In Switzerland, as in many other European countries, the government pays for extensive health insurance coverage for its citizens. Naturally, the government and the citizenry want cost-effective healthcare for their money. One important aspect of achieving this is not to pay for therapies that don’t work. So it is understandable that in 2005, the Swiss Interior Ministry stopped paying for several alternative therapies, including homeopathy and Traditional Chinese Medicine (TCM), that failed to meet their criteria for adequate scientific proof of efficacy.
What is less understandable, is that in 2009 60% of the voters in Switzerland voted to force the government to pay for these therapies. Apparently, these voters were, as so often proponents of alternative medicine tend to be, less interested in whether the therapies worked than in their “right” to use them, even if other taxpayers had to foot the bill. The government’s own review panel recommended outright rejection of these therapies, but in a pragmatic political move the government has decided to continue funding them for a 6-year trial period, during which a supposedly independent review of existing scientific research is supposed to be conducted to determine, yet again, if there is adequate evidence of efficacy to justify providing these therapies at taxpayer expense.
One possible candidate for this external review agency is the National Center for Complementary and Alternative Medicine (NCCAM) here in the U.S. Given that NCCAM has spent over $1 billion dollars of U.S. taxpayers’ money, has failed to find solid evidence to support any specific CAM approach, and is nevertheless actively promoting an entire academic industry dedicated to researching CAM therapies (see these posts at Science-Based Medicine for details), it hardly seems a neutral party. Another candidate is the British National Institute of Clinical Excellence (NICE). This seems a better choice in that the organization exists to evaluate all medical therapies froman evidence-based perspective.
However, the unfortunate reality is that the negative findings of the original Swiss government panel were not sufficient to dissuade Swiss voters from demanding the government pay for CAM. And the extensive work NICE has done in Britain, along with strong statements from British physicians organizations about the complete fiction that is homeopathic medicine, the British National Health Service still pays for homeopathic hospitals. The negative findings of NCCAM here in the U.S. have had no discernable impact on the popularity of CAM therapies here. So the hope that a balanced, rational review of the evidence, which I have no doubt would lead to the conclusion that these methods are unproven at best or, as in the case of homeopathy, complete nonsense, is a slim one indeed.
The more I look at the evidence and people’s responses to it, including the vicious hostility of so many comments posted here by those who feel I am wrong about the evidence, the more CAM begins to look like a religion, not a rational approach to healthcare.