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Why I voted in favour of alternative medicine
Posted: 23 May 2009 01:33 AM   [ Ignore ]
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As you probably know, in Switzerland there exists referendums: recently there was one about the obligatory health insurance. The question was if this insurance should pay for the most common alternative medical systems, like homeopathy and traditional Chinese medicine.

I do not believe in homeopathy at all, and I think most of Chinese medicine is quackery. But the referendum was not about the question if these methods objectively work or not. With some hesitation, and a little bad feeling, I voted in favour. I have 2 grounds:

1. Some insurance already offered voluntarily alternative medicine, as addition to the obligatory modern medicine. It turns out that overall these insurances are cheaper, because people do not go to expensive modern medical care. Obviously they are ‘healed’ (mind the quotes!) by the alternatives and do not come on some expensive modern medical treatment path. My interpretation: many cases of medical interventions were not necessary at all, the symptoms would have gone away also without medical treatment. We must never forget that all kind of healers, alternative or medical doctors, earn their money with their treatments. Scientific methods do not guarantee ethical behaviour, and medical doctors are humans as any other, with the same human traits as any other. But their methods are more expensive…

2. In modern society many people feel oppressed by the fast technical changes. What was valid yesterday is not today anymore (why, I work in the IT. I have become really good at things… that do nobody uses anymore). They have no influence on these changes, and have simply fear. Orienting on ‘softer’ (again, note the quotes!) healing methods, on traditional herbal remedies, gives them room to breath. Introducing modern technologies in society never works out the way as the ‘introductors’ meant it. They might see only the positive sides of it, where others see the negative, new applications of the technology get introduced that were never thought of (TV was once a medium to educate people, nowadays it is mostly a medium to amuse people), the technology has negative side effects that we never thought of (side effects of medical treatment, environmental problems), etc. Forbidding alternative medicine would be oppression of the ‘technofobes’. It is my impression that they would react with even more irrationality. If we want to lead people to more rationality then we must convince them, not force them. Emotional response like ‘I do not want to pay for this bullshit’ will turn against us.

So the question is not about objective truth, but about the best strategy to reach our goals. Even modern society cannot handle too much truth at once.

GdB

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Posted: 23 May 2009 06:09 AM   [ Ignore ]   [ # 1 ]
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Well, you will not be surprised to hear that I disagree. In a crucial part of your reasoning you state, “Forbidding alternative medicine would be oppression of the ‘technofobes’.”

This isn’t right for various reasons. First, even on the proposal you discuss, quackery (let’s not call it “alternative medicine”. It is not “medicine” in any sense) wouldn’t be “forbidden”, it simply wouldn’t be paid for by public funds. Public funds should be restricted to those treatments which are actually medicine, that is, which have been demonstrated safe and effective.

If someone wants to waste their money on homeopathy or chakra alignment, that’s up to them, but should not be paid for by the general public.

Further, it is not oppressing anyone to make ineffective treatments less generally available. Indeed, it is doing them a benefit.

One might as well argue that mandating air bags in cars oppresses the suicidal. Or that mandating information about the odds of winning a lottery oppresses the stupid.

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Posted: 23 May 2009 06:42 AM   [ Ignore ]   [ # 2 ]
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dougsmith - 23 May 2009 06:09 AM

Well, you will not be surprised to hear that I disagree. In a crucial part of your reasoning you state, “Forbidding alternative medicine would be oppression of the ‘technofobes’.”

I didn’t expect anything, so I am not surprised, and not not surprised… wink

This isn’t right for various reasons. First, even on the proposal you discuss, quackery (let’s not call it “alternative medicine”. It is not “medicine” in any sense) wouldn’t be “forbidden”, it simply wouldn’t be paid for by public funds. Public funds should be restricted to those treatments which are actually medicine, that is, which have been demonstrated safe and effective.

Even if it turns out cheaper?

Further, it is not oppressing anyone to make ineffective treatments less generally available. Indeed, it is doing them a benefit.

Of course. But ‘patients’ of quacks do not see it that way. I can assure you from the discussions in the swiss newspapers, people feel themselves pushed into a corner. The reaction on not taking these quackeries in, might be very hard. It would increase the ‘technophobia’. For me it must be clearly separated: the truth itself, and the way we can convince people of it.

One might as well argue that mandating air bags in cars oppresses the suicidal. Or that mandating information about the odds of winning a lottery oppresses the stupid.

Again, I am not saying that we oppress these people. I am saying that they feel oppressed. We must find ways to seduce people to have a rational world view. It is not a question if we are right, it is the question of strategy.

I notice an increase of technophobia and fundamentalism. Is there nobody here that thinks that part of the reason might be in how people feel confronted with the way they encounter changes in modern society?

GdB

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Posted: 23 May 2009 07:23 AM   [ Ignore ]   [ # 3 ]
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As a physician, I dislike the term alternative medicine.  I would prefer it be labeled superstition based treatments.  Then we could propose to patients the choice of a remedy based on superstitious or non-rational ideology.  Or science based medicine (coined by Steven Novella, MD) which is a rational methodical process of optimizing treatments based on best available evidence.science based medicine

Alternative medicine is not medicine any more than offerings to Zeus were by the ancient Greeks.  If a treatment has benefit it is medicine.  But it must demonstrate through a rigorous and continually reviewed process.

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Posted: 23 May 2009 08:18 AM   [ Ignore ]   [ # 4 ]
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One of the main reasons these alternative medicines exist is the fact that they replace the availability of “scientifically proven medicine”. Western Sanctioned medicines. Whether they sprouted from the lack of scientific knowledge, or they sprout due to the fact that the technologies and services are unavailable due to cost restrictions for the patient.
To me, many times hearing your arguments against alternative medicines, it sounds as if a bunch of BMW drivers are decrying the fact that loads of people must drive Hyundai or Plymouths. The argument being that the BMW is a much more comfortable and safer ride.
I thought Gdb made good points there, framed in an actual view of reality and current economics. To say nothing of peoples own free-will, and choice.
From a completely analogous viewpoint, the anti-alternative meds crowd should also be suing for the banishment of Mc Donalds and all other such eateries.
Food is as essential to people as medicine, and yet there are alternative food sources which are proven detractors of health.
I can’t help but see some very faint connections to certain industries in the passion to eliminate these medicinal sources. And I’ll be G-damned, if someone tried to deny the existence of such connections.
I think quackery is a joke too. It can be harmful, or downright unethical, but can we take a serious look at he the reasons these medicines exist? Quackery, home-remedies, alternative medicines, etc..

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Posted: 23 May 2009 09:35 AM   [ Ignore ]   [ # 5 ]
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GdB - 23 May 2009 06:42 AM

Even if it turns out cheaper?

Well, I admit that if it could be shown that your plan was cheaper for the public than not funding quackery, that might be at least some prima facie reason to support it. But I don’t believe it would be cheaper, not for the public anyhow. Do you have evidence otherwise?

GdB - 23 May 2009 06:42 AM

For me it must be clearly separated: the truth itself, and the way we can convince people of it.

Well, fair enough. But I don’t think you are doing anything favorable to convincing people of the inefficacy of quack treatments if you are suggesting that the government support them as they would effective medicines. What you are, instead, likely to do is to convince people that quackery is effective. After all, if the government supports quack treatments, they must do so because they work, no?

I mean, what government would be so stupid as to fund ineffective treatments?

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Posted: 23 May 2009 10:43 AM   [ Ignore ]   [ # 6 ]
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Doug-

I mean, what government would be so stupid as to fund ineffective treatments?

Most Governments. Ours does certainly. So do all the private insurance companies. Many treatments are ineffective. Also, many treatments are ineffective due to the fact that the treatment wasn’t needed in the first place.
There are plenty of treatments that are scientifically sanctioned, and AMA “approved” which aren’t effective.
There are tons of FDA approved medications which aren’t effective. Prescription and over-the-counter. These are on a case by case basis. If we have to compare CAM vs. AMA, then we must compare on a case by case, or on a demographic chart.
The Swiss Govt is funding it, as GdB said. I’m guessing they put some thought into it.
If an entity can ascertain that homeopathic treatments can forego the use of far more expensive treatments, administered to a large group of folks who either are not truly ill, or have chronic issues which have no real cure, then I can see some cost savings there.
The problem lies with the above statement of mine “...folks who are not truly ill…”. This is almost a blasphemous thing to say in America. The Doctors and the Insurance companies are largely to blame. Medical Care is provided in this country as Service Orientated operation. Competition based, and customer service oriented. Everyone is ill who wants to be. No one can be denied the right to proclaim an illness. And there is a system set up to completely cater to these illnesses. This has brought about the near collapse of our healthcare system.

In situations like this;although it isn’t the only reason; homeopathic, or CAM will flourish-Obviously!! It is one more way for people

to get the “cures” they so badly need, or “desire”.

[ Edited: 23 May 2009 10:47 AM by VYAZMA ]
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Posted: 23 May 2009 11:06 AM   [ Ignore ]   [ # 7 ]
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Hawkfan - 23 May 2009 07:23 AM

As a physician, I dislike the term alternative medicine.  I would prefer it be labeled superstition based treatments. 

Well, this forum group is called ‘alternative medicine’. At least it seems to be a lable that works for us all.
From the content I agree that for the most part it is ‘superstition based treatment’. However, I think it is not wise to call it that.

GdB

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Posted: 23 May 2009 11:21 AM   [ Ignore ]   [ # 8 ]
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dougsmith - 23 May 2009 09:35 AM

I mean, what government would be so stupid as to fund ineffective treatments?

A government that is democratic chosen, may be? In fact, here in Switzerland the government wanted to throw out all the ‘complementary medical treatments’. The referendum was an initiative of the people, and was agreed on by a 2/3 majority.
It is just not that simple as ‘it does not work, so we decide to throw it out’. There is a deep mistrust of a lot of people in technology and modern medicine. How do we handle this? It is perfectly OK that organisations like CFI show why modern medicine really is medicine, where most of the alternatives are not. But to decide over the head of the people that they do not get paid for what they believe in might not be the correct way. Again, one should convince them. The extreme of your position would be the platonic state where the philosophers (i.e. the seers of the truth) would govern us. (You are also philosopher, aren’t you? wink)

GdB

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Posted: 23 May 2009 11:21 AM   [ Ignore ]   [ # 9 ]
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GdB - 23 May 2009 11:06 AM
Hawkfan - 23 May 2009 07:23 AM

As a physician, I dislike the term alternative medicine.  I would prefer it be labeled superstition based treatments. 

Well, this forum group is called ‘alternative medicine’. At least it seems to be a lable that works for us all.
From the content I agree that for the most part it is ‘superstition based treatment’. However, I think it is not wise to call it that.

GdB

I wouldn’t say for the most part it is superstitious. A small part-yes.
1. placebos aren’t superstition.
2. massage, or chiropractry isn’t superstition.
3. homemade remedies aren’t superstitious mostly.( a hot onion and mustard chest compress on a bronchial sufferer- zb.)
4. tonics, salves, foods, herbs, alcohols aren’t superstitious.
Praying is superstitious.
Wearing a gold earing because it protects against blindness is superstitious.
Dr Florians Mysterio Electron-Ether Cleansing Chamber is superstitious. That’s quackery.
Magnetic Bracelets-that’s quackery.
Toxic FootCleaning Pads-that’s quackery.

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Posted: 23 May 2009 01:29 PM   [ Ignore ]   [ # 10 ]
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GdB - 23 May 2009 11:21 AM

It is just not that simple as ‘it does not work, so we decide to throw it out’. There is a deep mistrust of a lot of people in technology and modern medicine. How do we handle this? It is perfectly OK that organisations like CFI show why modern medicine really is medicine, where most of the alternatives are not. But to decide over the head of the people that they do not get paid for what they believe in might not be the correct way. Again, one should convince them. The extreme of your position would be the platonic state where the philosophers (i.e. the seers of the truth) would govern us. (You are also philosopher, aren’t you? wink)

Well, first of all, I do think that it’s as simple as ‘it does not work, so we decide to throw it out’. Of course, we are always open to further evidence that shows that something we thought ineffective is actually effective, and vice versa. But until that other evidence comes in, yes, we should not publicly fund ineffective medicine. Just as we should not fund incompetent engineers.

What makes the argument of yours even odder, however, is that this was apparently itself a public referendum. So there’s no platonic state throwing stuff out over the objections of the populace. As I understand it, it would have been the populace itself throwing the stuff out.

That said, I do not believe that this sort of decision should be up to a vote of the populace. The sophistication needed to understand the difference between an effective and an ineffective medicine is simply not something that most people have. And even among people who do have such sophistication, very few indeed have the time or energy to go looking for the relevant studies, and gauging whether those studies were well designed, etc. That is why we have professional organizations like the FDA staffed by people with the right sort of background.

It is exactly the same as we would design a bridge. You do not design bridges (or airplanes) by popular vote. They are designed by experts. The vote of the populace comes in at a more abstracted level: essentially, choosing the people who choose the experts.

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Posted: 23 May 2009 01:42 PM   [ Ignore ]   [ # 11 ]
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VYAZMA - 23 May 2009 11:21 AM
GdB - 23 May 2009 11:06 AM
Hawkfan - 23 May 2009 07:23 AM

As a physician, I dislike the term alternative medicine.  I would prefer it be labeled superstition based treatments. 

Well, this forum group is called ‘alternative medicine’. At least it seems to be a lable that works for us all.
From the content I agree that for the most part it is ‘superstition based treatment’. However, I think it is not wise to call it that.

GdB

I wouldn’t say for the most part it is superstitious. A small part-yes.
1. placebos aren’t superstition.
2. massage, or chiropractry isn’t superstition.
3. homemade remedies aren’t superstitious mostly.( a hot onion and mustard chest compress on a bronchial sufferer- zb.)
4. tonics, salves, foods, herbs, alcohols aren’t superstitious.
Praying is superstitious.
Wearing a gold earing because it protects against blindness is superstitious.
Dr Florians Mysterio Electron-Ether Cleansing Chamber is superstitious. That’s quackery.
Magnetic Bracelets-that’s quackery.
Toxic FootCleaning Pads-that’s quackery.

I agree with Hawkfan. As a fellow physician I cringe at the term Alternative Medicine as it implies that these methods are a “reasonable alternative” to traditional medicine. I never use the term “Alternative” “Natural” or “Complimentary” medicine in my practice. I call them “Unproven medicine” and explain to patients that in fact the only difference between these treatments and traditional methods is that they have not been tested for safety or efficacy and as such, should be viewed with a healthy dose of suspicion. Patients far too often view these treatments as somehow ‘safer’ when in fact just the opposite is true. I think its important to change that public perception. Having a government openly fund these treatments lends a level of legitimacy to them that they do not deserve and endangers patients in the long run.

[ Edited: 23 May 2009 01:45 PM by macgyver ]
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Posted: 23 May 2009 01:54 PM   [ Ignore ]   [ # 12 ]
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I dislike the term alternative medicine because it’s not medicine at all. What sounds better… quack pseudo-remedies? I like that one.  wink

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Posted: 23 May 2009 01:57 PM   [ Ignore ]   [ # 13 ]
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fake, failed, and voodoo medicine are a few other name possibilities.

Occam

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Posted: 23 May 2009 01:58 PM   [ Ignore ]   [ # 14 ]
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Back in 19…what was it? 62,64, how succesful was Congress in passing legislation at controlling the relationship between doctors and the medical supply, technology and pharmaceutical companies? How about the consolidation of hospitals nowadays and the entrance of these concerns on the Stock Market?
Are doctors allowed to own pharmacies still? Or just the stock of pharmacy companies?
Again on this Forum we see various specialists, entrenched specialists, who still are beholden to the idea that they know about what’s good for people(and are probably right!!)yet are vastly outnumbered by the sheer will of the people.
These dynamics are covered above. And, if we are to believe the stump speeches, a change is coming to this particular entrenched industry, that is going to modify some of these Hippocratic Audacities.
Prime example: what person hasn’t seen the pull and tug going on for years in this arena, and has the consumer/patient benefited?

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Posted: 23 May 2009 02:03 PM   [ Ignore ]   [ # 15 ]
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Jules - 23 May 2009 01:54 PM

I dislike the term alternative medicine because it’s not medicine at all. What sounds better… quack pseudo-remedies? I like that one.  wink

What does it say in the dictionary under “Medicine”?

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