The Center for Disease Control (CDC) defines Health Equity as “the state in which everyone has a fair and just opportunity to attain their highest level of health”. Medicare is the primary government provided health insurance for seniors 65 years and older. However, with Medicare insurance recipients cannot achieve their personal highest level of health. Most of the coverage provided is for medical care to treat acute and chronic injuries or disease conditions. For those who are basically healthy and desire natural and alternative treatments without serious side effects or complications are challenged in finding qualified naturopathic providers and safe alternatives. There is either specific, very limited, or no coverage for naturopathic physicians and alternative therapies.
The cost of for Medicare premiums does not include drugs placing the burden on recipients to obtain separate insurance (Part D) which does not allow for coverage for nutritional supplements and natural alternatives.
Medicare.gov does not provide access to educational resources related to disease prevention and health promotion. Elderly Medicare recipients are tasked to navigate the Internet and social media platforms seeking out this information unassisted which could potentially yield negative outcomes.
Medicare does not provide coverage for individualized nutritional counseling, nutrient requirements evaluation and dietary planning. Physical fitness evaluation and exercise therapies are not covered despite the fact that scientific evidence supports physical exercise to maintain health and prevent certain diseases.
Vision is not covered under Medicare and many older low income adults opt out of vision insurance settling for low cost eyewear as their vision deteriorates. Dental is not covered by Medicare therefore recipients must purchase their own insurance and often opt out due to very high cost. Oral health and related education is important to the maintenance of overall health as the recipient ages. Many recipients are unaware of vision, and dental changes which occur with aging and most can benefit from educational information and alternative care resources.
Medicare approved naturopathic physicians would be required to share recipient health information among all natural health providers including but not limited to nutritionists, physical fitness trainers, licensed chiropractors, herbalists, and acupuncturists.
On the initial Medicare “wellness visit” and continuum for alternative care consider the examples listed:
Health Promotion:
- Baseline blood work for nutritional assessment
- Physical examination:
—physical strength
—cardiac/respiratory status
—Current health conditions - Educational needs assessment
- Physical fitness evaluation
- Nutritional Counseling and diet planning
- Sleep assessment-alternative methods
- FDA approved dietary supplements
- Oral exam/natural therapy alternatives
- Vision evaluation and alternative therapies
- Age related vision education:
—age related macular degeneration - Provide links on the Medicare website to evidence based and approved alternative providers, therapies, and education.
12. Permit naturopathic and alternative therapy providers to refer recipients to appropriate medical physicians if alternative therapies are ineffective.