The Only Solution Possible to the Healthcare Crisis in America / 

The Physician has but a single task: to cure; and, if s/he succeeds, it matters not a whit by what means s/he has succeeded.                          

Hippocrates (400 BC) 

Contradictions do not exist. Whenever you think you are facing a contradiction, check your premises. You will find that one of them is wrong.

Ayn Rand

Abbreviations used in this paper:

FSMB – The Federation of State Medical Boards of the United States, Inc.

CAM – Complementary and Alternative Medicine

OPMC – The Office of Professional Medical Conduct

Introduction – Is the US Healthcare System Good for Us?

Most people will agree that the US healthcare system is struggling and suffering from a severe ailment, but there is widespread disagreement about possible treatments and solutions.  In this paper, I am going to tell you about the only remedy that could possibly heal the healthcare system and reverse its terminally ill condition.  This remedy is unlike the popular, pulp fictions circulating in the media, a remedy which you may have not encountered until now.  But before we can provide that remedy, we must properly diagnose the patient and become very clear as to what causes its illness.

The so-called “Healthcare Crisis in America” has been in vogue for decades. It usually refers to the fact that tens of millions of Americans are uninsured, underinsured or uninsurable, as if throwing more money at healthcare to make everyone insured will somehow make the problems go away. The US already spends far more money per capita and as a percentage of the US GNP than any country in the world[1]. Various other problems – the lack of Medicare prescription drug benefits, malpractice insurance, and deaths from medical errors – are identified by consumer organizations, political parties and the media, and they all  are based on a common premise – that the US healthcare system is good for us. Therefore, if it is good for us, anything which deprives us of our access to the “good” healthcare, is thought to be the problem. 

Fortunately, this blatantly false premise has been questioned. The Journal of the American Medical Association, arguably the most authoritative medical journal in the world, has reported that the US healthcare system itself is the third leading cause of death [behind cardiovascular disease (#1) and cancer (#2)], killing over 200,000 Americans per year as a conservative estimate, mostly due to the effects of prescribed drugs[2]!  When doctors went on strike recently in Israel, mortality statistics apparently declined![3]  There appears to be a contradiction here.  Is healthcare good for us or not?  Is the healthcare system in a crisis because so many believe they are facing a deadly dilemma by not having access to modern healthcare, or is it in crisis because those who avail themselves of modern healthcare could find themselves in an equally deadly dilemma?  One might reflect on Ayn Rand’s admonition above that: “Contradictions do not exist. Whenever you think you are facing a contradiction, check your premises. You will find that one of them is wrong.”  

Apparently millions of Americans have already checked out their premises regarding healthcare and have decided that at least some aspects of modern healthcare are dangerous, perhaps reasoning that anything capable of killing at least two million Americans per decade should be avoided.  They are a rapidly expanding group of Americans[4] who are putting their faith and their dollars into CAM[5] (Complementary and Alternative Medicine):

“Estimated expenditures for alternative medicine professional services increased 45.2% between 1990 and 1997 and were conservatively estimated at $21.2 billion in 1997, with at least $12.2 billion paid out-of-pocket. This exceeds the 1997 out-of-pocket expenditures for all US hospitalizations. Total 1997 out-of-pocket expenditures relating to alternative therapies were conservatively estimated at $27.0 billion, which is comparable with the projected 1997 out-of-pocket expenditures for all US physician services.”

Note that these are out-of-pocket expenditures. Although amounting to tens of billions of dollars, nevertheless these fall far short of the expenditures of Medicare (277 billion)[6], Medicaid and private insurance companies, which are derived from compulsory taxes or employment benefits and which generally cover very few CAM services.  Why are Americans forced to pay for healthcare that is potentially dangerous and which does not cover the generally non-invasive, increasingly popular and far safer CAM services? 

In order to answer this question and those posed above and potentially solve these apparent contradictions, we must check out another basic premise that rarely gets asked.  Are the command and control structures and organizations within the US healthcare system, especially those charged with the responsibility to protect consumers of healthcare, actually concerned that the system they have designed and maintain is itself the third leading cause of death?  Is anyone missing sleep over the fact that at least two million Americans are killed every decade?  Or do these command and control structures and organizations within the US healthcare system have some other motivation that compels them to obstruct genuine progress and innovative solutions to the so-called healthcare crisis in America?  

Who Determines the Policies that Govern the Professional Conduct of Healthcare Professionals?

In Jacobson v. Massachusetts[7] and Dent v. West Virginia[8] the United States Supreme Court has held that the police power of the states allows them to regulate the practice of medicine in order to protect the health, safety, and welfare of its citizens.  The means by which state medical boards are supposed to protect consumers of health care is through proper licensing and regulation of physicians and, in some jurisdictions, other health care professionals.[9]  The fundamental premise of these regulations is that:

“the practice of medicine is not an inherent right of an individual, but a privilege granted by the people of a state acting through their elected representatives. To protect the public from the unprofessional, improper and incompetent practice of medicine, it is necessary for the state to provide laws and regulations that outline the practice of medicine and the responsibility of the medical board to regulate that practice. This guidance is outlined in a state statute, usually called a medical practice act.[10]”

The FSMB[11] (Federation of State Medical Boards of the United States, Inc.) is a national organization comprised of the 70 state medical boards of the United States, the District of Columbia, Puerto Rico, Guam and the U.S. Virgin Islands.  The FSMB initiates and strengthens cooperation among boards, facilitates collaborative efforts between boards and other entities, develops unified policy positions and acts as a trusted advocate for these positions[12].  The medical boards of each state enforce their regulation of the practice of medicine with the use of police powers, however they are obliged to obey the directives of the FSMB, the parent organization that sets forth the policies by which those police powers are used.  

One of the policy documents published by the FSMB is entitled the Report on Questionable and Deceptive Health Care Practices:[13]

“In April 1995, Federation President Robert E. Porter, MD, established a special committee on health care fraud. The need for such a committee arose from the proliferation of unconventional and unproven medical practices and promotions in the United States[14], some of which may be questionable and thereby pose a risk to public health, safety and welfare. Recent national and state legislative initiatives[15] (footnote mine) prompted further concern because they could result in restricting state medical boards' ability to provide appropriate regulation of such practices. The Federation of State Medical Boards' governing body accepted this Report (Report on Questionable and Deceptive Health Care Practices) as policy in April 1997.” [16]

The Report on Questionable and Deceptive Health Care Practices further states that[17]:

“Additionally, for the purposes of this report, the terms “alternative medicine/therapy” and/or “complementary medicine”[18] (footnote mine) have not been utilized by the committee due to a lack of consensus among both practitioners and the public as to their meaning. The committee has chosen to use the term "questionable health care practices" to include those treatments, procedures and/or promotions, conventional or unconventional, which may be unsafe and thereby considered a risk to the public's health, safety and welfare and/or which may be worthless and thereby likely to deceive or defraud the public.”

Besides the terms “unsafe,” “questionable,” “worthless” and “deceptive” used repetitively by the FSMB’s special committee on health care fraud in this report, a denigrating litany of other adjectives are provided to clarify their position about Complementary and Alternative Medicine (CAM) and their bias against CAM physicians.   The FSMB’s special committee on health care fraud in this report suggests that CAM is supposedly posing “a risk to public health, safety and welfare,” that CAM is “unproven,” “unprofessional,” “improper,” “unlawful,” “fraudulent” and “felonious,” and that CAM physicians are “incompetent,” “unprofessional,” “fraudulent” and are not practicing “responsible medicine.”

The FSMB’s special committee on health care fraud lists several objectives of the report including:[19]

• To develop recommendations to assist state medical boards in identifying, evaluating, investigating and prosecuting cases involving questionable (CAM)[20] health care practices.

• To develop strategies to monitor legislative initiatives supporting increased access to unconventional and unproven treatments and assist state medical boards in responding to such initiatives in the interest of public health, safety and welfare.

Frightening tactics suggestive of McCarthyism[21] pervade the FSMB’s recommendations:

“State medical boards should carefully evaluate all avenues of potential prosecution and coordinate such with appropriate federal, state and local agencies[22].

• Federal Trade Commission (deceptive/fraudulent health care promotions/claims);

• State Attorney General (consumer complaints/protection and deceptive/fraudulent health care promotions/claims);

• State Insurance Board/Commission (billing practices);

• Health Care Financing Administration (Medicare claims);

• U.S. Postal Service (mail fraud);

• U.S. Customs Service (import of unapproved/illicit drugs/devices);

• Food and Drug Administration (unapproved drugs/devices); and

• District Attorney (unlicensed practice of medicine and related criminal offenses).”

Thus the FSMB is the lynchpin[23] responsible for the prosecution of CAM physicians and as will be discussed below, by virtue its supervision of its member state board’s use of police powers, the FSMB’s exercise of its virtually unlimited power to control the US healthcare system through its providers is the primary obstacle to genuine progress and innovative solutions to the so-called healthcare crisis in America. 

The Chilling Effect of CAM Physician Prosecution 

versus 

the Explosive Growth and Popularity of CAM

The prosecution of CAM physicians by state medical boards strongly discourages conventional doctors from expanding their scope of practice to include innovative CAM methodologies, thus generating a chilling effect in the medical community that spreads far beyond those CAM physicians who are singled out.[24] 

“These practices and court decisions have indeed had a chilling effect on physicians who might consider integrating innovative medical care into their practices.  Physicians who currently use any innovative medical care in their practices have been particularly vulnerable to charges of professional misconduct.  Physicians who have been investigated and charged with misconduct by the OPMC[25] have faced financial devastation, loss of reputation, and the eventual revocation of their medical licenses.  Tens of thousands of patients (in New York State alone)[26] have simultaneously lost their choice of medical treatment and physician.  In addition, because of the limited availability of physicians who practice innovative medicine and the chilling  effect of the risks associated with the practice of nonconventional medicine by others who may consider it, these patients will be severely limited in their future choice of medical treatment.”[27]

Despite the FSMB’s and their member state medical boards’ efforts to curtail consumer access to CAM by prosecuting CAM physicians, surveys[28] now suggest that more Americans consult CAM practitioners than conventional medicine trained physicians.  The Report on Questionable and Deceptive Health Care Practices[29] states that:

“The need for such a committee (special committee on health care fraud)  arose from the proliferation of unconventional and unproven medical practices and promotions in the United States, some of which may be questionable and thereby pose a risk to public health, safety and welfare. Recent national and state legislative initiatives prompted further concern because they could result in restricting state medical boards' ability to provide appropriate regulation of such practices.”

As noted above, the special committee on health care fraud suggests that CAM is unproven, unprofessional, improper, unlawful, fraudulent, felonious, unsafe, questionable, worthless and deceptive. Therefore, one can only conclude that from the committee’s perspective, as well as from the FSMB’s and its member state boards’ perspective, the popularity of CAM could not possibly be due to any intrinsic value of such “worthless” CAM practices. We can only surmise that the special committee on health care fraud, the FSMB and its member state boards operate from a fundamental and false premise that the surge in CAM’s popularity is due to “promotions” perpetrated by “fraudulent” CAM providers that have mislead the public. This operating false premise provides the rationale for the zealous prosecutions of CAM physicians. In other words, CAM physicians are dangerous to the public and therefore they must be prosecuted in order to protect the public. 

“In order to offer reasonable protection to the public, state medical boards must be able to identify physicians who engage in questionable (CAM)[30] health care practices which may endanger the public, either directly or indirectly. Direct harm may result in adverse patient outcomes and indirect harm may result in delay of appropriate diagnoses and/or treatments.[31]”

Most importantly, note the FSMB’s premise that CAM’s harm is also based on distracting consumers from “appropriate diagnoses and/or treatments” provided by supposedly “safer “conventional medicine care. And again, suggestive of McCarthyism, the special committee on health care fraud instructs the member state medical boards about surveillance of CAM physicians.

• “Encourage consumer/patient reporting by increasing awareness among the public through distribution of educational materials and utilizing media sources.

• Encourage and expand reporting from licensees and other health care professionals by increasing awareness of reporting requirements through newsletters, announcements, alerts, advisory opinions and collaboration with state and local medical professional organizations and societies.

• Expand liaison efforts with regulatory agencies (federal, state and local), including the Federal Trade Commission, other state licensing authorities, state attorneys general, district attorneys and public health departments.

• Improve reporting from third party payers and peer review organizations (PROs).

• Periodically monitor health care promotional materials, including random review of newspapers, periodicals and other advertising mediums.

Thus an airtight surveillance system is constructed to spread the chilling effect far and wide in the medical community.  Prosecution of CAM physicians sends a clear message to conventional medicine physicians that they had better not expand their scope of practice to include CAM interventions.  Advertisements, periodicals, health care promotional materials and newspapers are monitored to detect CAM activity. Insurance companies are encouraged to report any suspicious CAM activities, so they are certainly not going to cover CAM services for fear of being singled out for prosecution as well.  Other governmental agencies including the attorney generals office and the FTC are put on notice to report CAM behaviors.  Citizens groups and professional organizations are instructed to all be vigilant for any supposedly unproven, unprofessional, improper, unlawful, fraudulent, felonious, questionable, worthless, unsafe, questionable and deceptive CAM care and do their civic duty by reporting it to the state medical board.

Essentially CAM physicians secretly blacklisted as potential criminal and subversive elements in society and a secret shadow bureaucracy skulks in the shadows keeping secret dossiers on mostly unsuspecting, innovative physicians who are willing to utilize safer, less invasive, natural and often more efficacious and cost effective CAM care.  Perhaps one premise that needs to be checked out when contradictions seem to exist in healthcare, is that this could not happen in America.

The Dangers of Conventional Medicine and the Popularity of CAM

The FSMB’s special committee on health care fraud’s suggestion that CAM could be unsafe, implies conversely that “appropriate[32],” conventional medical care must be safe.  How valid is this assumption?  As discussed in the introduction above, an article published in the Journal of the American Medical Association addresses the question about the safety of the US healthcare system and compares the US mortality and morbidity statistics to more than a dozen leading western nations. Considering the suppression of innovation and health freedoms discussed above, it should come as no surprise that the US is found to rank in next to last place. But more importantly, this article identifies the United States healthcare system itself to be the third leading cause of death (behind cardiovascular disease and cancer), killing as a conservative estimate over 200,000 Americans per year, mostly due to drug reactions. 

[32] Various terms used in place of  “appropriate” medical care are in vogue, such as “usual and customary care,” “medically necessary care” and treatment which follows the “accepted standards of care.”  These terms are often used to deny insurance coverage for CAM interventions and even some conventional medical treatments.  

Thus the explosive interest in CAM might not be due to mislead consumers.  Instead, perhaps consumers are acting on their best instincts and/or in their own self interest, realizing that much of conventional medicine, especially drug treatments, either pose an unacceptable risk of harm or are potentially ineffective for many kinds of medical problems.  The FSMB’s premise, that consumers are mislead and uninformed and in need of protection from CAM physicians, borders on delusional and paranoid ideation.  The obvious evidence points to an opposite conclusion, that consumers are indeed mislead, but not by CAM providers.  They are mislead by the FSMB and its member state boards of medicine who have a chokehold on American healthcare policy and capriciously use the police powers of the state to maintain it.  The prosecutions of CAM physicians and the consequent chilling effects on conventional medicine physicians, the very professionals who would reform US healthcare and have been trying for decades to solve problems, such as the JAMA mortality statistics cited above, has brought innovation and reform to a dead halt.  The FSMB and their member state medical boards have not only created a condition whereby “patients will be severely limited in their future choice of medical treatment.[33]” The FSMB and their member state medical boards are bringing unfathomable harm and suffering to the American public.

It should be noted that those western nations that ranked at the top of the list in their morbidity and mortality statistics in the JAMA reference cited above, such as France (#1), are nations where physicians openly promote and practice CAM (e.g., colonic therapy, homeopathy) without fear of prosecution by regulators.

[33] Barrette, op. cit. p. 121  

Negligence, Incompetence and Fraud

When a physician expands their scope of practice beyond the conventional practices of drug treatments, radiation or surgery, to include certain non-pharmacological and non-surgical CAM interventions such as homeopathy, nutritional medicine or craniosacral therapy, they risk being charged with “violating the accepted standards of care.”  In other words, the three main kinds of alternative medical practices, structural (e.g., massage therapy), energetic (e.g., homeopathy) and biomolecular (e.g., nutritional interventions) are considered by the FSMB’s special committee on health care fraud to be based on “unacceptable standards of care.” After the initial secretive investigations and interrogations of a physician, who is suspected of devoting a significant portion of their practice to CAM, is concluded, and they are deemed to have crossed some ill-defined threshold which qualifies them to be sufficiently in violation of the equally ill-defined “accepted standards of care,” charges of negligence, incompetence and fraud are sure to follow.

    Let’s examine the basic dictionary definitions of the terms negligence, incompetence and fraud to get to the heart of this issue.

neg·li·gent   adj.  1. habitually failing to do the required thing; neglectful   2.  careless, inattentive, etc. – neg’li·gence n.

in·com·pe·tent   adj.  without adequate ability, knowledge, fitness, etc.  –n.  an incompetent person – in·com’pe·tence n.

fraud   n. 1. deceit; trickery   2. Law intentional deception  3. a trick  4. an imposter.

The critical phrase here is “the required thing” contained in the definition of the term negligent above.  “The required thing” that a CAM physician must do, is entirely different from “the required thing” that a physician’s medical school training required them to do.  A CAM physician is “required” to cure or heal their patients or provide a means by which their patients can engage in a curative or healing process.  Stated another way, the primary objective of a CAM physician is to reverse diseases and disorders by recruiting dormant internal processes within their patients or by doing so prevent illnesses from happening at all. 

The “required thing” learned in conventional medical school training, is generally to manage the symptoms of disease, usually with drugs, but to not necessarily reverse disease by addressing the underlying bionutritional or energy imbalances that actually cause disease.  A conventional medicine doctor, although compassionately every bit as interested in healing and helping patients, is “required” to conform to the “accepted standards of care,” which essentially boils down to managing the symptoms of disease and disorders with drugs, surgery or radiation. 

“The required thing” that consumers increasingly want of their physicians is to prevent, cure and heal diseases and disorders, and only manage them with drugs, surgery and radiation as a last resort.  The quote from Hippocrates at the beginning of this article, that “The Physician has but a single task: to cure; and, if s/he succeeds, it matters not a whit by what means s/he has succeeded,” suggests that a much older, traditional version of the “accepted standards of care” is in greater compliance with the objectives of CAM physicians and many consumers.

From the perspective of a CAM physician, the conventional physician is potentially negligent because by not emphasizing the prevention, cure and healing of disease and disorders in the care of their patients. They are in violation of CAM’s accepted standards of care.  From the perspective of a conventional physician, the CAM physician is potentially negligent because they have violated their version of the accepted standards of care, by not emphasizing the management of the symptoms of diseases and disorders with drugs and surgery in the care of their patients.  Each group is not doing the “required thing” that the other group does.  Each group is violating the “accepted standards of care” of the other.  Each group appears negligent to the other. 

The FSMB and their member state medical boards fail to validate CAM’s accepted standards of care and consequently proceed to enforce conventional medicine’s standards of care at the expense of CAM’s standards of care. CAM physicians are often prosecuted to “protect the public,” but those prosecutions are based solely on an interpretation of an accepted standard of care that CAM physicians would consider to be incomplete, mostly obsolete and dangerous. CAM physicians are now well-equipped to level a substantive countercharge, that if single entity or group deserves prosecution for violating medically sound standards of care, it should be the FSMB, their member state medical boards and conventional medicine physicians.

After decades of CAM practice, admittedly many CAM physicians fail to keep abreast of the latest drug treatments and surgical procedures.  Why should they?  As CAM physicians devote an increasing portion of their time and resources to CAM and thereby improve their healing skills, many symptom management strategies using drugs and surgery become increasingly obsolete and they fall out of vogue in a CAM practice.  Thus CAM physicians increasingly appear to be incompetent to conventional physicians.  Likewise, most conventional physicians were never trained in CAM and as a CAM physician becomes more skilled and knowledgeable, conventional physicians appear to be increasingly incompetent.  As with the issue of negligence, each appears incompetent to the other.

Likewise each appears fraudulent to the other.  Conventional physicians believe that prevention, cure and healing is impossible for most of their patients with chronic degenerative disorders, a valid position indeed if treatments are only limited to drug, surgical and radiation therapies. When CAM physicians witness apparent cures in patients with “irreversible and incurable” problems, naturally they often have difficulty containing their exuberance and can inadvertently make claims that are unjustified. Conventional physicians dismiss CAM physician’s claims of efficacy as fraudulent because their CAM interventions, often involving a dozen or more different interventions simultaneously are not “proven” by controlled studies.  In fact they cannot be “proven” because each array of non-drug, non-surgical treatments is tailored to the exact needs of the patient.  CAM physicians counter that conventional physicians are fraudulent, because they claim that disease management with drugs and surgery is prevention, cure and healing, which is absurd. Except under limited circumstances such as antibiotic treatments for infectious diseases, treatments using drugs, surgery and radiation by their very nature cannot prevent, heal or cure disease or disorders.  Optimizing biochemical functioning and energy flows in the body cannot be achieved by cutting (surgery), burning (radiation) or poisoning (drugs) the body. 

Conventional medicine physicians often believe that alternative medicine physicians are guilty of negligence, incompetence and fraud.  CAM physicians often believe that conventional medicine physicians are guilty of negligence, incompetence and fraud.  Both are right in their assessment of the others, because both practice from a different standard of care.  Often there is no compromise between these two camps because each side’s position is well staked out and impregnable.

However, CAM physicians do have formal training in conventional medicine and certainly find value in some applications of drug therapies and surgery.  The first word abbreviated in the acronym CAM, complementary, connotes an attempt to arbitrate a truce and complement the conventional with the non-conventional.  From the CAM perspective, that may be a wise option as their potential adversary has all “the guns” and obviously relishes the opportunity to use them.

Both standards of care can and eventually will coexist peacefully but the decisions as to when to apply one or the other, or mix them together, add tremendous complexity to clinical decision making.  However, as long as most conventional medicine physicians, the FSMB and its member state medical boards remain ignorant of CAM, they can be expected to continue blindly on, holding to their false premise that they are protecting the public by preventing innovation and prosecuting physicians who could usher in a new age of medicine – an age where authentic healing and curing becomes the treatment of first resort and the equally important palliative symptom treatments with drugs, surgery and radiation will be relegated to treatments of last resort.

Economic Considerations

The ethical foundation in the practice of medicine has been and will always be at odds with economic factors governing a successful medical practice.  When patients become well, they no longer return for regular office visits and they no longer purchase drugs or medical services. Therefore if a physician holds to the CAM version of accepted standards of care, that the “required thing” is the prevention, healing and curing of disease, they will inherently find themselves in a financial conflict of interest.  One cannot build an economically successful practice on well patients only.  CAM physicians who follow CAM accepted standards of care and also contractually agree to maximize earnings as part of certain corporate responsibilities, must find creative ways of continuously generating new business in order to meet their financial obligations, because their CAM treated patients frequently and rapidly become well and once well, will no longer depend on their healthcare provider for their products and services.  CAM patients are frequently “lost to wellness.”     

Conventional medicine physicians are also potentially in a conflict of interest but for opposite reasons.  By adhering to the accepted standards of care of conventional medicine, which is the management of disease symptoms primarily with drugs, since patients don’t generally get well, they must regularly return for office visits and prescriptions.  There is no economic conflict of interest here as such a practice maximizes the patient’s dependency on the providers products and services, thus the conventional medicine physician is meeting their fiduciary obligations.   However, if such a physician comes to understand CAM and its very different accepted standards of care, they could be an ethical conflict of interest.  Remembering the quote from Hippocrates at the beginning of this paper, “The Physician has but a single task: to cure; and, if s/he succeeds, it matters not a whit by what means s/he has succeeded. Allowing patients to stay fundamentally ill and dependent on ongoing products and services, in order to keep them as a customer, is a gross ethical violation however well their symptoms are managed with drugs.

In order for any corporation to be economically successful, its products and services must be marketed in a manner designed to maximize consumer dependency or a belief of dependency in the mind of the consumer.  For instance, the marketing objective of those annoying ads for promising drugs or for the local HMO (health maintenance organization) that now flood the media, is to plant a need, a perceived dependency, for that product or service.

Alternative medicine’s products and services undermine corporate healthcare’s economic objectives because in various ways, consumers come to a realization that healing is a natural inward process which is fundamentally independent of corporate medicine’s products and services.  What if large numbers of consumers discovered that the technology of life within them possesses virtually infinite complexity and healing capacity? What would happen if consumers were to find out that the best of modern medical technology is comparatively crude and barbaric in comparison to only one of the hundred trillion or so cells in one’s body? Their belief in a dependency on conventional medicine’s drugs, surgery and radiation could be shaken. Therefore, “the required thing” of the corporate, conventional healthcare system is economic success, and charges of corporate negligence could be leveled at CAM physicians who might assist consumers to come to the realization that they are capable of healing themselves. 

Information in any economic system flows between the buyers and the sellers.[34]  In the conventional “healthcare” system, actually more properly designated as the disease management system, the buyers of healthcare are the government (Medicare and Medicaid) and the insurance companies. The sellers are the doctors, hospitals and clinics.[35]  The consumer is not in the information loop and is only provided enough information, often misinformation and disinformation as is necessary, to keep them dependent (or believe they are dependent) on the disease care system.  Market forces that would govern the rest of the US economy, where the consumer out of their own self-interest shops around for the best service at the best value, play a minor role in the US disease management system.[36]  As discussed above, consumers are increasingly interested in becoming well, staying well and becoming independent of drugs, surgery and radiation as much as possible.  But consumers are forced, especially by the chilling effects of prosecution of CAM physicians, to accept the services assigned to them by insurance companies and the government, a system that economically thrives on disease management and discourages wellness and consumer independence.

Physicians who cooperate with the objectives of a disease management system receive handsome economic compensation and benefit from a relatively high social status.  CAM physicians must be somewhat willing to risk their economic success and professional prestige in order to support their patient’s objectives of wellness and independence.  Because CAM physicians threaten the monolithic disease management sy