Chronicles of Health Creation: Gratitude to Integrative Medicine and Health's Retiring Champion U.S. Senator Tom Harkin

In the context of this grassroots uprising of interest, singling out the historic contributions of one person seems inappropriate. Yet for complementary and integrative health policy and inclusion, there is such a giant.
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The movement for complementary and alternative medicine is famous for its consumer base.

The rising tide of our collective personal choices overflowed conventional medicine's barriers. The medical industry was pushed to look outside its towers at choices being made in the community, among the people.

In the context of this grassroots uprising of interest, singling out the historic contributions of one person seems inappropriate.

Yet for complementary and integrative health policy and inclusion, there is such a giant. This person has flipped open so many switches to cast light on new, health-focused methods and practices that mere human decency suggests we take time to honor him in this, the year of his retirement.

I speak of integrative health and medicine champion Tom Harkin, the senior U.S. Senator from Iowa. He promotes this movement as an instrument of his larger vision to create a "wellness society" in lieu of what he calls our present "sick care system."

The courage to speak against powerful conventions runs deep in Harkin's career. I first became aware of him in 1981 when his action on a foreign policy matter as a young Congressman showed courageous political independence.

I was covering Asian trade issues as a journalist in Seattle when I learned of a democratic uprising in the city of Gwangju, South Korea. Official tallies say 241 demonstrators were killed. The U.S. government refused to step in. The demonstrators' leader, Kim Dae Jung, was imprisoned and sentenced to death.

While investigating the story I discovered that just one member in the U.S. Congress was speaking out against this suppression of democractic yearning in the South Korean people: Tom Harkin.

Years later, Kim as South Korea's elected president, promoted peace talks with North Korea. He was later granted the Nobel Peace Prize. I once told Senator Harkin how I first heard of him. He responded that it was a highlight of his professional life when Kim invited him to sit at his side when Kim received the Nobel.

This same courage and independence propelled Harkin to become a steady champion for what is effectively another people's movement for democratization against a profoundly repressive establishment.

Harkin's early connection to non-conventional medicine came through a boyhood friend though whom he gained respect for chiropractic. This was the dark ages for integration in the 1980s when the chiropractic profession was locked in a protracted, decade-long anti-trust lawsuit against the American Medical Association (AMA) and the American Hospital Association.

Back then the AMA didn't shy away from branding as "fraud" or "quackery" chiropractic, acupuncture, naturopathic medicine, and all forms of mind-body care. Chiropractors had hospital and laboratory doors slammed on them, by collusive agreements, even though chiropractic scope of practice allowed them, for instance, to order imaging. This was gross discrimination in health care. The very idea of respectful team care was suppressed and incarcerated.

In 1989, by federal court decision, the chiropractors won. The potential for integrative health and medicine opened.

Harkin's first big move for exploration of chiropractic and other heath care alternatives arrived quietly in 1991. Via an adroit legislative move, he hooked a nearly invisible section into a multi-billion dollar U.S. Senate Appropriations Committee bill. Harkin's language spoke of the importance of examining "unconventional medicine." It referenced, as an example, early resistance to radiology. The section set aside $2 million for the National Institutes of Health (NIH) to begin such exploration.

Nowhere did this legislative whisper from Harkin, with his mentor, former Congressman Berkley Bedell at his side, suggest that they were intentionally creating a place in the hallowed halls of the NIH for acupuncture, massage, chiropractic, natural products and other "alternative medicine."

A half dozen years later, Harkin managed purse strings as chair of the powerful US Senate Appropriations subcommittee that oversees the NIH to transform this early exploration into the National Center for Complementary and Alternative Medicine (NIH).

Harkin has faced a great deal of heated opposition inside and outside of the NIH for his outspoken advocacy. Meantime, by breaking down medicine's barricades, we see flourishing evidence for mind-body, yoga, tai-chi, massage, chiropractic, acupuncture, naturopathic approaches and also of costs savings through these practices.

The indirect impacts are immeasurable. Expanded NIH research funding propelled the growth of the Consortium of Academic Health Centers for Integrative Medicine from 12 academic centers to nearly 60 centers today. By requiring the NIH to fund researchers from the licensed "complementary and alternative medicine" professions, a kind of Prague Spring stimulated the development and maturation of research communities in the chiropractic, naturopathic medicine, acupuncture and massage disciplines. New evidence influences more hospitals to include such services each year.

Harkin's wholistic vision didn't stop with research. The transformation toward a "wellness society" that he foresaw led him to include $2 million in the NCCAM legislation to create the White House Commission on Complementary and Alternative Health Care Policy. This Clinton-era report, while buried during the Bush II presidency, laid out a blueprint for inclusion.

Harkin's next profound contribution to the democratization of U.S. medicine came as the go-to broker for integrative approaches in the Affordable Care Act. "Integrative health" and "licensed complementary and alternative medicine practitioners" gained first-time inclusion in the law of the land in sections related to prevention, payment, delivery, research, and the healthcare workforce.

Most important is Harkin's authorship of Section 2706, "Non-Discrimination in Health Care." Harkin's language states that if one is licensed to provide a service that is covered by a plan, then insurers have no business discriminating against the type of provider one chooses.

Yet powerful forces in regular medicine continue to dismiss Congressional intent. While hardly the military suppression of citizen action in South Korean that Harkin stood up against 30 years ago, the failure to respect "non-discrimination in health care" continues a historic line of suppression of medical minorities in the United States.

Harkin increasingly expresses his wisdom as a prophetic, society-wide need to shift from sick care to health care. His theme is finally showing up in the dialogue of medical leaders.

Meantime, the senator is not sleep-walking into retirement. He continues to battle. His committee recently reminded the Center for Medicare and Medicaid Services, again, that their version of implementation of "non-discrimination" did not "reflect the law and congressional intent." The agency, his committee wrote, has "not complied with [the non-discrimination] directive."

Senator Harkin, what an amazing and equalizing blessing your torch bearing has been. Our grossly under-funded movement for integrative health and medicine -- and for health creation! -- has leaped ahead through your courage, decency, political power and appropriations clout.

Your contributions to human health are immeasurable. Our best means to honor you will be to rapidly advance your vision of a wellness society.

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