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Via Lawyers, Guns, and Money, here is an extremely stupid idea and evidence that those calling for health care reform to put an emphasis on science-based medicine aren’t blowing smoke out their asses: There’s a small provision in the health care bill that would cover Christian Scientists who want to pay for prayer

The measure would put Christian Science prayer treatments—which substitute for or supplement medical treatments—on the same footing as clinical medicine. While not mentioning the church by name, it would prohibit discrimination against “religious and spiritual healthcare.”

It would have a minor effect on the overall cost of the bill—Christian Science is a small church, and the prayer treatments can cost as little as $20 a day. But it has nevertheless stirred an intense controversy over the constitutional separation of church and state, and the possibility that other churches might seek reimbursements for so-called spiritual healing.

It’s not just the immediate issue of paying for Christian Scientists to do nothing, because while that’s offensive to thrift and decency, it’s not really all that expensive.  It’s also that this sort of thing opens the door to all sorts of charlatans who charge a lot more than $20 a pop to do nothing, using what amounts to magical arguments about healing.  “Religious or spiritual”  healing is a nice way to dress up the claim that you’re going to be healed by some sort of supernatural cause outside of science.  If you’re going to allow that prayer is a form of healing you’re willing to finance, then where do you draw the line?  Are we going to be paying thousands of dollars to faith healers and psychic surgeons?  Homeopaths currently bury their bullshit in pseudoscientific babble, but if the money is in “religious or spiritual” healing, prepare to see them all start coming down with lucrative religious revelations.  Acupuncture already makes magical claims about “chi” being routed through your body with the needles.  That shit ain’t cheap, or effective.

And what about the growing evangelical movement that increasingly treads into magical healing claims?  A lot of those churches claim to “heal” people by casting out demons, and they’re not just claiming to heal them of psychological distress, but also of physical and mental illness.  Right now, those churches don’t charge a lot for the “service” of convincing people to pretend they’re casting out imaginary demons, and it’s often free, but as soon as they find out that the Christian Scientists are getting faith-based kickbacks, they’re going to want their share, too. 

If praying and casting out demons were actually effective forms of medicine, we wouldn’t need health care reform.  We wouldn’t need to pay for the hospitals, the doctors, the research, the drugs, the nurses, the surgeries.  Like so much of the culture war stuff, it comes down to a simple fact: Recent history has demonstrated that humanity doesn’t need religion, and religion is retaliating by honing in on the space of non-charlatans.  We shouldn’t let them.  They had thousands of years to make their case and failed miserably.  Science has done more for humanity’s well-being in a fraction of that time, and science should get the rewards for it.

Can’t believe that they’re actually going to pass a bill where prayer is covered but abortion isn’t.

 

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Posted by Amanda Marcotte on 02:22 PM • (129) Comments

Easy solution—offer “prayer abortions.”

Comment #1: Punditus Maximus  on  11/04  at  02:52 PM

Since the bill mentions no specific church or a limit as to how much they will pay, I want them to pay for my prayer treatments from the Church of My Own Awesome Ass. I will pray for myself billing the government the perfectly reasonable rate of $1000 per prayer (20 prayers min).

Comment #2: Michael Clear  on  11/04  at  02:54 PM

...I still trying to get past the “paying for prayer” part.

Comment #3: preying mantis  on  11/04  at  02:56 PM

One problem with a democracy is that you have to cater to the majority.  Right now the majority of U.S citizens have a lot of unfounded supernatural beliefs and inorder to get elected politicians have to cater to those beliefs.  It sux but I don’t know how you change it.

Comment #4: John Rove  on  11/04  at  02:56 PM

Tactically I’m not sure I have a problem with this. The alternative is for 435 Republicans running for Congress in 2010 saying “the Democrats are trying to tell you what to believe.”

That’s tactically, of course; I don’t think that’s a stronger argument than those based on science, and on the Constitution, and on freedom even for other people.

Comment #5: Hershele Ostropoler  on  11/04  at  02:57 PM

I for one don’t think acupuncture belongs in that column. Not only because acupuncture works for everyone I know who gets it for pain, but because it’s not a representative practice of a lobby clamoring for tax exemption, it’s not a ruse to disenfranchise or displace legitimate medical practices, and it’s not totally incompatible with belief in evolution, that women are people, that bodily processes have a chemical and physical basis that we can study empirically. It works just like massage therapy and fresh air, as far as I know. It’s got a long history of working for a lot of people, and it only started to be called “alternative” medicine recently. Lots of insurance plans cover it now.

Comment #6: serena kitt  on  11/04  at  02:58 PM

Tactically, it’s a bad idea to give the religious right loopholes to line their pockets with taxpayer money, which gives them more resources for recruiting.

Comment #7: Amanda Marcotte  on  11/04  at  03:00 PM

Acupuncture studies of any legitimacy show that it’s a placebo effect.  Taking a lot of money from people to give them what a cheap aspirin would do better is pure charlatan behavior, and the government shouldn’t reward it.  Acupuncture’s “theory” is magical in origin.  It fits, even if lefties are the ones who get sucked in more than right wingers.

Comment #8: Amanda Marcotte  on  11/04  at  03:03 PM

Can’t believe that they’re actually going to pass a bill where prayer is covered but abortion isn’t.

That sounds like wingnut America in a nutshell.

Comment #9: junk science  on  11/04  at  03:07 PM

“Can’t believe that they’re actually going to pass a bill where prayer is covered but abortion isn’t. “

Well, why cover a completely legal procedure that can save actual lives, when you can cover people talking to themselves which does absolutely nothing but make the pray-er feel better.  Makes perfect sense!  After all, talking to yourself doesn’t have the tragic consequence of female autonomy.

Comment #10: Gypsy Lee  on  11/04  at  03:07 PM

Who ever thought we’d live to see the Senate finally passing a bipartisan Single Prayer bill?

Comment #11: Pesto  on  11/04  at  03:08 PM

It’s the Scientology amendment.

Seriously though, this is the GOP plan.  Prayer is cheaper, so if you get cancer and you are uninsured, just go pray it better.  Unless you can afford to pay for ‘real’ medicine, you should take what you can pay for, and that’s prayer. 

It’s even better than sending people to the ER…just pray it better:  If you don’t recover, then you are a bad person and God hates you, so you should die.  As quickly as possible.  Get on with the dying, already.

If you do get better, well, that’s unexpected, but it’s proof that GOD CURES GOOD PEOPLE WHO PRAY THE RIGHT WAY.

Fuck this shit.  Medicine is medicine and praying is NOT medicine.

Comment #12: Caren-Sun-blocking Creator of Animorphic Pancakes  on  11/04  at  03:10 PM

Acupuncture studies of any legitimacy show that it’s a placebo effect.

Which is why it tends to work well for things like chronic pain, which is strongly affected by one’s stress levels, and drug addiction, which has a strong psychological component.  Does it work in those cases because of a placebo effect?  Sure.  But “placebo effect” and “ineffective” are not the same thing, especially when we’re talking about things that are strongly affected by one’s emotional state.  Getting a massage doesn’t do a whole hell of a lot medically, either, but it’s still helpful for people with chronic pain and allows them to reduce the amount of medication that they need.

Comment #13: Mnemosyne  on  11/04  at  03:15 PM

Every single asshole who voted to include this amendment should be prohibited from obtaining any medical treatment other than prayer.  Ever.  That should speed up the turnover in Congress enough to get some real representatives.

Comment #14: libdevil  on  11/04  at  03:19 PM

That prayer-instead-of-medicine stuff is just a bunch of superstitious nonsense.

OTOH, I’ve got this bottle of Dr. Hiram Smith’s Genuine Apache Snake Oil, and I swear it will cure whatever ails you.  And it only costs $10/day!...

Comment #15: MikeEss  on  11/04  at  03:23 PM

Mnem, if we’re going to pay for placebos, they should be less expensive, don’t you think? 

I get massages.  I love them; they’re relaxing.  But they aren’t medicine.

Comment #16: Amanda Marcotte  on  11/04  at  03:31 PM

I have a slightly different take on this.

Direct Service Workers for people with developmental disabilities have long appreciated a space most commonly called the “Snoezelen Room.” These spaces are designed to provide a multi-sensory experience – i.e., various means of visual, audio, tactile, and olfactory stimulation – in a soothing atmosphere with low ambient light and a variety of soft surfaces. There are no expectations in the room; the clients can explore as they will, or simply relax while watching a bubble tube or other soft light source.

I can’t speak highly enough of this experience. It’s very neat.

I’m too lazy (and otherwise occupied) to dig up the studies or even share my own anecdotal stories, but time in these specialized rooms can calm clients significantly, such that there is a measurable drop in blood pressure and agitated behavior. The rooms are now being tested for agitated people with dementia, and some of them have experienced marked benefits. They can interact with their environments in simple ways (for example, by pressing a large button to change the color of the light in the bubble tube). They can occupy their minds with simple tasks that produce results they enjoy. Difficult feats of concentration and memory are not expected of them.

In other words, the environment is a warm, inviting sensory garden for people of all ages and abilities.

Some clients – especially those with stiff joints and other physical disorders – can have their massage therapy in these rooms. Others – especially in rooms with whirlpools – book regular times as part of their pain management program.

Direct Service Workers and room attendants are directed to make the experience as comfortable, soothing, and non-threatening as possible.

Many non-profits (especially in Europe) offer access to these unique rooms, and I think they should be covered by either primary healthcare or supplementary private insurance.

No one will be cured of their ailments through exposure to Snoezelen. It’s simply one tool among many designed to enhance quality of life – and quality of life for patients IS a healthcare issue.

Likewise, Christian Scientists’ lives are somehow improved when they learn that another human being is praying for them. They feel better, despite what ails them, because they feel safe and valued. I have no idea why this prayer thing should have to cost money, but if there’s a demonstrable benefit for the individual, thus improving her quality of life, then the expense should at least be considered for that reason alone. 

The fact prayer would be covered while abortion would not – well, that’s simply inexcusable.

Comment #17: Nil  on  11/04  at  03:38 PM

Mnem, if we’re going to pay for placebos, they should be less expensive, don’t you think?

You could make the same argument for psychotherapy.  After all, there’s no medical proof that it works, the value of what you get varies wildly by practitioner, and really all it does is help your mental state if you’re lucky.  Plus it’s way more expensive than acupuncture, usually a minimum of $100 an hour.  Should we remove psychotherapy from the healthcare bill, too?

Comment #18: Mnemosyne  on  11/04  at  03:40 PM

You want reduced stress, get the government to pay up so that everyone in America gets to work a 4 day/28 hours week without any reduction in their weekly wages. That will give a whole lot effect for the state’s money than throwing it at acupuncture charlatans.

But OMG SKY IS FALLING COMMUNISM !!

Comment #19: BlackBloc  on  11/04  at  03:42 PM

Is there a provision to cover court costs when the prayer fails, the kid dies, and the parents go up for negligent homocide?

Comment #20: damnedyankee  on  11/04  at  03:42 PM

You want reduced stress, get the government to pay up so that everyone in America gets to work a 4 day/28 hours week without any reduction in their weekly wages. That will give a whole lot more effect for the state’s money than throwing it at acupuncture charlatans.

But OMG SKY IS FALLING COMMUNISM !!

Comment #21: BlackBloc  on  11/04  at  03:43 PM

Sorry for double post.

Comment #22: BlackBloc  on  11/04  at  03:43 PM

Mnem, while most schools of massage are based on woo, there is at least one (deep tissue) that has provided measured therapeutic benefit, as studied by sports physiologists.

Comment #23: bomberE  on  11/04  at  03:44 PM

Mnem, while most schools of massage are based on woo, there is at least one (deep tissue) that has provided measured therapeutic benefit, as studied by sports physiologists.

Link to a medical journal, please.

Comment #24: Mnemosyne  on  11/04  at  03:46 PM

TDAv1.1, you’re comparing apples and oranges. If being in the Snoezelen Room brings down patients’ blood pressure, then that is an objective effect (and if there are reputable studies demonstrating the effect then there’s no reason not to cover it).

But if being prayed for makes Christian Scientists “feel better” then that’s a subjective effect, aka a placebo, aka nothing at all. There is no evidence it actually does anything apart from the naturally-biased patient’s desire to believe that it does.

Which is how the placebo effect works, btw. It’s not a magical phenomenon that leads to objectively measurable improvements because people believe it will; it’s a description of self-reported, subjective improvement like “hurts less” or “feels more relaxed”. If something causes a measurable change, like blood pressure lowering or red blood cell count going up, it’s not the placebo effect.

Comment #25: kristin  on  11/04  at  03:51 PM

The little devil on my shoulder tells me she wants those people to pay to kill themselves off! Let them find out once and for all the real consequences of their superstitions.

Comment #26: LCforevah  on  11/04  at  03:54 PM

Acupuncture and massage may not be “medicine” in the “I can get an accredited MD in this field” sense, but at least they’re actually doing something physical to the body.

On the other hand, praying for your patients’ health is roughly as effective as reading sports statistics at them until their tumors go away.

Comment #27: Dan, Grand High Emperor of Bananas Foster  on  11/04  at  03:55 PM

Effects of myofascial induction techniques on physiologic and psychologic parameters: a randomized controlled trial.
Altern Complement Med. 2008 Sep;14(7):807-11.

http://www.ncbi.nlm.nih.gov/pubmed/18724827?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=1

Comment #28: whooie  on  11/04  at  03:58 PM

Caren, it is the Scientology amendment. It seems inevitable to me that if the provision makes it into law, then the CoS is going to be pushing hard to get covered as well so they can charge the taxpayer *and* the church member for their audits.

Comment #29: Falconer  on  11/04  at  04:00 PM

Effectiveness of Massage Therapy for Chronic, Non-malignant Pain: A Review

Evid Based Complement Alternat Med. 2007 June; 4(2): 165–179. Published online 2007 February 5. doi: 10.1093/ecam/nel10

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1876616/?tool=pmcentrez

Comment #30: whooie  on  11/04  at  04:00 PM

If this lunacy is what it takes to get millions of people real healthcare, then fine, give them their “therapy” - as long as it comes with strict mandatory price caps set really low. Folding broader arguments over empiricism and science into this whole debate is just going to be too exhausting. People are suffering here.

Comment #31: ballast  on  11/04  at  04:00 PM

On the other hand, praying for your patients’ health is roughly as effective as reading sports statistics at them until their tumors go away.

I think this is where the basic misunderstanding is coming in.  I agree that prayer (or acupuncture, or psychotherapy) isn’t going to do much to actually cure the person’s disease.  However, it is potentially useful to help support the patient’s mental state and if this proposal was that people who prefer it could pay $20 to have someone come pray with them instead of paying $100 to go to shrink’s office for emotional support, then honestly I wouldn’t have a problem with it.  It wouldn’t work for me, but I could see it working to reduce some people’s stress levels while they’re getting medical treatment or just need some emotional support.

Unfortunately, we’re so disdainful of mental health in this country that unless you can show an actual chart or graph proving that talking to a psychotherapist once a week has actual physical benefits beyond just, “My relationships are better” or “I don’t feel as depressed,” then clearly it’s all bogus and there’s no reason for anyone to get it unless they pay out of their own pocket.

I don’t think this kind of therapy should be paid for as a medical treatment that’s meant to cure or treat an actual physical disease, but I see no problem with classing it under mental health treatment.  Well, until they try and put “pray away the gay” programs in there.

Comment #32: Mnemosyne  on  11/04  at  04:07 PM

There is a long and “distinguished” tradition of “spiritual healing” in the Evangelical and Pentecostal movements.  Having grown up a bit north of Oral Roberts monument to the efficacy of faith healing for fleecing the rubes, I can attest to its power and success.  Many of these asshats charge considerably more than $20 a whack.

Comment #33: DrDick  on  11/04  at  04:09 PM

Look on the bright side: maybe this will thin out the fanatics! I never thought I’d see the day where MY country is highjacked by Buy Bull thumpers.

Comment #34: pitbullgirl65  on  11/04  at  04:09 PM

Effectiveness of Massage Therapy for Chronic, Non-malignant Pain: A Review

Interestingly, that study showed that chiropractic treatment (aka spinal manipulation) actually worked better than massage in those studies.  I can haz my chiropractor paid for by my health insurance now?

Comment #35: Mnemosyne  on  11/04  at  04:11 PM

Like I said, I’m a bit preoccupied right now, or I’d take the leisure of posting a butt-load of Snoezelen studies – some showed little or no effect, while many others from equally reputable researchers showed marked (and positive) physiological effects related to this sensory experience. (Here’s one study survey: http://www.informaworld.com/smpp/content~db=all~content=a713813356)

Bear in mind, there’s no universal set of best practices or guideline on how to successfully create and use this sort of environment. My own bias leads me to believe there’s a structural or staffing flaw in those rooms that don’t produce positive results. (I’ve seen a couple of really bad examples of the sensory room in both design and implementation.)

Anyway, I don’t think these matters are applies and oranges. They’re part of the same continuum: if a thing works – e.g., it creates a physiological effect or leads to less agitation – then it doesn’t matter if that thing is a placebo or not. The Quality of Life issue is, in some ways, distinct from the core medical treatments some people have to endure. There’s more to healthcare than simply fixing the problem – especially when the underlying condition can’t be fixed.

Comment #36: Nil  on  11/04  at  04:21 PM

Does any private health insurance pay for stuff like this?

Comment #37: Bitter Scribe  on  11/04  at  04:23 PM

“I never thought I’d see the day where MY country is highjacked by Buy Bull thumpers.”

The European phase of America was started by people who left England because they couldn’t thump their bibles they way they wanted in peace.  There’s been an undercurrent of bible thumpiness ever since.

The better question is: How long before America is no longer hijacked by religious looneys?...

Comment #38: MikeEss  on  11/04  at  04:24 PM

The better question is: How long before America is no longer hijacked by religious looneys?…
MikeEss.

Idk. Maybe in 5 generations?

Comment #39: pitbullgirl65  on  11/04  at  04:28 PM

Who ever thought we’d live to see the Senate finally passing a bipartisan Single Prayer bill?

Thread over. This wins.

Comment #40: Ross Lincoln  on  11/04  at  04:29 PM

Well, until they try and put “pray away the gay” programs in there.

That’s next.  Paid for by your tax dollars.

Comment #41: Caren-Sun-blocking Creator of Animorphic Pancakes  on  11/04  at  04:30 PM

I can haz my chiropractor paid for by my health insurance now?

My chiropractor is.  He told me of studies done in Wisconsin where WI wanted to get out of paying for chiropractic.  As has been the truth in my case, chiropractic is more effective than medication for migraines. 

Not the result WI wanted, so they did it again, and got the same answers. 

Sorry I’m too busy right this minute to use my GoogleFu—this would be at least 10 years ago.

The unfortunate thing is that it’s not a permanent fix.  If I don’t keep going, the effects will eventually wear off, and I will end up with migraines again.  How that is different from having to take medication for life to manage the pain, I’m not sure, but it’s enough to make my insurance company limit the visits per year I can have vs. allowing all the meds I can take if I use their formulary and fucked-as-hell-mail-in-service.

Comment #42: Caren-Sun-blocking Creator of Animorphic Pancakes  on  11/04  at  04:36 PM

I’m not paying for some stupid motherfucker’s “prayers” just because their too fucking stupid to go to the doctor when their sick intead of praying (read: wishing it were so).

This reminds me a little bit of a statement by a friend of mine about churches not paying taxes: “Chuch is on fire? Since you don’t pay taxes, you can’t call the Fire Dept. You have to pray for rain.”

Comment #43: Mark  on  11/04  at  04:40 PM

I could be wrong about this but I was under the impression that the placebo effect referred to the effects on a patient’s health (whether entirely subjective or measurably objective) of providing what they believe to be a cure but which is actually known not to have any actual effect when the patient does not believe it to be a cure.  For example, a sugar pill. 

Some studies have shown marked improvement in patient’s conditions when they took these placebos, other studies…not so much.  In any case, if you provide some form of medical treatment that you believe to be effective, but that has no more effect then simply making the patient believe he has received the treatment when he actually has not, then you are not providing an effective treament.

Comment #44: JMitzman  on  11/04  at  04:56 PM

I’m not paying for some stupid motherfucker’s “prayers” just because their too fucking stupid to go to the doctor when their sick intead of praying (read: wishing it were so).

Yeah, but if it’s between the idiot in question paying into your insurance plan and then claiming $20 a pop for prayer vs. not having the idiot in question in your insurance plan at all, is the latter really worse? As long as the costs of prayer are kept not-too-ridiculous, Christian Scientists would arguably be assets. Think how much cheaper prayer can be than real medicine.

Comment #45: ballast  on  11/04  at  04:57 PM

Then offer Christian Scientists an opt-out provision. Forcing them to pay in even though they can’t receive benefits is manifestly unfair.

Comment #46: Hector B.  on  11/04  at  05:01 PM

JMitzman—that statement is false.  Placebos have become effective enough that doctors are now getting ethical training in how to prescribe them.  They are, after all, low in side effects.

Comment #47: Punditus Maximus  on  11/04  at  05:01 PM

This should be clear-cut and simple.  Treatments that show effectiveness over placebo in a double-blind study should be covered.  We should put prayer to the test just like anything else, and cover if it shows a benefit.  If it doesn’t show a benefit, then you can keep getting it but pay for it yourself.  This isn’t really about religion; it’s about doing what is actually effective.

Comment #48: bananacat  on  11/04  at  05:03 PM

Think how much cheaper prayer can be than real medicine.

Sure, prayer can be cheap, but it often isn’t.  Christian Scientists can end up paying really high prices to get a professional in their church to pay for them.  I think a lot of people don’t realize that they do actually charge for healing prayers, and they often charge a lot.

Comment #49: bananacat  on  11/04  at  05:05 PM

Science has done more for humanity’s well-being in a fraction of that time, and science should get the rewards for it.

This! Thank you for saying this. Repeated for truth.

If something causes a measurable change, like blood pressure lowering or red blood cell count going up, it’s not the placebo effect.

This is not how the placebo effect works. When medical studies are done the treatment must be MORE effective than the placebo. So the placebo effect can alleviate symptoms - it just does it less well than actual medical treatments. Also, the placebo effect is very unlikely to address the underlying cause of the illness. Just because your symptoms go away doesn’t mean you’re better.

Comment #50: Entomologista  on  11/04  at  05:05 PM

Then offer Christian Scientists an opt-out provision. Forcing them to pay in even though they can’t receive benefits is manifestly unfair.

Of course they can receive benefits, and I’d wager they seek modern medical care more often than you think. Every now and then you’ll hear a news story about parents being prosecuted for trying to pray away diabetes and letting their kid die, but those stories are rare. However, childhood illness is common. That suggests these people really are going to the doctor - or there would be a lot more of them in jail for negligent homicide.

Comment #51: Entomologista  on  11/04  at  05:11 PM

I’m not going to demand that money that could go to prevention or cancer treatments pay for my placebo, sorry.

And yes, I think psychological treatments shown to be ineffective in controlled studies should be ditched for those found effective.

Comment #52: Amanda Marcotte  on  11/04  at  05:16 PM

nyway, I don’t think these matters are applies and oranges. They’re part of the same continuum: if a thing works – e.g., it creates a physiological effect or leads to less agitation – then it doesn’t matter if that thing is a placebo or not. The Quality of Life issue is, in some ways, distinct from the core medical treatments some people have to endure. There’s more to healthcare than simply fixing the problem – especially when the underlying condition can’t be fixed.

Comment #36: The Devil’s Advocate v 1.1 on 11/04 at 08:21 PM

A lot of things lead to less agitation, both in people who are currently classed as “patients” of some branch of medicine or other, and of people who are perhaps not right this minute undergoing medical treatment but who are nevertheless part of the target constituency of this bill (i.e. everyone): decent public transport, reduction on noise pollution, easy and stress free access to public services, a non-threatening environment in commercial spaces such as banks and offices, less economic inequality in society at large, access to affordable fresh produce, green urban spaces… The list goes on.

These are all things that are within the remit of the government, but not within the remit of this healthcare bill. I think what’s happening here is that the introduction of prayer into the debate blurs the line between what is classed as medicine and what isn’t. Things like a dog and a park to walk it in or a supportive family have measurable positive effects on patients with dementia, heart attack survivers, chronic pain sufferers, depression patients etc., but nobody would dream of expecting the industrio-medical complex to be tasked with their provision. The same goes for religious and spiritual benefits.

Quite apart from any arguments about its actual effectiveness, prayer is a lifestyle choice and not a therapy. That should be enough of an argument to exclude it from the bill on scientific grounds, and the fact that it’s included is nothing but a sop to the more hysterical wing of the GOP’s base. To pretend otherwise is naive to the point of disingenuousness.

Comment #53: MarinaS  on  11/04  at  05:16 PM

This should be clear-cut and simple.  Treatments that show effectiveness over placebo in a double-blind study should be covered.  We should put prayer to the test just like anything else, and cover if it shows a benefit.  If it doesn’t show a benefit, then you can keep getting it but pay for it yourself.  This isn’t really about religion; it’s about doing what is actually effective.

Yes, this exactly, I agree.

Think how much cheaper prayer can be than real medicine.

Only until the pray-me-well brigade start realizing their magic chants/magic water/magic needles aren’t working, and come wanting evidence-based medicine to fix the problem. At which point we have people sicker than they would have been if they’d had some sensible treatment in the first place, which is way more expensive—plus the insult of having paid for their quack treatments as well.

Comment #54: kristin  on  11/04  at  05:21 PM

Haven’t we already had this argument about massage therapy?  Massage therapy often works for what it says it does - and it certainly reduces things like bedsores and pain.  WTF, sheesh.

Grr.

We should study options.  If prayer did work, we should pay for it.  If it didn’t, we don’t.  It should be decided on facts, not votes.

(Of course, then you get terrible studies sometimes that show ineffectiveness, but then you find out the study was flawed because he target group wasn’t defined enough or the medicine they studied wasn’t at all like what’s being used.  Case in point:  Studies paid for by the feds about the drug MDMA.  The study ‘accidentally’ used a methamphetamine amalgam instead of actual MDMA.  And yet, the study was used because it ‘showed’ that the drug was harmful.)

Comment #55: Crissa  on  11/04  at  05:33 PM

Acupuncture is closer to casting out demons in terms of a “medical treatment” than it is psychotherapy.  Like casting out demons, you have temporary relief for your pain, because you went through a powerful experience with a strong placebo effect.  When the effect wears off, you have to go back. For both, the argument is the same.  With casting out demons, it’s about riding the bad energy from your good energy.  With acupuncture, it’s about routing energy properly through your body.  Same bullshit.

Psychotherapy, by contrast, had some soft beginnings and a few loud charlatans, but there are real attempts to experiment and find effective treatments, and also an attempt to classify different disorders to apply different treatments. It’s easy to pick on psychotherapy, because they’ve only embraced controlled studies in the past few decades.  But you know, at least they did.  Acupuncture tends to run “studies” in journals established to put a veneer of science on woo, and the studies don’t have any controls.

It’s a real shame to try to raise up woo by linking it to psychotherapy, because the only result is casting more aspirations on a form of intervention that controlled studies demonstrate can be very effective.  That there’s a lot about psychotherapy that is still out there to discover doesn’t mean that we can just call it “alternative”.  I think there’s a lot of value in funding responsible psychological research, and that standards should be high, especially when it comes to therapeutic stuff.

Comment #56: Amanda Marcotte  on  11/04  at  05:37 PM

Aspirin is, compared to acupuncture, freaking dangerous. Until there’s an effective treatment for serious chronic pain conditions that doesn’t consist of high levels of organ-damaging medication, then the compassionate thing to do is to pay for palliative care of whatever type can be pardoned by the Constitution and fulfill the Hippocratic Oath, and if that means insurance pays someone to bring an adorable puppy to your house once a week because it decreases your pain levels by 50% then by the flying spaghetti monster, bring on the puppies, I say. However, federal funding of religious practices is still unconstitutional.

Comment #57: purpleshoes  on  11/04  at  05:39 PM

Problem is that acupuncture could easily be classified as “religious”, since its argument for why it’s effective is supernatural.

From what I understand, placebos work for a couple of reasons.  One is that the belief that you’re feeling better can make you (temporarily) feel better.  But a lot of it is regression to the mean.  For instance, if you catch a cold, and you take a Zicam or whatever the fuck that’s called, and you get better, you credit the Zicam, when you should credit your immune system that actually made you better. 

purple, the notion that we should withhold effective pain medication from people because no amount of risk is too small to take for mere pain is the kind of thinking that leads to withholding morphine from dying people for fear of addiction.  If you’re so worried about it, take a sugar pill.  It won’t make your headache go away like aspirin, but it will work about as well as acupuncture.

Comment #58: Amanda Marcotte  on  11/04  at  05:45 PM

One thing about science blogs ... while the information is usually good, the summary articles there are not peer reviewed like they would be in a journal.  Some of them pick and choose their sources to make a point more clear, others address the entire mess.  It is editorial content, not peer reviewed content - it is a blog, not a journal.

Comment #59: Ms Kate  on  11/04  at  05:48 PM

Taking a lot of money from people to give them what a cheap aspirin would do better is pure charlatan behavior, and the government shouldn’t reward it.  Acupuncture’s “theory” is magical in origin.

The philosophy behind acupuncture is bullshit. I get that. But even according to one of your links http://scienceblogs.com/insolence/2007/09/yawnanother_acupuncture_study.php
placing needles into the body is thought to disrupt pain by introducing competing pain stimuli. I think there is a difference between the philosophy being bullshit so any pain relief is a placebo and the philosophy being bullshit but there is a chemical/electrical process that is triggered that can give pain relief. If science dismissed everything that had a bullshit philosophy behind it we wouldn’t have things like aspirin since it was synthesized from White Willow bark. The White Willow tree never had any of the magical properties some of the rural European healers claimed it had. But aspirin is still one of the most widely used medicines for varying reasons. Hell, if it were “discovered” today we’d be paying 4 bucks a pill for it instead of paying 12 bucks for 400 pills at Costco.

Comment #60: shakahi  on  11/04  at  05:59 PM

Amanda, I’m actually referring mentally to a situation I know of with a young man with a chronic bone condition who was going back to school and had real trouble with the opiates his doctors gladly put him on, because they made him too drowsy to pay attention. It was a pretty brutal situation for him, and he relied on a lot of woo-type things because he just did not want to be taking soporifics while he was trying to establish some sort of quality of life. I’m also thinking of people I know living with fibromyalgia who are looking at living under conditions of chronic pain for four or five decades more - taking antiinflammatories constantly for decades can cause some serious organ damage, depending on drug and dose. Again, these are people who tend to rely on herbal medicine and acupuncture, and honestly, if it’s the lowest-harm option, simple reassurance and guaranteed human company seem worth public money. I realize that there’s a huge danger zone here: if woo can’t be classified by effectiveness, then it’s also hard to separate things with the potential for harm from things that are strictly in the category of making the patient comfortable. But then, I like superstition more than the next atheist.

I do have an internet acquaintance who would just love some damn opiates - her situation is such that organ damage is the least of her worries - but Drug War type policies keep her from getting enough to get through her day. So I get what you’re saying about that, I do, but for example, in my case, I’m taking tumeric instead of naproxen because I need my knee and my liver to work for the next six decades. And as far as my knee thinks, it’s working fine. So yes, I do fulfill your requirement of doing your woo at home on the cheap, but I am also not, say, a socially-isolated chronic pain patient who relies on their reiki group for human touch and company.

American English is really bad at recognizing “supernatural” as “religious” unless it’s explicitly theistic, so I predict non-prayer woo will dodge the Constitutional test for a while yet.

Comment #61: purpleshoes  on  11/04  at  06:00 PM

shakahi, in my part of North Carolina old people with arthritis also sting themselves with bees or whack the sore part of the body with nettles because it “stimulates the blood flow to the affected area”. What I have taken away from this is that arthritis must really suck.

Comment #62: purpleshoes  on  11/04  at  06:02 PM

Hm, I think my upshot is: atheists are really good at pointing out why social institutions that provide supernatural woo plus another function (like soup kitchens, or a bit of small talk to a lonely senior) should just cut out that woo crap before it hurts somebody, but we’re super bad so far at finding something to go in that space to fulfill all the other functions provided around the woo.

Comment #63: purpleshoes  on  11/04  at  06:05 PM

Amanda: you complain that well-designed research on acupuncture proves that it does not work, and then link to a negative review of a badly-designed study.  Why not to one of those well-designed studies that proves it’s all just a trick?
http://www.umm.edu/news/releases/back_pain.htm
Ummm, okay,. maybe not that one…
http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/HealthProfessional/allpages
Ah, not that one, either…
http://www.reuters.com/article/healthNews/idUSN1620285920071016
Geez, who knew that the Mayo Clinics and Duke University and like that were so full of woo woo wingnuts…?

Comment #64: Dr. Psycho  on  11/04  at  06:20 PM

Of course they can receive benefits, and I’d wager they seek modern medical care more often than you think.

Even if a vegan can’t resist a juicy steak once in a while, doesn’t mean he should be forced to buy half a cow.

Every now and then you’ll hear a news story about parents being prosecuted for trying to pray away diabetes and letting their kid die, but those stories are rare.

Christian Scientists are fairly rare, too. They don’t tend to have a lot of children, and juvenile diabetes is relatively rare as well. Rare x Rare = Really Rare.

However, childhood illness is common. That suggests these people really are going to the doctor - or there would be a lot more of them in jail for negligent homicide.

States have an interest in protecting the lives of their citizens. Planned Parenthood v. Casey A child is too young to make a binding profession of faith. If the religious beliefs of the parents put the life of their children in jeopardy, the state can step in to protect the children.

Further, the usual childhood diseases were rarely fatal—before acyclovir treatment consisted of making the patient comfortable, and treating the symptoms.

Comment #65: Hector B.  on  11/04  at  06:27 PM

On the placebo effect: it can, in fact, generate objectively measurable effects. For example, people who receive sugar pills that they believe are vitamin C, and believe vitamin C will protect them against colds, get fewer colds than people who receive either vitamin C or a sugar pill and are told it’s a sugar pill (as measured by regular doctor visits, not self-reporting).

The argument for not covering it is that what you are paying for tends to be vastly more expensive than an equally effective treatment (because, for instance, acupuncture doesn’t require training on the part of the provider to be equally effective, or just telling someone they are being prayed for works just as well as praying for them). But, it is important to remember that the placebo effect is, by definition, effective.

Comment #66: jalmondale  on  11/04  at  06:34 PM

Acupuncture and massage may not be “medicine” in the “I can get an accredited MD in this field” sense, but at least they’re actually doing something physical to the body.

No, they’re not medicine in the “actually works to alleviate or cure the condition they’re prescribed for” sense. Unfortunately, you can nonetheless get an accredited MD in the field of acupuncture - that’s how successful the con has been, so far.

Comment #67: Chet  on  11/04  at  06:36 PM

gllurphle

Comment #68: teac  on  11/04  at  06:37 PM

But, it is important to remember that the placebo effect is, by definition, effective.

But the effect is temporary and limited. And you need the patient’s cooperation, meaning they have to think it’ll have some effect. So the government shouldn’t pay for expensive, temporary and possibly ineffective, even by those low standards, placebos.

Comment #69: shakahi  on  11/04  at  06:42 PM

Comment #58: Amanda Marcotte on 11/04 at 04:45 PM

Problem is that acupuncture could easily be classified as “religious”, since its argument for why it’s effective is supernatural.

I think this argument is very problematic.  It requires that we assume that (a) the only grounds we could use to argue for acupuncture are by appeal to something supernatural, and that (b) anything that is “supernatural” is automatically religious.  I’m also worried that the assumption might sneak in that (c) any theory that’s not “scientific” will be classified as “supernatural” and therefore “religious.”

I of course think all three of those are false.  For (a), we can demand that arguments for acupuncture be made in a scientific manner.  For (b), it seems silly to claim that any form of belief in the supernatural automatically counts as “religion” for the purposes of the First Amendment.  As for (c), first I don’t believe that there’s a demarcation criterion for science, and second, I can already imagine some rabidly scientistic folks, if given that premise, trying to argue that large parts of social sciences are “religious” and thus must be divested of public funding.

Comment #70: sacundim  on  11/04  at  06:47 PM

Even if a vegan can’t resist a juicy steak once in a while, doesn’t mean he should be forced to buy half a cow.

Uh, yeah, that’s exactly what it means, Hector. We’re talking about health care, not woo-for-your-booboos make-believe magic time.

Comment #71: Chet  on  11/04  at  06:51 PM

Comment #69: shakahi on 11/04 at 05:42 PM

But the effect is temporary and limited. And you need the patient’s cooperation, meaning they have to think it’ll have some effect. So the government shouldn’t pay for expensive, temporary and possibly ineffective, even by those low standards, placebos.

Those comments could just as well apply to many mainstream treatments that we ordinarily pay for.  I mean, it’s ok to questions acupuncture’s effectiveness.  But the impression is sure being made that acupuncture’s being singled out for being foreign.

Comment #72: sacundim  on  11/04  at  06:53 PM

... if there’s a demonstrable benefit for the individual, thus improving her quality of life, then the expense should at least be considered for that reason alone.

What about demonstrable harm to the public? Dumbass chrisci tool may well feel better after being woo-wooed over by some charlatan, but they’re still spreading their flying pig flue, or whatever horrible and nameless pope-disease they have this week, to everyone they come into contact with.

I used to work with one of these drooling idiots. She would give the entire office a new disease at least twice a year. Even prayer is a last ditch effort for these fuckloons since admitting you are sick is admitting you have sinned and are being punished by the moronic deity they worship.

So, yea. If they want to have prayer covered for broken bones and other physical trauma I’m all for it (the more severe the better!), but communicable diseases should not be covered.

Comment #73: Sarcastro  on  11/04  at  06:56 PM

Comment #60: shakahi on 11/04 at 04:59 PM

If science dismissed everything that had a bullshit philosophy behind it we wouldn’t have things like aspirin since it was synthesized from White Willow bark.

We arguably wouldn’t have theories like heliocentrism or classical mechanics either.  Galileo and Newton believed lots of really whacky stuff.

Comment #74: sacundim  on  11/04  at  07:02 PM

We’re talking about health care, not woo-for-your-booboos make-believe magic time.

“Meat’s good for you. We all need animal protein to sustain life!”

If government health care doesn’t cover spiritual healing, then Christian Scientists can’t use it. And if they can’t benefit from it without violating their conscience, then there needs to be a conscientious objection exemption.

Otherwise, along with beef for vegans, let’s make Jews sign up for the Bacon of the Month Club. And start a special government program called “Trucks for the Amish.”

Comment #75: Hector B.  on  11/04  at  07:04 PM

So, Christian Scientists only have to buy into health insurance plans when they’re really sick, but the rest of us have to buy in all the time.  I wouldn’t have a problem with this in a single-payer system - if they really want less health care, that’s fine.  But in an insurance based model, it’s a ginormous problem.  You’re basically asking the rest of us to subsidize the care that CSs don’t pay premiums for (which, incidentally, is likely care that’s much more expensive than it needed to be, since they’d try praying away cancer until they were in real trouble).

That’s not going to work, and it’s entirely separate from the moronic notion that we should pay these charlatans to pray.

Comment #76: libdevil  on  11/04  at  07:47 PM

So, Christian Scientists only have to buy into health insurance plans when they’re really sick,

? If you opt out, you OPT OUT. Members of religious orders who opted out of social security don’t get to ask for money when they turn 66.

Comment #77: Hector B.  on  11/04  at  08:06 PM

woo-for-your-booboos make-believe magic time

Wasn’t that a Japanese game show?

Comment #78: Sour Kraut  on  11/04  at  08:13 PM

Except that we’re going to wind up paying for the healthcare of Christian Science nutjobs even if they opt out. Do you think they’re all going to have $100,000 laying around to pay for the amputation after gangrene has set in to their leg because they’re too fucking backwards to use antiseptic? No. Do you think the rule will be “Sorry, you opted out and you can’t afford treatment. Time to die!” The Hippocratic Oath would forbid it. So the only option is to have everybody buy insurance and/or the public option.

Comment #79: Entomologista  on  11/04  at  08:33 PM

Those comments could just as well apply to many mainstream treatments that we ordinarily pay for.

They should apply to every putative treatment whose efficacy cannot be established (as in, established as better than placebo.) Prostate screening, full-body MRI, etc.

But the impression is sure being made that acupuncture’s being singled out for being foreign.

It’s only been as successful as its been because it’s foreign. If it didn’t come from China, there’s no way it would be something you could pay for with insurance, or something recommended by the Mayo Clinic (gag me.) The con simply doesn’t work unless you can claim “ancient Asian secrets.

If government health care doesn’t cover spiritual healing, then Christian Scientists can’t use it.

The government shouldn’t cover “spiritual healing” because there’s no such fucking thing. And they can use everything else, just like a member of the KKK can go to a black doctor.

But the idea that CS don’t want actual effective health care, thus we need to pay people to do woo just to make them feel better, is absurd. It’s incredibly idiotic and insulting not only to us but to the Christian Scientists. I mean it makes no sense at all. “Prayer” isn’t health care. But the government has to pay for it like it is, because a small number of people won’t get any health care money otherwise? That’s completely circular.

Otherwise, along with beef for vegans, let’s make Jews sign up for the Bacon of the Month Club. And start a special government program called “Trucks for the Amish.”

Done, done, and done. The USDA raises and regulates beef and pork, including supplying these food products to low-income families. And of course, Amish taxpayers have as big a stake in General Motors now as you and I do.

Comment #80: Chet  on  11/04  at  08:40 PM

There’s a difference between saying it’s a placebo effect and saying that placebo effects shouldn’t be used.

I think, Amanda, you are overselling the factor by which effects should be used, even if they’re of placebo level.

Because it has been proven that placebo and treatment works better than treatment or placebo alone, even while treatment alone is greater than placebo alone.

So yeah, while a pillow might have a placebo effect on pain, that’s no reason not to pay for a pillow plus a pain pill.

Comment #81: Crissa  on  11/04  at  08:46 PM

As for (c), first I don’t believe that there’s a demarcation criterion for science, and second, I can already imagine some rabidly scientistic folks, if given that premise, trying to argue that large parts of social sciences are “religious” and thus must be divested of public funding.

First, there *is* a demarcation criterion for science it’s called the the scientific method and it’s really cool—you should look it up sometime (sure, it’s somewhat debatable right at the border, but you can tell when it’s straight-up discarded, believe me.) Second, the last part of that sentence is *ridiculous* ... at most the physical scientists I know gently tease the social scientists, and generally they seem to get along fine, as long as social scientists don’t pretend to use the scientific method during the times when they aren’t actually doing anything of the sort.

And yeah, plenty of social sciences do not, in fact, rely on woo at all. While studies often are limited to observational science rather than directly experimental science (this is what I tease people about, mainly :D) they still employ rationality and statistics and peer review, and all those other lovely scientific principles/methods.

You also seem to have a very exaggerated view of how powerful hard scientists are politically—I *wish* I could lay down the law about what constitutes rational policy/good science and what constitutes pure bullshit, but I can’t. Scientists are too busy trying to, yanno… study stuff… to fuck around disenfranchising other researchers all day.

Comment #82: Bagelsan  on  11/05  at  04:06 AM

We’re talking about health care, not woo-for-your-booboos make-believe magic time.

I keep reading that as “woo-for-your-boobies make-believe magic time” which I believe would be much less objectionable and far more entertaining, frankly. It would also likely have a powerful effect on mood, etc, when done with someone particularly delightful and good-looking. Can the government pay for that, now? :D

Comment #83: Bagelsan  on  11/05  at  04:10 AM

Which is why it tends to work well for things like chronic pain, which is strongly affected by one’s stress levels, and drug addiction, which has a strong psychological component.  Does it work in those cases because of a placebo effect?  Sure.  But “placebo effect” and “ineffective” are not the same thing, especially when we’re talking about things that are strongly affected by one’s emotional state.  Getting a massage doesn’t do a whole hell of a lot medically, either, but it’s still helpful for people with chronic pain and allows them to reduce the amount of medication that they need.

Which is the same argument for faith healing and a host of other woo nostrums.  Amanda’s point is that we ought to use science and empirical evidence to determine what should be funded by government mandate.  If you want to pay for a placebo effect out of your own pocket, have at it.  Just don’t divert pooled health care dollars toward your pet unproven therapy.  Buying a new outfit improves my emotional state.  Really gives me a bounce in my step and probably improves my overall cardiovascular picture, albeit fleetingly.  Shall I bill my insurer for that?

Comment #84: DonnaDiva  on  11/05  at  04:37 AM

And yeah, plenty of social sciences do not, in fact, rely on woo at all. While studies often are limited to observational science rather than directly experimental science (this is what I tease people about, mainly :D) they still employ rationality and statistics and peer review, and all those other lovely scientific principles/methods.

Whereas much of what is presented as “economics” does seem to rely on woo.  I mean, there’s not even observational data to bolster idiotic notions like trickle down and “free trade”, yet people hold them up as though they were revealed truths bestowed upon us from on high.  And scientifically sound, too.  Say, can you hard science types cast as skeptical an eye on economists as you do on shrinks and sociologists?

Comment #85: DonnaDiva  on  11/05  at  04:49 AM

Sorry, I know this is a little late in the thread but I couldn’t post it a few hours ago so..

But the impression is sure being made that acupuncture’s being singled out for being foreign.

Well, since I was one of the people arguing that acupuncture shouldn’t be completely dismissed as a placebo I don’t see how I was singling it out for being foreign. I would even agree with you to an extent that many dismiss “foreign” or “exotic” treatments out of hand. But I also think there’s a large group of people who are willing to give any non-western, non-FDA approved treatment approval because it’s just that…“foreign” in a system that’s broken. I have had to fight this knee jerk response. When you’re battling doctors (I know it’s hyperbole, but it takes an emotional toll) all the time just so you can pay $800 to get 15 minutes of their time so that they can tell you “Mmm uhhh, I dunno..wanna try this?” You become willing to believe anything. I’ll change the personal pronouns here…I have had to be aware of this bullshit, to protect myself from false hope, from becoming a victim of pseudo science, especially when it’s doled out by someone who listens, by someone who isn’t treating you like you’re inconveniencing them by having an appointment.

If we had a single payer system that allowed people like me, who have chronic illnesses while daring to be uninsured and uninsurable by private insurance, to have access to affordable comprehensive care then a lot of this bullshit would disappear because most of our medical needs would be met within the system.  Now, snake oil salesmen will ALWAYS appear. I think Amanda’s skeptical and cynical eye should be applied to all who claim they have the power to heal. They are too dangerous. My original point was that dismissing magical bullshit is good, I get it. My inbox is full of well meaning friends and family emailing every little article or ad they come across that claims to have “the” treatment. But dismissing or ignoring possible benefits because it’s an unintended byproduct of the original bullshit is counterproductive.

Comment #86: shakahi  on  11/05  at  04:51 AM

Say, can you hard science types cast as skeptical an eye on economists as you do on shrinks and sociologists?

I thought we did? I do. But I know less about economics than science, so I don’t have as much to say about how they’re doin’ it rong.

Comment #87: Bagelsan  on  11/05  at  05:40 AM

Trickle down and free trade aren’t even really economic theories per se.

While economics are hard to examine in the macro, they do exist and are measurable in small cases.  But like sociology, talking about it changes it, and when people talk about it, they tend to put their own opinions into it, and you end up with evolutionary psychology, which is based on, well, nothing, and isn’t testable evolution theory or psychology.

Comment #88: Crissa  on  11/05  at  06:34 AM

Long time lurker here.  Thanks for this wonderful blog/community.  I really enjoy reading it, though I don’t often comment.  I was raised in Christian Science, but before y’all pile on, I am definitely an atheist now.  It took a very long time, but I am over it, thanks in great part to y’all on this here “series o’ tubes” that leads to my ‘puter thingy. 

The proposed legislation some of you refer to as the Scientology amendment is probably Section 125 of HR 3200. “Prohibition of discrimination in health care services based on religious or spiritual content.”  (I believe all the pending bills contain similar language, as the Christian Science church maintains a very active lobbying effort.)  In any case, Section 125 reads:

“Neither the Commissioner nor any health insurance issuer offering health insurance coverage through the Exchange shall discriminate in approving or covering a health care service on the basis of its religious or spiritual content if expenditures for such a health care service are allowable as a deduction under 213(d) of the Internal Revenue Code of 1986, as in effect on January 1, 2009.”

What is striking is that all the similar amendments that I know of limit allowable religious expenses to those eligible for an IRS deduction.  As far as I know, Christian Science prayer treatments may be the only ones which qualify.  (BTW, it is Christian Scientists who have inserted this amendment, not Scientologists.  Not the same thing at all)  In some ways this language is good, as other faith healing does not qualify for the IRS deduction - although I’ll bet there will be lots more amendments to fix this oversight once the evangelicals realize it. 

While I agree that no religious “treatments” should be covered, this amendment is unlikely to be all that expensive, as Christian Science is rapidly dying out.  Most of their membership is over 50 with not many young people to take their places.  I read one estimate that there may only be around 400,000 left world-wide.  Many churches have attendance of only a dozen or even less, and remain open only because so many dead CSers have left millions for their upkeep. 

Regarding their signing up for health care, every CS family I have ever known uses medical treatment regularly for dental work and broken bones.  They also seek medical treatment for serious problems – albeit many times they wait entirely too long.  As an example, my own sister is unable to walk without aid today because she (as an adult) refused to seek medical help for what turned out to be her body’s inability to use vitamin B12 – as you know, an easily correctable condition.  And of course there are those exceptional tragic cases we read about in the papers, many of which are attributable to denominations other than CS. 

All this is not to defend the amendment.  I wholeheartedly oppose the special consideration religion gets on multiple fronts.  Just thought I should correct the misconception that it comes from Scientology.  Christian Science does not promote the sort of fraudulent behavior attributed to Scientology - just a lot of self-delusion.  (Oh my!  The “I-can-call-my-group-nuts-but-don’t-you-dare-do-it” syndrome seems to have lingered on in my religion-ravaged psyche.  I’m workin’ on it.)

Comment #89: Anfractuos  on  11/05  at  08:13 AM

Well Mnem, turns out the jury is still out on massage, which should teach me not to make sweeping claims.  Interestingly, the various journal articles I found (none from woo journals such Journal of Traditional Chinese Medicine) ranged from cautious endorsement to saying more study is needed.  Rather different from the outright rejection of the efficiacy of accupuncture.

Comment #90: bomberE  on  11/05  at  09:07 AM

”(BTW, it is Christian Scientists who have inserted this amendment, not Scientologists.  Not the same thing at all)”

That may well be, but I think the point being made RE Scientology is that they would love to have a precedent set that they can take advantage of.  After all, they have tons of their own “scientific” woo that needs to get sold to the suckers, and Tom Cruise ain’t getting any younger…

Comment #91: MikeEss  on  11/05  at  10:30 AM

You know how you can make sure that they aren’t spending your tax money on someone else’s goofball ideas of care? Don’t spend tax money on health care.

Once we decide that we’re going to get the government involved (and I think it should be involved, just to be clear) then we have to recognize that it’s not all going to be done according to our preferences. The kind of health care that’s done entirely according to our preferences is the kind that we pay for out of our own pocket.

Everything governmental is political. So every care decision is going to go through the political lens. If enough Christian Scientists or Scientologists or New Agers or snake-handling pentecostals vote/rally/lobby, then their nutty “therapies” are going to go on the approved list, and you and I will be paying for them.

Comment #92: Alkaloid  on  11/05  at  10:45 AM

Aspirin is, compared to acupuncture, freaking dangerous.

Yes, but it’s also actually effective.  Acupuncture also has risks, but no benefit.  The endorphin release caused by the needles could also be achieved in less risky ways.

Until there’s an effective treatment for serious chronic pain conditions that doesn’t consist of high levels of organ-damaging medication,

Many chronic pain conditions can be treated effectively with physical therapy.

Comment #93: bananacat  on  11/05  at  11:07 AM

You know how you can make sure that they aren’t spending your tax money on someone else’s goofball ideas of care? Don’t spend tax money on health care.

What a great idea!  Let’s just let a bunch of our citizens die and suffer horribly because they’re poor.

Once we decide that we’re going to get the government involved

The government is already involved in so many ways.

then we have to recognize that it’s not all going to be done according to our preferences.

No, this it the claim that is made about private insurance companies.  Because it’s voluntary, people will only spend their money on plans that cover their personal preferences.  Of course, this theory is wrong because private companies do everything they can to deny both what we want and what we need.

If enough Christian Scientists or Scientologists or New Agers or snake-handling pentecostals vote/rally/lobby, then their nutty “therapies” are going to go on the approved list, and you and I will be paying for them.

You probably already pay for them through whatever insurance you currently have.  Plenty of insurance plans already partially cover woo therapies.

Comment #94: bananacat  on  11/05  at  11:11 AM

Probably, catgirl. So? If I don’t want to be part of the woo-therapy-paying company, I don’t have to be.

Government isn’t optional. And if government is to cover everyone, then Amanda’s I-hate-woo position is no more relevant than Joey Fundamentalist’s I-hate-abortion position - totally irrelevant, unless they put the votes/political interest together to MAKE it relevant.

It shouldn’t be “wtf, why are we paying for this nonsense” - that ship sailed. It should be “wtf, what do I do to ensure that it is my choices that are privileged in the system”.

Comment #95: Alkaloid  on  11/05  at  12:38 PM

purpleshoes (57):

However, federal funding of religious practices is still unconstitutional.

Is yoga a religious practice?

Hector (75):

If government health care doesn’t cover spiritual healing, then Christian Scientists can’t use it

In the decade and change I’ve been paying taxes, I have had zero children. Why am I paying for public schools?

(Granted, someone in my household uses the school system, but only since 2005, and I can’t claim her as a dependant.)

If there were a government program to distribute bacon, I would object because it doesn’t meet a public need, but if it could be demonstrated that it did, well, Jews and Muslims are members of the public. Obsevant Jews’ and Muslims’ (and SDAs’) tax dollars pay for inspection of hog farms, after all. Unless you’re trying to claim that health care isn’t actually a need.

DonnaDiva (85):

Whereas much of what is presented as “economics” does seem to rely on woo

Tatë Ostropoler is an economist, and he assures me economics is pure undiluted woo.

Say, can you hard science types cast as skeptical an eye on economists as you do on shrinks and sociologists?

Look at the reaction Steven Leavett gets.

catgirl (93):

The endorphin release caused by the needles could also be achieved in less risky ways.

Not to mention more fun.

What, that’s not what you were talking about?

Comment #96: Hershele Ostropoler  on  11/05  at  12:57 PM

Catgirl, please believe me when I tell you that I know of what I speak. I am glad the chronic pain conditions you are aware of in your real life have clear, straightforward causes and clear, straight-forward cures. I am basically arguing that when people have situations where 1) there’s no clearcut medical cure 2) the clear-cut medical cure has tradeoffs that are unacceptable to the patient on a quality-of-life level 3) the patient is following responsible medical procedures but has unmet human, social, and/or cultural needs, there should be a sub-category called “making the patient and loved ones comfortable” that can include some demonstrably harmless woo. For instance, I guarantee you that your health insurance in some way pays for hospital chaplains, and I think that’s fair if the chaplain is expected to act as a responsible counselor for everyone who comes in the door without getting all theistic at them. I am a secular person and I have had several extremely positive interactions with hospital chaplains, and believe me when I say that that is a service I needed at the time. However, there is a clear distinction between harmless, “complementary” “woo” and “woo” that stands in for real medical practice. I find paying for chaplains who can act as general counselors acceptable; I find paying for religious hospitals that refuse legal care to pregnant women, or people who offer specifically creed-based services, or people who offer “woo” that’s harmful either in its own right or because it supersedes proper medical care to be ascientific and repugnant. However, I am also extremely cautious about excluding reasonably new-to-the-US practices on the grounds that they’re not proven yet: we really have not done enough rigorous scientific testing of many of these things, for all that we’re really stubborn about ditching the ones that science shows to be on the level of a bubble bath.

Comment #97: purpleshoes  on  11/05  at  01:20 PM

Aspirin is, compared to acupuncture, freaking dangerous.

Yes, but it’s also actually effective.

Cosign. It’s often better to have a tradeoff than to just do nothing—aspirin can be nasty, but one of my friends is on baby Tylenol for pretty much the rest of her life due to a blood clot she had in her arm; if she’d been prescribed acupuncture instead of surgery and blood-thinners she might have felt better initially but she also probably would have died by now. Health practitioners can’t take “do no harm” so far that they do nothing, and just prescribe a glass of water for everything (I’m looking at you, homeopathy.)

Comment #98: Bagelsan  on  11/05  at  01:25 PM

However, I am also extremely cautious about excluding reasonably new-to-the-US practices on the grounds that they’re not proven yet: we really have not done enough rigorous scientific testing of many of these things, for all that we’re really stubborn about ditching the ones that science shows to be on the level of a bubble bath.

And yet people flip their shit when a new drug is introduced without undergoing rigorous testing (and by “flip their shit” I mean the FDA says “hell no go test that thing for 5 more years, I don’t care how promising it is in mice.”) It seems bizarre to me that just because something is “ancient Chinese secret” we don’t put it through testing *before* dumping it on the public—shouldn’t everything be tested before being released for public use? How do you know it’s not harmful if it hasn’t been tested?

Everyone thought thalidomide was the bee’s knees in Europe, but a particularly crotchety American woman in the FDA was a total downer and insisted we hold off on releasing it for public use for a while ‘cause she wasn’t convinced it was safe. Guess which country never had a ton of “flipper babies” because a “totally safe” treatment for morning sickness was delayed for further study just because it was new to the US.

Comment #99: Bagelsan  on  11/05  at  01:33 PM

I agree with you, Amanda, on all the political issues, but the infallibility of your opinion on acupuncture and homeopathy is very repugnant, not to mention arrogant.  It places you in the company of fundamentalism.  Sure, disagree if you will.  That’s fine, even great.  Thank you for it.  But if you’re going to use “studies” as a weapon to inflate and support your personal opinion, then find and give links to the studies.

There is physiologic underpinning to both acupuncture and homeopathy.  Sure, there are lightweighs and outright quacks using them both ignorantly and making outrageous claims for each (by the way, why did you leave out chiropractors?  If ever there were bone-cracking quacks….).  However, for every study you wield against your medical enemies there are studies to support them - studies just as empirical and actual as your studies.

I do have experience receiving both acupuncture and homeopathy.  Used selectively and tactically they can be very effective with the right practitioners.  Someone very close to me has a recognized chronic immune-based illness that medical science completely fails to impact in the least, no matter how extreme or mundane the treatments offered.  Acupuncture helps regulate her health in ways that nothing else has.  You may cry ‘placebo’, but honest medical doctors would tell you that most of the ‘healing’ they do is a crap shoot with some drugs thrown in that may or may not be effective in what they’re used for.  Homeopathy, though it has a large contingent of parasitic overclaiming quackery attached to it, similarly helps manage my dear friend’s health as well when specific conditions manifest.  Not a one-thing-fits-all thing at all, but specific treatments for specific conditions.

Again, your fundamentalist triumphalism of omniscience is very disturbing to me.  It works very well on matters of political prudence and the morality of treating everyone with equanimity and fairness.  To the degree that you abandon these sterling qualities for your even considered opinions in the case of what I’ve been discussing, you are throwing out the baby with the bathwater and losing a modicum of respect among certain quarters such as my household, which I never thought would happen.

What is the personal basis for your fundamentalism?  What personally causes your rigidity to set in rigor mortis-like?

Comment #100: News Nag  on  11/05  at  01:43 PM

In the decade and change I’ve been paying taxes, I have had zero children. Why am I paying for public schools?

You benefit from living in a society of educated persons. How would you get anything accomplished if no one could read or write? In contrast, you don’t benefit significantly from having other people be healthy while health care is unavailable to you.

Ento’s position that eventually Christian Scientists will abandon their beliefs and demand conventional medicine reminds me of the anti-abortion argument that eventually pro-choice women will abandon their beliefs and sink into depression as they realize what they have done. You can’t build a compelling argument around a speculative future change of heart, even if you can point to individuals in both cases who have done so.

Comment #101: Hector B.  on  11/05  at  01:53 PM

Hector B, on the other hand we have clear evidence that some pregnant pro-life women, when up against a wall, will trade in the baby Jesus for a clear-cut medical resolution to their problem, which is a great argument for continuing to make sure that everyone funds services that not everyone will need. No one can swear up and down that they will never use the treatment that’s proven to work, even if they never announce it to their neighbors.

News Nag, while I am being more conciliatory than you, nods. I am glad a chronically ill person very dear to me finally found the one surgeon in North America who could provide a medical, permanent fix, and I’m glad that research on that issue is ongoing, but it took five years of horrifying pain to find that person and in the meantime a lot of woo made the patient much more comfortable than she would otherwise have been. I do, however, object to homeopaths who insist that there’s now no need for mumps vaccines or ongoing research into such conditions. That’s the cutoff between palliative care and danger.

Comment #102: purpleshoes  on  11/05  at  02:27 PM

The thing about a lot of traditional remedies is, a stopped clock is right twice a day. The “woo” of ancient superstititions often *does* turn out to have something to it… it just isn’t the thing that the people who came up with it thought it was.

And medical science changes. Remember that in the 1800’s, having doctors treat pregnancy was the latest and greatest scientific advance, and midwives were considered superstitious woo… and now we know that huge numbers of women died in childbirth for this reason, because dedicated midwives who only treated pregnancy *weren’t* treating septic wounds, failing to wash their hands, and then going and sticking their hands in a woman’s vagina.

Right now, medical science is really, really weak at dealing with chronic pain and mental illness. Many of the mechanisms of things that do work are poorly understood. So the fact that the theory behind something is bullshit does not in fact make it bullshit; my understanding is that massage and chiropractic will do more for your chronic back pain than surgery ever will unless you are one of the very rare people whose chronic back pain is actually caused by something visibly damaging the vertebrae. If you’re just a normal human whose back hurts all the time because evolution was crap at designing our backs for 80 years of standing upright, you cannot be helped by Western medicine as well as you can be helped by massage and chiropractic care.

So maybe acupuncture works and maybe it doesn’t; I haven’t reviewed the literature. But I am not ready to declare that a technique that was used for 4,000 years is *necessarily* crap because the people who came up with it had some nonsensical ideas about *why* it worked. I do, however, think the government needs to put more funding into studying “alternative” medicine, determining clearly what works, what doesn’t, what’s purely placebo versus what has an effect. (For example, a way to study whether or not acupuncture *works* is to recruit a sample of people who know nothing about *how* acupuncture is done, but have chronic pain and are willing to try it, and for some of the people, implement fake acupuncture—poke them but don’t puncture the skin, or use needles with blunt sticky tips and essentially glue them to the surface of the skin, or something else that a person who knows nothing about acupuncture might be fooled by.)

Likewise, I’d actually like to see prayer studied. I have a very strong belief that I already know the answer, but that doesn’t mean we shouldn’t subject the question to scientific scrutiny. We already know that people experience a benefit from *praying*... probably because, if you believe, then praying allows you to feel as if you have some control over an uncontrollable situation. The argument has been made that people who are prayed for feel better. So, test that. Tell some people they are being prayed for when they’re not, tell some people they aren’t being prayed for when they are, and see who does better. (I recall one study I found fascinating when I studied psychology; people told they had drunk alcohol who *hadn’t* were more aggressive than people who were told they hadn’t drunk alcohol who had. The aggression tracked the belief that you’d drunk alcohol, not whether you’d done so.)

Comment #103: Alara J Rogers  on  11/05  at  02:48 PM

Prayer covered.  Check.  Abortion not covered.  Check.

We’re in America, Amanda.  Only in America, and certain benighted third-world countries, would you see something like this.

I chalk nearly all of this up to our totally bungled reconstruction after the Civil War.  Had we really subjugated and totally re-conceived the South, and done it right, many of our current problems simply would not exist.  But we didn’t.  And so they do.

The South never had to really pay the price of starting a war they could not win.  The South got off easy.  Hard, and savage, as it was, the South still got off easy.  Total annihilation and rebirth would have been the better solution.  Instead, every last stupid, primitive notion of the old south just stayed and stayed, to continue to plague us to this day.

Comment #104: Aurelius  on  11/05  at  02:54 PM

Is yoga a religious practice?

Yoga is a spiritual practice. Doing yoga asanas, however, is no more inherently spiritual than any other stretch in the world. Muscles and ligaments know no religion and whatever stretches and strengthens them, stretches and strengthens them.

the infallibility of your opinion on acupuncture and homeopathy is very repugnant, not to mention arrogant.  It places you in the company of fundamentalism.

Oh bullshit. Fundamentalists have their opinions formed by the dogma with no consideration of evidence. Having a firm stance on something, based on the evidence, is exactly the opposite of fundamentalism. I know you think Amanda is all mean and shit because she won’t indulge your desire to believe in magical healing, but “You’re being MEAN! I WANT to believe this!” isn’t a valid argument.

Comment #105: kristin  on  11/05  at  02:58 PM

Comment #82: Bagelsan on 11/05 at 03:06 AM

First, there *is* a demarcation criterion for science it’s called the the scientific method and it’s really cool—you should look it up sometime (sure, it’s somewhat debatable right at the border, but you can tell when it’s straight-up discarded, believe me.)

You’re not going to convince me of that with the good old pound-the-table-with-your-fist argument, you know.  Either you know that this is a big controversy in the philosophy of science, in which case you’re being disingenuous, or you don’t, in which case you’re being ignorant.  I’d recommend not picking between those two.

Comment #86: shakahi on 11/05 at 03:51 AM

Well, since I was one of the people arguing that acupuncture shouldn’t be completely dismissed as a placebo I don’t see how I was singling it out for being foreign.

Well, I wasn’t really accusing you specifically of such a thing.  It’s just that the fact that we are all spilling so much ink on acupuncture gives the impression that it’s being unfairly singled out.

Basically, I’m just remarking on the fact that we’re having an argument about acupuncture, and not having any about, say, doctors prescribing drugs for uses they were never approved for, which is something that they do routinely on the basis of word-of-mouth from other doctors and pharma reps.  Like the time I was prescribed “sleeping aids” that turned out to be anti-depressants with unpleasant side effects I was never warned about.  Or all those doctors giving children antidepressants that have only been approved for adults, or all the people taking drugs over the long term that were only approved for short-term use.

So in actual practice, a lot of people are treated with drugs that have only rigorously shown to work for something else, sometimes on the basis of inconclusive evidence (from studies funded by the manufacturer) that the drug might also help for something else, and sometimes on the basis of just assuming that the drug will just work.  Because of this, all the talk about how drugs are treatments that have been proven to be effective loses a lot of its bite.  For all you know, most of those “proven effective” drugs are being used in ways that do more harm than good.

Comment #106: sacundim  on  11/05  at  03:48 PM

Had we really subjugated and totally re-conceived the South, and done it right, many of our current problems simply would not exist.

Who is this “we”? Most of the kooky religious-tinged things originated or came to the US in the North. The founder of Christian Science was born and raised a New Englander. Boston is still the headquarters of her church. Theosophy came to the US through New York. The Women’s Christian Temperance Union was headquartered in Chicago. There was no North of light and reason to sweep away the superstitions of the South.

Another fact to consider: at the time Christian Science became popular, conventional medicine was more likely to kill you than no treatment at all. For example, doctors washing their hands between patients was a new doctrine, just becoming accepted at that time.

Comment #107: Hector B.  on  11/05  at  04:14 PM

In the decade and change I’ve been paying taxes, I have had zero children. Why am I paying for public schools?

What Hector said. You benefit not only from living in a society of educated people, but also, for example, from living in one where more children are in school instead of in gangs.

Hector, I’ll have to disagree with you here:

In contrast, you don’t benefit significantly from having other people be healthy while health care is unavailable to you.

You do, actually, benefit from having people around you be healthy. If the people around you are healthy, they’re not going to infect you.

Comment #108: Rebecca  on  11/05  at  04:48 PM

Had we really subjugated and totally re-conceived the South, and done it right, many of our current problems simply would not exist.

Actually, this is true, for certain “wow, you really like subjugating, huh” values of true. If Reconstruction had been less deliberately punitive and less outrightly bungled, and focused more on a Marshall Plan-like reconstruction of the economy along what were at the time modern lines, we wouldn’t have a third of the country that’s profoundly suspicious of all and any public works projects, we wouldn’t have populations in Appalachia that were stranded with no infrastructure into the 1960s, we might not have lost five generations of potential doctors and scientists to resourceless segregated schools, and a lot of the widespread health problems in the poorest states might not have the hold that they do. Hell, there might be some hope for Mississippi. Congratulations, kind of the right answer to kind of the wrong question. Religion is the opiate you take because that stupid thing you did a while back has left you with some aches and pains, but it really does only treat the symptoms.

Let’s get this derail from acupuncture to the Civil War! Meanwhile, I’m pretty sure we all agree that there shouldn’t be direct federal funding for prayer healing.

Comment #109: purpleshoes  on  11/05  at  04:58 PM

There is physiologic underpinning to both acupuncture and homeopathy.

Do you know how dilute a homeopathic solution is? Imagine crushing up a single grain of rice and diluting in a volume of water the size of the solar system. That’s how laughably stupid homeopathy is.

Um, Hector? Did you read the comment by the former ChriSci who attested to the fact that ChriScis tend to get medical treatment for emergency situations? Hey, I know! Have the government do a study to find out how many ChriScis actually receive care from a doctor or hospital. That would resolve the question of whether or not they get an exemption from paying their taxes.

Comment #110: Entomologista  on  11/05  at  05:01 PM

In contrast, you don’t benefit significantly from having other people be healthy while health care is unavailable to you.

Are you stupid? Maybe you’ve never heard of herd immunity. It’s how the anti-vax crowd has been getting away with not vaccinating their children and not having them all die of diphtheria.

Comment #111: Entomologista  on  11/05  at  05:03 PM

Hector (101):

You benefit from living in a society of educated persons. How would you get anything accomplished if no one could read or write? In contrast, you don’t benefit significantly from having other people be healthy while health care is unavailable to you.

Fair enough, though, as has been pointed out with varying degrees of politeness, I actually do. But what about inspection of pork products? If I were observant, how would I benefit from that? It’s a better analogy, to, since that too is a religious restriction.

Comment #112: Hershele Ostropoler  on  11/05  at  05:43 PM

My uncle and aunt were Christian Scientists. She converted him to CS when they married. Like mist new converts he dove in with doctrinal enthusiasm. She died of a brain tumor leaving a young son behind. They had tried to pray it away.

My uncle (and I) have a family history of diabetes/heart disease. His diabetes was uncontrolled due to his religious exclusions although I know that he did consult with CS faith healers. He could have controlled it with diet and exercise but apparently that was being too proactive.
After his untimely death at the age of 64, I sat down and read Science and Health with Key to the Scriptures. I have never read a more scattered pile of claptrap in my life. The CS theory if illness in short, as I understand it, is that illness is caused when the individual hosts faulty beliefs and that illness will disappear when good thoughts replace the bad.


p.s. I hope that if CS practitioners are included in the bill that Native American shamanic cures will also be covered.

Comment #113: Therealhellkitty  on  11/05  at  05:52 PM

So in actual practice, a lot of people are treated with drugs that have only rigorously shown to work for something else, sometimes on the basis of inconclusive evidence (from studies funded by the manufacturer) that the drug might also help for something else, and sometimes on the basis of just assuming that the drug will just work.  Because of this, all the talk about how drugs are treatments that have been proven to be effective loses a lot of its bite.  For all you know, most of those “proven effective” drugs are being used in ways that do more harm than good.

Well, yeah, the medical industry had problems with non-evidence-based practices. So does the education industry, and the clothing industry, and the food industry ... and the cure for bad science is more science. Antidepressants leading to bad results for pediatric patients? Quick! Start funding more studies so we can determine what will lead to better results. Don’t decide that drinking magic water is the solution. Improve on the results by improving on the information we have.

Because that’s the difference: even when it’s done imperfectly, modern medicine is at least based on a model that follows the evidence. Whereas homepathy and acupuncture, when they’re done RIGHT, are based on completely magical thinking, in other words, wishful bullshit. There’s nothing there to improve on except by making up different wishful bullshit.

Comment #114: kristin  on  11/05  at  06:04 PM

Substitute HAS for HAD, above. “The medical industry has problems with non-evidence-based practices.”

what about inspection of pork products? If I were observant, how would I benefit from that?

You do know that uninspected meat can CAUSE DISEASE, don’t you? Communicable disease?

Comment #115: kristin  on  11/05  at  06:07 PM

Hershele—as long as your beef and poultry are inspected, it shouldn’t matter to you if other people’s pork and rabbit are also inspected. Only if government inspection were limited to treyfs would you have grounds to complain similar to the Christian Scientists.

And for vaccination fans: “herd immunity” only protects against a limited number of diseases.

Comment #116: Hector B.  on  11/05  at  06:51 PM

Comment #114: kristin on 11/05 at 05:04 PM

Well, yeah, the medical industry had problems with non-evidence-based practices. So does the education industry, and the clothing industry, and the food industry ... and the cure for bad science is more science. Antidepressants leading to bad results for pediatric patients? Quick! Start funding more studies so we can determine what will lead to better results.

You’re missing the connection between the non-evidence-based practices and the discussion of placebo effects above.  Instead of the case of antidepressants leading to bad results when used in children, we could imagine of an antidepressant prescribed as a sleep aid that doesn’t actually work as such, but which induces a placebo effect—at the cost of some pretty uncomfortable adverse effects (and hey, the adverse effects may contribute to inducing the placebo effect).  Is that really any better than acupuncture?

Because that’s the difference: even when it’s done imperfectly, modern medicine is at least based on a model that follows the evidence. Whereas homepathy and acupuncture, when they’re done RIGHT, are based on completely magical thinking, in other words, wishful bullshit. There’s nothing there to improve on except by making up different wishful bullshit.

The problem I have with this answer in the context of this thread is that the only people I see insisting on acupuncture being inseparable from Chinese philosophy are people setting up strawmen.  I mean, how many people here are really claiming that we shouldn’t demand that acupuncture be judged by a medical model?  What makes the “magical thinking” the “RIGHT” way of doing acupuncture?

And also, I really don’t think that the doctors making the prescription decisions are reasoning in a way that’s much different from your “real” acupuncturist’s “magical thinking.”  Actual medical practice relies on magical thinking too—rules of thumb like “giving a patient drug X will cause effect Y,” without really deep understanding of why this is supposed to be so, or when the rule of thumb breaks down.

So it’s not really that medicine sometimes has problems with non-evidence-based practices; it’s more like actual applied medicine is not an evidence-based process, because that’s the only way to actually get the job done.  What we do is we fund research institutions and regulatory bodies to keep the practices and rules of thumb in line with scientific standards as well as we can.  The results are absolutely nothing to sneer at, but still imperfect, and a lot of it can doubtless be attribute to the placebo effect of using “science” (as a mysterious black box) to cure people.

So, by all means, yes, subject acupuncture to these standards.  But don’t go around pretending that Western medicine is more “scientific” than it actually is to make acupuncture look that much worse in comparison.

Comment #117: sacundim  on  11/05  at  08:15 PM

</i>The results are absolutely nothing to sneer at, but still imperfect, and a lot of it can doubtless be attribute to the placebo effect of using “science” (as a mysterious black box) to cure people.</i>

Seriously? Of course science is imperfect, but do you really think that science is mostly a *placebo* effect? Bacteria and mice don’t give a shit that they’re being tested on, and PCR doesn’t work better if you really, really want it to. You can’t “placebo” away the vast majority of once-fatal childhood illnesses—but you *can* vaccinate them away.

Little babies don’t know they’ve been vaccinated and then decide to not get diptheria. Cancer cells don’t hear the word “chemotherapy” and just roll over and die. TB isn’t all like “oh, were you mutating some of my membrane proteins? Now I’m self-conscious and I’ll probably be less pathogenic now.” The placebo effect as a term doesn’t even make sense in the context of research—there can certainly be bias on the part of the researcher but exacting publication standards, peer review, and good controls reduce it a lot. Please don’t confuse mis-reporting of symptoms by patients with scientific research.

Comment #118: Bagelsan  on  11/05  at  09:30 PM

we could imagine of an antidepressant prescribed as a sleep aid that doesn’t actually work as such, but which induces a placebo effect—at the cost of some pretty uncomfortable adverse effects (and hey, the adverse effects may contribute to inducing the placebo effect).

So don’t just go off and stick needles in people instead. Do a study and find out whether the antidepressant works better, as a sleep aid, than a placebo does. The cure for bad science is more science. Not chucking it all over in favor of magic.

Comment #119: kristin  on  11/05  at  10:00 PM

So here’s the deal: as long as everything covered is subject to effectiveness research, this could be a fine idea.

Comment #120: paul  on  11/05  at  10:12 PM

Comment #118: Bagelsan on 11/05 at 08:30 PM

Of course science is imperfect, but do you really think that science is mostly a *placebo* effect?

I did not say anything of the sort.  I’m trying to convey something much more subtle.  Let’s try again.

Simplifying somewhat, the medical profession can be roughly divided into two groups: (a) the researchers, who perform scientific experiments to establish the efficacy of treatments; (b) the practitioners, who then apply rules of thumb to determine which treatments to apply to each patient.

My point is that the folks in group (a) demonstrate the effectiveness of treatments under circumstance X, but then group (b), the practicioners, apply those treatments to patients under circumstances X, Y and Z.  The research done on the treatment gives us high confidence that the treatment will be effective on the X patients, but that doesn’t guarantee that it will help the Y and Z patients.  It may in fact help the Y group and not help the Z group.

My argument is that both the Y and Z group’s situations are common.  So in actual practice, medicine involves lots of effective treatment, but also lots ineffective treatment that nonetheless has a placebo effect.

And none of this is meant as a negative criticism of medicine; I’m not saying that medicine is insufficiently scientific.  Rather, I’m claiming that medicine cannot reasonably be made strictly scientific in the sense that you seem to demand.  Doctors need to treat their patients urgently, plus we need lots of doctors, so we need to teach those doctors good rules of thumb to apply quickly to each case.

Comment #119: kristin on 11/05 at 09:00 PM

So don’t just go off and stick needles in people instead. Do a study and find out whether the antidepressant works better, as a sleep aid, than a placebo does. The cure for bad science is more science. Not chucking it all over in favor of magic.

There is never enough time for everything, given the urgency of treating patients.  In fact, that urgency and the workload creates a culture among practitioners that makes it hard to get them to abandon their old rules of thumb about which treatments to apply in which cases; actual practicing doctors don’t have a lot of time to read journals and critically evaluating the studies.  At any rate, studies done to answer questions like these are often flawed or contradicted by other studies.

So “more science” doesn’t always solve these problems, partly because more science may confuse the issue (by producing inconclusive results), and partly because the problem isn’t just a scientific problem, it’s a medical problem that has many social dimensions, one of which is the culture of the doctors that actually treat patients.

At any rate, I’m not really advocating for acupuncture here.  I just think that the way people are comparing it to medicine is unfair, because they’re making assumptions that make medicine look better and acupuncture worse than they actually are.  A lot of the practices that we justifiably sanction as medicine are comparably efficient to acupuncture.

Comment #120: paul on 11/05 at 09:12 PM

So here’s the deal: as long as everything covered is subject to effectiveness research, this could be a fine idea.

And then the problem is that we don’t have enough resources to demonstrate, for every treatment, whether it is effective in every circumstance where we think it might be effective.  Again, in my hypothetical example above with patient groups X, Y and Z, demanding that the treatment in question only be used for group X means that it won’t get used for group Y, where it will in fact also help.  But to get that, we have to live with giving it to group Z, where we think it will help but it does not in fact do so.

Comment #121: sacundim  on  11/05  at  11:07 PM

Well Mnem, turns out the jury is still out on massage, which should teach me not to make sweeping claims.  Interestingly, the various journal articles I found (none from woo journals such Journal of Traditional Chinese Medicine) ranged from cautious endorsement to saying more study is needed.  Rather different from the outright rejection of the efficiacy of accupuncture.
Comment #90: Emmett on 11/05 at 08:07 AM

As someone who has had both physical therapy and massage, why cover one, but not the other?  Both practitioners did relatively the same thing, the difference being the PT focused only on the specific complaint, necessitating more therapy when that caused an imbalance or a recognition that the other side was in the same state, but hadn’t been as bad, so wasn’t as noticeable.  On teh other hand the MT did both sides to start, and was a whole bunch cheaper, too.  Legitimate MT does indeed work to relax muscles, often taking the muscle causing a pinched nerve out of spasm,  and does so without side effects - muscle relaxers, the pharma solution mean lost days of work and productivity.

Comment #122: phylosopher  on  11/06  at  01:05 AM

You’re not going to convince me of that with the good old pound-the-table-with-your-fist argument, you know.  Either you know that this is a big controversy in the philosophy of science, in which case you’re being disingenuous, or you don’t, in which case you’re being ignorant.  I’d recommend not picking between those two.

Fair enough, I wasn’t being particularly serious—just wanted to pound a table. I know that your initial point about there being a debate about what constitutes “science” is fair (I obviously take a side!), but it got my back up a bit that you leapt from that to “I can already imagine some rabidly scientistic folks, if given that premise, trying to argue that large parts of social sciences are “religious” and thus must be divested of public funding.” ‘Cause I’m pretty rabidly scientistic but I’m not an asshole offline, for the most part. :p Nor do I hate on the soft sciences, except for gently (my anthropology friend gets some teasing. She has to read stuff about African tribes by white guys who literally have never been to Africa!)

I don’t think hard scientists hate on the soft sciences as much as you seem to think; half of the hard scientists I know are or should be in therapy (that’s pretty soft in places) and plenty are religious of some flavor so it’s not like we just spend all day calculating the inefficiency of love and calling things “illogical” and trying to convert people to atheism. Also, I’m pretty sure we suck at organizing on the level required to divest anyone of anything.

Comment #123: Bagelsan  on  11/06  at  03:23 AM

My argument is that both the Y and Z group’s situations are common.  So in actual practice, medicine involves lots of effective treatment, but also lots ineffective treatment that nonetheless has a placebo effect.

And none of this is meant as a negative criticism of medicine; I’m not saying that medicine is insufficiently scientific.  Rather, I’m claiming that medicine cannot reasonably be made strictly scientific in the sense that you seem to demand.  Doctors need to treat their patients urgently, plus we need lots of doctors, so we need to teach those doctors good rules of thumb to apply quickly to each case.

I’ll buy that second paragraph, albeit with some reservations (“haste makes waste” and all that—there are rules about clinical trials for a reason and they are enforced for a reason, even when both the researchers and doctors swear up and down that their discovery will seriously cure all cancer right now and my grandma will die without it.)

But I don’t agree that, just because a treatment that was tested for group X works on group Y as well, there is necessarily a placebo effect. Maybe the two groups just have that particular bit of physiology in common, and a clinical trial of group Y would have shown the same results as X did. If group Y saw that the treatment worked for group X and then mistakenly thought that they belonged in group X, and then reported success with the medicine but all along it actually never worked for group Y, then that would be a placebo effect, I think. (Maybe people with a virus getting an antibiotic and “feeling better” afterwards would be an example of this. Doesn’t mean that a large number of antibiotic treatments are mostly placebo effect though.)

I don’t think that incomplete clinical trials or discovery-by-trial-and-error means that medical treatment is largely placebo effect; if it were, doctors wouldn’t *have* to try lots of different things, would they? They’d just wave their hands and give everyone the same thing with some ridiculously long chemical name and call it a day, and all their patients would get better.

Comment #124: Bagelsan  on  11/06  at  03:37 AM

Hector, I’m going to stop analogizing your argument because I, at least, am losing sight of the issue at hand. I think Kristin’s reasning is sounder. We all benefit from a healthy populace, as a culture, as a society, and as an economy.

Comment #125: Hershele Ostropoler  on  11/06  at  11:13 AM

I do, however, think the government needs to put more funding into studying “alternative” medicine, determining clearly what works, what doesn’t, what’s purely placebo versus what has an effect.

The government already funds therapies on alternative medicine.  If it’s shown to be effective, then it’s no longer “alternative”.  However, many of these studies have had underwhelming results, which is why you don’t hear about them in the news.

</blockquote>(For example, a way to study whether or not acupuncture *works* is to recruit a sample of people who know nothing about *how* acupuncture is done, but have chronic pain and are willing to try it, and for some of the people, implement fake acupuncture—poke them but don’t puncture the skin, or use needles with blunt sticky tips and essentially glue them to the surface of the skin, or something else that a person who knows nothing about acupuncture might be fooled by.)</blockquote>

This exact study has already been done.  It showed the people who got correct acupuncture had the same amount of pain reduction as people who had needles poked into random places, and people who had fake needles that never even punctured the skin.  There was even a study that showed the poking people with toothpicks was as effective as correct acupuncture.

I know that prayer has been studied at least once.  It turns out that the prayed-for group of hospital patients actually fared slightly worse than the control group, although that it was not a statistically significant difference.  This didn’t involve Christian Science prayers though.

Comment #126: bananacat  on  11/06  at  12:57 PM

Comment #123: Bagelsan on 11/06 at 02:23 AM

I don’t think hard scientists hate on the soft sciences as much as you seem to think; half of the hard scientists I know are or should be in therapy (that’s pretty soft in places) and plenty are religious of some flavor so it’s not like we just spend all day calculating the inefficiency of love and calling things “illogical” and trying to convert people to atheism. Also, I’m pretty sure we suck at organizing on the level required to divest anyone of anything.

I never claimed that most hard scientists “hate” the soft sciences.  I’ll be blunt about this: you keep attributing claims to me that I haven’t made.

Comment #124: Bagelsan on 11/06 at 02:37 AM

But I don’t agree that, just because a treatment that was tested for group X works on group Y as well, there is necessarily a placebo effect. Maybe the two groups just have that particular bit of physiology in common, and a clinical trial of group Y would have shown the same results as X did.

I must not have made myself as clear as I wanted, but that is exactly what group Y was intended to convey.  Group Z is the group where the treatment strictly speaking does not work, but may easily have a placebo effect.  And again, I argue both cases are common.

I don’t think that incomplete clinical trials or discovery-by-trial-and-error means that medical treatment is largely placebo effect;

I said this earlier and I’ll say it again: you keep attributing claims to me that I haven’t made.

Comment #127: sacundim  on  11/06  at  02:46 PM

sacundim: To your groups X, Y, and Z, we could also include group A- those whose off-label prescriptions cause significant harm and groups X(1) and Y(1) whose use is helpful but harmful in combination with other drugs.

If patients’ records of conditions and treatments, as prescribed by the practicioners, were standardized, computerized, anonymized to protect privacy, and made available to the researchers, we’d have a whole hell of a lot more success in determining exactly what treatments are or aren’t effective (or actually harmful) under whatever conditions actual practicing doctors are prescribing them in the real world. 

I’m pretty sure that’s one of the features of most of the proposed HC reforms.  It makes perfect sense: it would make health care delivery safer, more effective, and cheaper for everybody.  Naturally the pharma lobby’s against it as it would necessarily mean lower sales as Groups Z and A are identified and those uses curtailed.  And the right wing assholes are against it because Obamunistofascism.

Comment #128: Chocolate Covered Cotton  on  11/07  at  12:57 PM

RobW, I am always absolutely stunned by how many side effects of prescribed medication are undocumented in the literature but well-documented on yahoo groups.

Comment #129: purpleshoes  on  11/07  at  09:39 PM

purpleshoes, of the two ways I know you know that could be taken, whch did you intend? After all, only tone differentiates those words in the mouth of the conspiracy loony and of the skeptic.

Comment #130: Hershele Ostropoler  on  11/08  at  08:16 PM
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