Every so often, as the health care reform initiative spearheaded by the Obama Administration wends its way through Congress (or, more precisely, wend their ways through Congress, given that there are multiple bills coming from multiple committees in both Houses), I've warned about various chicanery from woo-friendly legislators trying to legitimize by legislation where they've failed by science various "alternative" medicine practices. This began much earlier this year, when I pointed out how Senator Tom Harkin (D-IA) invited the Four Horsemen of the Woo-pocalypse to the Senate to testify. These included Dr. Andy Weil, Director, Arizona Center for Integrative Medicine, University of Arizona, Vail, AZ; Dr. Dean Ornish, Founder and President, Preventive Medicine Research Institute, Sausalito, CA; Dr. Mark Hyman, Founder and Medical Director, The UltraWellness Center, Lenox, MA; Dr. Mehmet C. Oz, Director, Cardiovascular Institute and Complementary Medicine Program, New York-Presbyterian Hospital, New York, NY. This occurred after Harkin had famously complained about the National Center for Complementary and Alternative Medicine, the Center in the NIH that he, more than anyone else, had created, because it had not validated enough quackery. (Yes, I know he didn't use those words, but that was what he had done.) Most recently, Harkin tried to insert language that would mandate that the government and health insurers pay for quackery, as long as it was from licensed practitioners. Given that some states license naturopaths and even "homeopathic physicians," such an amendment, if it stayed in place, would open the way for paying for all manner of nonscientific quackery.
However, there is another bit of chicanery that legislators are pulling, this time with the Senate version of the bill, that I have been made aware of by Rita Swan of CHILD and Kimball Atwood. This time, the threat is religious, with Senators trying to insert measures into the health care reform initiatives that will pay for "religious" treatments, such as Christian Science prayer. Indeed, one of these, S.1679, entitled Affordable Health Choices Act requires the government or private party insurers to pay for faith-based therapies:
SEC. 3103. PROGRAM DESIGN.
(D) The essential benefits provided for in subparagraph (A) shall include a requirement that there be non-discrimination in health care in a manner that, with respect to an individual who is eligible for medical or surgical care under a qualified health plan offered through a Gateway, prohibits the Administrator of the Gateway, or a qualified health plan offered through the Gateway, from denying such individual benefits for religious or spiritual health care, except that such religious or spiritual health care shall be an expense eligible for deduction as a medical care expense as determined by Internal Revenue Service Rulings interpreting section 213(d) of the Internal Revenue Code of 1986 as of January 1, 2009.
What this paragraph appears to mean is that health care insurers, be they private or government, would be required to pay for religion-based treatments, such as Christian Science "practitioners" for their health care "services." More specifically, the bill emphasizes nondescrimination. I will be honest with you here. I'm not sure if that means only that the bill requires that insurers do not discriminate against paying for religious woo, such as Christian Science prayer "treatments" or, as Kimball fears, that such language might reasonably be construed to mean that such fees paid to religious "healers" would have to be comparable to those paid to legitimate practitioners. One thing that's truly ridiculous is that the IRS already allows "medical deductions" for Christian Science prayer charges and a bunch of other woo. Indeed, here is what the IRS has to say about the subject:
If you itemize your deductions on Form 1040, Schedule A (PDF), you may be able to deduct expenses you paid that year for medical care (including dental) for yourself, your spouse, and your dependents. A deduction is allowed only for expenses paid for the prevention or alleviation of a physical or mental defect or illness. Medical care expenses include payments for the diagnosis, cure, mitigation, treatment, or prevention of disease, or treatment affecting any structure or function of the body. The cost of drugs is deductible only for drugs that require a prescription, except for insulin.
Medical expenses include fees paid to doctors, dentists, surgeons, chiropractors, psychiatrists, psychologists, and Christian Science practitioners. Also included are payments for hospital services, qualified long-term care services, nursing services, and laboratory fees. Payments for acupuncture treatments or inpatient treatment at a center for alcohol or drug addiction are also deductible medical expenses.
In other words, this passage, if allowed to stand, would mandate that insurers pay for faith healing by Christian Scientists. Indeed, as the Senate tries to merge Harkin's bill with the bill that emerged from the Senate Finance Committee, chaired by Senator Max Baucus (D-MT), an amendment has been promoted by, of all people, the odd couple of Senators John Kerry (D-MA) and Orrin Hatch (R-UT), that says mandates in essence the very same "nondiscrimination" as the passage above using almost identical language (scroll down to Amendment C-14, also known as the Kerry/Hatch Amendment). At first glance, one might wonder why on earth Senator Kerry would support such nonsense, which seems more suited to conservative Christians. However, the Church of Christ, Scientist was founded in Boston and is based in Massachusetts; so maybe it's not so strange after all. Indeed, maybe it's stranger that Orrin Hatch, a Mormon, would be supporting such an Amendment.
But it's not just the Senate, unfortunately. There is very similar language in House bill HR3200, sponsored by Representative John Dingell (D-MI):
Section 125. PROHIBITION OF DISCRIMINATION IN HEALTH CARE SERVICES BASED ON RELIGIOUS OR SPIRITUAL CONTENT.
Neither the Commissioner nor any health insurance issuer offering health insurance coverage through the Exchange shall discriminate in approving or covering a health care service on the basis of its religious or spiritual content if expenditures for such a health care service are allowable as a deduction under 213(d) of the Internal Revenue Code of 1986, as in effect on January 1, 2009.
My question upon reading this is: Why on earth is there a tax deduction for Christian Science "prayer" medical services in the first place? This is not medicine by any stretch of the imagination; certainly it's not any sort of medicine that has been scientifically tested and validated as effective. It doesn't even have a possible use in a narrow area, such as back pain, as chiropractic might. It's nothing more than wishful thinking, faith healing. Let me further ask a question. If Christian Science faith healing (which is all that it is, really) is considered a tax deductible "medical expense" by the federal government and, if these provisions remain in the health care reform bills, is also a service that the government will require health insurers to pay for, why not reiki, which, as I've pointed out before, is simply faith healing that substitutes Eastern mysticism for Christian belief? Why not pay for Scientology E-meters? After all, if one form of religious woo is considered a tax deductible medical expense by the IRS and may well be considered a valid medical expense that the government and health insurers will have to pay for, why not Scientology? There's no reason at all to distinguish one from the other. Both are considered legitimate religions under the law, aren't they?
If I were in the hierarchy of the Church of Scientology, if these provisions favoring Christian Scientists remain in the final bill that passes, I'd be licking my chops to sue the government to force it to pay for E-meter treatments and" auditing." Ditto if I were a reiki practitioner or any other faith healer. In fact, if this bill were to pass with some variety of this "nondescrimination" provision in it, I guess my only consolation would be the entertainment value of the government trying to justify not covering Scientology auditing treatments. (My guess is that the government would cave rapidly on reiki, given that it's viewed by most as being "alternative" therapy rather than the faith healing modality that it is.) One would think that this sort of provision would be unconstitutional, but apparently it's not (or it's never been challenged) given that the IRS has apparently been allowing these deductions for Christian Science prayer "treatments" without difficulty for years now, even though, as far as I know, no other religion's faith healing charges are given a similar tax deduction.
I warned before about the copious mischief being perpetrated upon health care reform efforts by proponents of ideology- and religion-based, rather than science-based, medicine. And make no mistake, those provisions are still there, requiring health insurers to pay for "integrative" practitioners, chiropractic, acupuncture, and "licensed" alternative practitioners. However, these new provisions, spearheaded by Christian Scientists and other religions through useful idiots like John Kerry, Orrin Hatch, and John Dingell, are every bit as worrisome, if not more so, than the provisions slipped in by Tom Harkin and his allies. The reason is that faith healing nonsense like this harms children, as the CHILD website documents. Remember Madeline Neuman, the 11-year-old child whose parents let her die of diabetic ketoacidosis? If her faith healing had been performed by a Christian Science "practitioner," under this bill that practitioner could have billed for his or her "services." For instance, if Neuman had been Ian Lundman, who was the same age when he died in 1989 of diabetic ketoacidosis because his parents relied on a Christian Science "practitioner" instead of doctors to treat his diabetes. This practitioner billed $446 for his "services." Under this bill, the insurance company would have had to pay the bill. Ditto if Madeline had been instead Amy Hermanson or Andrew Wantland.
So the question remains:
Legal scholar Marci Hamilton has no problem with adults declining medical treatment for religious reasons, but she worries some of the proposed language could let parents to opt out of health coverage for their children.
"That's another reason they may not take the children to the hospital when they become very ill," said Hamilton, an expert in law and religion at Cardozo School of Law, a nondenominational affiliate of Yeshiva University. "The federal government should not be in the business of providing incentives for parents not to treat children."
While enforcement could be difficult, no one knows how widely this loophole could be embraced.
From my perspective, one child suffering because of this loophole would be one child too many. I agree that competent adults should have the right to refuse treatment, even for life threatening conditions, for in essence any reason they want or even no reason at all, as long as they understand the likely consequences. That is not my concern. What is my concern is that these loopholes will make it even easier than it already is for parents to choose prayer-based woo instead of science-based treatment for their children. Children should not be made to pay because their parents believe that prayer will save them from a life-threatening illness and thus eschew proper medical care. I've argued this time and time again, be it in the case of Daniel Hauser, Abraham Cherrix, Katie Wernecke, and others. My worry about these provisions is that they would provide a custom-made defense for parents like those of Madeline Neuman or Ian Lundman, namely: How can you prosecute us for providing a service for our child for which the government not only allows a tax deduction as a medical expense but even mandates that health insurance companies reimburse me?
That's why we all need to contact our Senators and Representatives now, this week, to voice our concerns. Some key talking points have been provided by Rita Swan to use, along with the contact information for Max Baucus. When a bill reaches several hundred, or even a thousand, pages, it becomes easy for woo-meisters and religious quacks like Christian Science "practitioners" to insert all sorts of little provisions into the bill that not only appear to be unconstitutional but give faith healers legitimacy through law that they can never obtain through science or medicine.
Who cares if it makes a mockery of medical science? Who cares if it shreds the First Amendment prohibition against the establishment or favoring of one religion over another by giving not only a tax break to one Christian sect that is not given to any other religion but providing a mandate that insurers pay for the prayers for the sick of that one Christian sect and no other? Who cares if it means letting children die of preventable diseases when parents choose prayer instead of medicine? Who cares if it means that insurers have to pay for the "services" of the faith healer quacks who let children die?
Does anyone care?
Offtopic: Suzanne Somers was just on the Today Show a few minutes ago promoting her quack book "Knockout": http://today.msnbc.msn.com/id/33347291/ns/today-today_health/
I think the bill sounds great. I can claim a deduction for going to the sweat lodge to have my toxins leached out.
True, there's a bit of risk involved, but I'd feel better knowing my surviving spouse can get a break on taxes.
In other words, this passage, if allowed to stand, would mandate that insurers pay for faith healing by Christian Scientists.
This has been true of Medicare for decades. In fact, there are different levels of Christian Science "treatment" that Medicare pays for at different rates. (One wonders - what do they do, pray harder?)
The Medicare provisions were courtesy of Massachusetts' senior Senator, the late Ted Kennedy. This may help explain the Kerry-Hatch "odd couple," since both were close friends of Kennedy.
I wonder why praying costs money?!?...oh right religious callousness and greed. Silly me. continue...
How is this consistent with the recent case where a child died because they received prayer instead of treatment for diabetes and the parents went to jail?
If the government is mandating payment for something doesn't that mean the government is endorsing it as cost effective?
Paying for Christian "Science" treatment?
And to Jud, Medicare has been reimbursing this crap for years???
That clattering sound you just heard was my jaw hitting the floor. If you shortly hear a loud explosion from my direction, you'll know the shock has worn off and the rage has hit.
This is intolerable. I'm not even sure where to begin in describing how wrong this is. It's so wrong it's hard to imagine it makes sense in anyone's head.
Daedalus, you're forgetting that the vast majority of people in governments (not to mention in general) are idiots, assholes, or both.
such as Christian Science "practitioners" for their health care "services."
Not enough scare quotes.
such as Christian "Science" "practitioners" for their "health" "care" "services".
Who cares if it shreds the First Amendment prohibition against the establishment or favoring of one religion over another by giving not only a tax break to one Christian sect that is not given to any other religion but providing a mandate that insurers pay for the prayers for the sick of that one Christian sect and no other?
Indeed. If this passes, just go to the Supreme Court. They'd have to act like in Bush v Gore to let that stand.
How this nonsense can continue in the face of all the evidence and high-profile deaths is beyond the pale. The more I read on this topic, the more my innocence is lost regarding public figures I used to regard as heroes.
My letters have been sent - thanks so much for the heads up. Your observation about Scientology was right on the money - Scientology has been able to insert themselves expediently and successfully when faith-based allowances are made. For example, their "education" arm Applied Scholastics is an approved Supplemental Educational Services provider in eleven states' Depts of Education, serving public districts.
(Some source info for anyone interested, Dr Dave Touretzky's http://studytech.org/home.php)
I can not say it enough; how Obama says, "Part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works" and then our representatives turn around and call for funding for things that have been shown NOT to work, really makes my head spin.
I see there is another "Jen" posting here. To avoid confusion, I'll be signing my posts "Jen in TX" from now on.
(Jen, who disses antipyretic overuse every chance she gets.)
"If I were in the hierarchy of the Church of Scientology, if these provisions favoring Christian Scientists remain in the final bill that passes, I'd be licking my chops to sue the government to force it to pay for E-meter treatments and" auditing."
Actually, sad fact is that Scientologists can already deduct the costs for their "religious" training under a special secret tax exemption created by Goldberg, the head of the IRS, in 1993: the IRS was subject to extortion by the COS, including roughly 2,500 individual lawsuits. Goldberg, a failure, caved into the pressure. At it stands now, no real religion or its members enjoy the tax examption that the Scientologists do. I think the e-meters are already tax deductable. The secret agreement was later printing in the Wall Street Journal, but the IRS, for obvious reasons, has refused to acknowledge its existence (or deny it). In effect, the IRS decided to make Scientogists America's "chosen people". As reported in a recent Ninth Circuit legal case.
In effect, this new law would just even the playing field. Two wrongs make a right. Pretty soon, we will all have to join cults or we will be become virtual economic slaves. Thanks Goldberg!
As an oncology massage therapist, people will ask if they can get reimbursed. I do not take insurance because I know insurance companies are a nightmare to deal with it and most won't cover massage. Waiting to get paid would be a nightmare on top of it. Maybe if I "pray" over my clients and patients I can say it is "Christian Science" and then it would all work out.
This (post and comments revealing Medicare, IRS and church shenanigans) is all too much. I think I'm going to explode! I just finished reading about similar goings-on over at Marion Nestle's blog, Food Politics, and my outrage-meter has exceeded capacity.
I'm getting tired of writing to representatives only to get a form letter email or no response at all. Telephoning brings only a bored sounding intern intoning a snotty "thanks for calling". I am particularly disappointed in John Kerry--I expect this from Hatch who represents not only the cultish Mormons, but a state that makes its living off supplements, but I worked for Kerry's campaign and voted for him. If this is the kind of "compromise" the Kennedy enthusiasts were praising after his death, count me out of "going along to get along". Where DOES it end?
I think that this is a great example of why "health care reform" (more appropriately called "health insurance reform") will never come from "the government". There are too many "special interests" (e.g. chiropractors, Christian Science "believers", woo-peddlers of various hues and crystal structure) that will "lobby" (i.e. "bribe") legislators to get their slice of the pork pie.
No matter how banal and "evil" insurance companies may be, their perfidies could at least be brought to the agents of the government. Once the government is the insurance company, to whom do we appeal for justice?
What will eventually come of this frenzy to "reform" will be more expensive health care insurance (either directly, as fees and premiums or indirectly as taxes and "penalties") and an explosion of quackery. This is just the beginning. Wait until the bill actually passes - then the amendments and add-on legislation to "cover" aromatherapy, "energy medicine", etc. will be quietly slipped into every bill from farm subsidies to defense appropriations.
There are a lot of powerful legislators who are in the hip pocket of the woo-mongers - they will be working overtime to get their "constituents" (i.e. "campaign contributors") covered under the umbrella of "health care reform"
As for Obama's promise to "put science in its proper place" - I don't think he's going to be able to keep that one, either.
And, yet, those of us who want less government involvement in healthcare are portrayed as the lunatic fringe...
As they say, "Be careful what you ask for, because you might just get it."
"That's why we all need to contact our Senators and Representatives now, this week, to voice our concerns"
This post needs to go viral NAO! Twitters, start your engines!
Just e-mailed my senator, John Kerry. I urged him to withdraw the amendment (I know he won't, but one can hope), pointing out that not only would it potentially endanger people (I mentioned the kids at the CHILD web site and included a link), but it would drive health care costs up as more claims would be made to both private insurers and Medicare/Medicaid. Quite contrary to the title of the amendment.
As much as it might "feel good" to contact your Senators and Representatives, it is a futile effort. Unless you include a large (six figure or more) "campaign contribution", your letter, phone call or e-mail won't have even the impact of a sluggish neutrino on their vote.
The sad fact is that we are currently much more in need of legislative reform than we are of "health care reform". As the system stands now, the voices of tens of thousands of voters are insignificant compared to the impact of a single "large contribution".
The distinction between large "campaign contributions" and bribes is lost on me - perhaps someone can explain it.
A few notes.
(1) By its terms, this appears to only apply to insurance offered through the exchanges (i.e., the individual market and a very small number of small employers).
(2) The tax provisions I don't mind. The point behind the tax break is not to encourage the use of medicine. Its that it would be immoral to tax something that is a necessity. And to them it is, even though I disagree with them. And frankly, do we expect Christian Scientists to spend more than people who actually get medical treatment? So I don't mind giving them a break on their replacement.
(3) The coverage mandate I do mind somewhat more - but again, I'd imagine if you're a Christian Scientist with health insurance, you're probably using it much less than the rest of us. So you're dropping my prices - I can abide by you having a faith healer. [Of course, there's a potential counterargument here that they'll break from their faith at the end, and be much more expensive. In which case I'd be more annoyed.]
(4) I would be very annoyed if that was expanded to homeopathy, or if "spiritual" ends up meaning "Reiki." Which it probably will - basic canons of statutory construction means that spiritual will have to be different in meaning from religious.
(5) My best guess as a (non-health care) attorney on the nondiscrimination provision: the only way this gets interpreted as a mandate to pay woomeisters a particular amount is if an insurer tries to use negligible payments as an end run around that law. Granted, I think they'd have a fair argument that minimum wage overpays these people compared to their effectiveness . . .
Remember, nondiscrimination in the civil rights context means you can't treat people differently based on their race, but you can pay them differently based on their experience, job difficulty, and qualifications. And I don't think many religious or spiritual healers can even clai mto match up with someone who went through med school, 100 hour a week residencies, etc.
Also, the cynicism about calls is misplaced. Representatives do pay attention to the calls you make without you having to bribe them. It'll take more than one person calling to change their mind, but they do care about people in their district being upset. Particularly if its not organized by an opposing partisan group.
Correction: It's Rep John Dingell, not "Charles" (as your first reference has him). The district next to mine, sadly.
I feel diffident in commenting on this post as I am a british citizen resident in England, but surely,failing to provide proper medical treatment to a minor resulting in death is Manslaughter and the "medics" and parents should be prosecuted and jailed for many years. Several such cases would stop this type of woo.
In some of the cases mentioned, the parents were tried for manslaughter. Click the links in Orac's post to find more info at the CHILD site.
"...they [Representatives] do care about people in their district being upset. Particularly if its [sic] not organized by an opposing partisan group." [emphasis added]
The problem in my region of the country is that our Representatives have convinced themselves that anyone objecting to the pending "health care reform" bill(s) is - by definition - "organized by an opposing partisan group" [see: Nancy Pelosi and "astro-turf"]. They may learn differently when the next election comes around, but that doesn't help right now.
This is one of the biggest problems with the current situation - people who disagree with the "health reform" bills are labeled as "astro-turf" (organized by insurance companies - you'd think they'd have better signs), "racists" (because they disagree with the president) or "ignorant" (because they don't want to do what the "experts" in the administration feel is the "best option"). As such, the Representatives feel that they can be safely ignored.
If you think I overstate the case, I suggest that those of you in Senator Harkin's district give his office a call and see how respectfully your concerns are treated.
I understand your cynicism very very well. But I would also like to happily report that my conversation with my own representative was taken in a very positive spirit. The aide I spoke to not only understood my concern, he almost finished my sentences for me. It was a very positive exchange. And my representative has seniority, power, and popularity.
Though I know that there are bigger forces at work than an individual constituent's concerns, I prefer to operate in the spirit of asking my elected officials for their time. If it comes to nothing, at least I tried. All I lost was 6 minutes of my life.
As for my senators, I have only emailed so far. My senators are also levelheaded, and one is quite powerful, so I feel that my emails will be received constructively.
Since I am concerned with the religion and spirituality part of the bills, and not trying to shoot down health care altogether, and I'm not screaming that Obama is a socialist or wailing about death panels, I see no reason why I'd be labeled as an astro-turfer or a racist.
One of the things being forgotten in this discussion is that if Christian Scientists are required by law to purchase health insurance, which they might not have otherwise bought, then there should be some form of reimbursement for treatment that they will use. Secondly, how many children are dying for lack of medical treatment because their families could not afford it? Are these parents being prosecuted? Thirdly, if medical care always resulted in the recovery of a child who is ill, then one could mandate that care for everyone. But, as we all know children die every day even when they do receive medical care, and then it is often called the will of God.
I agree with comments # 26. Being a Christian Scientist perhaps I can clarify that Christian Science treatment has nothing to do with faith-healing which is often performed in different churches and sometimes successfully. Christian Science goes further than simply a wishful thinking which often may bring more harm than benefit. For example if a patient has a blood pressure after he/she drinks some alcohol any treatment would be useless until the thought of the patient will be changed. So a Christian Science treatment includes the deep meditation and realization of a practitioner and the patient what is good in tis life and what is dream or so-called evil and make a decision freely whatever side to choose.
In other words, Christian Science is faith healing. It's no different than reiki, which also heavily into "intent" and just as devoid of evidence that it does any good.
A thought occurs: if woo-meisters are "healthcare practitioners" now, are they open for malpractice suits? I understand that few lawyers go after uninsured practitioners, but if you convince one to go for glory rather than cash...
It'll certainly give your average faith healer second thoughts before telling someone to not see a real doctor as well if they get treated exactly the same as any other healthcare professional.
It may be an idea to write to Teresa Heinz Kerry whose father, according to Wikipedia, was a medical doctor practicing in Portuguese East Africa (Mozambique) during her childhood there. The impressive list of charities and foundations associated with her today may just give her the power to influence John Kerry and make him rethink.
Why is this necessary? Can't a sick person simply hand $50 to Ernest Angley for a curative smack upside the head?
St Petersburg Times, Oct 12
Religions that rely on prayer to heal add twist to health care reform debate
Nice detailed exploration from a paper that has a reputation for good investigative series.
"Does anyone care?"