Health Insurance – I’m Not Buying It

I haven’t paid much attention to the debate about health care. It didn’t seem to affect me, until I heard that everyone would be required to buy health insurance. OK, now I’m listening. Now I’m getting the knitting ready.

Let me explain. Although I have practiced medicine for over 30 years, I haven’t had health insurance for ages. I don’t go to doctors, can’t remember the last prescription medication I took. I don’t use health insurance and am not willing to pay for it. The knitting? I remember that when Murphy Brown went to jail for not revealing her sources, she spent her time knitting. I figure if I don’t buy health insurance and they put me in jail, I can get caught up on my knitting.

I am a psychiatrist. Recently I have worked at several Veterans Administration clinics, where most of the veterans I saw had post-traumatic stress disorder. I found that none of the pills or therapy we were using were as effective for this condition as a technique called EFT, Emotional Freedom Technique. This technique is like acupuncture without needles. The veterans can do this technique themselves at any time, even in the middle of the night, and they don’t have to re-experience traumatic events as they do in traditional therapy. Now, EFT is not formally accepted in most VA facilities. I had to do it under the table (you know that’s just a figure of speech, right?) I didn’t hide the fact that I was doing it; I just didn’t ask permission.

According to an article in the Journal of the American Medical Association, there were 628 million visits to alternative health-care practitioners in 1997, 243 million more than visits to all primary-care physicians. This was twelve years ago. So which is alternative and which is mainstream? And who decides which is which?

Some people prefer not to be part of the conventional medical model, with its aggressive, disease-is-the-enemy, the-body-is-stupid, dying-is-losing approach. Some don’t want the mercury in vaccines. Conventional medicine is not everyone’s preference, it is not the only game in town, and it is not necessarily the best for every problem. It is the most expensive without being the most-used. Think about that.

Let’s say that you wanted to understand how an electric outlet works. You could dissect it and examine all the parts. With a high-powered electron microscope, you could see the very atoms of the outlet. You understand how the plug fits in and what keeps it in. But then you say, “There is no evidence of this ‘electric current’ you’re talking about. It doesn’t exist. Trust us – we’re the scientists and we have the equipment.” That is the mainstream medicine approach to humans. Anything that is not reducible to three dimensions is invisible. You could gather bushels of evidence for the current and it would still be ignored because it doesn’t fit preconceptions.

The word science is used as a thought-stopper. Anything scientific is to be believed, no questions asked. But science, like accounting and economics, can be distorted to meet other aims. And medicine is beholden, to a stunning extent, to the drug companies. (I appreciate Senator’s Grassley’s efforts to show the industry’s effect on psychiatry.)

Evidence, to Aristotle, meant that you observe for yourself what is going on. Evidence, to modern medicine, means something very different. The only thing that counts as evidence is enormous, expensive, elaborate studies. For the most part, only the drug companies have the money to pay for those studies. So we have this evidence only for newer drugs, still in patent, that make the drug companies money. Older, cheaper drugs have no evidence. Anything not connected to a pill, machine, or surgery that makes someone money has no evidence. We are currently making a big effort to save money in an industry where any inexpensive treatment is not allowed. And we wonder why we haven’t solved the problem.

My job is to determine what is and what is not crazy, and this industry is crazy. Congress may get away with this – citizens seem awfully passive these days. But I’m tired of being passive. No vaccines for me, and I’m not paying for health insurance. I’m thinking of sending some knitting needles to my legislators, just so they know.