Last month, the U.S. government-funded National Center for Complementary and Alternative Medicine released a study which found that Americans spent $34 billion annually on alternative medicine. Although this is just 1.5% of total health care spending in the country, it represents over 11% of all out-of-pocket expenditures. The report estimates that about 38 million adults visited alternative practitioners in 2007.
Unusually for a mainstream media outlet, the Boston Globe offers a much-welcomed skeptical perspective on this news, via a quote from Public Citizen which points out the important fact that most of these therapies are untested and largely unregulated:
Dr. Sidney Wolfe, who leads Public Citizen’s health research, has long criticized the government for what he considers lax regulation of prescription drugs and mainstream medicine. Yet, he also sees problems with the widespread use of dietary supplements.
“People think they are cleared” by the Food and Drug Administration, he said, when in fact they do not need proof of safety or effectiveness to go on the market.
“Mainly, they’re ineffective,” he said.
According to the NCCAM study, most alternative medicine spending goes to dietary supplements. Though supplements like fish oil and echinacea are massively popular, few of them have any clinically demonstrated effect, and even the ones that do contain active ingredients can vary dramatically in dosage and potency – which is, after all, what you’d expect from raw natural ingredients. The ability to isolate and purify the active ingredients found in nature, to deliver controlled doses at known potency, is the entire point of scientific medicine.
After supplements, some of the other alternative treatments mentioned in the study include acupuncture and homeopathy, both of which are useless placebos based on sympathetic magic and pseudoscientific theories about how the human body works. Another kind is massage therapy and chiropractic, which can be useful for some kinds of physical ailments but have nothing like the universal efficacy claimed by their more fanatical practitioners. Other therapies mentioned by the study include chelation, ayurvedic medicine, and “energy-healing therapy”.
I can only view these figures as a massive missed opportunity. Not just a missed opportunity to educate the public about why we should rely on evidence-based medicine, although it’s certainly that. But more than that, it’s a societal failure: a misallocation of society’s resources on an enormous scale. Just think what that $34 billion could have done if it were put toward genuine scientific and medical research – how many promising studies could have been funded, how many discoveries made, how many diseases potentially cured! (For comparison, the entire 2010 budget request of the National Science Foundation is only $7 billion.)
Obviously, there’s no direct tradeoff here. Even if all Americans decided to reject alternative medicine, these funds wouldn’t necessarily have gone to scientific research. Much spending on alternative medicine is for conditions that are still poorly understood or that have no effective treatment, since these are always the areas where pseudoscience springs up. What we’re seeing here is an opportunity cost: the price we, as a society, pay for the decisions we collectively make about how to allocate our resources. Money that we spend on alternative medicine and other pseudosciences is money that we can’t spend on areas that might genuinely improve our lives.