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Taking On Homeopathy in Germany

Homeopathy is having a bad year. From a scientific point of view, it has had a couple of bad centuries. The progress of our scientific understanding of biology, chemistry, and physics has failed to confirm any of the core beliefs of homeopathy. Like does not cure like (this is a form of superstition known as sympathetic magic, with no basis in science). Diluting substances does not make them stronger – a notion that violates the chemical law of mass action and the laws of thermodynamics. And countless clinical studies have shown that homeopathic preparations are nothing more than placebos. That homeopathy cannot work and does not work is settled science, as much as it is possible for science to be settled.

Despite the science, homeopathy has persevered through a combination of cultural inertia and political support. But in the last year there are signs that this trend may be reversing. In the UK The House of Commons Science and Technology Committee (STC) released a report, Evidence Check 2: Homeopathy, in which they conclude that homeopathy is failed science and should be completely abandoned – no further support in the NHS and no further research.

Following that the British Medical Association has openly called for an NHS ban on homeopathy, calling the practice “witchcraft.”

Now German politicians are starting to echo the same sentiments.

Karl Lauterbach, the centre-left Social Democrats’ chair on the Bundestag health committee, told German news magazine Der Spiegel that insurers should be “prohibited from paying for homeopathy.”

and

According to Spiegel, Rainer Hess of the Federal Joint Committee for doctors and insurers also characterized the current situation as “extremely unsatisfactory.”

The common thread in the UK and Germany is rising health care costs, which is creating the political will to oppose worthless interventions like homeopathy. Up until now systems like homeopathy which are not science-based have received political support from individual believers and promoted largely through the notion of “health care freedom.” But the political climate is changing, and suddenly paying for interventions that do not work seems unnecessarily wasteful. This creates an opportunity to focus attention on interventions like homeopathy.

In Germany, as in the US, homeopathy has received support from individual politicians. According to the cited news article:

“There have already been many attempts to drop protective provisions on such remedies, but influential politicians have consistently prevented this from happening,” Hess said, adding that despite hundreds of medical studies failing to clearly prove the benefits of homeopathics, insurers are still made to pay for them.

It sounds like Germany has had their own Tom Harkin and Orin Hatch to contend with. Political support for homeopathy in the US actually goes back much further. In 1938 Senator Royal Copeland from New York, a homeopath, managed to insert into the new FDA regulations automatic approval for homeopathic products. This situation continues to today – homeopathic products do not require any testing for safety and efficacy.

It is good to hear that politicians in Germany are now openly discussing not only removing the protections that force insurance companies to pay for homeopathy, but actually banning insurance companies from paying for it. This would be similar to the BMA proposed ban on NHS support for homeopathy.

In both cases no one is proposing that homeopathy itself be banned. If an individual wants to pay for water in the mistaken belief that it is an effective remedy, they are free to do so. However, the seller should not be free to make misleading or fraudulent claims – but that is a different type of regulation. What is now being discussed in Germany and the UK is simply preventing public money from being spent on treatments which have already been proven not to work.

I would like to see these efforts spread to the US. We are facing our own health care crisis here, with a new focus on cost-effective medicine. Amazingly, Harkin was able to hijack efforts to deal with the situation (through “Obamacare”) to increase public support for unscientific medicine. This trend needs to reverse – and homeopathy seems like the low-hanging fruit to me.

With homeopathy the science could not be more clear, and recent exhaustive reviews, like Evidence Check 2: Homeopathy, have shown that it simply does not work. It should therefore be an easy political position to take, that our limited health care dollars should not be spent on ineffective medicine.

Posted in: Homeopathy

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28 thoughts on “Taking On Homeopathy in Germany

  1. Smiles302 says:

    Go Germany!!!

    I am hoping Ireland will follow suit from England. The only “proof” expected of homeopathy here is a homeopathic proving… All the Irish Medical Board looks for. Sound like a scary joke.

  2. kirkmc says:

    I would like to see something like this happen in France, where I live, but it will never happen. Several years ago, when the government suggested reducing the percentage for which the national health system reimburses homeopathic remedies, the manufacturers started a petition drive in pharmacies and got plenty of people to sign them.

    Also, the political pressure is very high: the biggest homeopathic manufacturer in the world – Boiron – is French, and represents a lot of jobs, as well as exports.

  3. kirkmc says:

    BTW, I will admit that when I was younger, and more foolish, I went to homeopathic doctors, _because_ the national health system reimburses both visits and sugar pills. I assumed at the time that if they were reimbursed, this meant they were serious. I’ve since been disabused of such notions.

  4. xwolp says:

    A few things about the situation that should also be considered:

    Currently, homeopathic remedies are not paid for by the health care plans in Germany. They are just to cheap and so they join the ranks of most herbal and over the counter medicine.

    The main issue here is compensating patients for homeopathic consultations and other practices which are of course rather time intensive

    As it stands, homeopathic practices are mostly paid for by smaller health care plans which tend to do better than the big ones that inevitably have a lot of seniors in them. Some people have described homeopathy as a bait to gain mainly younger, more affluent people with higher education like academics (a demographic whose fondness for woo has been documented for a long time)

    Personally, I find it weird that anybody would reach for “medication” that avoids making any claims whatsoever. As it stands, a lot of homeopathy in Germany carries the disclaimer “homeopathic remedy, thus without therapeutic indication”. The only way you’d buy such things is if they get recommended by your “consultant”, something which sadly most people are willing to pay out of pocket.

  5. stavros says:

    That would be great news if it happens. German his one of the strongholds of homeopathy in Europe. France being the other one. Unfortunately, Greece also provides fertile ground for woo like this because not many people actually care to… care!

    At least in UK there seems to be some light at the end of the tunnel, but then you get the occasional bullshit in popular media:

    http://www.guardian.co.uk/commentisfree/2010/jul/15/homeopathy-works-scientific-evidence

    and take a step back in public awareness…

  6. ccbowers says:

    Now that we can measure such extremely dilute concentrations of chemicals in our drinking water, we dont need homeopathy. Just drink tap water… by the same rationale it should cure everything. I drink a glass or two everyday

    On a serious note – things are a little more complicated in the US. In order to have change regarding homeopathy, action would have to be taken at the federal level, and (depending on what action was taken at the federal level) individual states may have to pass legislation as well. There is no political push to do this.

    Of course the federal government could fix this by themselves with robust legislation, but we can’t even get support for more conservative reform like the DSSA. Thank Orrin Hatch for that…he puts his mouth where his money is.

  7. Draal says:

    I hear foot steps approaching. Hello? Dana, is that you?

    DANA?!!!!

  8. lizditz says:

    Here’s a start:

    a petition to WalMart, asking the company to remove homeopathic products from their stores:

    http://www.thepetitionsite.com/petition/969/675/763.

  9. Scott says:

    BTW, I will admit that when I was younger, and more foolish, I went to homeopathic doctors, _because_ the national health system reimburses both visits and sugar pills. I assumed at the time that if they were reimbursed, this meant they were serious. I’ve since been disabused of such notions.

    And this is exactly why it’s so pernicious to have woo be state- or insurance-funded.

    My story’s similar in spirit. In my case it was a chiropractor (insurance pays for it so it must work, right?). When he made my lower-back pain worse (passed off as “the spasm is releasing” and “it has to get better before it gets worse”), and insisted that I had to come see him twice a week forever, I started getting suspicious and doing some research. Found Respectful Insolence, then SBM and Quackwatch, never looked back, and now I’m a wiser and more skeptical person for it.

    It reinforced the results when my PCP was aghast at the chiro’s recommendations, more so when moving my wallet from my back pocket was far more effective than anything he did, and especially when an xray done for legitimate reasons showed that the one he’d shown me wasn’t OF me…

  10. crf says:

    The large private company Bosch has much of its shares owned by a family controlled German charitable foundation. This foundation (amongst other mainstream good works) finances a Homeopathic hospital housing the papers of Samuel Hahnemann.

  11. Gabor Hrasko says:

    This September at the 14th European Skeptics Congress (Budapest, Hungary) there will be a workshop about CAM in Europe and how to react internationally.

    I am happy to announce that Andy Wilson, Board member of Merseyside Skeptics Society and co-founder of the 2010 10:23 campaign will provide a lecture: How to take an “overdose” – The story of the 10:23 campaign.

    There will be other CAM related lectures as well with Simon Singh, Willem Betz, Michael Heap, Gergely Röst, Amardeo Sarma etc.

    I hope that with international co-operation we will be able to support this anti-homeopathy process in the region.

    Come and register at: http://congress2010.skeptic.hu/

    Gabor

  12. lizditz says:

    One of the things that happened to make 2010 such a bad year for homeopathy was the UK’s 10:23 campaign which was the brainchild of the Merseysides Skeptic Society. The campaign began with An Open Letter to Boots, and went on to the “Mass Homeopathic Overdose” on January 30 2010.

    There isn’t an institution like Boots in the US — it is synonymous with health care. Walmart doesn’t have that resonance, but it is one of the largest (if not the largest) pharmacy companies in the US, hence the petition, above.

    The U.S. health care system is so much more fragmented. It will be difficult to have something like the10:23 campaign at a national level in the US.

  13. Epinephrine says:

    I’m not sure how I feel about testing for safety and efficacy of homeopathy. The Canadian system (which has been examined and criticised at http://sciencebasedpharmacy.wordpress.com) has an approvals process for homeopathy, but it results in spending a lot of money to review sugar pills. While the pills should be safe, they certainly don’t have to demonstrate effectiveness (nor could they).

    On the one hand, safety testing is a necessity – especially given the adulteration of products in “alt-med” with active drugs (e.g., sibutramine, estazolam, tadalafil). On the other hand, it’s a large investment in resources and lends the appearance of legitimacy to homeopathy – giving homeopathic medicines their own drug identification numbers certainly makes it seem like the pills must do something.

    I should note that I work in drug regulation, though not in natural health products. I’m comfortable knowing that my work helps ensure the safety and effectiveness of medicine; I’m just not certain whether it should really be extended to pills that can’t actually demonstrate any effectiveness. Perhaps homeopathic preparations could be licensed like food products, guaranteeing that the manufacturing was clean and that they have lots tested for impurities. This could provide sufficient safety, and would also make a clear distinction between novelty items like homeopathic pills and actual drugs.

  14. daijiyobu says:

    Re: “the common thread in the UK and Germany is rising health care costs, which is creating the political will to oppose worthless interventions like homeopathy.”

    There’s an interesting similarity therein with the Madoff Ponzi scheme: it took the global recession to cause enough investors to pull money out of his fund [due to the pressures of the recession, even while they were making money in it] causing its collapse.

    Seemingly, it took similar fiscal pressures to cause, hopefully, collapse of funding for homeopathy WORLDWIDE.

    But, perhaps there’s a larger ethical aspect to this.

    Homeopathy in both Germany and the UK is a very very small part of their total expenses.

    So, though partly fiscal, it seems largely ethical: “hey, lets save money where ever we can. Hey, look at this crappola we’re spending money on. It’s not much money, but it’s a lot of crap.”

    -r.c.

  15. BillyJoe says:

    kirkmc,

    “I’ve since been disabused of such notions.”

    That’s a typical James Randi phrase so I’m guessing that it was he who disabused you of such notions.

  16. xwolp says:

    @epinephrine
    a friend’s cousin actually swallowed a bunch of “homeopathic” pills and had to be hospitalized. Now I don’t have the full picture and it could have just been a Nocebo effect… but given that he was a toddler it seems more likely they had some active ingredients in there.
    Then again, these “drugs” say that if you take them you might feel worse, that’s how it is intended. If it keeps getting worse, stop taking it and see a doctor.

    Gotta love these liability win-win situations.

  17. qetzal says:

    xwolp,

    I can also imagine a “nocebo effect by proxy,” where the parents’ over-reactions result in nocebo effects in the toddler – either by simple psychological reaction to the parents’ obvious stress and fear, or as a result of any actions the parents might have taken, e.g. to induce vomiting.

    If you have a chance to find out, it would be really interesting to know the identity of the pills in question.

  18. weing says:

    From what I know about homeopathic meds in the US, because of the dilutions, they end up containing just alcohol and water and are regulated by the FDA. I don’t know if there is a similar regulatory oversight in other countries, so that these “homeopathic meds” may actually end up having other ingredients besides just alcohol and water.

  19. Scott says:

    Not all products labelled “homeopathic” are diluted into nothingness, remember. Zicam, for instance. Ironically, the ones homeopaths claim are weakest are the least likely to have a non-placebo effect and the most likely to have side effects…

  20. Scott says:

    Bleh, that “least” should have been “most”. Editing fail; my apologies.

  21. Composer99 says:

    I’m surprised Dana hasn’t yet deigned to ‘grace’ this post with his presence.

    Also, re xwolp’s friend’s cousin, there is also the possibility of a manufacturer error, such as what led to Gary Null getting poisoned by his own vitamin supplements.

  22. TsuDhoNimh says:

    “especially when an xray done for legitimate reasons showed that the one he’d shown me wasn’t OF me…”

    OH REALLY? So maybe he had one X-ray he trotted out for everyone and his X-ray equipment was shooting blanks?

  23. Scott says:

    OH REALLY? So maybe he had one X-ray he trotted out for everyone and his X-ray equipment was shooting blanks?

    It wasn’t his equipment, but a facility shared with a decently large MD practice. So probably my real one just got thrown out and he trotted out, as you say, the one X-ray he uses for everybody.

  24. Alexie says:

    Don’t get too excited by the discussion in Germany – Germany is woo central and the Germans would riot if their homeopathy was affected in any way.

    Go to a pharmacy here and you’ll quickly notice that herbal remedies sit on the shelves with the pharmaceuticals. Ask a pharmacist for cold medicine, and you’re likely to be told that the medication you want is too ‘strong’ and you should take a herbal preparation instead. Midwives prescribe peppermint tea for nausea. Doctors discuss herbal preparations openly. Your friends offer herbal remedies for any and all problems, promising you that it’s ‘natural’.

    What’s interesting is that Germany is the ancestral home of pharmaceuticals and drugs continue to be one of their most profitable exports – yet a huge number of Germans, up to and including doctors, prefer not to use them.

    What might change this is that the bureaucrats in Brussels are currently evaluating alternative remedies, in the interests of proper labelling. So far, a significant number of preparations they have evaluated have proven themselves worthless – and they are asking manufacturers to say so on the labels. A big, interesting and fun storm is brewing.

  25. Kultakutri says:

    Alexie, I wouldn’t discount herbs as a whole. Mint infusion works for indigestions pretty well, as anise does for bloating – it wouldn’t fix some severe condition but I’d say it’s perfectly okay for something like lunch too big or clogged nose. And I’m the who’d fight fiercely for her ebil chemicals like corticoids that keep me breathing all the time, not just in random intervals.
    I’m all for herbs and I recommend them to people – with the condition that they themselves must pick them on the mountaintops. Good hike surely helps preventing (now I sound like a woomeister myself) indigestions and stuff. And now excuse me, I’m off to gather some tansy for dyeing wool. I’m up in the mountains improving my asthma, that’s it.

  26. Scott says:

    Herbs have useful effects only to the extent that they are drugs. But drugs of unknown purity and dosage, without safety or efficacy studies.

    Favoring herbs over “real” drugs is rationally unsupportable.

  27. BillyJoe says:

    A follow-up of the story about Mrs Penelope Dingle who, with the encouragement of her husband, Dr. Peter Dingle, a media doctor, chose alternative medicine to treat her rectal cancer untill she was almost dead.

    http://www.watoday.com.au/wa-news/dingle-death-a-result-of-poor-science-20100730-10zcu.html?from=age_ft

    Dr. Dingle later married his wife’s homeopath.

  28. Scott
    “Herbs have useful effects only to the extent that they are drugs. But drugs of unknown purity and dosage, without safety or efficacy studies.”

    Favoring herbs over “real” drugs is rationally unsupportable.

    Scott, I think the examples Kultakutri gave are food herbs for mild self-limiting issues. I agree that there is no reason to favor a herb over drugs in a generalized way, but I believe there are time that a specific herb (or other home remedy) may have an advantage over the available drugs in the risk/cost/benefit equation for the individual patient. I thought that was what SBM was all about.

    For instance, I can not take the standard OTC cold medicines. The Pseudoephedrine and Phenylephrine both produce unpleasant side effect worse than the cold itself. I find that eucalyptus salve and ginger tea (whoops is ginger an herb or a spice) offers some mild relief to nasal congestion without side effects. I don’t generally favor herbs over drugs, but I don’t think it’s in my best interest in this instance to take the drug, when those specific herbs works sufficiently.

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