The Alternative Medicine Racket
A decades-long campaign of federal funding for quackery
Sometime in the 1980s, Tom Harkin became convinced that bee pollen extract had cured his lifelong bouts with hay fever. The capsule-delivered supplement—which has also been touted as a source of longevity, a cure for PMS, and a way to enhance athletic prowess in runners—contains a variety of the pollen collected by worker bees on their daily rounds, plus nectar and bee saliva. "It's the most bizarre thing that ever happened to me," Harkin once told USA Today. "But I want you to know something: I've had my allergies completely cleared up. My nose doesn't run. My eyes are cleared up. I don't sneeze any longer."
Ordinarily, such a miracle-cure story would be an amusing dinner party anecdote (or a tiresome one, depending on your point of view). But Harkin was no ordinary American. He was a powerful Democratic senator from Iowa, a man whose Capitol Hill career would span four decades and include at least one serious bid for the White House. Crucially for our story, Harkin was also chairman of the Senate appropriations subcommittee charged with oversight of federally funded medical research.
In 1992, the Iowa senator set aside $2 million to establish within the National Institutes of Health (NIH) an Office of Alternative Medicine (OAM) whose stated mission was to "investigate" the medical value of alternative therapies such as acupuncture for back pain, remote prayer to treat HIV/AIDS, and coffee enemas to fight cancer.
Thus began a decades-long process of the government pushing alternative medicine onto the American people and dispensing taxpayer largesse to such holistic health gurus as Deepak Chopra. The NIH alone has spent more than $5.5 billion to mainstream an assortment of mystical therapies within the American medical establishment.
None of the therapies Harkin was so excited about has actually been proven to work. And Congress was once on the right side of that issue. In 1984, a congressional report called Quackery: A $10 Billion Scandal tidily summed up the state of alternative medicine: "The Subcommittee estimates the cost of quackery—the promotion and sale of useless remedies promising relief from chronic and critical health conditions—exceeds $10 billion a year. The cost of quackery in human terms, measured in disillusion, pain, relief forsaken or postponed because of reliance on unproven methods, is more difficult to measure, but nonetheless real. All too frequently, the purchaser has paid with his life."
Harkin pushed on with his goal of bringing the imprimatur of the federal government to therapies that not only were unproven but lack a plausible scientific account of how they might work. Reiki, for instance, relies on the manipulation of a "vital energy" that has never been shown to exist. "Even if you go back to 1992 when the Office of Alternative Medicine was created," says Johns Hopkins professor of biomedical engineering Steven L. Salzberg, "there was certainly no strong positive evidence at the time, and no real justification in any scientific sense, to start a training program."
When the OAM failed to provide new scientific validation, Harkin made conditions politically unpleasant enough that the center's first director resigned. The senator then elevated the once-small research body into a "national center," now called the National Center for Complementary and Integrative Health (NCCIH). By 2010, thanks largely to Harkin, annual NIH funding for alternative medicine reached a whopping $521 million.
That money has been spent on long-term studies of dozens of remedies, such as shark cartilage for cancer, St. John's Wort for depression, and acupuncture for pain. To date, all that tax-funded scientific exertion has yet to verify a single new effective treatment.
Harkin remained obstinate. During a hearing in 2009, he complained: "One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly, it's fallen short. The focus of this center has been on disproving things rather than seeking out and approving them." It was a frank admission of an unsavory fact: A powerful U.S. senator was using public money in an attempt to rubber-stamp scientifically dubious medical practices.
Harkin's explicit goal of validating nontraditional medicine was baked into the OAM's charter, which mandated that its 18-member advisory council be heavily weighted to favor practitioners of alternative therapies. Most of the people involved in the office had a strong financial incentive to certify and legitimize the practices.
New Age healer Deepak Chopra was an original member of the OAM advisory council, thus benefiting from the imprimatur of the NIH well before Oprah Winfrey catapulted him to national stardom. Chopra's board-mates included David Eisenberg, an expert in traditional Chinese medicine who had worked on the PBS series Healing and the Mind; Gar Hildenbrand, who preached diet and detox cancer cures from a clinic in Tijuana, Mexico; and Ralph Moss, a writer who had been fired by the Sloan Kettering Cancer Center for misleading the public by pushing alternative medicine over chemotherapy. (Moss still advertises his availability to write patients a "personal consultation/report" for $300.) Many of these early Harkinites (as they became known) would later receive millions in grants from the very NIH subdivision they were originally brought on to oversee.
The OAM's first director, Dr. Joseph Jacobs, might have seemed like someone who was also likely to look with sympathy upon alternative treatments. After all, Jacobs wasn't just an experienced primary-care physician boasting degrees from Columbia, Wharton, and Yale Medical School; he also had experience with traditional Native American remedies, having grown up on the Kahnawake Mohawk Reservation as the son of a Mohawk mother and a part-Cherokee father.
"I had been raised in a certain belief system, that there were other things besides white man's medicine that were important," Jacobs explains. "But at the same time, my job was to objectively evaluate whether or not these therapies had a therapeutic benefit. And I had to be dispassionate about that. Whatever my personal feelings were was totally irrelevant."
Jacobs turned out not to be willing to carry Harkin's water. "They wanted me to do their bidding," he says, "and I really couldn't do that without being intellectually dishonest." But the advisory council members "were inflamed with this political power that they had from Harkin, and they really tried to intimidate the NIH staff and me. They wanted things done the way they say, and that was it, otherwise we're going to get Sen. Harkin on your ass." (Harkin did not respond to multiple requests to participate in this story.)
One original member of the council, Rep. Berkley Bedell (D–Iowa), was especially difficult. "Many things that seem to be effective don't stand up to scientific research, but they still cure people," Bedell told the Journal of the American Medical Association shortly after his appointment to the advisory council. "If that's the case, then I hate to think we may squelch something by insisting it has to go through scientific investigation."
The Harkinites "wanted us to look at charts, rubber-stamp them, and publish them in the New England Journal of Medicine," says Jacobs. "It just doesn't work that way."
Jacobs says he appealed to his bosses, including then–NIH head Harold Varmus, who "would try to run interference" for him. But Harkin had the power to summon the OAM director to testify before Congress and then berate him for his work. "After a hearing he would say to me, 'We need to go through this public vilification of you, and it's nothing personal,'" Jacobs says. "But when my personal integrity was being attacked, that's where I drew the line."
Jacobs resigned after only two years on the job, telling The New York Times at the time, "I prefer the ticks of Connecticut to the politics of Washington."
With Jacobs out of the picture, and with a rising budget at its disposal, the advisory council was free to pursue its own vision of American medicine. Government grants for "training" in "complementary therapies" have since helped seed alternative medicine centers at dozens of prominent hospitals and medical schools, including Harvard, the University of Maryland, and the Mayo Clinic. NIH studies have suggested that reiki—an energy-"channeling" treatment—is useless, but that hasn't stopped Dr. Mehmet Oz from introducing it to a new generation of surgeons at Columbia University, which just happens to be a major recipient of NCCIH money.
Despite the explosion in government-fueled alt-medicine activity, scientific validation has remained stubbornly out of reach. "People were saying that cures for cancer were hidden within the alternative medicine universe. And they weren't," says Jacobs. "They felt that with the stamp of approval of NIH, these approaches to cancer therapy would be unbridled, and arthritis and other diseases would have a major advance in terms of therapy. And physicians would have all this stuff in their armament to deal with various diseases. But it hasn't happened. We've grown accepting of alternative medicine theories, but you'll notice, there are no strong claims of therapeutic benefit."
In 2011, a withering investigation from the Chicago Tribune titled "Federal center pays good money for suspect medicine" shed light on the absence of positive evidence coming out of the NCCIH (at the time known as the National Center for Complementary and Alternative Medicine). "Thanks to a $374,000 taxpayer-funded grant, we now know that inhaling lemon and lavender scents doesn't do a lot for our ability to heal a wound," the paper found. "With $666,000 in federal research money, scientists examined whether distant prayer could heal AIDS. It could not."
That same year, the new director of the center, Josephine Briggs, made the first official admission of failure. "When making treatment decisions, unproven 'alternative medicine' approaches should not replace conventional medical care approaches known to be useful or helpful," Briggs wrote. "Simply put, the evidence is not there."
First Do No Harm
As long as alternative therapies do no harm—premum non nocere, as the venerable medical maxim goes—and the placebo effect makes patients feel a bit better, what's the problem? For one thing, explains Jacobs, "there might be an opportunity clinical cost, where it delays the patient from getting the appropriate treatment."
Apple CEO Steve Jobs, for example, famously postponed medical treatment of his rare but treatable form of pancreatic cancer for nine months. Instead, Jobs tried acupuncture, bowel cleanses, herbs, and a vegan diet. Although we will never know for sure, the technologist's faith in alternative medicine (and his decision to delay surgery) may have hastened his death.
Jobs is likely not alone. Numerous reports of injuries and fatalities from alternative treatments have been documented at Whatstheharm.net. To be sure, even the best medical treatment comes with serious risks. But unlike standard medical care, the dangers associated with scientifically unrepeatable alternative treatments come with virtually no possibility of a health outcome better than a placebo.
Although Harkin has retired from the Senate, government support for alternative medicine now seems secure. In 2000, President Bill Clinton created the White House Commission on Complementary and Alternative Medicine Policy—a committee, like the OAM before it, stacked with members who stood to gain financially from promoting alternative medicine. The following year, 14 scientists sent a protest letter to the U.S. surgeon general expressing their concern "that the commission does not include a single scientific expert on alternative and complementary medical practices who has expressed informed doubts regarding the efficacy of these practices." Nothing came of their objections.
According to Salzberg of Johns Hopkins, the national board that oversees medical school curriculums now recommends that alternative medicine be included. States have opened the Medicaid coffers to naturopaths, and Section 2706 of the Affordable Care Act mandated equal treatment (and equal reimbursement) for nontraditional practitioners. Even Democratic presidential candidate Hillary Clinton has a medical advisor, Dr. Mark Hyman, who evangelizes his own brand of alternative therapy, known as "functional medicine."
"One thing that's allowed the proponents of these methods to keep going is it's quite easy to do a bad study," Salzberg explains. "If you go into a study wanting to prove that something is true, and you don't design it very carefully, it's not uncommon at all to find an effect when no effect is in fact there to be found."
Meanwhile, many livelihoods now depend on the continued interest in alternative medicine, from the staff at the NCCIH to the university administrators who get grant funding for such work to the practitioners of "complementary and integrative" approaches themselves. "It's a recipe for bad science," Salzberg says.
So what about that bee pollen extract that inspired Harkin to start the Office of Alternative Medicine to begin with? As with much of the rest of alternative medicine, scientific studies have long since debunked the substance's alleged power to minimize hay fever—or any other illness. "Think about it, Harkin," Jacobs muses. "Your allergies can go away the next day when the pollen level goes down. It's just not what I'd call rigorous thinking."