It’s time to embrace a new paradigm
Recently, practitioners of unregulated natural therapies have been up in arms at the proposed changes to private health funds introduced by the Australian Federal Government.
From 2019, private health insurance will no longer cover natural therapies, including aromatherapy, Bowen therapy, Buteyko, Feldenkrais, herbalism, homeopathy, iridology, kinesiology, naturopathy, Pilates, reflexology, Rolfing, shiatsu, tai chi and yoga. This move comes after a recent review by the Commonwealth Chief Medical Officer found there was no clear evidence of the efficacy of these therapies. (SMH)
In Australia, private health insurance is estimated to pay out over $90 million a year on natural therapies, with the government rebate covering nearly a third of this cost (Wardle 2016). The review ordered by the then Treasurer of the Labor Government Wayne Swan in 2012 was for the purpose of looking for budget savings. Part of the decision-making was to examine efficacy of treatment. The trouble with this, as shown by Wardle in his article is that,
while the Review noted that there was no clear evidence of clinical efficacy across a broad range of conditions, it also noted that this was largely due to the paucity of research rather than evidence of inefficacy, that many natural therapies showed promise in several specific conditions, and that further research should evaluate these therapies further. (Wardle 2016)
Mainstream medicine zealots will most likely be clapping their hands with glee. And given some of the other changes that are planned for Private Health Insurance, so too would the CEO’s of these health funds. However I want to refrain from constructing some kind of bizarre conspiratorial narrative and focus instead of the reality facing the natural therapies professions.
Why do I say this?
Australians are said to have spent $3.9 Billion on natural therapies in 2016 (SMH). In a free market economy, money talks and bullshit walks. Australians are using natural therapies for any number of reasons. And the rebates on these at present are more-or-less pitiful. So those who spend money on these therapies do so knowing that they are paying for it themselves.
As a former clinician, I can tell you that the paying public vote on your efficacy with their wallets. People do not go back time and time again for treatment if it hasn’t worked. Most people who return to their natural therapist choose to pay out of pocket for these services even when they could essentially get mainstream medical care — which is proven to be efficacious — for FREE!
This should tell us something about the efficacy of these therapies, even if the standards of research utilised for this review suggest otherwise. It suggests there is a market for such therapies. And that simple fact cannot be ignored.
This review is a shining light on the future of natural therapies. And for this, I want to turn my attention elsewhere briefly.
New kids on the blockchain
I’m a newcomer to the world of blockchain and cryptocurrency. And I need to state very clearly I am not a tech-geek or a polymath.
From my historical anthropological perspective however, I understand the implications of this technology for what this could mean for our civilisation. And I’m genuinely excited and in awe of where we are going. For the record, I do believe we are living in a time that is not too disimilar to the Renaissance in Florence, for example, or the Axial Age in the Mediterranean, China, and India.
There’s already HEAPS of good articles on blockchains and cryptocurrencies — so I’m not going to try and regurgitate any of that info here. This article by Angus Hervey is a good intro read.
One of the key things about the open-source blockchains is that they are consensus-based, decentralised systems. Assets — cryptocurrencies such as Bitcoin, Ethereum, and Steem — are ways that the blockchains’ value is measured. However (and maybe more importantly), cryptocurrency, or tokens, are a way to value engagement within a blockchain.
In this sense, a community within the blockchain can be created, with tradable tokens being used to encourage and support the members of that community. And because blockchain technology is tamper-proof and provides decentralised authentication, it means that those who hold and trade the tokens, and communicate in the blockchain — from miners to witnesses — could be seen as having a safe investment in that community.
A bit of further background on this. Late last year, Ned Scott the CEO of Steem, released a white paper on Smart Media Tokens.
In a nutshell, this appears to be the framework which the website Steemit operates. At Steemit, authors who produce good content are rewarded by getting upvoted, which produces a certain value of Steem (the native coin). But not only are the content-creators rewarded, but also those who comment, share, and upvote the content, receiving Steem for curating quality content.
For an example, check out my Steemit page. You’ll be able to see who is following me, and also how much Steem I’ve earned from creating and curating (not much, I’m just a “minnow”). I’ve seen some others’ posts that have earned over US$500.
As a cryptocurrency, I can purchase Steem, which I can invest directly into Steemit by increasing my voting power. I can also trade my earned Steem for other assets such as Bitcoin.
However, you don’t need to have purchased any Steem to begin to engage and earn on Steemit. Upon becoming a member, you are “delegated” a small amount of Steem by the community in order to begin creating and curating content on the site.
Smart Media Tokens have the potential to be a game-changer in the way that blockchain tech and cryptocurrency can be used in a wider context. This post kind of explains it in a wider context quite well.
Decentralise or die
So what does this have to do with natural therapies and private health insurance?
A medical professional told me something once: “Don’t waste your money on private health insurance. The money you’d pay in premiums each month, save it into a separate account, maybe one that earns some interest, and then use it where ever and when ever you need to.” Interesting.
Her rationale? Because I am then in complete control of how my money is spent (on health care).
The problem with natural therapies is not so much their efficacy — as Wardle established in his article, and as openly stated in the Review of the Australian Government Rebate on Natural Therapies for Private Health Insurance:
The absence of evidence does not in itself mean that the therapies evaluated do or do not work… Where there is limited evidence in some modalities, there is value in conducting more research… With the research gaps that have been identified, there are numerous opportunities for future research in this field as there is a clear lack of high-quality research available. Future research should focus on rigorous, well-designed,randomised controlled trials that assess the effectiveness of the method in improving health outcomes in specific patient populations.
Here lies an opportunity for the various natural therapies professions to stop playing the same game as the overly-subsidised, monopolised medical industry, to create a community of practitioners and end-users, and to raise funds for much-needed research.
This could entail the establishment of some kind of token (“Natural Therapy Coin”).
Users would stop paying for health insurance premiums, and invest into this token, which could them be used to either part-pay or fully-pay for the visit to the Naturopath or Myotherapist.
Perhaps also, users could trade some of this amount to promote the services of a therapist within the system, thus creating a tokenised word-of-mouth referral system. Sort of like the upvoting system in Steemit.
And perhaps also, tokens could be awared to practitioners for achieving the desired outcomes of the end-user. Thus a truly meritorious system (perhaps something similar could be implented into mainstream medicine also?). One of the problems I have with EBM (Evidence-Based Medicine) is that sometimes laboratory results don’t necessarily translate into clinical efficacy all of the time. There is always going to be a cohort of patients who don’t respond to the medicine that has evidence behind it; and sometimes the medicine that research shows to lack general efficacy (and therefore less profitability) may actually be effective for only a small cohort of patients. A merit-based reward system would then reward practitioners who are able to thinkk outside of the box and focus on the specific needs of the end-user.
Investment into this community could also fund the research needed — given that the impediment to research in this field is the sheer amount of money needed to do so. Money which the mainstream medical system has in no short supply to do so — hence the volume of research in this field. And rightly so, also.
I imagine that the blockchain technology could also be useful for recording and maintaining client medical files, a very important aspect of being professional natural healthcare practitioner.
I clearly don’t know how this could be set up and what it would take. However I am confident that the tech exists, and the people to create the tech are also out there.
Given we are still in the place of exploring of what this revolutionary technology is truly capable of doing, and what exactly it will disrupt, and where, its imperative that we explore new possibilities of how the vital aspects of our society are to continue, given finite planetary resources, growing populations, growing health concerns, and failing fiat currencies.
The health fund rebate changes proposed for natural therapies should be seen as an opportunity to start moving in the direction of creating new models that will serve the highest benefit for everyone, not just the few.