January 2003
see
also: WCA fights Wal-Mart decision on
chiropractic
Wal-Mart's assault on chiropractic
by Dr. Jeffrey Shay
Which organization:
-- Is the largest in its class?
-- Has a wage structure generally below the poverty level?
-- Opposes free speech and assembly?
-- Restricts health care choices available to its people?
If you answered Wal-Mart, you're right. But it's
understandable if you answered Communist China.
Many chiropractors are already aware that Wal-Mart has
eliminated chiropractic from its health coverage (and almost nothing
else), and that the World Chiropractic Alliance (WCA), the American
Chiropractic Association (ACA) and the International Chiropractors
Association (ICA) have issued responses to the situation.
ACA indicated that it has been discussing the issue with
Wal-Mart, and recommended that chiropractors "inform patients of
their ERISA rights."
ICA
said something about a "nationwide call for
reevaluation of this decision." All of which is about as effective as
hiring a negotiator to talk King Kong down from the
Empire
State
Building
(in modern
America
, he would probably be
viewed as a terrorist anyway).
(Note: a separate report on the WCA response is included in
this issue of The Chiropractic Journal)
This is not so much a criticism of the chiropractic
associations as to point out what kind of company we're dealing with. As
WCA's Director of Insurance Relations, I'm taking a different approach to
the problem, which I feel will be more effective. My letter to Wal-Mart
follows.
-----
Dear Wal-Mart:
I am in receipt of your letter notifying me of cancellation
of chiropractic benefits from your health plan. Frankly, it confuses me.
If there had been any question of the cost or benefit of
chiropractic care, there is little evidence that you have sought advice or
information. Almost every unbiased study has shown chiropractic to be
cost-effective and competitive; in fact, chiropractic is usually
considered to be alternative care. Alternative, loosely defined, means
that the patient has chosen to be in a chiropractor's office instead of a
medical office. Since the decision is only a transferal of cost, your
estimated "savings" are illusory.
Perhaps your real attitude is shown by the greeting in your
letter, "Dear Jeffrey." Is it your policy to address all health
professionals in this manner? Perhaps this salutation is used only with
chiropractors, as I've been informed by other chiropractors of similar
salutations in their mail. It's hard for me to imagine that you would
address medical physicians as "George" or "Frieda,"
but please let me know if this is not the case. Doctors of chiropractic
have many years of extensive training in their field and meet strict
licensure requirements. The tone of your letter seems to be a cheap shot.
Sincerely,
Jeffrey A. Shay, D.C.
Insurance Chairman, World Chiropractic
Alliance
-----
No one has called me "Jeffrey" since my eighth
grade science teacher (I believe the issue was a girl's purse that landed
in a dumpster two stories below).
The real story of Wal-Mart's treatment of employees is
different than its public image, as indicated in an article in Business
Week, entitled "How Wal-Mart Keeps Unions at Bay." For a
business magazine, the article was a fairly balanced view of Wal-Mart's
labor relations.
The article points out that Wal-Mart has been accused of
surveillance of employees and of firing union sympathizers. It also
indicates that illegal anti-union actions (which Wal-Mart denies) carry
insignificant fines or require workplace posting. Firing activists, the
article notes, "is difficult to prove and takes years to work through
the courts." Some former Wal-Mart managers indicate that the hard
line is standard company policy. After a union organizer appeared in
Scottsburg
,
Indiana
, the store sprouted
"a multitude of cameras." Wal-Mart denied that their appearance
had use in anti-union activity.
The union involved is the United Food and Commercial Workers
(UFCW), which has been active recently in
Michigan
,
Ohio
,
Indiana
and
Kentucky
. It was recently
involved in attempting to unionize a store in
Las Vegas
, but canceled its
efforts after concluding that the workers were too intimidated to vote at
that time.
The union's website notes that Wal-Mart:
*** Faces 38
state and federal lawsuits for forcing employees to work off the clock
*** Faces the
largest sex discrimination lawsuit in history
*** Has been
charged by NLRB with violations of workers' rights in 25 states
*** Two-thirds of
Wal-Mart's workers cannot afford the company health plan, e.g., 700,000 do
not have company health insurance. Asking "Who pays?," the UFCW
quotes Wal-Mart: "Our associates get health insurance from a spouse
or a state or federal program." This means that either the taxpayers
or other companies are carrying Wal-Mart's load.
The Walton family is worth $102 billion. Less than one
percent of that amount could provide affordable health care for its
associates, including chiropractic coverage. Wal-Mart did not contact any
chiropractic association to find out more about chiropractic, nor did they
even try to tailor a managed care plan. They just slashed chiropractic
benefits and mailed us insulting letters.
I recently contacted the UFCW about its Wal-Mart campaign and
health care policies and found much common ground. The union is just as
concerned as we are about the poor health care package offered to Wal-Mart
employees Actually, "offered" is not a word that fits here.
Wasn't Socrates "offered" a hemlock cocktail?
UFCW representatives have indicated that they would welcome
chiropractic support for the union's drive to secure justice for store
employees.
For this reason, the World Chiropractic Alliance announces
its support for the UFCW and its efforts to improve conditions for
Wal-Mart employees. We also encourage other chiropractors and chiropractic
associations to join us in this effort to remedy Wal-Mart's actions
against chiropractors and their patients.
Wal-Mart is not our friend, and never has been. I should
point out that the elimination of chiropractic coverage is only the final
step. None of my Wal-Mart patients have cleared deductibles on their
claims in the past year, and even then the chiropractic coverage was very
limited. My discussions with other D.C.s indicated that claims for their
patients met the same fate. This means the employees' coverage was ersatz
more than real, and the recent announcement is pro forma.
To summarize: High deductibles, limited coverage. As Yakov
Smirnoff says, "What a country!"
Tell your Wal-Mart patients about their real coverage and how
Wal-Mart's actions have stiffed them. Heck, tell all of your patients
about Wal-Mart's policies. If there are union activities in your area,
contact them. Call the WCA. Check out the UFCW's website. For myself, I'll
try to shop elsewhere whenever possible. It won't be easy, as Wal-Mart's
appearance in my town closed up most of the other merchants.
It's been a bad month for chiropractors. First came the
Wal-Mart news, followed by an attack on the profession by Walgreens on its
website. The FOX network distributed its usual anti-chiropractic hype.
Then The Wall Street Journal made another attack on chiropractic.
The UFCW's attitude toward us is a breath of fresh air, as
they're glad for any help we can give them. We also need to remember that
when stores are unionized, the union negotiates health care contracts as
well as wages.
Wal-Mart claims that it "is experiencing unprecedented
cost growth that is forcing us to make some tough choices."
Admittedly, things have been tighter for most businesses recently.
However, here in
Iowa
we have an insurance
equality law that requires coverage of chiropractic in most health plans.
Wal-Mart is using an ERISA exception to get around this requirement, while
most other companies continue to provide coverage.
In recent years, Wal-Mart enjoyed record earnings, not to
mention a high-flying stock. During that time, the company made no effort
to improve its parsimonious benefit plan or to cover chiropractic on a par
with its medical coverage. The recent recession only gave it an excuse to
target chiropractic.
When I look around my waiting room, I don't see any Wal-Mart
executives. Nor do I see CFOs from Enron, Global Crossing or WorldCom.
Most of my patients are factory workers, store employees, day-care
workers, self-employeds -- groups that have traditionally been
chiropractic patients and supporters. My business has never had help from
or support by large corporations, major business groups, or even the
Chamber of Commerce.
I've learned to support the people who support me. In the
long run, that's the only way to beat the Wal-Marts of this world.
(Dr. Jeffrey Shay, a graduate of
Palmer
College
of Chiropractic and
the WCA's 1996 "Chiropractor of the Year," is the World
Chiropractic Alliance Director of Insurance Relations. He welcomes
comments or questions regarding any insurance-related subject appearing in
this column. Dr. Shay is available to speak to your state or local
organization. Contact him at
1300 Cedar St.
,
Muscatine
,
IA
52761
, or the WCA offices,
FAX 480/732-9313.)
