Should Government Health Insurance Cover Back Cupping, Clysters and High Colonics?

The Ancient Practice of Trephining

Many medical practices go back a surprisingly long way. There is evidence that the ancients knew how to drill a hole in the skull to release the pressure of a sub-dural hematoma on the brain. The fact the skulls showed evidence of healing attests to the fact that some of these patients survived the ordeal. Well before the discovery of penicillin, barber surgeons were identified by the white on blue/red barber shop pole depicting their white bandages staunching the bleeding of a wound.

Certain surgical practices such as casting fractures and bracing weak joints have stood the test of time. The term “orthopedic” is derived from the words for straightening the leg. Some of the other practices such as “cutting for stone” and amputations were effective treatments but awful experiences.

Given this long history of success, it’s no wonder that we are often drawn back to these days. In fact, as most medical illnesses are “self-limited”, given enough rest and fluids, 90% of patients will recover from colds, flus and other infections. Our current crisis in physician availability is largely the result of health care economists in the 80’s who noted that the availability of access to modern medicine has very little impact on mortality. However, with their vision clearly focussed on the rear-view mirror they neglected to factor in that there’s more to life than crude mortality.

During the golden age of health care economists in the 1980’s and 90’s, Canadian university health experts convinced the government to cut back on the numbers of medical school spots because they called physicians “cost villains”. “Why pay for all the tests and medicines they ordered, if it didn’t improve mortality?”

What the economists missed was that humans experienced a great deal of suffering and misery before you could demonstrate the effect of treatments on mortality. In fact, in their unguarded moments the economists whispered that caring for dead patients was a lot less expensive than the costs of keeping the old and the sick alive.

There is universal recognition that the big improvements in life expectancy generally resulted from public health initiatives like better housing, clean water and sewage treatment. While improvement in infant mortality yield 80 added years of life expectancy compared to the measly statistical improvements of a year or two seen with care of aging adults.

Getting back to the medical care of antiquity, it was only with the development of modern statistical methods that it proved possible to assess the efficacy of the plethora of snake oil preparations pedaled on the internet, our current form of “back of the wagon” health hucksters.

Canadians spend $8.8 billion on alternative health care (75%) and products like herbs and vitamins (25%). Unlike in the United States, in Canada, the government tries to walk a fine line, demanding some truth in advertising and preventing the advertising of intoxicants and powerful medications to the public in newspapers, magazine, television and radio.

You can use your own judgement about the effectiveness of this attempt at government control in a country where 90% of Canadians live within 90 miles of the American border and consume so much of their media from American outlets. The little “Truth in Advertising” control government had once exerted is now further eroded by the ubiquity of the internet which doesn’t recognize Canada’s borders.

One of the underlying issues is the “placebo” effect - any treatment has about a 50% chance of making people feel better if they expect it to work. If there’s no harm done, why not let people drink orange juice and take vitamins to prevent catching a cold, if it makes them feel better and doesn’t do any harm?

Proponents of this kind of thinking, feel that consumers are “fair game” if packaging provides information allowing consumers to make informed choices, ignoring the fact that the emotions behind worry and anxiety are not particularly amenable to reason.

Viewed another way, we can barely afford a health care system to look after the essentials of health care. It would certainly make our finances much worse if the government were to undertake to finance the well-being of the entire population for all the public’s minor complaints and self-limited illnesses.

Back in the 80’s, I received a valuable education in how good intentions quickly generate 6-digit figure government expenditures s as part of the Canadian Government’s effort to get into the wellness business. Before the era of Zoom and Microsoft Teams, our committee of 10 “experts” met several times a year around the country staying in comfortable hotels. We were kept well fed and watered, while various experts expounded the virtues of wellness and natural healing. This went on for a year and half until our leader confided in me that she was getting her inspiration from a pastel (“pink”) elephant that emerged from her back in the evening and guided both our wellness project and her grocery shopping choices. The project was quietly shut down without further consequence except for the romance kindled between two of the participants. So much for the Government commitment to wellness and disease prevention without measurable outcomes.

All things considered, government health care, supplemented by private health insurance, does a pretty good job of recognizing an array of allied health providers such as chiropractors, traditional healers, physiotherapists, occupational therapists, practitioners of eastern medicine, psychologists, optometrists’ chiropractors and pharmacists. (admittedly an incomplete list).

Ultimately, if the public health system does its job of monitoring air and water quality and food safety, preventing epidemics, the Canadian health care system managing serious accidents and acute illness, the broad array of health professionals play an important role in meeting the ever increasing and infinite demand for a care that addresses chronic complaints, health worries and self-limited illness.