Quackonomics!

The Cost of Unscientific Health Care in the U.S. ...and Other Fraud Found Along the Way

Ethan L. Welch M.D.

• Publisher: Page Publishing, Inc.
• Year: 2020
• ISBN:
  9781645845164
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Fake news is bad enough. We cannot allow ourselves to be buried in fake medicine.This book looks at quackery practiced under the cover of CIM (Complementary and Integrative Medicine). Why? To inform the consumer that there is a better way to spend their health-care dollar. How? By a better understanding of science and the scientific method.A brief summary of the development of science is given, from early Greece, through the Dark Ages, and into the twenty-first century. This history emphasizes that the development of the scientific method originated purely in Western culture, contrary to other interpretations by Islam and the Chinese. It traces the origins of anti-science in the United States. The placebo effect, an essential part of the science of medicine, is clearly defined.The absence of science is documented in twenty-five examples of CIM from acupuncture to homeopathy, from herbal medicine to aromatherapy, from spiritual healing to iridology. The history and the departure from science are emphasized. The weakness of the literature supporting these frauds is cited as are the politics of reimbursement. A section on marijuana stresses the need to take a hard look at the perils of legalization.While researching the cost of unscientific health care (over $40 billion), I discovered quackery embedded in the system (over $100 billion), including fraud in the scientific literature, fraud in the medical profession, in Big Pharma's pricing of drugs and hospital billing fraud. The extent to which legislatures are influenced by the money pharma spends on campaigns on an annual basis was tabulated. It exposes the weakness of our response to the opioid crisis.This book will be of interest to everyone in the United States interested in the quality of their health care. The aim is not to be all-inclusive but to stimulate national dialogue.

Part I

Historical Perspective

Chapter 1

Science

Science is the attempt to discover by means of observation and reasoning, particular facts about the world and then laws connecting facts with one another and making it possible to predict future occurrences.

—Bertrand Russell.1

Understanding and making decisions on health care is difficult, if not impossible, without the basic understanding of science. Understanding science requires knowledge of the scientific method. Our modern world is divided between scientists and nonscientists. Scientists, particularly those involved in research, know about and understand the scientific method. Nonscientifically trained people may have a variable understanding or none at all.

The scientific method is best understood in the context of history. Prior to the emergence of science, all progress was by trial and error. Plato believed that all knowledge could be obtained from reasoning, and it took a long time before observation and recording of knowledge preceded experimentation. The ancient Egyptians had knowledge of setting fractured bones, draining abscesses, tooth extraction, and trephine of the skull and had a code of ethics long before the Hippocratic Oath. Carlo Rovelli, a professor of theoretical physics and a historian, calls Anaximander, the sixth-century BC Greek philosopher the first scientist because “he was the first to suggest that order in the world was due to natural forces, not supernatural ones.”2 Anaximander’s influence put Western culture on the path toward the dawn of science.

Aristotle had a method. He gathered what others knew about a topic, looked for relationships between topics or subjects, and then developed a system of study by subdividing and naming things into different branches such as biology, physics, zoology, and even poetry. Hippocrates, in the fifth century BC, provided the foundation of early medicine and gained great credence by simply observing and recording symptoms and signs provided by his patients. These early Greek physicians were empirical humanists and recommended treatments such as herbal remedies rather than appealing to the gods. The people of the Greco-Roman era were limited, however, by the extent to which their “method” understood the nature of the human body, believing that their bodies were made up of four humors: blood, phlegm, yellow bile, and black bile, each identified with a natural element: air, fire, water, and earth. Although the science was rustic, the Greeks laid the foundation for the art of medicine as well, traveling through Egypt, Persia, and Southern Italy.

With the fall of Rome in the fifth century CE and the emergence of the Dark Ages, evolution of the scientific method was halted by the focus on religion. The writings of St. Augustine of Hippo, converted to the Christian faith in AD 387, directed the faithful to see only the hand of God behind every and all aspects of nature. Christian teaching saw disease as punishment by God for the sins of man. Curiosity was thwarted and reason banished. It was not until the Crusades in the late eleventh century that the Western world had any exposure to the next phase of prescience as it was progressing in the Muslim world, a dominion that spread from the Atlantic to Afghanistan. Arabic became the language of inquiry and discourse, as the Arabs had found and translated Greek libraries and, together with Persian and Sanskrit sources, molded the early essentials of Arab science. Schools of higher education were formed in cities from Cordoba to Baghdad. The first teaching hospital was established in Damascus in AD 707.3 The early Arab astronomers and seafarers were keen observers of the heavens and named many of the brighter navigational stars in their own Arabic language. Islamic science was closely aligned to the Quran, and all knowledge needed to fit into the Muslim worldview. The principles of science and medicine were synthesized in a twelfth-century publication, Cannon of Medicine, by the Persian genius Avicenna, better known by his Muslim name Ibn Sina. Although this vast compendium, describing the diagnosis and treatment of many ailments together with a collection of drugs, was translated into Latin and served as a text well into the seventeenth century, it was still a long way from our modern scientific method. Ill health was still considered an imbalance of the body’s four humors and their associated opposites—blood (hot vs. moist), phlegm (cold vs. moist), the yellow bile (hot vs. dry), and black bile (cold vs. dry). Although it is easy to dismiss the contributions of the earliest Islamic world, focus on scholarship and the belief that knowledge of science provides man with a unique power over the forces of nature without abrogating a belief in their God is a legacy tilted toward progress.

Emerging from the Dark Ages in the Western world, one of the earliest contributions to the notion of the scientific inquiry came in the thirteenth century. The English Franciscan friar Roger Bacon and a number of his contemporaries, during the time of the founding of universities at Oxford and Paris, described the importance of observation, hypothesis, and experimentation. They stressed the need for independent verification and less emphasis on theology. Bacon wrote of optics, mathematics, and alchemy. His inquiring mind often put him at odds with the church and his own order. He fought reliance on translations of Aristotle, superstition, and magic. His writings are a brilliant marker on the road to the scientific method.

Throughout the second millennium, there were several forces that contributed to the evolution of the scientific method and, hence, the growth of science in the Western world. The founding of the great universities, a gradual abridgment of the divine right of Kings, the emergence of a parliamentary system of government, the questioning of the writings of the Ancients, and the fall of Constantinople to the Turks (1453) all contributed in their own way to the growing emergence of reason as a basis of knowledge.

Leonardo da Vinci (1452–1519) trained himself to be an intense observer and experimenter as Walter Isaacson points out4:

Leonardo became one of the major Western thinkers, more than a century before Galileo, to pursue in a persistent hands-on fashion a dialogue between experiment and theory that would lead to the modern Scientific Revolution.

Leonardo da Vinci, had he published his scientific writings during his lifetime, would have been considered the father of modern science, rather than Galileo born 112 years after.

The mathematical and the philosophical wr...

Table of contents

• Introduction
• Part I
• Part II
• Part III
• Part IV
• Part V