The National Governors' Association (NGA) drafted and signed a health care reform/cost-containment policy position February 1, during its Washington, D.C. meeting. The NGA's plan is quite similar to the approach that President Clinton endorsed during the campaign.
The policy endorses NGA's version of managed competition, which would set up large purchasing cooperatives made up of individuals and employers who would negotiate for health care coverage from large provider networks or super-HMOs.
Ominously, the NGA's plan calls for the development of a core benefits package "comparable with those now provided by the most efficient and cost-effective" HMOs, which, of course, do not currently provide chiropractic coverage. The policy states that "there may be some state or regional variations in the basic benefit package," but these would have to be approved by a national health care board created by the NGA. Unfortunately, the plan does not indicate whether these national health care board members would be elected or appointed, or on what basis members would be chosen.
Another provision under the NGA's plan puts limits on tax deductions for health insurance, meaning that any benefit not included in the core benefits package, such as chiropractic care, would be subject to full taxation.
Also, the NGA supports federal minimum standards which would include "limitations on the variation in rates that different individuals and groups charge." This is to regulate health insurance applying to both "nontraditional insurance mechanisms" like ERISA and Multiple Employee Welfare Arrangements (MEWA) plans, as well as the newly formed health insurance purchasing cooperatives.
On the positive side, the plan recommends federally organized outcomes research to support the development of national practice guidelines. One component of this research would be devoted to primary and preventative care. The plan also recommends expanded federal support of primary and preventative care such as health screenings, childhood immunizations, and prenatal care.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
