White Man’s Burden of Proof

March 21, 2010

This week, I received a letter from my health insurer specifying the levels of benefit afforded me by my coverage. It’s a regular sort of thing, that covers the limits for various types of health care.

On this letter, as has been standard for many health funds in recent times, it includes my coverage for treatment with naturopathy, accupuncture, and chiropractic. I can claim a combined $400 (subject to sub-limits not specified) for these services, and “remedial massage”. (Now remedial massage sounds like something that might actually work, so I don’t know why it’s bundled in here.) More worrying, is that they also tell me that from June, I will also have coverage for myotherapy, reflexology, shiatsu, homeopathy, herbalism (Chinese and western), Alexander technique, Bowen therapy, aromatherapy, and kinesiology. A veritable cornucopia of quackery.

I don’t want coverage for these things. I’m not even sure I’m comfortable with the idea that my private health insurer (which is wholly owned by the Australian Government, at least so far) covers anyone for these treatments.

The fact that it is almost accepted these days (if not expected, most of the funds cite popular demand for such coverage) that health insurance will cover such unreliable, unproven (if not unprovable) treatments, raises the question of why modern medical procedures need to go through all that pesky testing just to make sure they won’t cause any harm. Quite rightly, new therapeutic treatments need to undergo several levels of experiment and testing to make sure they will a) actually work, and b) not cause any harm. In recent years, the methods and process for such testing has been called into question, plus there has been a reported increase in prescribing “off-label”. (Where a drug is used to treat something not covered by the approved usage.) Now, you would think that this would apply to all treatments, but many have been effectively “grandfathered in”, since they have been in use for so long.

Anyway, I think, before my next premium is due, I may try to discuss this coverage with my insurer. See if there’s any way to get these items excluded (and hopefully reduce my premium).



February 7, 2010

This week, the British Journal The Lancet retracted the article by Andrew Wakefield et al that kicked off the whole “MMR Causes Autism” movement. (Well, OK, I’m not convinced that it started with Wakefield’s paper, but it certainly gave the argument an air of respectability it wouldn’t otherwise have had.)

This is largely being reported by the mainstream media as The Lancet reversing its position on the alleged link between MMR and Autism, however this is not the case. As I understand it, if the journal had a position on a proposed link, then it was at the very least one of “Inconclusive”, if not in line with the majority opinion of the medical community.

The Lancet only retracted the paper because it had become apparent that the actual study was poorly conducted. There were issues with the lack of ethical review, and in how the subjects’ illness were presented. And so they withdrew the publication because it failed to meet the appropriate standards for publication, not because they suddenly accepted that the conclusions were incorrect.

In the initial debate after the original publication of the paper, during which many criticised The Lancet for publishing something many considered to be based on bad science from authors with a clear conflict of interest (Wakefield was acting as an expert witness for families seeking compensation for autistic children). The journal stood behind its decision to publish the paper as it was important to publish new ideas. This is a reasonable stance for them to take. Provided the study met with standards for process, ethics, and the reasoning was sound, scientific journals should publish the papers. It is not the place for the editors of The Lancet, or any other journal, to question results of research. That is done by the community debating the issue, follow-up studies and so forth.

In any case, the fact is that they did not suddenly reverse their opinion on whether MMR is linked to Autism, they reversed their decision to publish the paper. There has been rather a lot of evidence that the link between MMR and autism is non-existent for some time. I don’t know the opinions of the editorial board of The Lancet (even though I have the relevant editor’s book on the subject – two copies, even – I just haven’t read it yet), but I don’t think this represents the change in position some are reporting it as.

Now for the 350kg gorilla in the room. This is not going to stop the anti-vax movement. They are convinced that there is a link, because they have the one thing that evidence and properly conducted studies can never disprove: personal experience. They had a child which was fine, then they got it vaccinated, and then something was wrong. To them, this is a provable causal link that event B caused event C. Meanwhile, the evidence seems to suggest that event A causes event C. (Or, to put it another way, Autism has a genetic cause.)

In any case, I’m sure the anti-vax movement aren’t about to admit that maybe they’re wrong. This latest thing is just another part of the medical heterodoxy attempting to push toxins on our kids. They won’t distance themselves from the Wakefield paper, any more than they will accept responsibility for the deaths of the children killed by the diseases the vaccinations protect against.