Insurance should pay for Tai Chi classes for people with osteoarthritic knees!
Based on a recently published study, Tai Chi (Taiji) is effective as physical therapy in treating patients of knee osteoarthritis, not including additional health benefits. Why is the cost of Tai Chi classes not being covered by medical insurance?
Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis was funded by National Institute of Health (NIH) and conducted by 11 MDs and PhDs in the Boston area and the prominent research scientist Chenchen Wang, MD at Tufts University. It was just published on Annals of Internal Medicine, a major medical publication established in 1927 by the American College of Physicians.
In 2010 -2012, an estimated 52.5 millions or 22.7% of US adults annually were diagnosed with some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. Osteoarthritis is the most common problem among them. Nearly half of the Adults 65 or older had arthritis in the same period. The only cure for knee osteoarthritis is knee replacement. Patients can suffer from excruciating pain and immobility. The usual treatments are over-the-counter painkillers, medication injections, and prescriptions including opiate medicine. Physical therapy can alleviate pain and improve mobility but it can be costly unless covered by medical insurance. Depending on the length of a session, the service provider, and type of service rendered, the out-of-pocket costs per session typically consist of a copay of $10-$75 or coinsurance of 10%-50% or more. For patients not covered by health insurance, it typically costs $50-$350 or more.
Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis was a 52-week clinical trial with 204 patients with mean age of 60. The participants were randomly assigned to either a Tai Chi Chuan group or a Physical Therapy (PT) group. Following the standard medical practice, the PT group had treatments twice a week for 6 weeks, followed by 6 weeks of monitored home exercise. The Tai Chi group met twice a week for 12 weeks. At 12 weeks, the osteoarthritis index score was substantially reduced in both groups. Both groups also saw similar clinically significant improvement in mobility. The health benefits were maintained up to 52 weeks with both groups. One difference was that the Tai Chi group had significantly greater improvements in depression and the physical component of quality of life.
Robert H. Schmerling, MD, and Clinical Chief of Rheumatology Division at Harvard Medical School, pointed out in a June Issue of Harvard Health Publications that the reason that patients choose PT over Tai Chi is that Tai Chi is not covered by health insurance.
Tai Chi Chuan is a holistic exercise system. Practitioners not only benefit from its effect on arthritis but also other healing results as well, e.g. improved physical balance, reduced hypertension, better pulmonary functions, enhanced mental agility. It is also enjoyable to learn and practice. Once they study it, they can continue to practice it and gain lasting health benefits without additional cost. It is a huge loss for patients that medical insurance companies do not cover the cost.
The nation as a whole also loses by not including Tai Chi Chuan lessons as part of treatment paid by insurance. As Dr. Schmerling pointed out, the average cost for a Tai Chi class is $20 in Boston – it is cheaper in other cities. The cost of 24 sessions of Tai Chi Chuan as employed in the study would be $360-480 nation-wide. On the other hand, the combined cost of Physical Therapy to the patients and the medical system is at least $200 per session or $2,400 for 12 treatments. It is no brainer to recognize that Tai Chi Chuan can save this country billion dollars annually.
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