The United States arguably has the most innovative and successful biomedical research community. Through our universities, corporations, and our ability to recruit native and imported talent, many of medicine’s most important breakthroughs have come from the U.S.. But by many measures we have a chaotic, expensive, and ineffective healthcare system.
One of the many faults of our system is our unstoppable desire to provide futile and unnecessary care, but the savings to be gained by changing our approach may be minimal (about 3% by some measures). But small numbers do eventually add up, and waste may eventually bankrupt us. Rationing care saves money but Americans fear it; we want what we want and we want it now, no matter what the cost, no matter what the science says.
Americans spend about $25 billion dollars yearly on supplements produced in a “wild west” mish-mash of factories which are effectively unregulated. We spend additional billions on other so-called “alternative therapies” such as chiropractic, energy healing, homeopathy, and other superstition-based treatments.
People are of course free to waste their money in an legal way they wish, but too often insurance companies pay for these therapies despite lack of evidence. It’s common for my patients to be denied coverage for important tests and medications while these same insurance companies easily pay for chiropractic, naturopathy, and acupuncture.
Most people have heard of these therapies and assume them to be relatively mainstream and effective, but the evidence is disappointing. Chriropractic, while popular, is based on a failed 19th century theory of “subluxations” that block the flow of vital energies. While some studies have found modest efficacy for low back pain, the bulk of the evidence shows chiropractic to be useless, and sometimes harmful. Naturopathy is another failed hypothesis about vital energies that somehow affect our health. Naturopaths often bill themselves as primary care doctors and claim that their education is “medical school plus”. The evidence shows that nautropathic education is not only deficient in science-based medical facts, but the practice is a chaotic “hodge-podge of mostly unscientific” therapies.
Acupuncture is becoming more and more popular, and is increasingly offered by mainstream medical centers, but the evidence for it’s effectiveness is anemic. In controlled studies, “real” acupuncture has been found inferior to “fake” acupuncture. Like chiropractic, while some studies show benefit, the bulk of the evidence shows no effect. Blind acceptance of unproven therapies can lead to some pretty horrific results.
I support the freedom of any fool to be parted from his money, but our healthcare dollars are a precious resource and when we waste it on dreams, we all become fools.