The HEAL saga of 1991 has become the HEAL saga of 1991-1992. Since my last report on the HEAL issue (see "HEAL Saga," parts I & II in January 17 and January 31, 1992 issues), to the drafting of this update, nothing has changed regarding reauthorization of the program by Congress. As it stands today, the House has passed their version and the Senate theirs; neither body has appointed conferees to resolve the differences.
We can however report on the attitudes expressed by key legislators and key staff persons. Their mood has changed dramatically. They are being more sensitive to the problems that the 'tiering' process has created for the chiropractic profession. We detect a definite sense that many in the legislative process believe we have been dealt with unfairly and in a discriminatory fashion, whether intended or not.
Relief will appear in the form of a House/Senate conference to resolve the differences in the bills. The next step will take it back to each body for a vote and then on the president. Once this phase has been completed, the supplemental appropriation process (for fiscal year 92) and reappropriation process (fiscal year 93) take center stage.
The colleges did receive some help since my last report. The Association of Chiropractic Colleges was notified that approximately $11.5 million of loan authority was returned to the Bureau of Health Professions (BHP). BHP in turn offered the authority to tier III and tier IV lenders who had a history of lending to chiropractic students. Based on reports from individual colleges, $6-8 million of the total amount was directed to chiropractic students.
The chiropractic profession can look forward to being joined by fellow travelers from many disciplines as the entire program is days to weeks from exhausting all available funding for FY 92 ($290 million). The problem will no longer be a chiropractic problem but will become a health care education problem.
Congress has certainly had plenty on its collective mind lately, but that does not relieve us of the duty to be diligent and to continue to let our needs and desires be known. This is an election year, and oddly enough, lawmakers seem a little more open to input at these times. If you haven't written your representative and or senators please do so. Let them know we need some movement on the issue and some relief during this difficult time.
Gerard Clum, D.C.
San Lorenzo, California
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.
On Feb. 1, 2024, two more legislators – John R. Carter (R-Texas) and Robert “Bob” Good (R-Va.) – co-sponsored the Chiropractic Medicare Coverage Modernization Act of 2023, bringing the co-sponsor total to 155, two more than the total achieved over the entire two-year congressional cycle in which identical legislation last appeared (2021-22).
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.
