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“Move along. Nothing to see Here”- F. Drebin

I am, I think, the slowest writer in the  SBM stable.  I start each entry about 10 days before it is due, and work diligently on it through the week.  As such, I run the risk that events may make my work pointless. Case in point.  I have been slogging away at this entry for the last week and had the final draft up and ready to go, only to find this morning that the Health Care Reform bill no longer carries the language that was the crux of this entire post.  So what is a poor, slow, SBM writer to do? Chuck the whole thing?  Repost my 12 reasons you are a dumb ass not to get the flu vaccine yet again? Leave a hole in the SBM line up? No.

Lets pretend we are in a parallel universe, perhaps an evil universe  where I have a goatee, and the language was not removed from the bill. Lets all pretend that this post is still relevant. Since the Christian Science Church has indicated they will try to get the bill amended to reinstate payment for their services, this post may be relevant again.

Or you could go read  Respectful Insolence instead. Don’t say you were not warned.

One of the ongoing themes of the H1N1 wackaloons is the concept that the current pandemic is not a natural phenomena but a Frankenstein’s monster, pieces of virus unnaturally stitched together in a government lab to be let loose upon the world village to kill and maim.

As a rule I have little sympathy or understanding for the conspiratorial world outlook.  It strikes me as ludicrous at best and insane at worst.

Why would the government want to make a new vaccine and let it loose on the world? Some say to decrease the population to ameliorate global warming. Some say to cause panic and increase the use of vaccines and antivirals, a bailout for the pharmaceutical industry.  Others say it is to decrease health care costs.  I say, of course, it is primarily to decrease human death and suffering, but I am under the big pharma Imperius curse, so I would say that, wouldn’t I?

The cost of the medical industrial complex is spiraling (does it really spiral? One definition of spiral is a “continuously accelerating change” but that is not what I think of when I think spiral. A corkscrew spirals. But I digress) out of control and expenditures on health care only increase (not, by the way, in a manner that ends up in my wallet.  I wonder just who is getting all that cash. Sure as hell hasn’t been me. I digress again; my overlords have advised me to stay on topic).

Who is spending all these health care dollars? The elderly and the chronically ill, particularly during the last year of life. What better way to cut medical costs than to send an influenza pandemic into the world to thin the herd. Of course, the current H1N1 has a predilection for killing the healthy, but the government has never been known for its competence. To judge the conspirators of the pandemic by their work, I would say they are not up to Dr. Evil level evil. It is impossible to take the conspiracy wackaloons seriously as their statements seem totally divorced from reality.

Or so I thought. Now I am not so sure.  The reason for the change of heart? The LA times.

“Backed by some of the most powerful members of the Senate, a little-noticed provision in the healthcare overhaul bill would require insurers to consider covering Christian Science prayer treatments as medical expenses.

The provision was inserted by Sen. Orrin G. Hatch (R-Utah) with the support of Democratic Sens. John F. Kerry and the late Edward M. Kennedy, both of Massachusetts, home to the headquarters of the Church of Christ, Scientist.

The measure would put Christian Science prayer treatments — which substitute for or supplement medical treatments– on the same footing as clinical medicine”.

No way.  What does the real Senate bill say?

“(D) The essential benefits provided for in subparagraph (A) shall include a requirement that there be non-discrimination in health care in a manner that, with respect to an individual who is eligible for medical or surgical care under a qualified health plan offered through a Gateway, prohibits the Administrator of the Gateway, or a qualified health plan offered through the Gateway, from denying such individual benefits for religious or spiritual health care, except that such religious or spiritual health care shall be an expense eligible for deduction as a medical care expense as determined by Internal Revenue Service Rulings interpreting section 213(d) of the Internal Revenue Code of 1986 as of January 1, 2009.”

The House bill has similar wording:

“Section 125. PROHIBITION OF DISCRIMINATION IN HEALTH CARE SERVICES BASED ON RELIGIOUS OR SPIRITUAL CONTENT.

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.”

The sponsor of the bill, Senator Harken, has said

“It is time to end the discrimination against alternative health care practices.”

“This is about giving people the pragmatic alternatives they want, while ending discrimination against practitioners of scientifically based alternative health care. It is about improving health care outcomes. And, yes, it is about reducing health care costs. Generally speaking, alternative therapies are less expensive and less intrusive – and we need to take advantage of that.”

I was shocked at this. But then I considered.  Sen. Harken is interested in ‘scientifically based alternative health care’ and science is in the title of Christian Science. So it makes some sense. And he is trying to reduce costs by encouraging medical therapies that are not effective.  Something smells fishy.

Why would the government want to make sure prayer could be reimbursed as form of medical intervention? Surely our elected representative would not pander to their constituents? That would be beyond the pale.  There must be a deeper, more sinister, reason.  And I remember: dead people cost no money.

Christian Science was, like many of the topics discussed on this blog, invented. In this case it was Mary Baker Eddy, who,  in 1866, published the Science and Health with Key to the Scriptures, the guiding document of Christian Science.  Their approach to all illness and injury is prayer.  To quote the ever helpful wikipedia:

“Christian Scientists believe that sickness is the result of fear, ignorance, or sin, and that when the erroneous belief is corrected, the sickness will disappear. They state that the way to eliminate the false beliefs is to replace them with true understanding of God’s goodness. They consider that suffering can occur only when one believes (consciously or unconsciously) in the supposed reality of a problem. If one changes one’s understanding, the belief is revealed as false, and the acknowledgment that the sickness has no power, as God is the only power, eliminates the sickness.”

The application of Christian Scientology, er, no, it must be Christian Scientist therapies has well documented effects upon the Christian Science population. And those effects are not beneficial to anyone who is not a mortician.

For example, in 1989 JAMA published a cohort study (Yes, I know from the last post that cohort studies prove nothing nothing nothing, but I am uncertain how one would apply Christian Science in a randomized, placebo controled, double blinded manner).

They looked at outcomes in 5,500 Christian Scientists and compared them to a group of almost 30,000 controls using conventional medicine.

For each age group from 1934 to 1983, there was a greater death rate in the Christian Scientists when compared to the control population, a difference made more remarkable as Christian Scientists neither smoke nor drink.

The JAMA study confirmed an earlier study from 1965 that demonstrated the death rate from cancer among Christian Scientists from was double the national average, and 6 percent died from preventable causes. Not being a Christian Scientists gave an average of more four years  of life to women and two more years of life to men (Wilson GE. Christian Science and longevity. J Forensic Sci. 1965;1:43-60).

Subsequently the CDC did a study where they compared a similar cohort of Christian Scientists to 7th Day Adventists and again found a decrease in longevity for all age groups of Christian Scientists.

Of course, those studies looked at the life expectancy of adults.  Christian Science children do not get vaccines and as a result, get diseases like measles and as a result, people die . Of measles.  That is so 19th century.

Children of Christian Scientists occasionally die of diabetes and trauma that could otherwise have been treated or cured. Christian Science is not a healthy lifestyle and demonstrably shortens life expectancy.

So why would our Senate give incentives to people to seek prayer for their diseases?  As I said, I cannot imagine a politician deliberately pandering to voters endorsing a useless intervention that demonstrably kills and maims. Unless.

There must be a reason.  And the only reason I can think of is that the conspiracy wackaloons are right.  The government is out to get us.  Costs are going up in health care and the best way to save money is to encourage people into worthless treatments that will lead to their early deaths.  That is the surest way to keep health care costs down.  So it makes sense for the government to encourage people to use alternative medicine and pay for Christian Science.  Worthless therapies offer far more promise to thin the herd than the H1N1 pandemic or HIV.  And they sponsors look like they are being good guys in the process.  It is absolutely diabolical.

And yet.

The government, in its occasionally schizophrenic approach, is also funding comparative effectiveness research as away of improving care and decreasing costs by demonstrating what works. Given the current track record of alternative therapies, if comparative effectiveness research bears any fruit, it will probably be the death knell for alternative therapies.  In the end alternative therapies will not have a prayer.

I have shaved my goatee.  We are returned to the previous time continuum.

Posted in: Faith Healing & Spirituality, Humor, Politics and Regulation

Leave a Comment (19) ↓

19 thoughts on ““Move along. Nothing to see Here”- F. Drebin

  1. a says:

    While I respect your argument regarding the usefulness of Christian Scientist “treatment,” I think you (and Congress) may be arguing the wrong point.

    Isn’t prayer usually free in most religions? If prayer is free, what would insurance need to cover? Doesn’t charging for prayer services mean you should lose your tax exempt status?

  2. Draal says:

    http://www.theness.com/neurologicablog/?p=1190
    If I was a smartass I would point out that the L.A. Times article was published Nov. 3 and Steve’s post was Nov. 5th. Maybe Rocinante needs some PRP therapy (hey, that rhymes) to get back in the race? “I kid, I kid.” -Triumph

  3. Dr Benway says:

    They took the prayer bit out of the house bill but not the senate bill. Or so I was told.

  4. Pieter B says:

    “Christian Scientology, er, no, it must be Christian Scientist”

    Funny I was thinking the exact same thing as I read the CS blurb. “If only they could jazz this up with some space aliens, it could be huge!”

  5. Calli Arcale says:

    a:

    Isn’t prayer usually free in most religions? If prayer is free, what would insurance need to cover? Doesn’t charging for prayer services mean you should lose your tax exempt status?

    Religions as a whole cannot get tax exempt status. This is because taxes don’t really apply to ideas and social networks and things. But religious organizations can apply for and receive tax exempt status. So the presence of a for-profit entity calling itself Christian Science would not preclude a non-profity entity also calling itself that from getting tax exempt status.

    Also, tax exempt status doesn’t mean you can’t charge money for services. You’re not supposed to turn a profit, but you can charge money to cover the cost of services that you provide. For instance, it is commonplace for churches to charge a fee for weddings. (At my old church, it was $200 unless one or both of the happy couple were members of the congregation. If was free if you were a member.) Non-religious non-profits can also charge money. Consider that many zoos, museums, etc charge an entrance fee, yet are non-profit organizations. The Red Cross and Memorial Blood Centers do not just give blood to hospitals; they sell it. And of course all hospitals, even the non-profits, generally charge money for what they do. They would quickly go bankrupt if they didn’t.

    So charging a fee for prayer does not invalidate their tax-exempt status. It does raise some rather pertinent theological questions, however, and I do think it is wrong to charge money for prayer. Renting church space, that’s one thing. It costs money to maintain the space, after all. But prayer should be altruistic or it isn’t true. I think we Christians had a bit of a to-do about that around, oh, 1518 or so. (One of the big issues of the Reformation was the sale of indulgences.)

  6. Draal says:

    Just imagine Benny Hinn and Reinhard Bonnke charging health insurance companies for their “services.” Bleh.

  7. edgar says:

    Great post however, I would like to complicate things a bit. Let’s talk about mental health. How does spiritual practice fit into mental wellness. Especially when related to historical trauma?

  8. overshoot says:

    edgar:

    How does spiritual practice fit into mental wellness. Especially when related to historical trauma?

    I don’t really see the point, but there really isn’t much controversy over the historical role of spiritual practices such as the Crusades, Inquisition, Thirty Years War, etc in causing medical trauma. Or for that matter disease, such as the well-documented increase in Plague following the Crusades or TYW.

  9. micheleinmichigan says:

    I’m relieved to hear that language was dropped. I was reasonably livid that our insurance company can deny a mainstream medical device based on an insufficient evidence rational yet might be required to pay for religious healing.

    “The government, in its occasionally schizophrenic approach, is also funding comparative effectiveness research as away of improving care and decreasing costs by demonstrating what works.”

    I’ve been wondering about this comparative effectiveness stuff. I couldn’t quite decipher the linked article. (at least not today.) A plain english interpretation would be appreciated. I heard about it and I think some work being done at the Mayo Clinic, on NPR.

    I’m curious how or if it will effect patients with very individualized care needs. My son has two separate congenital differences that suggest a genetic syndrome. We had to do quite a bit of expensive testing to confirm that his heart was up to snuff and that he had the recommended number of kidneys, etc.

    Also his surgical needs are above average. They are by no means experimental, but there is a certain amount of “Well MAYBE if we do this surgery early we won’t have to do that more invasive surgery later” So the doctor openly makes recommendations based on his surgical experience, since the data, evidence for that particular situation is not available. I don’t think this is unusual.

    I just wonder if the a comparative effectiveness program will more likely be a help or a hinderance to this sort of situation. Crystal Ball anyone?

  10. If prayer is free, what would insurance need to cover? Doesn’t charging for prayer services mean you should lose your tax exempt status?

    A about a month ago I explained that by quoting Rita Swan of CHILD.

  11. DLC says:

    Ahh yes… Sen. Harkin and his “discrimination against health care practice”
    Um. . . Senator . . . with all due respect, we discriminate against that which has been proven time and time again to Not work. It’s not wrong to not do something that doesn’t help the patient, Senator. As hard as that may be for you to understand.

  12. windriven says:

    @ edgar

    I hope that you will amplify your thoughts and that the alouatta caraya in the community will think through the implications of this before they post. Various ‘faith based’ and otherwise spiritually informed treatments for alcoholism, drug abuse, PTSD and other conditions that have strong mental or behavioral components have achieved some success – and can sometimes be compared quite favorably with treatments offered by mainstream medicine. The possibility that such success derives largely from dependence transference might be compelling but (and this is not my field) I am not aware of careful research examining this.

    The point is that while we point and snicker at wackaloons who claim to treat diabetes with prayer, some clever alpha wackaloon is going to trot out the apparent success of some flavors of spiritual woo in mental health settings thereby getting the camel’s entire forequarters through the door.

    Just sayin’…

    All the sturm und drang surrounding the healthcare debate so far isn’t very meaningful. What really matters is what comes out of conference committee where the real healthcare bill will be shaped. Those who overestimate the commitment of our elected representatives to rational thought or who underestimate the ability of the woo-meisters to package vaguely plausible arguments with the inchoate threat of millions of crystal-gazing, echinacea-guzzling VOTERS will be disappointed.

    Make sure that your representative and both of your senators know precisely how you feel about your tax dollars supporting carefully deodorized bullshit. If you don’t know who your representative is, go here: http://www.house.gov/zip/ZIP2Rep.html

    If you don’t know who your senators are, sign up for a remedial civics course and then go here: http://www.senate.gov/general/contact_information/senators_cfm.cfm

  13. The Blind Watchmaker says:

    If it passed, I was interested in finding out the CPT code for therapeutic prayer. To limit this reimbursable service to Christian Scientists would be discriminatory.

    If enough doctors started attaching this code to the list of services on the billing slips, I think the legislation would be overturned quickly (if it went through, which it didn’t, apparently).

  14. edgar says:

    my point is that we discount faith based healing as it concerns the physical body, quite rightly so, at least when it come to payer.

    This distinction loses a bit of clarity when we apply it to mental health services. As I have stated before, I work in Indian country. Mental health services have failed to undo the damage left my historical trauma (which is not limited to centuries ago, specifically I speak of the boarding school movement). When often spiritual healing is critical to the success of a positive outcome, as that is what is culturally relevant to Indian people. The traditional ‘psychoanalysis’ method that we are all aware of is deeply rooted in culture, and as such may not be appropriate for all. If culture and faith cannot be separated from each other where does that leave us in terms of providing quality mental health services that has positive outcomes, especially when culturally traditional forms of healing are utilized?

    This is a pretty new area (new, and ancient at the same time), and difficulty arises when you throw the ‘R’ word into the mix in Indian country, especially when it relates to spiritual practice. Who owns the data? It seems clear to me, but other researchers do not agree. Are practitioners willing to part with it? Read up on unethical research in Indian country. It still goes on.

    here is the bottom line: Indian people may speak up and say that psychotherapy (for lack of a better term, I speak of all aspects of mental health services as we know then) is not appropriate for them, it is not their way. They have a way that works for them, and has for a very long time… And our response is what? That it isn’t evidence based? That there is no data? That they must do it the EBM way?

    I am a firm proponent of EBM, but I mean to throw a wrench in the works to say that things aren’t always so clear, especially when dealing with mental health services.

  15. windriven says:

    Edgar, I am so far out of my depth here that I am hesitant even to write. I know precious little of the native American experience or of mental health services in that community. Perhaps someone with credentials in this are can address some of your specific points.

    But I will say that there is nothing inherent in EBM that is at odds with what you describe as spiritual practice. Your broad conjecture is that Indian spiritual practice offers better outcomes for this subset of humanity than does psychotherapy. It would appear simple enough to construct a study that confirmed or disproved this conjecture.

    If your broad conjecture proved true than it would seem an interesting area of research to determine what elements of Indian spiritual practice generated these benefits, why these practices appear to work, and whether these practices were applicable to other populations. This is science at work.

    If, on the other hand, your conjecture is disproved, would you wish to wrap your people in a cloak of ignorance while time and tide passes by? How does that punctuate the tragic history of the Indian nations over the last 250 years?

    Are you perhaps confusing cultural, social and political issues with medical ones? For instance are most psychotherapists working in the Indian community white? Would the outcomes be different if the therapists were native American?

  16. edgar says:

    “Edgar, I am so far out of my depth here that I am hesitant even to write. I know precious little of the native American experience or of mental health services in that community. Perhaps someone with credentials in this are can address some of your specific points.”

    That is what this blog is for, right to learn stuff?

    “But I will say that there is nothing inherent in EBM that is at odds with what you describe as spiritual practice. Your broad conjecture is that Indian spiritual practice offers better outcomes for this subset of humanity than does psychotherapy. It would appear simple enough to construct a study that confirmed or disproved this conjecture.”

    That is the crux of the problem, Indian people and Tribes are incredibly wary of this study idea, although more and more Traditional practitioners are willing to step forward and DESCRIBE their work. Also, may of the ceremonies and rituals are supposed to be secret. Sort of like saying “So you went to confession, and you felt better. In order to determine if confession really worked, you need to tell us exactly what you said.” Although there is getting to be more and more emphasis on Community Based Participatory Research, especially in Indian Country, so this might just change in the future, as trust relationships are built. I am currently designing a surveillance system (I work for a regional Tribal Epidemiology Center) for a Traditional Practitioner who works in the clinic and who is given referrals by the MD mental health provider. That data will belongs to the Tribe and the practitioner. Who knows what they will do with it? It is their decision to make. As I mentioned before, historical trauma is very real, and it affects even practitioners…Who were told for generations that their ways were wrong. Add to that the private nature of such things, and past abuses by outside researchers, and you can see the problem.

    “If your broad conjecture proved true than it would seem an interesting area of research to determine what elements of Indian spiritual practice generated these benefits, why these practices appear to work, and whether these practices were applicable to other populations. This is science at work.”

    It is science at work, but it has been also used incorrectly, and has been a sensitive area of cultural misappropriation (as in the recent case of the sweat lodge deaths). I am also unsure that spiritual practice can be picked apart that way. At the very least, that would impact the very spirual-ness nature of the treatment. I do not think they are applicable to others, at least in their concrete form.

    “If, on the other hand, your conjecture is disproved, would you wish to wrap your people in a cloak of ignorance while time and tide passes by? How does that punctuate the tragic history of the Indian nations over the last 250 years?
    Are you perhaps confusing cultural, social and political issues with medical ones? For instance are most psychotherapists working in the Indian community white? Would the outcomes be different if the therapists were native American?”

    Cultural, social and political issues generally cannot be separated from medical ones in Indian country. As for the cloak of ignorance, that is a tough one. I see what you are saying, do we perpetuate something that ‘doesn’t work’ medically speaking, about what would be the implications of doing so? A new method of telling a population that their ways are invalid?
    Thanks for the discussion.

  17. momkat says:

    “my point is that we discount faith based healing as it concerns the physical body, quite rightly so, at least when it come to payer”
    The point of the legislation is not to discount faith-based healing, but rather, do we, as taxpayers, pay for a particular treatment shown to be useless. If a non-standard treatment works in a particular setting, then by all means, use it. But don’t expect the taxpayers to pay for it unless its efficacy can be established.

  18. Overshoot sez: “I don’t really see the point, but there really isn’t much controversy over the historical role of spiritual practices such as the Crusades, Inquisition, Thirty Years War, etc in causing medical trauma. Or for that matter disease, such as the well-documented increase in Plague following the Crusades or TYW.”

    Ah, the old “Christianity is evil” line. What a classic. It comes in many varieties, but I especially savor the old “Crusades” line. Ah, Yes, yes, yes. How true. The Crusades. Enough said. we are all scientists here. we have no need for spirituality. Yes, indeed. The Crusades. Jimmy Swaggart. Jim Jones. Yes, indeed, Christianity is evil. Need I say more?

    Well, let’s see. We could question our knee-jerk assumptions and look at the evidence, or we could mention the Crusades anytime Christianity is mentioned.

    Probably nearly all of us healthcare-based people have worked, at some time, at Christian-founded hospitals. Sure, nowadays they are bereft of such values, but somehow those Christers developed a model that continues to thrive, providing an amazing bulk of hospital-based care, despite the shift to a mere tax-evading survival strategy. In fairness to Christianity’s roots in Judaism, let’s throw in the “Sinai’s,” too. What’s in a name. I know – not much anymore.

    OK, OK, so maybe a scrap of good was once done by a Christian. Or Jew. but, the Crusades! For Pete’s sake ! The Crusades! Jimmy Swaggart!!

    And, foreign aid. Evidence: private, Christian-based foreign giving dwarfs United States foreign aid. Dwarfs.
    http://www.america.gov/st/washfile-english/2007/May/20070524165115zjsredna0.2997553.html

    Going to every corner of the globe. Wait, the globe is not square! It has no corners! Therefore, that is no argument! The Crusades! Benny Hinn!!

    Doh! I would have gotten way with the Christianity-Is-Evil ruse if it weren’t for you pesky kids! But still the Crusades! Benny Hinn!! and what-s-his-name who would speak in tongues on command? Tilton!! Yes, Tilton!! The one who did not actually pray over those prayer-request-with-checks! Yes, Tilton!!! That, my dear friend, is not called an “anecdote,” but is PROOF!!! And the Crusades!!!

    Per ‘National Philanthropic trust:’
    “The 5 Largest Nonprofit Organizations
    United Way of America ($4.2 Billion)
    Salvation Army ($2.0 Billion)
    American Cancer Society ($1.0 Billion)
    Food for the Poor ($1.0 Billion) [FeedTheChildren, a Christian organization]
    YMCA ($1.0 Billion)

    But, but, but – the Crusades!! Ted Haggart! Billy Swaggart! Jim and Tammy Faye! and the Crusades!

    And most of those blue-hair volunteers in your hospital? Yep. Most of the volunteers at your local polling place every school board election? Yep.

    But carry on. We are all enlightened here, and don’t need something like data to spoil a perfectly good theory. Yes, The Crusades. Ahh. A classic. Those evil Christians. And the medical harm of spirituality. Need I say more? No, it was enough just to mention the Crusades. Sorry I could not work Hitler, too, into this line of argument about the evils of spirituality. Just the Crusades.

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