In contrast, MedPage Today Editor-at-Large and former editor of the Journal of the American Medical Association, George Lundberg, has written a post called The Effect of Therapeutic Touch is Based on Pure Chance. In it, he makes a bold set of statements regarding alternative therapies: “There is no alternative medicine. There is only medicine.” Well, let’s not confuse bold with bull.

What starts out as a lecture, arguing that the only health care therapies with value are those based on hard scientific methodology and evidence, ends as a diatribe, lacking clarity or logic. The main problem with it is that Lundberg begins with an arrogant statement, then goes on to support his position with a single thirteen-year-old study regarding one small subset of alternative therapies. In fact, the particular therapy upon which he unleashes his venom (Therapeutic Touch, a modern variation of the ancient “laying-on of hands”) is in no way representative of alternative medicine as a whole. Curiously, it also does not have a track record for harm. Lundberg fails to identify even a single safety concern, but simply whines that there is no basis for its effectiveness. Then he contradicts himself by observing: “even the non-touch of an individual believed by a sick person to be a healer can heal.”

The article ends with with a check-in to “the arbiter, Mr. Google,” finding more than two million hits for the search term “Therapeutic Touch.” He follows this observation with, “Such are the ways of the world. There ain’t no justice. They know not what they do.” The jump he makes here is clearly absurd. Using the same illogical approach, I checked with Google and was returned 2.6 million hits for the search term “drug recall.” What does this mean? Without evaluating content, absolutely nothing. There are no conclusions to be drawn, no judgments to construe. It’s all nonsense.

Unfortunately, even without supportive evidence for their assertions, articles like these can be influential, especially when written by field experts with impressive credentials. In the case of this post, it’s most important to question Lundberg’s assumption that his definition of medicine is meaningful to anyone other than him. Would you want another person dictating the choices made available to you? Is it the job of the doctor to tell you what qualifies as therapy, or to withhold options that he doesn’t like? In my opinion, it is the duty of the physician, as a service provider in the health care industry, to educate his patients in a manner that respects each one’s values. This involves presenting choices – including those that might not be the doctor’s personal favorites, disclosing associated risks and benefits, and answering the patient’s questions in a way that helps him make the best choice for himself. Because, at the end of the day, it is you, the patient, who must sign-off on your medical decisions and assume full responsibility for them. Don’t you think, then, that you deserve to be as informed as possible?

I think that there is confusion around the meaning of comprehensive health care reform. Many in the media and government (no finger pointing here) have equated the idea of reform to socialized medicine, and worry that it will both be expensive and take away our freedom to choose private health insurance plans. Over and over again, it has been reiterated by President Obama that this will not be the case. The President admits that health care is complicated, and so, instead of drafting specific proposals, he has set forth general principles and has called on Congress to draft appropriate legislation [1]. These guiding principles are as follows:

• reduce long-term growth of health care costs for businesses and government;
• protect families from bankruptcy or debt that is due to health care costs;
• guarantee choice of doctors and health plans;
• invest in prevention and wellness;
• improve patient safety and quality of care;
• assure affordable, quality health coverage for all Americans;
• maintain coverage when people change or lose their jobs;
• end barriers to coverage for people with pre-existing medical conditions.

John Mackey, co-founder and CEO of Whole Foods, has offered some thoughtful plans for solving our health care dilemma too, which he wrote about in a Wall Street Journal Op Ed. He states in the title that these ideas are an alternative to “ObamaCare,” but I think many of his proposals are well-aligned with the President’s guidelines, and should be seriously considered. They are [3]:

• “Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs). The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems.”
• “Equalize the tax laws so that that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.”
• “Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.”
• “Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.”
• “Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor’s visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?”

Regardless of anyone’s particular stance or perspective on the issue, I think we can all agree that the status quo for health care in this country is not working. American citizens may not be entitled to health care, but it is likely that we would be better off as a nation if a humanitarian approach to this problem was taken. “The stakes are high,” says Jessie Gruman, PhD, President of the Center for Advancement of Health in Washington, DC. “Essentially this debate is about whether having a bad diagnosis like cancer bankrupts your family, whether people have to choose between feeding their kids and getting health care, whether being sick and losing your job means you also lose your health care. This is what’s on the table. That’s why it’s vital [1].” For those who haven’t yet been affected by health care issues in life, it’s easy to be apathetic at this point. Keep in mind, however, that if too many of our citizens fall, eventually we all do. Let’s get started with the basics for everyone before we’re all feeling the pain.

Health Care Fact Sheet (.pdf)
What You Can Do to Reform Health Care (.pdf)

References:
1. Zablocki, E; Pathways to Healing; Townsend Letter, July 2009, pp. 23-25
2. MacDorman, M and Mathews, TJ; Recent Trends in Infant Mortality in the United States; CDC National Center for Health Statistics Brief; Number 9; October, 2008; http://www.cdc.gov/nchs/data/databriefs/db09.htm
3. Mackey, J; The Whole Foods Alternative to Obama Care; The Wall Street Journal Opinion Journal; August 12, 2009; http://online.wsj.com/article/SB20001424052970204251404574342170072865070.html