Complementary alternative health care in Israel and the western world

This is a commentary on http://www.ijhpr.org/content/1/1/7/ webcite.Complementary alternative health care (CAHC) presents fascinating challenges and opportunities for health policy and research - from issues of definition to training and licensing, to insurance reimbursement and evidence regarding clinical efficacy and outcomes. The article by Shuval and Averbuch [1] provides a remarkable overview of developments in this field in Israel, a country where such practices are both widespread and mainstream. As the authors note, over 1.7 million visits are estimated to take place annually in a country of less than 8 million people - and 65% of CAM services in Israel occur and are integrated into the public sector through the major health (sick) funds.Clearly defining complementary alternative health care is the likely starting point for any discussion of this topic and, like many aspects of CAHC, it is filled with controversy. Although complementary and alternative health care is more comprehensive than the commonly used term complementary and alternative medicine (CAM), the latter is utilized in the article to refer to array the plethora of "non-conventional health practices" frequently used in Western societies. Even the question of what is CAM or if CAM even exists is a topic of debate. As noted by the NIH National Center for Complementary and Alternative Medicine, "Complementary and alternative medicine (CAM) is the term for medical products and practices that are not part of standard care." [2,3] This definition is one of exclusion - treatments that are not standard are thus considered alternative if used instead of standard ones or complementary if they are used in tandem with standard care. What constitutes "standard care" in any society is dynamic over time and varies widely from country to country based on everything from ever changing laws and regulations to payment mechanisms and even immigration patterns.For example, treatments such as osteopathic or chiropra