Q. Will I have access to integrative medicine after health care reform?

A. This year the Hawaii State Consortium for Integrative Healthcare celebrates its 10th anniversary of service to our island community.

It is dedicated to safe and effective integrative care guided by research and offered by skilled professionals.

It is critical that the consortium determine how best to embrace and contribute to health care reform as we undergo the biggest overhaul since the inception of Medicare.

Health care reform will likely result in more meaningful access for the underserved and will cost far more than current estimates. This will mean higher taxes, lower reimbursements and restrictions on expensive procedures and medicines.

If we are to provide all Americans with both access and quality care at a reasonable cost, substantial investment in preventive medicine is critical. Integrative medicine is grounded in prevention. Primary prevention is what we do to avoid getting sick in the first place. It emphasizes diet, lifestyle, stress management and healthy spirituality.

Secondary prevention means early detection, and utilizes mammogram, Pap smear and colonoscopy techniques.

It may also include therapies like acupuncture or osteopathic examination.

Tertiary prevention focuses on rehabilitation to minimize the impact of an injury or heart attack.

Integrative medicine has a profound capacity to apply full spectrum prevention to the nation's most lethal and expensive ailments, such as obesity, heart disease, stroke, cancer, and diabetes.

So, the question remains: Will I have access to integrative medicine after health care reform?

The answer is still to be determined.

Now is the time for integrative medicine to become recognized for its valuable role in prevention and to take its place as a major contributor to health care reform.

This will ensure ongoing access to integrative medicine for all of us.

Dr. Ira Zunin, M.D., M.P.H., is medical director for the Manakai O Mälama Integrative Healthcare Group and Rehabilitation Center. He is board certified in preventive medicine. www.manakaiomalama.com. Please submit questions to info@manakaiomalama.com.