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the USA"; the programme that the conspiracy was founded upon is _ jailed chiropractor) was given an award. He said "I was arrested called the “Iowa Plan". twelve times and sent to prison four times for practising chiropractic The conspiracy was aimed at restraining the liberty of patients to in Concinnity, Ohio. A sizeable portion of my life has been spent attend chiropractors in public health care facilities and programmes, —_ behind prison walls for practising this profession of ours. The sheer and to deny them access to health insurance refunds for their ser- / wickedness and callousness of prosecuting in those days, and the vices. Restraints cause patients prolonged unnecessary suffering _ tenacity and vindictiveness and jealousy of the medical authorities, and expense, begs description." In the USA, Chester Wilk, DC, led a group of chiropractors to Internationally, the imprisonment of chiropractors is now uncom- challenge the right of medical associations to participate in anti- mon. Growing public and political acceptance has forced the adop- competitive practices against the chiropractic community (Wilk et tion of far more subtle, but intriguingly similar methods of contain- al. y. AMA et al., US District Court, 1987). ment. Court actions were served upon the American Medical Association and thirteen other bodies which included The American La us CORERIRAGT . Academy of Surgeons, The American College of Radiologists, The This brilliantly simple conspiracy was based on the Iowa Plan. It American Hospitals Association and The Illinois State Medical Went roughly like this: ; ae a Society. (1) Destroy the good image of chiropractic via a disinformation After fifteen years, all of the above had either sought pre-court Programme portraying it as an “unscientific cult", a threat to patient settlement, pleaded guilty or were found guilty. The AMA appealed —‘'leTest. as oo. to the Supreme Court and Jost. A restraining order now outlaws that (2) Create an ‘ethics'-based boycott to protect patient interest. anti-competitive conduct in the USA. (3) Use ‘ethics’ to justify keeping chiropractic out of public and Those associations represent hundreds of thousands of medical Private health care with the aim of containing and eliminating it practitioners, The seriousness of their conspiracy is reflected in through attrition. their being forced to live Withif (1 {To J U0I—VCV__< (1) Disinformation. The first objective of an injunction, to pay multimillion dollar was disinformation—it was crucial to the court costs and an undisclosed but appar- test. In marketing warfare, the battle- ently vast sum for damages. These governments would not rund is the mind. According to lawyer The courts defined the conduct as * * David Chapman-Smith's The Chiropractic "restraint of trade" created by a "conspira- knowingly permit laws, Report, "...similar disinformation, heard throughout Australia and New Zealand, " whose objective was "the complet 4 1 irel ch eaination of ie deen rafension”. r egu lations or ethics that echoed the central policy of the AMA." The US courts’ findings clarified motive. il - Terms aimed at destroying the self-esteem The an of Schon! teharst sire = precluded Jews, Aborigines or of the chiropractor, and lowering the proved. The US District Court found that females from access to public image of chiropractic in the mind of the the motive, concern for scientific method, . consumers, included: "chiropractic is an did not justify a ateewlde pte t) health care, but their laws unscientific cuit"; “philosophically incom- imi i i [ pipeare, tiene tible with edicine"; an " - ciminat » lceeed profession, Tis US | discriminate againstthe = SSeagnut was motivated by "economic concerns as 4 hir i mi i I, (2) Without proof that patients who well”. © opractic es munity . choose chiropractic care rather than med- Globally, organised medicine stood to ical treatment face a greater risk, a need gain a multibillion dollar windfall if it suc- = was implied for ‘safe medicine’ to protect ceeded in the complete elimination of the chiropractic profession in _ Patient interest by boycotting ‘dangerous chiropractic’. To be effec- the USA and elsewhere. "One of the principal means used by the _ tive, an ‘ethics'-based boycott needed the continued passive or AMA to achieve its goal was to make it unethical for medical physi- tive, overt or covert, support or complicity of a majority of med- cians to professionally associate with chiropractors."? That boycot. _ ical practitioners. To ensure that degree of support across America, is illegal in the USA but retained by medical associations elsewhere. 2 regulation, called Standard X, was applied to medical practition- In other countries, members of the medical profession stand to STS: , It effectively made associating with chiropractors economic share in a similar substantial economic windfall from anti-competi- Suicide by threatening to deny medical practitioners who breached tive discrimination within health care. In the absence of similar “at Tule their hospital visiting rights. ; . court precedents in their own countries, the Wilk trial serves as a @) Containment. Passive preclusion denies the real victims of benchmark for the international chiropractic community to judge Containment and restraints (patients who have subluxation-related parliaments, individual practitioners and medical associations who disorders) the liberty to choose chiropractic care within taxpayer- permit the continued use of ‘ethics'-based boycotts against the inter- funded health facilities and programmes. Like a system of gates ests of the local chiropractic community. Australia is one of those used to direct sheep, restraints, in this instance, work unobtrusively, countries. subtly. The patients who are being deflected away from access to chiropractic care may not be aware that it is happening. THE HISTORY OF ANTI-COMPETITIVE PRACTICES Restraints include: Chiropractic began competing with medicine in 1895 in the USA. Information restraints. Factual knowledge about chiropractic Over the intervening decades, millions of consumers (the most empowers consumers to take ideal advantage of chiropractic. important judges of the value of a service) have made outcome _Preclusion from taxpayer-funded health education restrains access assessments of what medicine and chiropractic have to offer. to that knowledge. Millions voted with their feet and migrated with their patronage and Economic restraints. In spite of repeated requests from chiro- payments from medicine to chiropractic. Growing public accep- practors for genuine legislation, governments retain flawed registra- tance coincided with relentless opposition toward chiropractors tion acts that do not define and confine the relevant separate ‘mini- from organised medicine. . ~~ . mum standards’ for all persons manipulating the spine for fee or Extremely vague definitions of the practice of medicine permits reward. the misuse of medical acts in the prosecution of would-be competi- It is a paradox that flawed Registration acts permit insurance to be tors for practising medicine without a licence to do so. The record iudi i ‘i 4 - 4 prejudiced by reversing refunds, so as professions whose members of sixty-six arrests was held by chiropractor Charles C. Lemly of have less or no accreditation in this speciality (medical personnel) Texarkana, Texas. . are permitted refunds or a better refund for this service, while the In the USA during 1991, Herbert R. Reaver, snr (a frequently —_experts (chiropractors) attract no refund or a lesser refund. jailed chiropractor) was given an award. He said "I was arrested twelve times and sent to prison four times for practising chiropractic in Concinnity, Ohio. A sizeable portion of my life has been spent behind prison walls for practising this profession of ours. The sheer wickedness and callousness of prosecuting in those days, and the tenacity and vindictiveness and jealousy of the medical authorities, begs description." Internationally, the imprisonment of chiropractors is now uncom- mon. Growing public and political acceptance has forced the adop- tion of far more subtle, but intriguingly similar methods of contain- ment. THE US CONSPIRACY This brilliantly simple conspiracy was based on the Iowa Plan. It went roughly like this: . (1) Destroy the good image of chiropractic via a disinformation programme portraying it as an “unscientific cult”, a threat to patient interest. (2) Create an ‘ethics'-based boycott to protect patient interest. (3) Use ‘ethics’ to justify keeping chiropractic out of public and private health care with the aim of containing and eliminating it through attrition. FAN Nintntaweatinn Pha Rene ats. THE HISTORY OF ANTI-COMPETITIVE PRACTICES Chiropractic began competing with medicine in 1895 in the USA. Over the intervening decades, millions of consumers (the most important judges of the value of a service) have made outcome assessments of what medicine and chiropractic have to offer. Millions voted with their feet and migrated with their patronage and payments from medicine to chiropractic. Growing public accep- tance coincided with relentless opposition toward chiropractors from organised medicine. Extremely vague definitions of the practice of medicine permits the misuse of medical acts in the prosecution of would-be competi- tors for practising medicine without a licence to do so. The record of sixty-six arrests was held by chiropractor Charles C. Lemly of Texarkana, Texas. In the USA during 1991, Herbert R. Reaver, snr (a frequently 40¢NEXUS OCTOBER - NOVEMBER 1993