(This is the 3rd of four posts on the effectiveness of “natural” or “alternative” health care.)
Third Party Coverage
Presently Germany, which has publicly guaranteed health care for all its citizens, is the only country to offer “natural” health care on a par with western medicine. However even in the US, where most health care funding is private, an increasing number of insurance companies offer coverage for “natural” or “alternative” health care. There is usually a requirement these services be offered in conjunction with traditional or “allopathic” care. The jargon used for these mixed mainstream-alternative health models is “complementary” or “integrative” medicine. Most insurance companies require that complementary and alternative medicine (CAM) providers be represented by a professional body with a formal accreditation process. There is also an expectation 1) that the accreditation body will establish clear treatment standards and 2) that all funding will be evidence and outcome-based. In other words, CAM providers must demonstrate a treatment actually works to be eligible for funding.
Some analysts are projecting that insurance coverage for natural health care will be even easier to access under Obamacare – at least for patients who can afford the higher premiums of silver, gold, and platinum plans. The uninsured and patients locked into Medicaid or bare bones bronze plans will be out of luck.
Natural Health Databases
The requirement for natural health services to be “evidence based” has led to the creation of a number of natural health research databases. Three of the most popular are the Mayo Clinic Alternative Medicine database, the NIH Complementary and Alternative Medicine database, and the Cochrane Complementary Medicine database.
The Mayo Clinic is a world famous “mainstream” medical center in Minnesota. Their database is by far the most comprehensive and user-friendly. The following statement on their home page summarises their philosophy:
“Exactly what’s considered complementary and alternative changes constantly as treatments undergo testing and move into the mainstream.”
The site provides up-to-date research summaries on a broad range of alternative treatment approaches. For example, here is what they have to say about aromatherapy:
Research on the effectiveness of aromatherapy — the therapeutic use of essential oils extracted from plants — is limited. However, some studies have shown that aromatherapy might have health benefits, including:
- Relief from anxiety and depression
- Improved quality of life, particularly for people who have chronic health conditions
Essential oils used in aromatherapy are typically extracted from various parts of plants and then distilled. The highly concentrated oils may be inhaled directly or indirectly or applied to the skin through massage, lotions or bath salts. Aromatherapy is thought to work by stimulating smell receptors in the nose, which then send messages through the nervous system to the limbic system — the part of the brain that controls emotions.
Many essential oils have been shown to be safe when used as directed. However, essential oils used in aromatherapy aren’t regulated by the Food and Drug Administration. When applied to the skin, side effects may include allergic reactions, skin irritation and sun sensitivity. In addition, further research is needed to determine how essential oils might affect children and how the oils might affect women who are pregnant or breast-feeding, as well as how the oils might interact with medications and other treatments.
I find the NIH and Cochrane databases less helpful. Both seem quite biased towards mainstream medicine and randomized controlled trials (RCTs). Many alternative treatment methods don’t lend themselves to RCTs because it’s virtually impossible to provide “sham” treatment (e.g. sham acupuncture, cupping, or aromotherapy) for the placebo group. Both NIH and Cochrane ignore the abundance of crossover design CAM studies in which the patient serves as their own control. In these studies, treatment is withdrawn once a clear response is established. It’s then reintroduced when symptoms recur.