Universal Health Care?

Leigh Anne Jasheway-Bryant

It does require a leap of faith to believe that you can be cured by an 85-year old Chinese man whose office is next to a Laundromat and who makes his diagnosis based strictly upon your pulse and the color of your tongue (Word of advice: don’t eat Red Hots immediately before going in). Not to mention that he doesn’t speak English and everything he says has to be translated by his son-in-law.

[Editor's note: Today, our roster of regulars is joined by Leigh Anne Jasheway-Bryant, a humor writer, stand-up comic, and host of "Women Under the Influence of Laughter" - on KOPT, the progressive talk radio station in Eugene.]

How Universal?

Now that the Democrats are in control of the Congress and the Terminator is moving forward on it, universal health care is on the tip of everyone’s tongues again, if not on the top of their budgets. But just exactly how universal will health care be? If we end up with a system that simply provides the opportunity for every man, woman, and child in this country to see an M.D. for every sniffle, sneeze, rash, and unexplained eye tic, that’s not universal enough for me.

I consider traditional western medicine “alternative.” Or, to be politically-correct, “complementary.” If I get a headache, I’ll try everything – self massage, visualization, pet therapy, acupuncture, energy field work, karaoke, sorting my mismatched socks, calling my mother… Only if those all fail to provide a cure will I break down and take an aspirin. Calling a doctor is my last resort.

Many of my friends think it odd that I respond to the first signs of a cold by trying to align my chakras. But how is that odder than going to a doctor, sitting in a waiting room with other people who are coughing and sniffling, and getting a prescription for antibiotics that everyone knows do nothing to kill a cold, but somehow make you believe the visit was worth the time and effort? What’s so “alternative” about staying at home with a hot cup of tea and practicing deep breathing between sneezes? Especially since I don’t charge myself a co-pay.

The majority of Americans, however, don’t feel secure in their health choices without a framed piece of paper on the wall that assures them that their practitioner graduated from a major medical school, even if it was at the bottom of his or her class. If there’s not a sphygmomanometer, a prescription pad, and an exam table with stirrups (yee-haw!) they’re out of there faster than you can say “Do you have major medical?”

One of my friends goes to the doctor so often that if she wanted, she could easily build a replica of Howard Hughes’ Spruce Goose out of tongue depressors. When I mentioned that I was taking Chinese herbs to help with hot flashes and shoulder pain, she scoffed, “I just can’t make that big of a leap of faith.”

It does require a leap of faith to believe that you can be cured by an 85-year old Chinese man whose office is next to a Laundromat and who makes his diagnosis based strictly upon your pulse and the color of your tongue (Word of advice: don’t eat Red Hots immediately before going in). Not to mention that he doesn’t speak English and everything he says has to be translated by his son-in-law.

But is mine any more a leap than those made by the majority of the sick and injured in the U.S. every day? It takes a long jump to believe that somehow wearing a backless paper gown for half an hour is a vital part of getting cured, especially if your only problem is a funny-looking mole on your scalp. You need a trampoline to swallow the idea that drugs that can cause seven times as many side effects as your original ailment, including a side effect that IS your original ailment, can make you feel better. You have to be able to soar over buildings with a single bound to accept that a health practitioner who looks so young you suspect he eats paste at lunch can be trusted with your health because he is “up on the latest technology.”

Life is a leap of faith. Sure, there are some who are certain that if I feel better after visiting my “quacks,” it’s just because I THINK I’m better. But when it comes choosing between a shot in the arm or the placebo effect, I’ll take the placebo effect every time. And I don’t think it’s such a bad idea to have translators in all doctor’s offices.

Now we’ll just have to wait and see whether universal health care will cover that

Comments

  • urban planning overlord (unverified)
    (Show?)

    I hope for her sake (and the sake of anyone whose health care choices she controls) that Ms. Jaseway-Bryant is merely being whimsical and is not in fact a medical luddite.

  • (Show?)

    The author's "leap of faith" is actually a misnomer as there are numerous scientific studies that confirm the efficacy of different "alternative" approaches to health care for a variety of health challenges. The problem is that you don't hear about them because the mainstream medical media is controlled by pharmaceutical company interests and they can't make money when the public uses "alternative" treatments. Pure and simple.

    If you look at just Portland, we have accredited colleges for Chiropractic medicine, Naturopathic medicine, Oriental medicine, Acupucture and Massage therapy. We have state boards that regulate and license all of them. Their members have guidelines that must be followed. To think that they are "alternative" is not correct. They are as mainstream as can be. They are mainstream because they are effective and they work! Otherwise the marketplace would not keep them in business.

    In short, they should be covered in any universal health care plan proposed by the government. Not just because they are popular, not just because they are recognized by the government as legitimate therapies, but because they help people with out the use of man-made synthetic pharmaceutical drugs, as they have for literally thousands of years.

  • (Show?)

    They are as mainstream as can be. They are mainstream because they are effective and they work! Otherwise the marketplace would not keep them in business.

    When I was ten, a bunch of guys were helping my dad build our house. One of 'em had a heart attack and lay on the ground turning blue. The crowd decided that prayer was the proper treatment rather than that newfangled CPR crap. After all, they'd been using this method effectively for thousands of years. It "worked" too!!!

    When I was the designated Emergency Medical Technician on a construction job in Iran in 1978. One day a guy got nailed through the lung with a 16 penny nail gun. A mob of around 300 afghanis quickly formed around the injured man determined to stand him up and face him toward Mecca, so that he could die properly. They've been treating lung punctures that way for hundreds of years, so it obviously works.

    George Washington, of course was killed outright by quacks who had a similar level of scientific understanding to that of Ms. Jasheway-Bryant and Moses. Nothing was more "mainstream" at the time.

    Let's get that funding rolling. Hair of newt and eye of toad, I say.

  • (Show?)

    Yes, of course, acupuncture = prayer = quackery. Nicely drawn, if totally absurd.

  • Michelle (unverified)
    (Show?)

    The issue we should be discussing is not the benefits (or not) of alternative medicine.

    The real issue (that I hope this party has not lost sight of) is the family who has to hold a benefit dinner to cover the cost of their child's heart transplant, the woman who had to get her foot amputated because she couldn't afford preventative treatment for her diabetes, and the man who is now in a coma because government provided health coverage wouldn't pay for the medication that woud have prevented the seizure that put him in the coma in the first place.

    17% (nearly one in five)of Oregonians have NO health insurance. The number is even higher in rural parts of the state (one in four in northeast Oregon have NO health insurance). (Data from the Oregon Office of Rural Health).

  • Brian (unverified)
    (Show?)

    To anyone who would claim that acupuncture, naturopathy, homeopathy, chiropractic, energy field work, et al., provide any real health benefit beyond the placebo effect, there's a quick one million dollars to be had.

    Moses Ross, Jeff Frane, I'm lookin' at you (at least in this thread).

    What one does with all that money, of course, is entirely up to the successful claimant.

  • Greg Tompkins (unverified)
    (Show?)

    WAAAAH! People don't have health insurance!! WAAAH!!! You know how many times I have been without health insurance the last 10 years and I still paid out of pocket to go see the doctor. I think the plan to communize health care is going to be the last nail in America's coffin. Way to go, liberals! First, Venezuela, now the great Communist Republic of America.

  • (Show?)

    The responses I see here surprise me, considering that we are readers of a progressive blog in a progressive state such as Oregon. But in all actuality, it doesn't surprise me one bit.

    You see, to borrow a favorite phrase of my friend Mr. Ryan, we've all been drinking the Big Pharma kool-ade for a very long time, so long in fact that many people don't even know that its there, slowly being dripped into them like a morphine IV into a cancer patient. I use this example intentionally because Morphine has no value against illness except to kill pain, which is a symptom of an illness. Big Pharma's approach to health care is to deal with the symptoms of illness and not the underlying problems of the illness.

    Why do I say that? Because think about it, when you have a cold, for instance, what is the first thing most people do? They run to the store and buy some Nyquil or some sort of drug to deal with the symptoms of the cold. Why is that? Because a long time ago, agressive marketing campaigns by Big Pharma convinced the public that modern science can give you a pill and make you feel better. The quick fix. And that is that. They want you to relinquish personal responsibility for having a weak immune system, that caused the cold in the first place, due to poor diet or poor lifestyle habits and modern medicine will take care of you and fast, by you taking a little yellow pill. Ah, the marvels of modern allopathic medicine.

    What they don't tell you is that before the invention of Nyquil, Acupucturists in China would use their needles to activate certain nerve areas to stimulate the immune system response within the body, so that you could deal with and even prevent the cold from occuring in the first place. They don't tell you that there are certain naturally occurring plant compounds that act as natural histamine blockers, that have been used for centuries in Oriental Medicine. Why don't they tell you these things? Well, first and foremost, because, they can't patent natural compounds, meaning they can't make money from them, so its not in their best interest to tell you about these "alternatives".

    Now, I truly dislike the term "alternative" medicines because it comes across as an all or nothing approach to treatments. They frame it as either "traditional" medicine or "alternative" medicine. That contrast was created intentionally by your friendly folks at the AMA to discredit these other forms of treatment, specifically chiropractic. Even though Chiropratic Doctors are licenced to practice in all 50 states. Now before you start to dog me about bad mouthing the AMA, it was proven in a case that went all the way to the US Supreme Court that the AMA had engaged in an unlawful conspiracy in restraint of trade "to contain and eliminate the chiropractic profession." (Wilk v. American Medical Ass'n, 671 F. Supp. 1465, N.D. Ill. 1987). The AMA lost, by the way.

    Now let's face it, if I break my arm in a accident, I want drugs to kill the pain and I want a MD to set my break and put my arm in a cast. But at the same time, I would want a Chiropractor to make sure that my spine is aligned properly so that my mobility is restored. This is why I prefer the term "complemetary" therapies to describe these types of procedures.

    As far as the legitimacy of these "complemetary" medical approaches, Pat's example of a heart attack victim getting prayer "treament" and of being pointed towards Mecca is just flat out misleading. That person was done a disservice by those prayer fanatics and probably died because of it.

    Same holds true for Brian's post on the psychic "challenge". How does that even relate to what I was referring to??

    Once again, its the kool-aid talking.

    In my post I only refer to professions that are licensed and peer reviewed by state boards. You don't have to be certified to say a prayer but Chiropractors must be certified by the Oregon State Board of Chiropractic Physicians and Naturopaths by the Oregon Board of Naturopathic Examiners, etc.

    Chiropractic Doctors and Naturopathic Doctors both require extensive post graduate education for their state certification. Did you know that the educational requirements for both Chiropractors and Naturopaths are equal to or greater than Medical Doctors? We are talking a four year degree plus a four year degree from an acredited college plus any specialization post-college education, plus ongoing yearly continuing education requirements for licensure on a state and national level.

    So, in brief, there is ample evidence of the efficacy of "complemetary" therapies, not only in the marketplace, but in the scientific journals. As such, in my opinion and in the opinion of millions of patients each and every day worldwide, they should be included in insurance health plans and in any universal health care coverage that comes down the pike.

    And in response to Michelle's excellent point, yes, we should be focused on the high cost of health care and the lack of health care coverage for the majority of Americans and Oregonians. A main tenant of Complementary medicine is prevention. In fact, when you go to the Oregon Naturopathic Physicians Association website, on the front page they clearly state their five principles of practice: 1) The healing power of nature, 2) First do no harm, 3) Find the cause of illness, 4) treat the whole person and 5) the prevention of illness.

    Sounds like a logical approach to me.

  • JHL (unverified)
    (Show?)

    Greg, you have no understanding of the issue at all.

    Comprehensive coverage isn't getting considered because we like to help people out of the goodness of our hearts... the benefit is that it keeps MY business's health insurance costs down and keeps MY tax dollars down, and the savings I get much outweigh the costs incurred... and I'm talking dollars, not sunshine.

    I'd explain it to you, but it doesn't seem like you want to discuss the issue.

    Essentially, we use the money already in the system more efficiently... The phrase "a stitch in time saves nine" applies just as well to medical stitches.

  • (Show?)

    The fact that the AMA could legitimately be referred to as a "gang" with their own "colors" e.g. white lab coats, stethoscopes etcetera, does not automatically imply that their opponents in astrology, chiropractic, aroma therapy, etcetera are made legitimate by their opposition.

    I'm clear that big Pharma and big Medicine would be reluctant to do the double blind testing necessary to prove that some low cost and widely available "cures" actually worked. There's no money in it.

    However, it continues to be true, (and nothing in Moses' post indicates otherwise), that True Believers in.....well......non-medical medicine seem to have no interest in peer reviewed scientific results, beyond the gimme of 35% effectiveness offered by placebos.

    Just to refresh your memory Moses, in order for results to be scientifically acceptable, tests must be designed in such a way that your worst enemies doing the same test, will get the same results as you do.

    If they don't, it's junk science, and I am unwilling to pay for your access to it.

  • (Show?)

    Brian --

    The Million Dollar Challenge does not include, as you suggest, "acupuncture, naturopathy, homeopathy, chiropractic, energy field work"

    According to the FAQ on the site you link, it does include:

    Dowsing. ESP. Precognition. Remote Viewing. Communicating with the Dead and/or "Channeling". Violations of Newton's Laws of Motion (Perpetual Motion Devices). Homeopathy. Chiropractic Healing (beyond back/joint problems). Faith Healing. Psychic Surgery. Astrology. Therapeutic Touch (aka "TT"). Qi Gong. Psychokinesis (aka "PK"). The Existence of Ghosts. Precognition & Prophecy. Levitation. Physiognomy. Psychometry. Pyramid Power. Reflexology. Applied Kinesiology (aka "AK"). Clairvoyance. The Existence of Auras. Graphology. Numerology. Palmistry. Phrenology.

    Other than the fuzziness around chiropractic "healing", that million dollars doesn't seem to include what you suggest.

  • (Show?)

    Someone seems to have confused "alternative" medicine with the paranormal. Damn. There goes my million bucks.

    If acupuncture was only a "placebo effect" it wouldn't be used in so many hospitals for pain relief. My personal experience has included a separated shoulder and a treatment that gave me back nearly-full use of my arm in less than 24 hours, which was no placebo. And anyone who dismisses herbal treatments is just not paying attention -- not something you could say about the pharmaceutical industry which has been researching and utilizing herbal treatments for decades.

  • (Show?)

    I enjoyed this piece -- it's well written and humourous. I had a friend who was studying Chinese medicine and used me for practice. Though I've mostly stuck with Western remedies (out of habit, and I'm too busy to research the alternatives), I think there's something powerful in accupuncture and chiropractic care. Thanks for the post.

  • (Show?)

    This summer as part of my MPH program at OHSU I took a course on Complementary and Alternative Medicine (CAM) Epidemiology. As Leigh-Anne's piece suggests, the designation of what's "alternative" involves some presuppositions, a fact that we did address directly in the class. The MPH program is housed in the medical school and the course (though initiated by a student request to a prof) was offered as a regular course i.e. not specialized individual readings in the Department of Public Health and Preventive Medicine of the medical school. OHSU has a Center for Integrative Medicine, and has regular institutionalized relationships with both National College of Natural Medicine (formerly NW College of Naturopathic Medicine), Oregon College of Oriental Medicine and Western States Chiropractic College. The institutions share library access and resources.

    My point about this is that Moses Ryan greatly exaggerates the hostility and even more falsely asserts a homogeneity of hostile attitudes in "conventional" medical circles toward "CAM" -- which of course is a highly variable category. There certainly are some biomedical M.D.s and scientists who still want to dismiss "all of it" (whatever they may mean) as quackery. Probably they form a significant proportion though I believe such across-the-board dismissal is a minority. From my point of view, the broad-brush attitudes Ryan expresses are the mirror-image hostility. There are quite a lot of folks on all sides who, while primarily rooted in different traditions, are interested in "integrative medicine" i.e. looking for convergences, complementarities, mutual support.

    This seems sensible, because in practice most people are eclectic in how they seek health and healing. Recent studies by the NIH indicate that about 80% of Americans use some form of CAM, though the largest single category is prayer (ca. 60%) & with prayer excluded the figure drops to somewhere in the 40-50% range if I recall correctly. Of those who use CAM therapies and practices under either definition, the vast majority also use conventional medicine and doctors. It is important for health practitioners of all stripes to be aware of what else the people they work with or treat are doing or using, as combined treatments can either neutralize one another or cause harmful results, even if others support or complement each other.

    The most common attitude I see around "conventional" OHSU involves a degree of selective open-mindedness about the possibility that some "CAM" things might work for some things, combined with a desire for good evidence about which things work for what and how. Maybe I see that because it's a reasonable description of my own attitude :-). As a public health & prevention oriented person, I like the aim of many "CAM" practices toward wellness beyond treatment of illness, amd think holistic perspectives have much to recommend them. So do many of the med students and doctors and professors I cross paths with -- though my sample is undoubtedly biased being in the PHPM dept.

    But I'm more open to some things than others. Energy fields and homeopathy seem bizarre to me. Chiropractic is different, I'm afraid of it as much as anything else, don't really want anybody messing with my spinal column. I think the evidence shows acupuncture helps some people with some things, not sure I think it does with others. Why and how it works doesn't seem very clear, though the same can be said of various conventional treatments (also not clear how to intertranslate the Chinese bodily theories with biomedical physiology). Many other "CAM" practices seem likely to be health promoting in a general sense relating to issues of mind/ psychology/ spirit (though I personally don't see the world much in terms of spirit), stress, & nutrition. But their internal explanations e.g. chakras, seem to me to have a status like old European theories of bodily humors. At any rate the decontextualized, new-agey popularized for westerners versions seem that way.

    Ryan also is quite wrong to say that "CAM" therapies are not studied by conventional medical science and that positive results are suppressed. Actually there is an enormous literature in "regular" medical journals on at least some CAM therapies and practices, acupuncture certainly included, and specific herbal remedies, as well as others, and considerable amounts of it include positive findings, at least partially or to some degree.

    For example, for family reasons I have an interest in asthma, and read some interesting studies on Buteyko Breathing Technique (a quasi-yogalike practice rooted in Korea I believe) and asthma. They found that compared to general relaxation & asthma management training in one study, and that training plus a "sham" breathing regimen in another, Buteyko training after several months significantly reduced need to use short-term asthma medications via inhalers & also steroids. These medicines recognized by conventional medicine, which cannot cure asthma, to have significant health trade-offs in the long run, making it desirable to minimize their use.

    However, it is notable that these studies drew positive conclusions about the benefits of Buteyko breathing for managing asthma. However, if one goes to the website of the major international organization promoting Buteyko, there are links to the studies that misleadingly present them as supporting claims on the site that Buteyko has cured millions of people of asthma, for which there is simply no evidence. In addition to such wholly unfounded and not credible claims, considerable amounts of "CAM" research is not particularly well designed. As a result the evidence it provides is equivocal. This of course is also true of "conventional" medical studies. Such judgments about quality of research may be part of what Ryan means in claiming evidence of effectiveness is suppressed, but he is wrong at least in the sense that the same standards are applied to "conventional" research. The same applies to placebo effects too, btw -- they occur in both conventional and CAM studies, a fact that in itself probably plays a role in increasing "conventional" openness and interest regarding "mind-body" medicine.

    Despite interest in "integrative medicine" from "both sides," there remain some tough & in some cases probably irresolvable conflicts (apart from hostile prejudices on both sides). These mostly come at the level of ideas about how to know things, what kinds of things one wants to know, and understandings of how things work. This is not only an issue between western biomedicine and various "CAMS". The assumptions and understandings of body/ mind/ spirit underlying the Indian ayurveda tradition, Chinese traditional medicine, western Naturopathy and folk herbal traditions, western Homeopathy, as well as various "New Age" theories, are often not really the same at all, even if most of them invoke holism as a desirable attitude in the abstract. An eclectic Oregonian may combine attention to aligning chakras with acupuncture (and emergency appendectomies) but an acupuncturist won't have much to say a about chakras nor an ayurvedist about acupuncture.

    A final point -- I am not a big fan of "big pharma" at all, but that is mostly a function of thinking market mechanisms are actually a substantively bad way of handling health and medical issues in health terms, as well as being less cost-efficient than public mechanisms. I think research should be publicly funded and administered, with the results put in the public domain, that pharmaceutical "intellectual property rights" should be greatly circumscribed, and that a considerable amount of the restriction of direct pharmaceutical advertising to the public should be reinstituted.

    However, many of the same things that are wrong with "big pharma" are also problems with the "dietary supplement"/ patent medicine industry, largely unregulated since a federal law passed in 1994 excluded them from FDA purview provided they avoided certain types of health claims. While that law was supported by "health food" stores and coops which have an alternative veneer & sometimes genuine history, its main congressional promoter was Orrin Hatch, which ought to tell us something. Most of the herbal or natural remedies or preventives or other substances sold as dietary supplements or functional foods are quite as industrially processed and marketed as FDA-regulated pharmaceuticals, except that there is less control of actual content, less requirement of proof of efficacy, and less requirement to let the buyer know what's actually in them. Studies of the content of preparations of e.g. St. John's Wort (recognized in much conventional literature as a legitimate and sometimes preferable treatment for mild to moderate depression) or of echinacea or gingko biloba etc. (research much less consistent), have show huge variations in both quantity and even variety of the advertised herb as well as known or presumed active chemical agent. This is somewhat better regulated in Europe than the U.S. Herbs in less processed forms still vary in content, and effect with age/shelf life, and sometimes geographical origin.

    Moreover, partly because of American eclecticism, the food supplement marketers have found that adopting the rhetoric of biomedicine helps sell the stuff. When we choose to self-medicate, we face appeals to being alternative and natural combined with claims that substances are "clinically proven" (often quite dodgy claims) and/or claims about the scientific quality of production processes insuring uniformity of content. What does this say? Apparently many customers, while often skeptical of aspects of biomedicine or just finding it lacking something they need, still want the reassurance of science (in the most consistently produced, & thus least "natural" products) or the veneer of claims of scientific "clinical proof."

    This industry is no less out to make money off of people's illnesses and fears than big pharma, though it lacks monopoly patent protection in most cases & consequent artificial pricing power.

  • (Show?)

    Wow Chris, nice piece. I think that this could easily be promoted by Kari to "Guest Column" status.

    Just to clarify a minor point, I'm Pat Ryan. "Moses" is my pal Moses Ross. There is no Moses Ryan commenting on this thread.

    As for your excellent comment, I'd say if we had more folks with your outlook in the medical debate, we'd be extremely well served.

  • Aaron V. (unverified)
    (Show?)

    I don't know if I should laugh or scream at this article.

    I agree that there's some faith involved in anyone's trust of a professional. But it's stunning how many "progressive" people doubt the efficacy of well-intentioned medical personnel, but swallow any New Age claptrap without investigating it.

    No, your child is not an Indigo Child". S/he's a brat who you should discipline when s/he acts out in public. (I said "discipline", not "beat". And yes, I have "negative energy" - your kid screaming and running around is disturbing my attempt to have a decent conversation with my wife/friend/client or just read the paper in peace.)

    And for Moses Ross - acupuncture ain't free. It's a hell of a lot more expensive to get acupuncture every week to "ward off a cold" than to spend a few bucks for NyQuil to alleviate the symptoms when you do get one. And don't discount the fact that relieving pain or symptoms of disease helps a patient.

    Not to mention the fact that acupuncture, which has helped me with knee pain, has no effect on colds and the immune system - my acupuncturist, who's also an MD, won't do acupuncture on people if he doesn't believe it will help me - he told me to see an allopathic physician with other injuries.

    Some herbal remedies may work; others are quackery. Homeopathy, crystal work, and other New Age crap have no scientific basis, and it's distressing to see (presumably) educated people falling for these things.

  • Greg Tompkins (unverified)
    (Show?)

    What rationale do you give to support the government running Health insurance? Everything the government does ends up an utter disaster, overbudget, etc. etc. Why do you want the incompetant government making choices on YOUR health? Go to Canada or Europe and try to get help! Their level of service is awful. Canada is considering eliminating their federal health care program. And yet you want that here even after it's failed elsewhere? The only way out of this morass is to smash bureaucracy and eliminate the practice of using health insurance for the little things. At the same time, end the practice of overzealous litigation of medical professionals. For the people who are TRULY needy, then maybe give them a voucher to go see the doctor. Don't have the government run the health insurance though. That is recipe for disaster.

connect with blueoregon