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The economic argument against woo…

Yesterday was a travel day, which means I was too exhausted to grind out a piece of peerless logorrheic prose full of Insolence, Respectful, not-so-Respectful, or both. Fortunately, readers sent me something rather amusing that is also timely given some of the conversations we had at the Lorne Trottier Symposium Monday and Tuesday, where questions about why various forms of woo are not accepted by mainstream medicine, chemistry, science, etc. One answer that came up is that, if these things worked, there’d be a lot of really interesting things to study, applications of these things to real world problems, and, of course, money to be made off of people other than the marks who believe in this stuff. The ever-resourceful xkcd produced just the cartoon, formulated as the economic argument:

The Economic Argument

For those who may have criticisms of this chart, please visit the URL and pay attention to the mouseovers…

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]

37 replies on “The economic argument against woo…”

I surfed over to XKCD this morning, saw the comic, and thought it would be great to share here. Looks like I was beaten to the punch line.

Never underestimate the monetary value of woo : according to WikiInvest, the Carlyle Group ( you know who *they* are!) acquired NBTY, the LI, NY-based supplement maker( Nature’s Bounty, Solgar, Sundown, Ester C, etc.) for $4 billion on 10/1/10. Wouldn’t it be ironic if a skeptic who knew a bit about investing could harness woo’s earning power by investing in companies whose profit derive from pseudoscience ?

Awesome chart. Not that this is a criticism of the chart, but I think if we knew how much things like tarot were actually used in business planning, it would be very disturbing…

Lhun, I think you should read the mouseover.

The comments in the forum could do with some insolence though. So much magical thinking and ignorance. The same tired old arguments we have heard so many times.

Not to mention the Nobels to be won for proving that they work and showing how!

And the patents! This stuff would be a gold mine if it worked.

Awesome chart. Not that this is a criticism of the chart, but I think if we knew how much things like tarot were actually used in business planning, it would be very disturbing…

Actually, it would probably explain quite a bit. Come to think of it, when Orange County was bankrupted by speculative ventures, a mail psychic was used to help choose investments.

Not that this is a criticism of the chart, but I think if we knew how much things like tarot were actually used in business planning, it would be very disturbing…

Considering that the alternative is to believe that the business decisions in question were made by supposedly rational thinkers, in many cases I would be relieved to find out that tarot or some similar nonsense was the basis for the decision. I mean, if something can be reduced to a yes/no decision and you decide at random, you have a 50% chance of making the right call. Some of the companies involved in creating the economic mess have track records a whole lot worse than that.

Great chart. It should be noted that police have used psychics before, with varying degrees of success. And I wouldn’t be surprised if somewhere the military is spending money on looking into curses and hexes!

Considering that one of the things that created the current economic mess was banks deliberately going against the data—issuing mortgage loans, and then mortgage-backed securities, that their own guidelines said were a bad idea—the pure randomness of tarot or a simple coin-toss might be an improvement. Someone tossing a coin at random may at least make an unbiased decision, rather than going in there with the intent of making bad decisions and then lying to the customers.

@#6
The mouseover isn’t really a help. If you take it as part of the “economic argument” it’s circular, because to know which industries make money because their woo works as opposed to those that make money by selling to gullible people requires you to know which woo is real in the first place.

The key to note is that the money making methods listed in the chart are technologies that result from the phenomenon working, not in simply convincing people that they work. People make money selling homeopathy, but no one has used it to actually lower health costs.

Putting dowsing here is a bit problematic. From what I have read (including Gardner’s classic “in the name of science”), skilled dowsers have demonstrated a reasonable amount of success. The presumable reason is that they have enough of a grasp of the science of what they are looking for to respond unconsciously to signs of it (eg. more plants near a reserve of groundwater).

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Those ‘skilled’ dowsers performed no better then chance on a double blind study where all they had to do was find the pipe filled with water among 6 buried (no link saw this on TV).
Should have seen the explanations they gave for their failure.

With regards to dowsing:
Many years ago, when I was in school, a teacher told me a story about him meeting a dowser on his parents’ farm as a child. What he said was that the dowser held his hand at one point, and the teacher got a shock from the static.
There are people who can build up large charges of static electricity in their bodies, and it seems reasonable that such people would be able to dowse for water, if it is a real phenomenon, but if someone could fill me in or even suggest a way to test this I’d be grateful.

(Mr. Frost, I know you don’t know why your free blog network sends us “forbidden” messages when we click on your name… so this is a request that you switch to something more visible. That is because it looks like you have interesting things to post.)

@Julian Frost

I would recommend visiting the JREF web site. They have done a lot of testing of dowsers. Search their archives and you’ll find plenty of reading material. James Randi’s book Flim-Flam, if I remember right, also talks about dowsing.

If there is someone that you would like to test personally, maybe make a phone call to the JREF to get some tips on how to set up the test.

“Putting dowsing here is a bit problematic. From what I have read (including Gardner’s classic “in the name of science”), skilled dowsers have demonstrated a reasonable amount of success.”

No, they haven’t – they’ve consistently failed every rigorous test put to them.

So let me get this straight. You guys (who believe in orthodox medicine so fervently) are arguing that homeopathy must be a crock because it hasn’t been successful at lowering health care costs. Epic Fail!!!

But, that chart can’t be right!
Alt-Med Works! Really!
It’s all a Big Farmer Conspiracy!
Or something.

oh and #26: could you explain why water shouldn’t lower the cost of medical care ? I mean, if it worked for everything as it’s supporters claim, why wouldn’t it lower the cost of medical care ? After all, it’s just water or sugar pills, and you wouldn’t need all that fancy diagnostic equipment, expensive drugs or surgery, you could just take a few drops of water and be cured. Oh, wait, you mean the fellow selling the water or sugar pills wants me to pay the same price for his nothings as I would pay for real drugs, or possibly even more ? I checked the prices — 8.00 for homeopathic headache remedy and 2.00 for 3x as much regular asprin. Not really a bargain there is it ?

@26 The cost of medical care can be reduced to nothing by not treating anything. If an effective treatment for a previously untreatable condition it will probably increase the cost of health care.

Logic Fail on your part.

I note that most ‘skeptics’ tend to be of the left – which no doubt explains their propensity to shove their ideas down others’ throats – so it is hard to swallow the notion that you guys are so attuned to economic arguments. But even if, like me, you happen to like the system of prices, property rights and profits the notion that your medicine must be better because homeopathy doesn’t reduce costs is so mind-numbingly stupid it is beyond me. First I don’t believe in homeopathy so I am not trying to defend it, but reduce costs compared to what – oh that’s right – compared to the current system of poisoning and mutilation for which we are so privileged to pay around 15 per cent of GDP (I believe that is the figure in the US (granted some of that is on non-mainstream and emergency medicine but it is the expense of pharmaceuticals that is the main reason)). So it is incredible chutzpah on your part to claim that alternative medicine is bad because it costs too much. It doesn’t cost anywhere near as much as your medicine. Of course you believe your approach is effective – but given that I don’t agree with this assertion there is no point in you using it axiomatically.

The reason your medicine costs so much is because of the intellectual property system (which I don’t agree with by the way) and various other regulatory requirements (such as licensing of doctors). All of these things – rightly or wrongly – involve government coercion. Governments all over the world, in other words, do everything it possibly can to ensure that pharmaceutical companies and doctors make as much money as possible and that alternative practitioners make as little as possible. And of course they back this up with international bureaucracies like the WHO etc which seek to support the same system. And yes, cue “conspiracy theorist!” accusations. But that is what the institutions do (it isn’t a conspiracy it is just that all the protagonists have the same incentives).

So your argument makes no sense on any level. The reason health spending is so high is nothing to do with alternative medicine and everything to do with mainstream medicine. And your arguments that this doesn’t count because you believe alternative medicine is useless is just a case of begging the question (circular argument). In other words, Epic Fail!

punter:

I note that most ‘skeptics’ tend to be of the left –

Have you ever heard of Michael Shermer?

Anyway, here is some actual data:

Homeopathic Headache remedies, each bottle of 500 tablets is $8.95. Amount of actual active ingredient is pretty much nil. I am pretty sure Boiron makes a decent profit from its sugar pills.

Two bottles with 500 tablets each costing $8.99. Amount of actual active ingredient, ibuprofen, is 200 mg. It actually works (the absolutely first thing that I found worked for menstrual pain!).

Now, punter, it is up to you present some actual data. You do have something other than that lame variation of the Pharma Shill Gambit, right?

Governments all over the world, in other words, do everything it possibly can to ensure that pharmaceutical companies and doctors make as much money as possible and that alternative practitioners make as little as possible

In my native (famously socialist) country, Boiron, a company creating homeopathic pills, is as big a business as Roche, Merck, or any else famous pharma brand you care to name.
There are also naturopath courses at my current city’s universities.
Not to mention a chiropractic clinic at my workplace. And the tenants don’t look like they are poorer than the ‘mainstream’ doctors next door.
Not very effective at keeping the CAMs down, are we?

But you are right. Way too many pesky regulations, we are acting like commies. Let’s just any bloke come forward, pretend he is a healer, and sell his wonder treatment. Survivors will correct by themselves.

To stick to the meaning of ‘health care cost reduction’ from the initial picture:

The question xkcd is asking is: If a specific CAM was effective, what’s stopping the members of mainstream medicine (be it pharma companies or physicians) to adopt it, make plenty of bucks out of it, and drive out of the competition anyone else?
Especially if, as you believe, governments are that supportive and protective of them.

So let me get this straight. You guys (who believe in orthodox medicine so fervently) are arguing that homeopathy must be a crock because it hasn’t been successful at lowering health care costs. Epic Fail!!!

Why, thank you, Punter, but I’m afraid you’re a little confused about nettiquette. You’re not actually obligated to announce it when you’re going to commit an epic fail. We’ll be seeing it for ourselves.

Julian Frost @ 22:

With regards to dowsing:
Many years ago, when I was in school, a teacher told me a story about him meeting a dowser on his parents’ farm as a child. What he said was that the dowser held his hand at one point, and the teacher got a shock from the static.
There are people who can build up large charges of static electricity in their bodies, and it seems reasonable that such people would be able to dowse for water, if it is a real phenomenon, but if someone could fill me in or even suggest a way to test this I’d be grateful.

I work in the computer industry. Electrostatic discharge is a very big deal to us, so I receive training about it every year.

Everybody can build up a decent charge of static electricity, especially if the air is dry. (Dry air is an insulator; damp air is mildly conductive, which allows the charge to gradually seep away, greatly reducing buildup.) Many objects can also build up a significant charge, and when you feel a static discharge, there is no way to tell if you or the object you’re touching was the charged entity. In fact, what’s really significant for a discharge isn’t that one be charged and one not — they just have to be sufficiently different to allow electricity to flow. The only exception is grounded objects or people; if you know it’s grounded, you know it’s not holding a static charge. (Broadly speaking, anyway.)

Static charges have to be HUGE in order to jump a gap. With the right instrumentation, you can read the field strength and tell how charged an item is. More than a foot away, you won’t detect anything unless it’s a dangerously big charge*. And that’s what’s crucial here for dowsing by static charge — people are not generally* sensitive to ESD fields, and even if they were, the water would have to be so close you could see it. And from the perspective of dowsing, being able to see it is probably cheating. 😉 Another point is that underground reservoirs will not be charged. They’re as grounded as it is possible to be, and will have the same static charge as the surrounding earth.

*For an example of a dangerously large static charge, watch a thunderstorm — or search for “Arc Attack” on YouTube. Their equipment (twin Tesla coils rigged to play music by controlling the frequency of the zaps) produces so powerful a field that when they appeared on “America’s Got Talent”, a special outdoor stage was constructed so the video and sound equipment could be kept far enough away to avoid interference. This sort of electrical charge is not going to be generated by a human under normal circumstances, and can actually be lethal, so you’re not going to see it in dowsing. There would be a lot of dead dowsers.

**Exception: when you get close to such a field, your hair may be attracted to it, and that you *can* feel. It’s kinda fun to try out with a latex balloon, or just watch kids climbing out of a plastic tube slide. It’s hilarious. 😉 (Though for sheer laughs, it’s hard to beat videos of cats with balloons stuck to their undersides, trying in vain to shake the balloon off while holding on to their dignity. Static electricity is fun.)

The reason your medicine costs so much is because of the intellectual property system

Well it is certainly true that CAM has no intellectual property to defend. I mean how much does “making stuff up” and “not testing for efficacy” really cost?

And, although you may not believe in this system, I can assure you that it does exist.
Oh, and please, we’d like you to regard it as your medicine too. We’re kind like that.

If homeopathy worked, it absolutely could be used to reduce the cost of medical care. After all, homeopathic remedies cost very little to prepare. The amount of active ingredient is typically less than one molecule per dose, which means negligible cost. The only expense is in the dilution, which is readily automated. Compare that to the huge expense of complicated chemical syntheses and purification, not to mention the much larger quantities of active ingredients, typically milligrams per dose.

But it’s not just cost reduction. If homeopathy worked it would utterly transform our understanding of biochemistry, pharmacology, and thermodynamics. Real science follows a very different trajectory than woo. A century ago, drug effects were mysterious. Nobody knew what components of a cell a drug interacted with or how that interaction produced a physiological effect. Drug receptors were hypothetical black boxes. Since then, drug receptors have been identified, purified, sequenced, and cloned. Drug receptors have been crystalized in complex with bound drug. In many cases, the interactions of drugs with receptors are understood on an atomic scale. And the study of drugs has transformed and enriched our understanding of biochemistry and physiology.

How about homeopathy? At least as old as pharmacology, homeopathy remains as mysterious is ever. No biological mechanism has been identified to explain “like treats like.” The mechanism of the supposed “water memory” remains to be demonstrated. While effects of conventional drugs are reliably demonstrated in experiments that even a student can perform, nobody has managed to come up with a reliable, easily reproducible assay to demonstrate biological actions of homeopathic preparations. After a century or so with essentially zero progress in a field, it becomes time to cut bait.

According to John Campbell editorials, businesses do use psychic phenomena … but keep it secret.

On the other hand, the mainstream media haven’t uncovered that. That means:

1. They’re missing an opportunity to do some scandal mongering (superstitious capitalists are wasting YOUR money!).

2. A bunch of humanities majors are missing an opportunity to bash the people who passed the classes they flunked.

To punter: In other words, the absence of headlines announcing that capitalists are using woo violates everything we wingnuts know about the mainstream media.

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