Rep. Bob Filner is at the forefront of a move to require all major veteran medical centers to staff an on-site chiropractor by the end of 2013. It’s meant to help vets whose backs have been tested in combat.
Filner, known to the industry as a “perennial chiropractic advocate,” sponsored a bill that would make the staffing mandatory. It also would give a significant boost to an industry that is among Filner’s top campaign contributors. The Democrat represents much of southern San Diego County and all of Imperial County.
Filner, chair of the House Committee on Veteran’s Affairs, has advocated chiropractic care for veterans for years with little success. His most recent bill passed the House overwhelmingly; a version is pending in the Senate.
A big hurdle is cost. The Congressional Budget Office estimates it will take about $46 million to staff a chiropractor in all veteran clinics. Currently, about 36 out of 153 offer chiropractic care, according to the Budget Office, and none are in San Diego.
In San Diego, veterans can get referrals from their doctors to see any licensed chiropractor, and the government pays for the treatment, said VA spokeswoman Cindy Butler. She said there is probably enough demand that they could justify hiring a chiropractor, but that would have a downside.
“It’s actually more convenient for the patient (right now) because they can go to someone in their neighborhood,” she said.
The cost to staff chiropractors is the reason Rep. Darrell Issa (R-Vista) was one of six Representatives to vote against it. His spokesman, Frederick Hill, said Issa fully supports chiropractors at veteran clinics but was frustrated “that Democratic leadership refused to include a spending offset” for the cost.
The American Chiropractic Association (ACA) continues to be a big Filner supporter. During his congressional career, ACA has given Filner $47,415—more than any other member of the House, according to the Center for Responsive Politics, a nonprofit organization that collects and analyzes federal campaign finance data.
The ACA is the second largest contributor to Filner’s campaign this year. Between January 2009 and September 13, it gave him $10,000 through its Political Action Committee—more than any other candidate for congress.
In all, the ACA’s PAC has contributed to nearly 100 members of Congress in the mid-term election. In most cases, it gave between $1,000 and $3,500.
Filner would not answer questions in writing or agree to be interviewed for this story.
Brian Adams, a political science professor at San Diego State University, said it is often difficult to discern whether legislation is a result of ideology or influence, or a combination of both.
“One possibility is that before he even came to congress he believed in chiropractors…and chiropractors are giving him money because he is an ally,” Adams said. “There is nothing wrong with that; that is how is should work.”
The other possible scenario: “The contributions are actually changing his behavior.” That is problematic, Adams said, “because elected officials are then supporting bills they might not think are great ideas.”
Emory Rogers, who manages the Chiropractic Association’s PAC, said it has favored Filner financially based on input from chiropractors in California and in his district.
“He has been helpful to them,” Rogers said. “He has been very supportive.”
The Chiropractic Association’s PAC received a total of about $72,000 (in donations of $200 or more) from chiropractors around the country. Out of that, about $2,000 came from chiropractors in California.
Nearly four years ago, Filner introduced legislation to require chiropractors at veteran’s clinics. The House passed the bill in May 2007 but it died in the Senate. Filner also has sponsored three bills—the first in March 2004—to help veteran’s bypass insurance claim hurdles to chiropractic care at VA hospitals. All of them died in the House Veteran’s Affairs subcommittee on Health.
Advocates say many soldiers return from war plagued with back pain from carrying heavy loads of combat gear, among other things, and they can get significant relief from a chiropractor. A study the Department of Veteran’s Affairs published in February states that “diseases of Musculoskeletal System/Connective System” are the most common ailment among veterans of the wars in Iraq and Afghanistan.
“However, the current statute is such that…a minimum of one VA medical center provides on-station chiropractic care…so, it is fair to say that on-site chiropractic care is not readily accessible for our veterans,” Filner testified at a hearing of the House Committee on Veteran’s Affairs earlier this year.
On May 24, the bill passed the House 365-6. The next day it was referred to the Senate Committee on Veteran’s Affairs.
On its website, the American Chiropractic Association lists Filner’s bill among the most important pieces of outstanding legislation and offers its members talking points to use when making calls to their congressional delegates.
One of the talking points: “Where implemented, the integration of chiropractic care into the DVA has proved highly successful.”
The Chiropractic Association reported lobbying specifically on Filner’s legislation. Since January 2009, it has spent about $675,000 to lobby members of Congress on this bill and others.
SDSU’s Adams said there also is an argument that $10,000 to Filner from the Chiropractic Association compared to the nearly $590,000 he has reported receiving in total for this election would not be enough to influence him.
“But I don’t buy that,” Adams said. “You need to have a reputation of responding to your campaign contributors.”
And influence is less about pressure than access, he said.
“What happens is elected official will give access to lobbyists who gave campaign contributions and have supported them in the past and then not hear the other side of the story,” he said.
“For too long, veterans have been denied access to the chiropractic care that they want, need and deserve through the VA,” said ACA President Rick McMichael in a press release the day the House passed the legislation. “I am proud that ACA has worked closely with our congressional allies, such as Rep. Filner, on behalf of our nation’s heroes and in support of this important bill.”
This story is part of the Watchdog Institute’s accountability reporting about the five congressional representatives from San Diego and Imperial counties. The institute is a nonprofit, independent investigative reporting center based at San Diego State University.
This story also appears on KPBS’s military blog and on KGTV, Channel 10’s Web site.