MINUTES OF THE SENATE COMMITTEE ON COMMERCE AND LABOR Sixty-eighth Session March 2, 1995 The Senate Committee on Commerce and Labor was called to order by Chairman Randolph J. Townsend, at 8:30 a.m., on Thursday, March 2, 1995, in Room 227 of the Legislative Building, Carson City, Nevada. Exhibit A is the Agenda. Exhibit B is the Attendance Roster. COMMITTEE MEMBERS PRESENT: Senator Randolph J. Townsend, Chairman Senator Ann O'Connell, Vice Chairman Senator Sue Lowden Senator Kathy M. Augustine Senator Raymond C. Shaffer Senator John B. (Jack) Regan Senator Joseph M. Neal, Jr. GUEST LEGISLATORS PRESENT: Senator Maurice E. Washington STAFF MEMBERS PRESENT: Scott Young, Senior Research Analyst Molly Dondero, Committee Secretary OTHERS PRESENT: Robert F. "Bob" Martin, Executive Director, Nevada Association of Homeopathic Physicians, Lobbyist, Nevadans For Health Freedom Jim Jeppson, Chief Insurance Assistant, Insurance Division, Department of Business and Industry Dorothy N. Colley, President, Nevadans for Health Freedom Pat Kessler Judy Silker, Nevada Association for Homeopathic Physicians Diane Gordon Freeman Johnson Dr. Frank Shallenberger Judy Shallenberger David Horton, Lobbyist, Alternative Therapy Support Group Max L. Jones Sandy Sullivan Ron St. Jean Rusha Bogdanovich Clinton Ray Miller, Health Freedom Legislative Advocate Ike Yochum, Independent American Party Juanita Cox Hunter Gibbs Lucille Lusk, Nevada Concerned Citizens Carol Pruner Senator Townsend began the meeting with an explanation that Senate Bill 193 had been withdrawn by the sponsoring group and suggested anyone in the audience with comments to make about the intent of the bill contact the sponsoring group. SENATE BILL 193: Regulates practice of dietitians. (BDR 54- 971) Senator Townsend opened the hearing on Senate Bill 196. SENATE BILL 196: Prohibits certain insurance coverages from excluding coverage for certain treatment by homeopathic physicians. (BDR 57-1424) Robert F. "Bob" Martin, Executive Director, Nevada Association of Homeopathic Physicians, Lobbyist, Nevadans For Health Freedom, presented Exhibit C, a collection of exhibits. He expressed his concern that neither insurance companies nor Medicare accept homeopathic care and do not pay any claims where a homeopathic doctor prescribes treatment. He stated the patients are bearing the entire cost of their treatments even though most also pay for their own insurance. He indicated medical doctors, doctors of osteopathy, and homeopathic doctors practice in much the same manner. They use the same medical tests for diagnosis and these costs should be reimbursed. He suggested paragraphs 1, 2, and 4 of the Commissioner of Insurance regulations be added to the insurance code. Any licensed practitioner would, then, be included under the insurance regulations. He stated the definition of homeopathic practice is defined in the licensing of the homeopathic physician. He commented the term physician is defined in Nevada Revised Statutes 0.40. He stated the exclusions practiced by the insurance carriers are discriminatory. Senator Neal asked what reasons have been given by the insurance companies for denying payment for homeopathic treatments. Mr. Martin stated the American Medical Association (AMA) does not recognize any treatments other than those sanctioned by the AMA, and the National Council Against Health Fraud. The treatments which fall into the category of "health fraud" are those which are in competition with established AMA procedures. Senator Neal asked for the educational requirements of a homeopathic physician. Mr. Martin explained they must have a Medical Doctor (M.D.) degree or a Doctor of Osteopathy (D.O.) degree from an accredited school. They must serve 1 year postgraduate training, must have a license which requires an additional 6 month training specifically in homeopathic medicine, and they must take a written exam. He stated homeopathic medicine dates back to the 1740s. Senator Neal asked where the AMA and the homeopaths disagree. Mr. Martin responded: Homeopathic physicians do a great deal of intravenous infusions (IV) therapy. In some instances, they use in the IV infusions an amino acid called EDTA. This is also referred to as kelation. EDTA and kelation therapy have been approved for lead poisoning. It has not been approved for the treatment of coronary artery disease. However, it is very effective on it. Treatment for the average case of coronary artery disease by homeopathic means is less than $10,000. Triple by-pass surgery [costs] $75,000. Generally speaking, most of the services cost less and are less harmful to the patient. Senator Neal asked if the law is changed to allow insurance to pay for homeopathic services, will the service still cost less than regular medicine. Mr. Martin responded the services would stay less expensive. Senator O'Connell commented homeopathic medicine is widely accepted in England and is the medicine of choice by the Royal Family. Senator Lowden commented she is in favor of homeopathic medicine and is treated by a homeopathic doctor, though her regular doctor is not in favor of her choice. She recognizes there is a conflict between the two types of medical treatments. She expressed her concern for the cost of insurance. She asked if changes are made allowing homeopathic medicine to be covered by insurance, would the insurance premiums go up. Mr. Martin stated it should not increase the cost of policies. He stated he feels it would reduce costs, if the insurance companies base their cost of premiums on the actual cost of treatment. He cautioned, he could not guarantee the insurance companies will base their premium costs on the actual cost of medicine. He shared the theory that insurance companies tend to set their premiums to make a 15 percent profit on every dollar which is paid out. Jim Jeppson, Chief Insurance Assistant, Insurance Division, Department of Business and Industry, stated he cannot comment how the change in the law will affect the cost of insurance, but will compile that information. Senator Lowden commented the company she is with has started a "wellness" program to encourage employees to stay healthy and to choose their health program. Alternative medicines such as acupuncture are covered by the health plan. Mr. Martin stated "wellness" programs are the health care system of the future. Dorothy N. Colley, President, Nevadans for Health Freedom, stated she believes everyone in Nevada should have the right to choose their health care and their doctor. She stated she feels homeopathic doctors are more caring and spend more time with their patients and expressed her support for S.B. 196. Pat Kessler presented Exhibit D and explained her son's experience with homeopathic medicine. Judy Silker, Nevada Association for Homeopathic Physicians, expressed her support for homeopathic medicine. She related her experience with homeopathic treatments to control her allergies. She stated her allergies are under control and she is experiencing a quality of life she had not experienced before. She has been under homeopathic care for 6 years and insurance has not covered any of her treatments. On her first visit with the homeopathic doctor she was given an electrocardiogram and blood tests, and even though these are standard tests, none of them were covered by her insurance. She expressed her outrage at the discrimination by the insurance company. If she had received the same tests from an approved doctor, the tests would have been covered by her insurance. She urged a change in the law to prevent insurance companies from barring homeopathic treatment. Diane Gordon expressed her support for homeopathic medicine. She stated she has a heart condition which was cured by homeopathic medicine when treatment by a cardiologist had not proved satisfactory. She expressed her concern that the less expensive treatments are not covered by insurance. Freeman Johnson spoke in support of homeopathic medicine. He related his experience in the Carpenters' Union where they were not allowed to give money to those who wished to seek alternative medicine and how it was a hardship on those who chose that form of care over regular medical treatment. He commented, eventually acupuncture became an accepted form of treatment, and many members in the union chose it for treatment. He pointed out many treatments over the centuries started out as nontraditional treatments, then became accepted. Psychiatric medicine used to be considered alternative medicine and is now paid for by insurance. He stressed it is time to allow homeopathic treatments to be accepted by insurance. Senator Lowden asked if members of the union would be willing to take less of a salary increase to have homeopathic medicine covered by insurance. She stressed the increase would have to be paid for somehow and she did not want to add an extra burden to only the employer for paying an increase in premiums. Mr. Martin commented the members have the choice to vote on the issue and he could not comment whether they would vote for the change in coverage. Dr. Frank Shallenberger introduced himself as both a medical doctor and a homeopathic doctor. He wished to speak on behalf of his patients in support of homeopathic medicine. He expressed over the years he has watched people improve with the homeopathic treatments where the medical treatments have failed, only to see them stop treatment. They could no longer afford treatments because their insurance will not pay for the treatments. These patients are left no alternative but to return to medical treatments, which, for them, have proven to be less effective, or totally ineffective, just so insurance will pay for their treatments. He commented he will often treat these patients at no charge because he cannot let them return to the less effective treatments. He stressed homeopathic medicines are safe. They do not have the side effects seen by medical treatments and they are less expensive. He stated he has two patients with rheumatoid arthritis who were greatly improved by homeopathic treatments, but who were going to stop because they could no longer afford the treatments. In good conscience, he could not allow them to stop, so he is treating them at no charge. He stressed he feels insurance premiums will go down if homeopathic treatments are approved. He stated he can give a $5 homeopathic treatment for a cold, verses a $120 prescription for antibiotics. There are no side effects for the $5 treatment. There may be side effects for the prescription. Senator Regan asked would the homeopathic physicians in Nevada supply a list of charges for insurance pricing if the changes in the law occurs and if the charges would remain at the same level they are now. Mr. Martin responded most physicians use the same codes used by the health care financing agency with whom they work. He stated IV infusion therapy has a set price by the health care agencies for the first hour of use, this would not change. The drugs used are prescription, they are dispensed by the physician, but the drugs are less expensive, thus lowering the cost of treatment. Senator Neal asked for an explanation of nosodes. Dr. Shallenberger explained nosodes is an inclusive term covering a broad spectrum of naturally occurring products which can be used as a therapy. He stressed there are times when medical treatments are best for a patient, but there are more times when homeopathic treatments are best. During emergencies, medical treatment is the appropriate treatment. He stated obstructed arteries and low back pain are two afflictions treated most successfully by homeopathic medicine, and if the homeopathic approach were used for these afflictions, insurance companies would save a great deal of money. Senator Augustine asked who manufactures the alternative medicines. Dr. Shallenberger stated most of the homeopathic treatments he uses come from companies and all the companies are FDA approved and the products are manufactured in the United States. He stated he makes a few of them himself. Mr. Martin stated many patients are extremely sensitive to preservatives such as mercury which is used in medicines. He stated many medicines are made in Germany and are registered and approved. David Horton, Lobbyist, Alternative Therapy Support Group, stated there is a system of internal politics within the insurance industry which leads to socialized medicine where someone else dictates what treatment will be given to a patient. He read from a transcript of a radio program he did. In France, about 11 years ago, homeopathy legislation was passed which allowed homeopathy to be covered under their national insurance plan. The average cost for taking care of a patient in France within 3 years after this happened, decreased 80 percent. Mr. Horton commented originally the oriental medical practice act covered all alternative medicines. When the osteopathic practice act was reworked, the language was changed by a lobbyist's suggestion. He stated the oriental medical profession has suffered under the same handicap as the homeopathic profession since the change of language. He questioned why insurance companies adopt policies which will keep insurance costs rising. He concluded they work on a markup. To lower the costs, will mean to lower the insurance companies profits. He stated a change in the law will make good economic sense for Nevadans. Max L. Jones testified about his wife's health. He related they had two couples for friends. Each husband and wife had colon cancer, as does his wife. The two men have died, one woman is in the hospital dying, his wife is doing well, has a quality of life, and she is the only one who used homeopathic treatments. Neither Medicare, nor their supplemental insurance will cover her treatments. They have mortgaged their home to pay her medical bills because insurance will not pay for her treatments. He stated she has been taking chemotherapy for 14 months. She has taken homeopathic treatments with the chemotherapy and has had no side effects. He stressed the need for the freedom to choose. Senator Townsend asked for a legal definition from Scott Young, Senior Research Analyst, and from Mr. Horton or Mr. Martin, of Medicare's policies. He asked if it is a state or federal issue. Judy Shallenberger stated she has worked in Dr. Shallenberger's office for many years. She explained if a person is still working and they have a primary insurance, Medicare will pay the unpaid percentage of the primary insurance company's authorized coverage. She stated when Medicare is the primary insurance company, then they will cover only what is under their usual and customary standards of coverage. Mr. Martin stated the United States Congress took away the Food and Drug Administration's (FDA) authority over homeopathic pharmacopeia so the FDA has no say in homeopathic treatments. He stated a separate review of the medicines used is conducted which is not a part of the FDA. Dr. Shallenberger stated the FDA does not approve medical treatments. He stated the drugs used in homeopathy are manufactured in the United States and are FDA approved. What is not approved is the alternative usage of the drugs and that usage is not recognized by insurance companies. He stressed the AMA is the only entity to approve medical treatments. Sandy Sullivan read Exhibit E and expressed her support of homeopathic medicine. Ron St. Jean testified in support of homeopathic medicine. He stated alternative medicine is the only way people will see an end to the escalating costs of medical care. He commented on the loss of freedoms of the people of the United States. He emphasized freedom of health care should not be one of those lost freedoms. He stressed health care costs will decrease if homeopathic treatments are allowed by insurance. Rusha Bogdonovich expressed her support for homeopathic medicine. She asked why the insurance companies do not cover homeopathy. It is less expensive to treat a person with homeopathic medicine than with medical treatments. Senator Lowden commented the question is not whether the insurance companies would cover homeopathic medicine. The question is at what price would it be to the employers and the employees. Clinton Ray Miller, Health Freedom Legislative Advocate, spoke on behalf of homeopathic medicine. He stressed the cost of alternative medicine is so much less than regular medicine, that people pay their own expenses and often spend less than if they were paying their copayments. He stated there are 140,000 deaths per year as a side effect of conventional medicine. He pointed out these people took FDA approved, insurance paid for drugs, and died. There have been no deaths from homeopathic care. He stated the FDA tried to outlaw high potency vitamins and minerals, but failed through the activities of himself and others who believe in the right to choose medical care. Mr. Miller complimented the committee stating he had never heard a better hearing than the one being conducted today. Ike Yochum, Independent American Party, expressed his support of homeopathic medicine. He stated government's purpose is to protect American's liberties and freedoms. He stressed enactment of S.B. 196 will allow American's the choice of health care to which they are entitled. Juanita Cox read Exhibit F. Hunter Gibbs expressed his support for S.B. 196. He stated his wife has carpal tunnel syndrome and does not wish to have surgery, but she is told it is her only choice. He asked for help because she wishes to try homeopathic treatment first and SIIS will not allow it. Senator Lowden stressed the operation for carpal tunnel is not guaranteed to work. Mr. Gibbs stated surgery should be the last option, not the first and his wife does not want the surgery. Senator Townsend requested Mr. Young to check the policy Mrs. Gibbs is covered by with the State of Nevada, and see if she has any choice in her treatment. Lucille Lusk, Nevada Concerned Citizens, stated she supports the bill as a liberty bill. Carol Pruner stated she had a virus which settled in her heart. Normally the patient dies. The doctors did not know what to do for her to treat the virus. She went to a holistic clinic. She had one treatment and she recovered. She also related an experience she had with her daughter's cat. The cat bit her finger and she developed a severe infection. Her medical doctor told her they would have to cut off the finger. She went to a homeopathic clinic and they saved her finger with their treatments. She stressed the need for insurance to pay for treatments. Senator Townsend closed the hearing at 10:45 a.m. RESPECTFULLY SUBMITTED: Molly Dondero, Committee Secretary APPROVED BY: Senator Randolph J. Townsend, Chairman DATE: Senate Committee on Commerce and Labor March 2, 1995 Page