A patient walks into a clinic with a broken arm. The patient’s primary care doctor is booked solid. Although the clinic has two other medical doctors, the patient is told the insurance provider won’t allow him to see the other available physicians. That’s because his health insurance — the coverage the patient pays monthly premiums for — only extends coverage if a patient is seen by the assigned primary care doctor.

Sound unfair? Of course it is! And so is the Seattle Post-Intelligencer's April 11 editorial suggesting that Gov. Chris Gregoire veto Senate Bill 5597 for "unjustifiably benefiting one group of medical practitioners" — in this case, chiropractors.

Let's look at the facts. SB 5597 passed both the House and Senate with bipartisan support. Lawmakers supported this legislation because it allows patients to receive chiropractic care in a clinic in which they are already established patients when their current doctor is unavailable.

Under the bill, if a patient's regular chiropractor has a contract to deliver care under a health insurance plan, then another chiropractor employed at the same clinic would be allowed to provide the same chiropractic services and under the same insurance plan, if the second chiropractor meets the plan’s qualifications.

Curiously, opponents have stated the bill will increase access to chiropractors, which would cost more money because patients will actually use the services that they are already paying for through premiums. In contrast, the P-I editorial claims that this bill has "little or nothing to do with expanding access to care."

Lack of access is exactly why this legislation is needed. The truth: This bill doesn’t increase any benefits that now exist under a patient’s health plan nor does it change an insurer’s requirements that verified contracted providers meet quality standards, adhere to contract expectations and provide cost-effective care. And it doesn’t increase the number of times a patient can be seen by a chiropractor, which is limited to about 10 to12 visits annually, under most health plans.

One particular insurer, for example, covers less than half of the doctors licensed to provide chiropractic care in Washington. Would an insurer consider excluding half of providers from any other health profession? Would an insurer consider not allowing a patient to see another medical doctor in the same clinic just because his or her primary provider is booked for days?

The bottom line is this: SB5597 provides chiropractic patients with access to licensed health care providers who have the ability, as documented in numerous health studies, to treat spinal conditions with better outcomes and at a lesser cost and without expensive drugs or surgical procedures.

As a legislator, I have seen insurers treat chiropractors and other non-MD providers unfairly. That’s why I supported this bill and similar legislation, which allows patients to receive the health care that works best for them.

SB5597 remedies yet another bias by insurers against non-medical providers and the patients who rely on them. Based on the strong bipartisan support the bill has received, Gov. Gregoire needs to ignore the questionable motives of those calling for a veto, and sign SB5597 into law.

Senator Rosa Franklin, D-Tacoma, is a former registered nurse with more than 40 years of health care experience. She is vice-chair of the Senate Health & Long-Term Care Committee.

WSCA President's Response to the PI:

When chiropractic patients require spine-related health care, it is essential that treatment be delivered in a timely and consistent manner to achieve the best possible outcome. That’s why I was disappointed to see the Post Intelligencer call for a veto of SB 5597.

The bill’s goal is to make sure that patients have regular access to their benefits. To accomplish this, patients need to be able to see other providers within the same clinic when their original provider is not available.

The PI’s claim that this bill expands treatment simply isn’t true. SB 5597 provides no new benefits: It allows patients to receive the benefits they already have available through their health insurance plan.

SB 5597 directly ties into the state’s existing Every Category of Provider law, which says that health care providers are required to meet the health insurance company’s standards for cost-effectiveness and clinical efficacy as long that requirement is applied uniformly across all the professions.

Health insurers violate the spirit of that law when they don’t allow patients the same level of access to chiropractic treatment as they do to medical care.

J. Michael Schweitzer, DC, President
Washington State Chiropractic Association