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Tuesday, July 20, 2010

Homeopathy and the right to health care

A recent piece in Der Spiegel highlights a problem with attempting to mix a state sponsored right to health care and consumer driven health care.
http://www.spiegel.de/international/germany/0,1518,706971,00.html
It seems that, despite a general European love affair with homeopathy, the scientific basis for this approach to treatment of disease is essentially non-existent. Over and over again, the results of studies is the same. There is no benefit that can be identified and the theoretical basis for effect is simply laughable. However, homeopathy is very popular. In a world of positive health care rights mandated by law, how should demand for such treatments be handled? Should they be paid for with public monies?

In a free society, humans have the right to make decisions regarding investment of their own resources. They can make what you or I might view as good decisions or bad decisions. It is their business based upon two basic assumptions. First, they have their own resources (time, money, talent) to invest and second, their decision is not a coerced one. I for one have been humbled more than once after judging someone else's decision unwise. It is not for me to be all knowing as to what someone else might be after when they invest their own resources.

In the Alice in Wonderland world of positive rights, this simple paradigm becomes hopelessly complex. The decision to invest resources moves from a personal decision made by individuals directing their own resources to a group (read political) decision allocating resources taken from individuals and thrown into a common pool. When trying to even develop a model for how best to allocate such resources, whose goals do we have in mind?  What is off the table in terms of possibilities and why? Who makes these calls and by what mechanism? Majority rules, super-majority rules, Philosopher kings?

What you end up with is passionate debates about the legal right to homeopathy and much more like this. Homeopathy has basically no scientific basis but should that mean that it should not be available to those who desire to purchase some element of it? Individuals should have the broadest realm where they can enter into agreements with others to further their own goals, whatever they might be. I strongly suspect they are making a poor investment  if they invest time and money in homeopathic approaches to their ailments but I cannot really know what their goals might be. I don't have to and my judgment of their decisions means little in a world where they are free to exercise their rights to make their own decisions, good or bad.

In a world where the decision was made to make health care a right, we will be forced to make blanket decisions which cannot be made without the state becoming the ultimate busybody. If homeopathy, with essentially not evidence to support its effectiveness, can become something paid for using resources extracted from skeptical taxpayers using the coercive force of the law, what is not within the bounds of possibility? What could taxpayer dollars end up supporting? If popular support or at least a highly vocal group demanding some specific good or service is all that is required, there are no limits.

Let me float some likely candidates:

1. Chelation therapy
2. Colonic irrigation
3. Biofield therapies
4. Expensive detoxification schemes
5. Sweat lodge therapy
6. Exorcism
7. Animal sacrifice
8. Here's one from "seven days in Tibet" by Brendon O'Neill http://www.spiked-online.com/index.php/site/article/9187/
On one stall a young British man in a white coat (seriously - a white coat) was trying to convince an elderly gent, who could barely walk and who looked jaundiced to boot, that if he put his name on a mailing list he would ‘experience healing’ the next time the young man in the white coat climbed a mountain in Tibet and ‘projected positive energy’ to the world. 
We would have to come up with a CPT code for this. I am sure you can come up with more. Send in your suggestions of what could become a covered service!

4 comments:

  1. Chauncey McHargue M.D.July 21, 2010 at 2:10 PM

    Then there is the issue of what to do and who is responsible for the cost of remediating the deleterious effects of homeopathy as for example the patients I see who have used an escarotic agent on a mole that was changing making both clinical and histopatholgic change indeterminable.

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  2. i am regular visitor of your site and you are writing very nice so keep posting university admission

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  3. I know that you could easily add a number of "conventional" medical procedures to your list of treatments lacking in scientific support. I encourage you to add these. Some of those medical treatments have done more damage to more patients in fewer years than the items you have listed ever could.

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