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Complementary and alternative medicine Medicine Politics Quackery

Science is irrelevant. Resistance is futile, part 2: Another domino falls

I’ve written extensively before about how advocates of non-science-based “medical” treatments, such as naturopathy, homeopathy, and all the woo that follows have been waging a war on all fronts against science- and evidence-based medicine in their effort to have their so-called “complementary and alternative medicine” (or the newer, brighter, shinier name “integrative medicine”) be perceived as co-equal with scientific medicine. They’ve infiltrated academia. They’ve insinuated their agenda into medical school curricula. They’ve even managed to have the teaching of woo become a mandatory part of the family medicine residency in several residency programs. But one victory has always eluded them. One victory that would cement their appearance of legitimacy. That victory is to have insurance companies pay for their unscientific modalities.

Say what you will about them (and there is certainly a lot bad to say), insurance companies are very hard-nosed. Even if a modality is cheap, they will not pay for it if there is no good evidence that it works. It’s all about the bottom line. Of course, sometimes if customers demand it, an insurance company here or there might agree to pay for acupuncture or chiropractic adjustments. It’s a business decision meant to keep woo-loving customers from deserting them. But such decisions were haphazard and in no way mandated by anything other than an assessment of the harm done by annoying customers versus the relatively small cost of paying for some woo.

I hadn’t realized that this isn’t the case any more.

Apparently, Vermont passed a law last year requiring insurers and third party payers to cover the cost of naturopathy. Apparently there are other states that mandate coverage for naturopathy as well, including Washington. I don’t know about you, but if I were paying into an insurance plan, and the company administering that plan were wasting money paying for woo, I’d be mightily pissed. This can only serve to drive up the costs for everyone, as patients with non-self-limiting diseases pursue non-science-based modalities, think they feel better for a while, and then find that their disease is progressing, at which point they seek out science-based medical care–which their insurance companies will have to pay for, too.

Of course, this is just one more reason to oppose the licensure of naturopaths. Licensure confers the legitimacy of the state upon a profession. Never mind that legislating the licensure and regulation of a profession is a political and policy decision and has little or nothing to do with whether science supports the efficacy of that profession’s methods. Once that legitimacy is conferred it’s very easy for those holding the licenses to make the argument that they are a legally regulated profession and that there should therefore be no reason why they are not treated as legitimate health care providers for purposes of reimbursement. After all, they’re licensed and regulated by the state! That appears to be exactly what happened in Vermont and Washington. Is Minnesota next?

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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