualify as a chiro and masquerade as a proper doctor!

Most chiropractors do manipulations that involve quickly snapping an area on the back.. A friend of mine lost sensation in her arm with such a movement.
Kaiser paid for 10 chiropractor treatmen's before my initial surgery and I specified that I only wanted the massage and stretching and and an ice pack which helped for about 3 days each time.
My PT does some massage and acupressure spots, so I don't have to pay for it.
Susan

[titaniumed]

Various insurance plans in the US do cover Chiropractic.....I have been surprised over the years with many plans.

After all my adjustments, over 1000 of them, I wouldn't consider any of them placebo. With the binding that I had, my adjustments were all done with a large amount of force. One time, I complained that my Chiro wasn't heavy enough to get the adjustment and laughed and told them that I need 2 Chiropractors at the same time. My skiing might have been to blame for being so tight.

You can go to Chiropractors and not get adjusted. They have stretching tables, stretching chairs (I used to own one years ago) Massage therapists, ultrasound machines, electrostim machines, Arch tables, VAX-D stretching machinery, (not recommended for scolis) De-weighting treadmill machines,(Excellent!) acupressure therapists, accupuncture therapists. My accupressure therapist was Chinese and trained in China. She worked miracles....

My Chiros knew that permanent correction wasn't going to happen....If you have scoliosis ask them, if they say they can straighten your spine, the you will know.

For immediate pain relief, they were invaluable to me. (Until major degeneration set in)

I had approx 12 Chiropractors keep me walking for 22 years....

Ed

[burdle]

You can go to Chiropractors and not get adjusted. They have stretching tables, stretching chairs (I used to own one years ago) Massage therapists, ultrasound machines, electrostim machines, Arch tables, VAX-D stretching machinery, (not recommended for scolis) De-weighting treadmill machines,(Excellent!) acupressure therapists, accupuncture therapists. My accupressure therapist was Chinese and trained in China. She worked miracles....

My Chiros knew that permanent correction wasn't going to happen....If you have scoliosis ask them, if they say they can straighten your spine, the you will know.

For immediate pain relief, they were invaluable to me. (Until major degeneration set in)

I had approx 12 Chiropractors keep me walking for 22 years....

Ed

The point being that nothing a chiro does cannot be done by a Physiotherapist who works and is trained within the medical system. Even Acupuncture.

Unfortunately chiros themselves also make other unsubstantiated claims regarding treatments that are completely unsupported by evidence. They also call themselves Doctors. They self-regulate themselves . Scolismart claim to straighten a scoliosis!

[titaniumed]

No. Physio's don't do adjustments unless they are Chiropractors. For those that "don't" want adjustments there is that option, I figured I would mention this.

In order to see a Physiotherapist in the US, you cant show up without an order, you have to go see a GP(General Practioner) first and pay them. That's where it starts, they are the gatekeepers. When I made my commitment for surgery, I changed my PCP (Primary Care Physician) to my scoliosis surgeon so I could save the money that was charged every time I went to the GP......To be honest, my GP did nothing but charge a whole bunch of money. And I never met my GP, he used a PA (Physicians assistant) for everything. Imagine paying and not even meeting your doctor. This happens in the US, you can have doctors orders from doctors you have never met. There is no doubt a lot of invoicing that happens. Heavy duty invoicing with a capital H.

In order to see a Chiropractor, you don't need an order from a GP. They get their own approval through the insurance company. You can get worked on the same day.

I went to Physio after my shoulder surgery and that was great. This was ordered by my shoulder surgeon. The shoulder therapy actually helped with my spine.(post surgery) I never had an order(Before surgery) for scoliosis physio since we didn't have a scoliosis surgeon in my town. My regular Orthopedic surgeon wouldn't order it for some reason. Herniated discs are not easy to deal with....especially 4 of them in a 70 deg lumbar curve.

Once again, my chiropractic adjustments were necessary. I was always adjusted and they would adjust every single level. Many times I was barely walking when I went in, and the next day I would go skiing....Huge amounts of pain improvement.
Chiropractic also frowns on medications and an opoid habit can be expensive and cause problems all across the board.

For those that elect to do Scolismart, that is their decision. Regardless of what they say or claim as far as correction, parents need to be aware, and take it with a grain of salt. If the therapy makes the kid feel better and it avoids surgery, I think that's a good thing. Its another tool in our arsenal battling this disease, and having that choice is so important. Feeling better has a lot of value....and scoliosis is never cheap.

Their training has a lot to be desired, so if one wants to use a Chiropractor, get approval from a scoliosis surgeon. If one has scoliosis, they should see a scoliosis surgeon first to rule out things that the untrained will not find.

Ed