Does alternative medicine have a place in health care reform?

Doctor displays a model of acupuncture points on the ear. © Matthew Lester
Courtesy: National Center for
Complementary and Alternative Medicine

Americans spent $33.9 billion out-of-pocket on complementary and alternative medicine (CAM) over the previous 12 months, according to a recently published 2007 government survey.

Mentioned in the first article of this Health and Science series, CAM is a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture that are not generally considered to be part of conventional medicine.

Well, not generally considered by conventional practitioners, but people are considering it because CAM accounts for 11.2 percent of total out-of-pocket expenditures. The remaining percentage, which amounts to $286.6 billion, goes towards out-of-pocket expenses for conventional treatments health care.

Approximately 38 percent of adults use some form of CAM for health and wellness or to treat a variety of diseases and conditions, according to data from the 2007 National Health Interview Survey. The data provide estimates of the cost of CAM use, the frequency of visits made to CAM practitioners, and frequency of purchases of self-care CAM therapies.

Of the $33.9 billion spent on CAM out-of-pocket expenses, an estimated $22.0 billion was spent on self-care costs --- CAM products, classes, and materials -- with the majority ($14.8 billion) going to the purchase of nonvitamin, nonmineral, and natural products such as fish oil, glucosamine and Echinacea. U.S. adults also spent approximately $11.9 billion on an estimated 354.2 million visits to CAM practitioners such as acupuncturists, chiropractors, and massage therapists.

To put these figures in context, the $14.8 billion spent on nonvitamin, nonmineral, natural products is close to only one-third of total out-of-pocket spending on prescription drugs, and the $11.9 billion spent on CAM practitioner visits is close to only one-quarter of total out-of-pocket spending on physician visits. Not so much when you look at it that way is it? Doctors can relax. Still, people are making their health care choices clear by using precious dollars for these unconventional treatments.

 "While these expenditures represent just a small fraction of total health care spending in the United States, they constitute a substantial part of out-of-pocket health care costs,"

Richard L. Nahin, Ph.D., MPH, acting director of The National Center for Complementary and Alternative Medicine's (NCCAM) Division of Extramural Research.

Who knows, patients might use CAM more if their insurance covered it more often.  That must be a scary thought for many.  There is not denying that people are extremely interested in what CAM has to offer.  Things like time to listen to patients, expertise, and cutting-edge understanding of complex conditions.

The National Center for Complementary and Alternative Medicine's (NCCAM) mission is to explore complementary and alternative medical practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals.

Left to do its work, without fearful criticism of special interest groups, NCCAM will provide the public with evidence-based information to make well-informed decisions.  On its website, NCCAM urges "Take Charge of Your Health" and "Be an Informed [health] Consumer."  Wise health mantras.

CAM clearly deserves a respectable place in whatever health care reform is upon us.  Stay alert.

For more information: Nahin, RL, Barnes PM, Stussman BJ, and Bloom B. Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007. National health statistics reports; no 18. Hyattsville, MD: National Center for Health Statistics. 2009