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Who can I talk to as to why Medicare doesn't insure acupuncture treatments.

We are assuming that you are asking your question from the United States. If you aren't and we have misunderstood, our apologies.

As a UK-centred organisation we are probably not the best placed people to offer comment on this question. As far as we understand it the Medicare system seems to run along similar lines to some of the major private insurance programmes in the UK with a flavour of National Health Service provision, which is practically none.

The problem with acupuncture and other CAM provision is that it lacks the evidence base which is now a requirement for provision in the NHS and with leading private health insurers (PHIs). When allocating funding a provider needs to have some assurance that the modality will work, and an equal assurance that there is a finite limit to what it will cost. Since most research into acupuncture is not accepted (complex methodological issues and funding difficulties abound) and most treatment is offered on an open-ended basis, this is not beloved by the actuaries who have to cost out provision.

We note that that you can get acupuncture if you pay for a higher level of service, and this mirrors some of the PHIs in the UK who offer money purchase packages alongside their main policies which offer additional benefits at a price. This was led, we believe, by patient demand and an awareness that keeping this group of users happy protected the mainstream PHI provision. However, it would be fair to say that as CAM has become more popular so some sectors within conventional medicine have seen it as a subversive threat, and the opposition to its inclusion within mainstream provision has greatly increased, certainly in the UK.

As an organisation we have been making representations to both NHS and PHIs throughout our whole existence to argue for the inclusion of acupuncture free at point of delivery within their offer. Some doctors and physios offer acupuncture within their existing scope of practice, and some PHIs will now pay for limited amounts of treatment. When patients ask for advice along the lines which you have done the best we can say is that you contact the local or national policy makers and try to make a case for your own needs. If you try to argue the national case you will not succeed unless you can get  a huge popular following, but you may be able to make a case for your own personal treatment if:

a) you can show that their is an evidence base for the condition with which you need help

b) you are able to make a case that a course of treatment is likely to cost less than any continuing care by conventional means. When you take into account the cost of doctor/hospital admissions and pharmaceutical products this is not a difficult case to make, especially if you have any low-cost community clinics in your area offering discounted treatment.

The best advice we can offer, though, is to talk to local acupuncture associations to see what they can advise. We are certain that they will have tried to address this issue, and will certainly have contacts whom you can follow up.

We wish you the best of luck!

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