Who pays the bills when patients seek spiritual healing?
DENVER — As healing rooted in spiritual understanding has gained public acceptance, and is apparently bringing the worlds of medicine and spirituality closer together, thorny issues remain. One now on the table for discussion is how differing spiritual treatments should be measured and paid for.
Participants at this week's conference here on Spirituality and Healing in Medicine raised a cluster of basic questions about the nature of healthcare that are sure to reverberate through the medical-and spiritual-care worlds. Can spirituality be integrated into medical practice in a team approach? Who determines the credentials for healers or therapists working outside of conventional medical practices? Who and how do you pay the bills?
Many at the conference see the medical world in crisis, out of touch with patients' real needs and ponderously expensive as dependence on technology increases in a swiftly moving world.
Gregory Fricchione, director of the Mental Health Program at the Carter Center in Atlanta, thinks the medical profession has lost the ability to simply talk with patients as people. "In our little guild we call medicine," he says, "talking is downplayed, but if we do something [to the patient], it's big bucks."
Enter the spiritual factor in healing as evidence of change. "The mind/body and spiritual relief-related treatments deserve a place in medicine and are now well established," says Herbert Benson, originator of the series of Mind/Body conferences and a Harvard Medical School professor, as well as president of the Mind/Body Medical Institute at the Beth Israel Deaconess Medical Center in Boston.
"We now want to shift the emphasis from scientific data and clinical practices of various religions to reimbursement," he told some 700 participants at the conference. "Mind/body, relief-related therapy should be paid for."
Healthcare experts say much remains to be clarified as the medical world begins to consider patient needs over physician needs. These include definitions of healing, concern with the spiritual needs of patients, acceptance of new terminology in the healthcare industry and all medical schools offering spiritual training. Few at the conference underestimate how difficult this task will be.
Several panelists indicated that as more Americans live longer, and as healthcare costs are expected to increase, patients need to be more responsible for their own health. "What this means," says Harold Koenig, founder of the Center for the Study of Religion/Spirituality and Health at Duke University, "is an increase in self-help care activity both in prevention and treatment." Accomplish this on a large scale, say the experts, and healthcare costs could go down
Virginia Harris spoke to the conference about Christian Science healing practices. She is chairman of the Board of Directors of the First Church of Christ, Scientist, which publishes this newspaper. Mrs. Harris says, "Reimbursement is not the full measure of the value of healthcare services, but it is an important form of recognition. It is encouraging that coverage for prayer-based healing methods is on the table for discussion. Christian Science treatment has for many years been reimbursed by private insurers."
Depending on the state, a number of insurance companies - responding to consumer demand for more personal treatment - already offer policies covering alternative treatments, such as acupuncture, meditation, chiropractics, and biofeedback, all offered usually at minimal or discounted rates.
A Yankelovich Partners survey last year found that "86 percent of Americans believe personal prayer, meditation, or other spiritual and religious practices can accelerate or help the medical treatment of people who are ill."
And 41 percent of Americans say they have been cured of illness or had their conditions significantly improved as a result of personal prayer or meditation.
Sloans Lake Managed Care in Colorado is one of the few insurance companies nationally to offer coverage for spiritual counseling. "We make a distinction between complementary medicine and spirituality," says Sloans Lake president Neil Waldron. "If you have a sense that something is out of sync in your life, and you think some sort of spiritual counseling would be beneficial," he says, "we would pay benefits for that up to a limit."
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