Independent Practitioners under Medicare: A Report to Congress (1968)

In December 1968, the Department of Health, Education, and Welfare (HEW) issued a report recommending that chiropractic coverage not be added to Medicare. The report concluded:

Chiropractic theory and practice are not based upon the body of knowledge related to health, disease, and health care that has been widely accepted by the scientific community. Moreover, irrespective of its theory, the scope and quality of chiropractic education do not prepare the practitioner to make an adequate diagnosis and provide adequate treatment. Therefore, it is recommended that chiropractic service not be covered in the Medicare program.

The HEW report—called “Independent Practitioners under Medicare”—contained over 300 pages and covered several professions. In May 1969, chiropractic organizations responded with a “White Paper” charging that the report was “biased,” “wholly unreliable,” and “totally unworthy of consideration.” HEW then published a response showing why the chiropractic response was invalid.

Taken together, these documents lay bare the pathetic state of chiropractic education and practice during the 1960s and 1970s, as well as the refusal of the leading chiropractic organizations to admit that there was anything wrong. Despite this negative report, Congress added limited coverage of chiropractic services under Medicare beginning in 1973. Since that time, although Medicare has paid billions of dollars to cover chiropractic services, no government agency or major media outlet has described what the money has been paid for.

HEW Report (Portions Not Relevant to Chiropractic Omitted)

• Cover Letter from HEW Secretary Wilbur J. Cohen
• Recommendations
• Chapter I. Dimensions, Methodology, and Background of the Study
• Chapter II. Issues Involved in Consideration of Changes in Coverage
• Chapter III. Reports on Professions Studied
  • Chiropractic
    • Present Medicare Coverage, Requested Change in Coverage, Professional Associations
    • Utilization of Chiropractic Services
    • Concept and Philosophy
    • Subluxation
    • Services of Chiropractors, Scope of Practice
    • Approach to Diagnosis and Treatment
    • Manpower
    • Quality:Indicators, Description of Chiropractic Schools
    • Evaluation of Chiropractic Education
    • Chiropractic Research
    • Summary: Chiropractic Education and Research
    • Current Status of Chiropractic
    • Special Studies of Chiropractic
    • Positions on Chiropractic
    • State Licensure of Chiropractors
    • Conclusions and Recommendations
• Appendix A. Ad Hoc Consultant Group & Expert Review Panel on Chiropractic & Naturopathy
• Appendix B. Statements by Professional Associations
  • International Chiropractors Association
  • American Chiropractic Association
• Appendix C. Additional Materials on Chiropractic
  • Selected Data on Schools of Chiropractic
  • Chiropractic Textbooks Cited

Chiropractic’s White Paper”

HEW Response to Chiropractic’s White Paper

This article was revised on August 5, 2018.