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Cost of Coverage Forces Search For 'Alternatives'

MANAGED CARE January 2005. © MediMedia USA
News and Commentary

Cost of Coverage Forces Search For 'Alternatives'

MANAGED CARE January 2005. ©MediMedia USA

People without health insurance will go where they will to get treated. That's one of the findings of a study on complementary and alternative medicine (CAM) released by the Center for Studying Health System Change.

"High Cost of Medical Care Prompts Consumers To Seek Alternatives" uses data from the National Health Interview Survey that show that of the approximately 43.3 million people who used CAM in 2002 to treat specific conditions, about 6 million did so because conventional medical care was too expensive.

Those 6 million people were nearly four times as likely to be without health insurance as those who did not cite costs as the primary reason for turning to CAM. The National Health Interview Survey uses data taken from about 31,000 interviews with adults.

"Herbal remedies were by far the most widely used form of CAM among people with cost concerns: Almost two out of three (63 percent) used herbal remedies," says the study.

One of the most popular such remedies "known to cause serious side effects" is St. John's wort. It was used by 1 in 8 of all CAM users citing cost concerns. Kava, another herbal remedy, was used by 1 in 12.

"Widely publicized as a depression treatment, St. John's wort can interact dangerously with other drugs," says the study. "Recent studies indicate St. John's wort may be ineffective against moderate to severe cases of major depression, leaving some people with worsening conditions and potentially severe consequences, including suicide. Kava, used to treat anxiety, stress and insomnia, has been shown in clinical trials to cause liver damage."

Another troubling finding: among those turning to herbal remedies because of the cost of conventional medicine, 54 percent did so without either telling a conventional medical professional or disclosing use of CAM during a medical visit.

The ramifications of CAM should be of concern to everybody.

"However," the study adds, "people who turn to CAM because of cost concerns are particularly vulnerable: Their lower incomes and rates of insurance coverage, coupled with worse health status, might make them more likely to seek cheaper — and potentially ineffective or unsafe — solutions to their health problems outside the realm of conventional medicine.

"Also, lower education levels among these consumers suggest that they might be less likely to seek consumer information about the safety and effectiveness of CAM treatments before using them. As health care costs continue to outpace incomes, and the number of uninsured Americans keeps rising, more people are likely to turn to alternative treatments like herbal remedies as they find conventional medical care less affordable."