Should Healthcare Cover Alternative Treatments? | Bogdan Chugunov
Bogdan Chugunov joins Dr Werrell to discuss alternative health practices from the Siberian people, and discuss whether alternative treatments like these should be covered by insurance.
ON THIS EPISODE OF THE BEST MEDICINE PODCAST
Our Guest: Bogdan Chugunov
Today's episode of BEST MEDICINE is a rather interesting one on the topic of alternative treatments.
I had the pleasure of speaking with Bogdan Chugunov.
Bogdan is a celebrity of sorts in his Russian community for utilizing Manuka honey and other alternative treatments to heal people.
I want to state up front - this episode is not an endorsement or disavowal of these practices. You should speak with your doctor about what's best for you.
With that in mind, I think you'll really love hearing from Bogdan and seeing where this episode goes.
The Ethics of Health Insurance
Many of us have noticed that Insurance Companies tend to only pay for Symptom Management.
It is obvious to most of us that's because giving a Diabetic person insulin for decades is more profitable than fixing their nutrition lifestyle over the span of one or two years.
However, there are many alternative treatments on the market. (Our guest, Bogdan speaks highly of Manuka Honey, for instance).
These treatments tend to be more relevant in the "disease prevention" category, not in symptom management.
Alternative treatments are dismissed as unscientific and ineffective.
I am NOT going to make scientific or medical truth claims in this article, but I am going to examine the incentive structure behind this implicit assumption.
Why Are Alternative Treatments Considered "Unscientific?"
There is an assumption that alternative treatments are unscientific, or ineffective compared to pharmaceuticals.
In certain cases, this is undeniable.
Bogdan is a huge proponent of Manuka Honey for treating ailments.
While I'm no expert in the exact functions of Manuka Honey, a brief search has told me there is medical and scientific literature out there that proves some kind of benefit.
But have you ever heard of a doctor prescribing honey in the west? I haven't!
I would posit that there is a fundamental bias in our system towards symptom management due to the way we incentivize product creation/approval and fund research.
In America, it is most common that a pharmaceutical company will note that there is a symptom, set of symptoms, or an illness.
In some cases, if they cant identify a real symptom or syndrome, they'll ask the marketing team to invent one.
There’s a substantial body of medical literature dating back to the early ’90s about the practice known as “disease mongering.” Pharmaceutical companies regularly pathologize everyday experiences, convince doctors that they are serious problems, tell a hypochondriacal public it needs help and offers the cure: a new drug. ~ Huffington Post
We now have a control for the study. In any scientific study we must have a control group and a testing group. For example, to test weight loss benefits of a ketogenic versus a vegan diet, you would need one group that is very overweight, and one group that was not. Then on each of those populations you'd have 1/3 try a ketogenic diet, 1/3 try a vegan diet, and 1/3 change nothing at all about their eating habits.
The entire purpose and standard of the study is answering the question:
"How does X treatment alter Y problem?"
This is all well and good, as far as learning how to cure problems go. That's pretty important!
But alternative treatments are often judged on a standard that they are not meant to hit.
Many people who are "into" alternative treatments will use them preventatively.
This does bring the risk of placebos (for example, "does eating celery help you lose weight, or are people who eat celery the kind of people likely to lose weight through a variety of functions?")
But on the whole, alternative specialists follow a reverse-incentivized model as traditional doctors. As such, their treatments follow an inverse (but allied) goal to the studies of mainstream science.
Traditional medicine aims to take sick people and manage specific symptoms (I mean, "cure" them).
Alternative treatments aim to give healthy people a way to lower their risk of developing health problems at a foundational or holistic level.
There's a whole other article to be written about the problems in the alternative health community. Where traditional doctors will peddle pills for decades, alternative healers will often dramatically exit their scope of practice and prescribe nonsense "cure-alls" as a means for treating serious illnesses. There is also a "pre-symptom management" problem in the alternative community (the overarching financial incentives in our system are still the same for both factions of the health industry, after all). Often times people will get stuck buying monthly health coaching, quarterly essential oils dropoffs, etc.
All this is to say:
The entire scientific and medical apparatus are geared around "manage symptoms" NOT "prevent illness." This leads to many "alternative" treatments that ARE useful being ignored completely as pseudo-science (despite in the case of Manuka Honey, there actually being scientific literature proving use). The reason the system is focused on this is because medical institutions, pharmaceutical companies and insurance groups get more money from managing symptoms than they do from preventing disease.
Ethics and Incentives in the World of Health Insurance, and "the 3% Rule" for ethical healthcare providers.
Bogdan ended up asking the question during a bit of a "debate" on the podcast: "Shouldn't our medical industry be ethically obligated to cover any treatment (pre or post symptomatic) that promotes health?"
This enters a debate that I don't quite feel is useful overall.
I don't think questions of ethical concern are relevant when discussing institutions that are incentivized in the ways outlined above.
What "should" any given party do is an irrelevant question compared to "how might one protect themselves given the reality of the current situation?"
As always, the universal truth is the "law of the jungle."
Insurance companies care about your health only insofar as they can profit off of you. It is an amoral function. Ethics do not apply to large corporations in the way they apply to interpersonal affairs.
So I instead promote the idea found in CrossFit marketing.
They want 3% of the human population to benefit from CrossFit. Not 100%.
Why is that?
Effecting 3% is enough for beneficial ideas to be tested in the market and spread organically.
Aiming to impact 100% of people would require CrossFit replicating the functions of the Medical Establishment. Since the Medical Establishment is an amoral entity concerned with profit, that will illicit conflict - not cooperation.
Aiming to help 3% is a small enough group to make a difference without starting institutional conflict.
If 30 or 35 groups can each effect 3% of the population, we have a changed world without the problems of institutional corruption.
This is why I love the long tail of the internet!
People with effective alternative treatments can find ways to make their solutions SO affordable that the question of "insurance companies" is irrelevant.
When smart healers and doctors begin playing the game they can win, then they'll start to win.
Of course, I'm trying to walk that talk myself.
I am well aware I can not change the entire insurance industry. No single entity can change that dynamic peacefully.
But many small actors can make a difference.
That's why I'm trying to model a new business model for other doctors with Wellspring.
At WellspringCare you can speak to me or any other Wellspring Doctors about ANYTHING that concerns you.
If you're in a state we're licensed in, (22 and counting) then we can give you prescriptions, if medically necessary.
And we do this conveniently from your home for the affordable price of $50 per session - regardless of your insurance status.
If you feel a meeting was not worth it, you get a 100% refund and a referral to someone else who might be able to help you.
Anyways, I hope you enjoy the episode.
If you try the Manuka honey, please reach out on social media @BradleyWerrell to tell me how it works for you!