As goes Vermont…

I hadn’t realized that Vermont has passed a law requiring insurers to cover naturopathic care.

We’ve covered extensively the quackery that is naturopathy, but really, if a patient chooses to see a quack, it’s their business. But with health care costs soaring, requiring insurers to pay for voodoo is a rather bad idea. Already, many plans cover chiropractic, another unproven treatment. Throwing more health care dollars at more unproved and disproved treatments will help no one (except the quacks who have boat payments to make).

There are many causes of high costs of health care: we hate the idea of rationing, so many American cities have more MRIs than the whole country of Canada; we incentivize doctors and others to order tests and treatments that may or may not be necessary; we inadequately reimburse preventative care. The list goes on.

Health insurance is about pooled risk. Plan members pay in, and hopefully there will be a diverse group of patients so that the healthy ones subsidize the less fortunate. The more benefits are utilized, the less money is left to pay for necessary services. If you pay for bull, you might not be able to provide, say, nutritional counselling for diabetes. The cost to everyone will rise.

Evidence-based medicine has helped us figure out what diagnostic and therapeutic modalities are most effective, but for health and for cost. There are still many grey areas. We need to focus on clarifying what we do and don’t need, rather than paying for care that has no proven benefit.