Deception in Medicare


Though well aware of the emerging record of successful chiropractic treatment for back and neck problems, the AMA leadership never provided this information to its members. Attorney McAndrews mentioned that the AMA also failed to inform its members of the New Zealand Report[1], or the California[2] and Oregon[3] workmen’s compensation studies, or the report by its own former trustee, Dr. Irwin Hendryson,[4] or any of the credible research showing chiropractic’s effectiveness.

In effect, the AMA steadfastly lied to its own members about chiropractic care in order to maintain its charade that chiropractic was an “unscientific cult.” This Big Lie also extended to the public in an effort to “educate” them and other people within the medical profession. The Committee on Quackery produced “Quack Packs” and organized “quackery conferences” around the country to focus on the “menace of chiropractic.” The AMA distributed anti-chiropractic literature by the gross, purchasing 10,000 copies of journalist Ralph Lee Smith’s book, At Your Own Risk: The Case Against Chiropractic, which was clearly a biased attack on the profession of chiropractic; in fact, records revealed the author was paid by the AMA.

Smith’s book exposed the few random tragic accidents at the hands of chiropractors, revealed the greed of some chiropractors, and ridiculed chiropractic training and treatments.[5] The AMA gave the book, which was partially based on the AMA’s Department of Investigation files and Smith’s earlier writings in an AMA magazine for consumers, to one thousand of the nation’s largest libraries.[6]

Another medical PR deception also occurred during the Medicare/Medicaid legislative debate in the early 1960s. It is a little known fact by the public that the AMA has opposed Medicare since its inception. Actually, the AMA and Republican Party, along with their celebrity spokesman, Ronald Reagan, were able to kill President John F. Kennedy’s original legislation in a covert campaign that came to be known as Operation Coffee Cup. Reagan used Red-baiting fear tactics to scare Americans into thinking these national health programs for seniors and the poor were a “slippery slope to Communism.” Apparently this scare tactic worked since the initial legislation was defeated.

Reagan’s efforts against Medicare were revealed in a scoop by Drew Pearson in his Washington Merry-Go-Round column of June 17, 1961. Pearson titled his item on Reagan, “Star vs. JFK,” and he told his readers:

Ronald Reagan of Hollywood has pitted his mellifluous voice against President Kennedy in the battle for medical aid for the elderly. As a result it looks as if the old folks would lose out. He has caused such a deluge of mail to swamp Congress that Congressmen want to postpone action on the medical bill until 1962. What they don’t know, of course, is that Ron Reagan is behind the mail; also that the American Medical Association is paying for it.

Reagan is the handsome TV star for General Electric…Just how this background qualifies him as an expert on medical care for the elderly remains a mystery. Nevertheless, thanks to a deal with the AMA, and the acquiescence of General Electric, Ronald may be able to out-influence the President of the United States with Congress.[7]

Little did the public realize the AMA was adamantly opposed to Medicare; in fact, it spent $950,570 alone on “legislative interests”[8] during the first three months of 1965 as it fought the Johnson administration’s program to provide health care for the elderly and, specifically, chiropractic care, which was not included until 1972.

In 1967, the AMA Committee on Quackery released its anti-chiropractic Final Solution campaign goals that included blocking the inclusion of chiropractic under Title 18 of the original Medicare legislation. The COQ was afraid that inclusion of chiropractors into Medicare would facilitate their inclusion into public hospitals.

Aside from Operation Coffee Cup, AMA resorted to other dirty tricks that many had never been revealed to the public to accomplish its goal to prevent the inclusion of chiropractic into Medicare. In 1968, HEW Secretary Wilburn Cohen was authorized by Congress to make recommendations of alternative healthcare into Medicare, and the AMA began to thwart the will of Congress.

Keep in mind this mid-1960s political battle in Congress came at the height of the AMA’s Iowa Plan to obstruct chiropractic’s involvement in any insurance program. However, many of the AMA’s clandestine efforts to sabotage chiropractic’s inclusion in Medicare began to surface during this period while direct evidence from the Wilk trial confirming this political sabotage would not come to light for another ten years.

Testimony later revealed this was a sham study engineered by biased panel members who were recommended by the AMA and appointed by loyal medical personnel within the Public Health Service. Wilk trial evidence showed the AMA secretly coached these panel members and suggested how they should vote. In fact, testimony revealed the outcome was decided five months before the study commenced.

In a February, 1968, letter, Doyl Taylor told Dr. Samuel Sherman, a member of HEW’s Health Insurance Benefits Advisory Council, of the need to keep the AMA’s involvement clandestine and to lie to the committee:

I’m sure you agree that the AMA hand must not ‘show’ in this matter at this stage of the proposed chiropractic study…We must guard against the possibility that HEW may decide to do only what is politically expedient and include chiropractic ‘as licensed at the state level’; or if a study is undertaken, admit chiropractic’s totally unscientific testimonials.[9]

Months before the study actually began, Sherman assured Taylor in a letter on March 1, 1968, that the final decision would be based upon chiropractic’s “lack of scientific merit.”[10] On October 2, 1968, six weeks before the chiropractors were due to testify before the Panel, Dr. John Southard of HEW told Dr. Samuel Stevens of the AMA Committee on Quackery that “Testimony by the AMA or the medical profession is unnecessary as the final answer has already been determined.”[11]

This predetermined decision did not sit well with a few members of the HEW committee. Sociology professor Walter Wardwell, PhD, was a participant in the investigation. He was an objective and knowledgeable source as indicated in his dissertation, Social Strain and Social Adjustment in the Marginal Role of the Chiropractor. Later in 1992, his pivotal work on chiropractic was published: Chiropractic: History and Evolution of a New Profession.  In his book, Dr. Wardwell mentioned that the 22-member committee of scholars, professionals, and businessmen assembled by HEW would have no actual voice in the final report, which had already been prepared by staff members of the US Public Health Service.[12]

Dr. John McMillan Mennell, another HEW panelist, was a distinguished orthopedist, professor, and expert on manipulative therapy who had taught at eight medical schools. In a letter dated October 28, 1968, to the HEW panel on Medicare coverage for chiropractic in which he participated, he mentioned the value of chiropractic care:

Manipulative therapy relieves symptoms of pain arising from mechanical joint dysfunction and restores lost joint function. No other modality or physical treatment can do this as effectively. This is clear from personal experience, from assessing the value of manipulative therapy in my practice, from experiences related by intelligent, well-educated people in all walks of life including other doctors…from the best figures available to me I would suspect that nearly 20 million Americans today could be spared suffering and be returned to normal pain-free life were manipulation therapy as readily available to them as empirical nonspecific drug treatment is. [13]

Dr. Mennell also complained of receiving phone calls “indirectly, but clearly inspired by the AMA, implicitly suggesting what the tenor of my paper should be.”[14] Dr. Mennell complained of the AMA’s coaching:

I was disturbed in the past four weeks to receive two telephone calls indirectly from, but quite clearly inspired by, the AMA implicitly suggesting what the tenor of my paper should be. I can only assure the Consultant Group that my conclusions are arrived at through my independent research, thinking and experience unaffected by extraneous pressure.[15]

Certainly Doctors of Chiropractic should not be penalized simply because of the bitter bias of the AMA when there is substantial evidence that manipulative therapy brings relief to sufferers from mechanical pain which only manipulative therapy can relieve.[16]

The final vote of the panel was four to four. This was changed, after an informal procedure, to five to three against inclusion of chiropractic in Medicare. Though it asked for a response to the charges of AMA involvement, Congress was never told that:

  • The results of the study had been concluded five months before the study even commenced;
  • The AMA had secretly “coached” the members of the panel;
  • The AMA had suggested how the panel members should vote;
  • The AMA had provided the panel members with AMA materials; that the AMA had procured and copied confidential documents from the panel during the study,
  • Biased members had been selected for the panel;
  • A 4 to 4 vote (changed 5 to 3) under these circumstances had supported the negative report;
  • The Principles of Medical Ethics of the AMA had been considered as a barrier to inclusions of chiropractic under Medicare; and
  • A HEW medical physician had been in private contact with the AMA during the study.

Not only did the AMA, through its Committee on Quackery, thwart the wish of Congress to include chiropractic in Medicare, it also broadened its deceptive war against chiropractic by distributing such propaganda to the nation’s teachers and guidance counselors as a part of the Quack Pack. The COQ also called for the elimination of the inclusion of chiropractic from the U.S Department of Labor’s Health Careers Guidebook, and establishing specific educational guidelines for medical schools regarding the “hazards to individuals from the unscientific cult of chiropractic.”

Indeed, the AMA was willing to lie to everyone about chiropractic care, even Congress, and they were eager to use celebrities to do their bidding, including the most prominent newspaper journalist in America, Ann Landers.

[1] Ibid. PX-1829.

[2] Ibid. PX-194

[3] Ibid. PX-193

[4] Ibid. p.42.

[5] RL Smith, At Your Own Risk: The Case Against Chiropractic, New York: Trident Press, (1969)

[6] H Wolinsky and T Brune, ibid. p.129.

[7] D Pearson, “Attorney General Gets Scolding, The Washington Merry-Go-Round,” The Washington Post, (June 17, 1961):C15.

[8] DE Biser, “AMA Spends $950,570 on Fight against Medicare,” Texas Chiropractor 22/10 (Aug 1965):14 reprint from the Dallas Times Herald

[9] SR Sherman, letter from H. Doyl Taylor, director, AMA Dept. of Investigation, 20 February 1968, Plaintiff’s exhibit 220, Wilk.

[10] Letter from Sherman to Taylor  (March 1, 1968)

[11] Ibid. PX-332

[12] WI Wardwell, “Chiropractic: History and Evolution of a New Profession,” St. Louis, Mosby, (1992):165.

[13] Null, ibid.

[14] Deposition of Mennell, in Wilk, p. 75

[15] G McAndrews, p. 52

[16] Ibid. PX-1529