TCS Daily


The Road to Hellville

By Todd Seavey - March 13, 2003 12:00 AM

Like many people who have Oxford health insurance, I got a pamphlet in the mail recently that said: "Acupuncture. Massage Therapy. Yoga. When you hear these words, do you think about your health plan? Probably not. But you should." I guess I will now.

It appears everyone on the Oxford plan is paying in part to sustain a network of "complementary and alternative medicine" practitioners. What's troubling is not that these practices are unconventional - indeed, they're increasingly common, as their inclusion in health insurance programs suggests - but that they are unscientific and have no proven track record at treating disease. That doesn't stop people from using them, though, especially people who are particularly susceptible to the power of suggestion, such as the artists, actors, and ex-hippies that New York City, where I live, has in such abundance - not to mention the desperate and chronically ill, which is more disturbing.

"At Oxford, we know there is more than one path to wellness," says the letter accompanying the pamphlet from Oxford's Medical Director, James Dillard (MD, DC, CAc - meaning he's a doctor, chiropractor, and acupuncturist). Of course, "wellness" tends to be so vaguely defined in alternative medicine circles that it's hard to say when a patient is getting better or worse. The Oxford pamphlet, for instance, notes that acupuncture "is based on the theory that life energy, called 'Qi'...flows through the body," and warns that "interruption of this energy flow could cause problems such as back pain, insomnia, or even migraines." Acupuncture is offered as the cure.

Needless to say, no one has ever observed or measured any Qi, and there is no more evidence for its existence than for the actual existence of "bad vibes" emanating from your mother in law. And if your mother in law decides that she finds it relaxing to have needles stuck into her skin, no one can argue with her choice of recreation, but for anyone - especially a Medical Director - to imply that this technique heals disease by harnessing mysterious energy is irresponsible and a distraction from genuine medical treatment.

In Connecticut, where Oxford Health Plans is headquartered, plan participants can even get coverage for "naturopathy" (illustrated in the pamphlet by someone contemplating a rock garden). In the pamphlet, we are told that "instead of taking medication" for conditions such as high blood pressure, "a naturopath may suggest diet modification and breathing exercises." The danger of encouraging people to dabble in these methods without large-scale, objective trials to demonstrate their efficacy is obvious. Absent statistics, patients and practitioners alike are tempted to fall back on anecdote and highly subjective personal reactions: It felt good to see my easy-going naturopath today, so I think I'm getting better.

I'm not dismissing the positive mental effects that such practices have on some people. If there were no benefits whatsoever, the methods probably wouldn't have such long traditions and so many millions of adherents. But there is no reason to fuzz the distinction between causing significant physical effects and merely setting a pleasant mood - unless you're trying to pull the wool over sick people's eyes and keep them paying for "treatments" that could just as easily be replaced with a relaxing (and inexpensive) walk in the park or a quiet evening reading the newspaper.

It's particularly embarrassing for me and my co-workers to be part of this New Age insurance trend, since our employer is the American Council on Science and Health, and the whole purpose of our organization is to steer people away from bad health decisions, toward rational ones based on solid, scientific evidence. Of course, Oxford has other things going for it, and we're free to switch to a different health insurance plan, but the scam that is alternative medicine is getting harder and harder to avoid, becoming a fixture in special "integrative medicine" wings of major hospitals and on the shelves of health food and drug stores throughout the nation.

Barring a huge upsurge in popular respect for science, technology, and mainstream medicine, the best hope for putting an end to bogus alternative medicine practices may be to unleash the trial lawyers who so plague mainstream doctors. If enough mainstream patients are lured into alternative medicine, sooner or later they're going to start noticing that the alternative healers aren't doing a thing for their Qi flow, not to mention their sprained ankles or bronchitis, and they aren't going to be happy about it.

Todd Seavey edits HealthFactsAndFears.com, webzine of the American Council on Science and Health, and is a Phillips Foundation Journalism Fellow.
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