Harkin: Failing to Adopt Integrative Approach to Medicine in Health Reform Would Be Serious Failure

[BurtWorm]

Does this mean he would hold up health care reform if alternative medicine were not given the due he thinks it should be given? Is it necessary to include alternative/complementary medicine in health care reform? How necessary? Should it be a priority for reformers? Can it wait until science-based medicine's role is affirmed?

Harkin's statement before the hearing on "the Use of Integrative Care to Keep People Healthy," which he co-chaired with Barbara Mikulski, follows:

http://harkin.senate.gov/blog/?i=0b48b652-1947-405e-b4db-622f58d2a76c



“It is fashionable, these days, to quote Abraham Lincoln. So I would like to quote from his 1862 address to Congress – words that should inspire us as we craft health care reform legislation. Lincoln said, “The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty . . . . As our case is new, so we must think anew, and act anew. We must disenthrall ourselves, and then we shall save our country.”

“Clearly, the time has come to “think anew” and to “disenthrall ourselves” from the dogmas and biases that have made our current health care system – based overwhelmingly on conventional medicine – in so many ways wasteful and dysfunctional.

“It is time to end the discrimination against alternative health care practices.

...

“This has been a priority of mine going back many years. In 1992, at my urging, Congress passed legislation creating the Office of Alternative Medicine at the National Institutes of Health. In 1998, I sponsored legislation to elevate that Office to what, today, is the National Center for Complementary and Alternative Medicine. That Center is sponsoring extraordinarily important research. It is helping us to “think anew” and “act anew.”

“Since 1992 the field has evolved and matured. Today, we are not just talking about alternative practices but also the integration between conventional and alternative therapies in order to achieve truly integrative health. We need to have practitioners talking with each other, collaborating to treat the whole person. And this is the model we intend to build into our health care reform bill.

“On several occasions, I have laid down a public marker, saying that if we pass a bill that greatly extends health insurance coverage but does nothing to create a dramatically stronger prevention and public health infrastructure and agenda, then we will have failed the American people.

“Well, this morning, I want to lay down a second marker: If we fail to seize this unique opportunity to adopt a pragmatic, integrative approach to health care, then that, too, would constitute a serious failure.”

[ayeshahaqqiqa]

1. Harkin is right, imho

there has to be a way to move from medicine that sees people as widgets who either fit into a model for disease or are out of its perimeters--and if they are outside, then treat with drugs. For one thing, this type of medicine neglects to see that individuals might not fit the model--there might be someone who tests "normal" on thyroid function but who exhibits all the markers for hypothyroidism. And there may be people who would do just as well, if not better, on a protocol of supplementation rather than going immediately to drugs. An example of this would be someone just diagnosed with Type II diabetes. A low glycemic diet coupled with use of supplements such as chrome (which regulates blood sugar) might mean this person never has to become insulin dependent.

Integrative medicine doesn't mean throwing alliopathy out the window. It doesn't mean some doctor says "Take Vitamin C and you'll get well and I don't have to check up on you." What it does mean is that all the various healing modalities can come into play as needed for each individual case. If a person can stop liver damage from Hep C by having Vitamin C IVs and taking Chinese herbs, and is closely monitored to make sure these protocols are working, isn't that better than putting him on Interferon and having him get a horrid reaction and be unable to work?

[BurtWorm]

2. Which do you think more urgently needs to be implemented in a universal care system?

Evidence-based therapies (whether science-based or alternative) or alternative therapies (whether or not there is peer-reviewed evidence for their validity)? Or do you think this is a false dichotomy?

[ayeshahaqqiqa]

5. Check the literature

you'll find, as you said, that there have been numerous studies on alleopathic and "alternative" therapies. You seem, by your sentence construction, to imply that alternative therapies aren't evidence based. As for therapies that have not undergone peer review--well, that is the realm for studies so that peer review can be done, is it not?

[BurtWorm]

9. On the contrary, I purposely did not make that distinction.

I made a point of including hypothetical alternative therapies under "evidence-based" and including hypothetical evidence-based therapies under the "alternative" category. I'm asking which should be given priority in constructing a universal health care plan: evidence-based therapies or alternative ones.

In other words, which criterion is more urgently needed for a reformed health care system, now that we have the chance to reform it?

I will make a case for and against evidence-based therapies being more important to be included in reform:

For: Evidence-based therapies are those that are demonstrated to be effective, and proven therapies are more likely to be cost-effective than unproven ones. Cost-effectiveness is no doubt going to be a central criterion for policy-makers when deciding how to implement reform, given the state of the economy. Unproven therapies, then, should be set aside until we have the luxury to prove or disprove them. Private funds can continue to go toward creating and testing these therapies, but public funds should be geared toward making only proven therapies available to the public.

Against: Just because a therapy is unproven doesn't mean it is uneffective. It often means it hasn't been tested or given a chance to prove itself. Thus, including only proven therapies in a reformed health care system might be barring therapies that are effective--and this often means so-called alternative therapies--but haven't been shown to be in controlled, peer-reviewed studies. Reform must have some flexibility built into it to ward against excluding therapies that might be effective on the philosophically (and possibly morally) dubious basis that they haven't been tested the way evidence-based therapies have.

Do either of these arguments seem more reasonable to you? Or are there different arguments you would make?

[ayeshahaqqiqa]

10. Like you,

I'm for using therapies and healing modalities that have been shown to be effective. But I'm also thinking that some public funding should go towards studies that can help us solve the mysteries of cancer and heart disease. I know that the ACS and AHA provide funds for research, but if government funding would help find therapies to cure these diseases or, better yet, prevent them, I'm all for it.

The key as far as I am concerned when it comes to keeping health care down is through prevention--and that comes from each individual finding out what they should eat, what exercises are right for them, and what supplementation might help them.

[MorningGlow]

3. Well said, Ayesha

I fit both your examples. My hypothyroidism is subclinical. No "regular" doctor would treat me. My homeopathic m.d. (she has a "real" medical degree and is well versed in supplements and alternative treatments) saved my life. She also helped me avoid becoming diabetic, although I am insulin resistant. Because she refuses to let an HMO dictate to her how long she should visit with a patient, her practices are "incompatible" with our standard HMO procedure and gradually parted ways with all of them. My previous HMO (Aetna) didn't give a rip if I listed her as my primary care doctor, so I continued to see her even though I had to pay full price for all my office visits. Now I'm covered under Mr. MG's BlueCross/BlueShield, and they threw a fit (I love being "threatened" by HMO customer service reps over the phone) until I picked a "real" doctor from their list. I don't like my new doctor much and just go to him when I have a sinus infection. I still see my holistic m.d. for thyroid treatment.

[ayeshahaqqiqa]

7. I fight with insurance companies all the time

because the MD at our Foundation has many patients whose thyroid test falls in the "normal" range and yet exhibit all the symptoms of hypothyroidism. Like your homeopathic MD, our MD saved a life--my husband's. He was going into cirrhosis of the liver from Hep C when she discovered it via an eye exam. He went on Vitamin C/Alpha Lipoic Acid IVs and Chinese herbs--and last year when he had a liver screening, the tech said his liver appeared perfectly normal--in fact, he said, "No way you could ever have had hepatitis!"

[Flying Dream Blues]

4. I agree with you, ayeshahaqqiqa!

There needs to be room for both kinds of medicine, especially with regard to preventive care.

[ayeshahaqqiqa]

6. Thank you for mentioning preventative care

I think everyone will agree that preventative care is one very big way to keep health costs down and to improve the quality of life. The task is to define preventative care. Is it merely the yearly mammogram for women, for example? Or is it consulting with your doctor to find out what is the right diet for you (I'm not taking weight loss here--I'm talking about foods you should eat and foods you should avoid), the right exercise plan for you, and the right supplementation for you? Obviously, I favor the latter, though I am also all for yearly check ups with screenings as needed.

[MagickMuffin]

8. What is Integrative Medicine?

Integrative medicine is healing-oriented medicine that takes account of the whole person (body, mind, and spirit), including all aspects of lifestyle. It emphasizes the therapeutic relationship and makes use of all appropriate therapies, both conventional and alternative.

* Patient and practitioner are partners in the healing process.

* All factors that influence health, wellness and disease are taken into consideration; including mind, spirit, and community as well as the body.

* Appropriate use of both conventional and alternative methods facilitates the body's innate healing response.

* Effective interventions that are natural and less invasive should be used whenever possible.

* Integrative medicine neither rejects conventional medicine nor accepts alternative therapies uncritically.

* Good medicine is based in good science. It is inquiry-driven and open to new paradigms.

* Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount.

* Practitioners of integrative medicine should exemplify its principles and commit themselves to self-exploration and self-development.



Dr. Andrew Weil has been practicing Integrative Medicine for decades he is a well respected Doctor. He has been trying to educate the public about Integrative Medicine for years. There is no reason to reject ALL forms of Healthcare. Most MD's refuse to acknowledge the aforementioned science of Integrative Medicine.