I am, I think, the slowest writer in the  SBM stable.  I start each entry about 10 days before it is due, and work diligently on it through the week.  As such, I run the risk that events may make my work pointless. Case in point.  I have been slogging away at this entry for the last week and had the final draft up and ready to go, only to find this morning that the Health Care Reform bill no longer carries the language that was the crux of this entire post.  So what is a poor, slow, SBM writer to do? Chuck the whole thing?  Repost my 12 reasons you are a dumb ass not to get the flu vaccine yet again? Leave a hole in the SBM line up? No.

Lets pretend we are in a parallel universe, perhaps an evil universe  where I have a goatee, and the language was not removed from the bill. Lets all pretend that this post is still relevant. Since the Christian Science Church has indicated they will try to get the bill amended to reinstate payment for their services, this post may be relevant again.

Or you could go read  Respectful Insolence instead. Don’t say you were not warned.

One of the ongoing themes of the H1N1 wackaloons is the concept that the current pandemic is not a natural phenomena but a Frankenstein’s monster, pieces of virus unnaturally stitched together in a government lab to be let loose upon the world village to kill and maim.

As a rule I have little sympathy or understanding for the conspiratorial world outlook.  It strikes me as ludicrous at best and insane at worst.

Why would the government want to make a new vaccine and let it loose on the world? Some say to decrease the population to ameliorate global warming. Some say to cause panic and increase the use of vaccines and antivirals, a bailout for the pharmaceutical industry.  Others say it is to decrease health care costs.  I say, of course, it is primarily to decrease human death and suffering, but I am under the big pharma Imperius curse, so I would say that, wouldn’t I?

The cost of the medical industrial complex is spiraling (does it really spiral? One definition of spiral is a “continuously accelerating change” but that is not what I think of when I think spiral. A corkscrew spirals. But I digress) out of control and expenditures on health care only increase (not, by the way, in a manner that ends up in my wallet.  I wonder just who is getting all that cash. Sure as hell hasn’t been me. I digress again; my overlords have advised me to stay on topic).

Who is spending all these health care dollars? The elderly and the chronically ill, particularly during the last year of life. What better way to cut medical costs than to send an influenza pandemic into the world to thin the herd. Of course, the current H1N1 has a predilection for killing the healthy, but the government has never been known for its competence. To judge the conspirators of the pandemic by their work, I would say they are not up to Dr. Evil level evil. It is impossible to take the conspiracy wackaloons seriously as their statements seem totally divorced from reality.

Or so I thought. Now I am not so sure.  The reason for the change of heart? The LA times.

“Backed by some of the most powerful members of the Senate, a little-noticed provision in the healthcare overhaul bill would require insurers to consider covering Christian Science prayer treatments as medical expenses.

The provision was inserted by Sen. Orrin G. Hatch (R-Utah) with the support of Democratic Sens. John F. Kerry and the late Edward M. Kennedy, both of Massachusetts, home to the headquarters of the Church of Christ, Scientist.

The measure would put Christian Science prayer treatments — which substitute for or supplement medical treatments– on the same footing as clinical medicine”.

No way.  What does the real Senate bill say?

“(D) The essential benefits provided for in subparagraph (A) shall include a requirement that there be non-discrimination in health care in a manner that, with respect to an individual who is eligible for medical or surgical care under a qualified health plan offered through a Gateway, prohibits the Administrator of the Gateway, or a qualified health plan offered through the Gateway, from denying such individual benefits for religious or spiritual health care, except that such religious or spiritual health care shall be an expense eligible for deduction as a medical care expense as determined by Internal Revenue Service Rulings interpreting section 213(d) of the Internal Revenue Code of 1986 as of January 1, 2009.”

The House bill has similar wording:


Neither the Commissioner nor any health insurance issuer offering health insurance coverage through the Exchange shall discriminate in approving or covering a health care service on the basis of its religious or spiritual content if expenditures for such a health care service are allowable as a deduction under 213(d) of the Internal Revenue Code of 1986, as in effect on January 1, 2009.”

The sponsor of the bill, Senator Harken, has said

“It is time to end the discrimination against alternative health care practices.”

“This is about giving people the pragmatic alternatives they want, while ending discrimination against practitioners of scientifically based alternative health care. It is about improving health care outcomes. And, yes, it is about reducing health care costs. Generally speaking, alternative therapies are less expensive and less intrusive – and we need to take advantage of that.”

I was shocked at this. But then I considered.  Sen. Harken is interested in ‘scientifically based alternative health care’ and science is in the title of Christian Science. So it makes some sense. And he is trying to reduce costs by encouraging medical therapies that are not effective.  Something smells fishy.

Why would the government want to make sure prayer could be reimbursed as form of medical intervention? Surely our elected representative would not pander to their constituents? That would be beyond the pale.  There must be a deeper, more sinister, reason.  And I remember: dead people cost no money.

Christian Science was, like many of the topics discussed on this blog, invented. In this case it was Mary Baker Eddy, who,  in 1866, published the Science and Health with Key to the Scriptures, the guiding document of Christian Science.  Their approach to all illness and injury is prayer.  To quote the ever helpful wikipedia:

“Christian Scientists believe that sickness is the result of fear, ignorance, or sin, and that when the erroneous belief is corrected, the sickness will disappear. They state that the way to eliminate the false beliefs is to replace them with true understanding of God’s goodness. They consider that suffering can occur only when one believes (consciously or unconsciously) in the supposed reality of a problem. If one changes one’s understanding, the belief is revealed as false, and the acknowledgment that the sickness has no power, as God is the only power, eliminates the sickness.”

The application of Christian Scientology, er, no, it must be Christian Scientist therapies has well documented effects upon the Christian Science population. And those effects are not beneficial to anyone who is not a mortician.

For example, in 1989 JAMA published a cohort study (Yes, I know from the last post that cohort studies prove nothing nothing nothing, but I am uncertain how one would apply Christian Science in a randomized, placebo controled, double blinded manner).

They looked at outcomes in 5,500 Christian Scientists and compared them to a group of almost 30,000 controls using conventional medicine.

For each age group from 1934 to 1983, there was a greater death rate in the Christian Scientists when compared to the control population, a difference made more remarkable as Christian Scientists neither smoke nor drink.

The JAMA study confirmed an earlier study from 1965 that demonstrated the death rate from cancer among Christian Scientists from was double the national average, and 6 percent died from preventable causes. Not being a Christian Scientists gave an average of more four years  of life to women and two more years of life to men (Wilson GE. Christian Science and longevity. J Forensic Sci. 1965;1:43-60).

Subsequently the CDC did a study where they compared a similar cohort of Christian Scientists to 7th Day Adventists and again found a decrease in longevity for all age groups of Christian Scientists.

Of course, those studies looked at the life expectancy of adults.  Christian Science children do not get vaccines and as a result, get diseases like measles and as a result, people die . Of measles.  That is so 19th century.

Children of Christian Scientists occasionally die of diabetes and trauma that could otherwise have been treated or cured. Christian Science is not a healthy lifestyle and demonstrably shortens life expectancy.

So why would our Senate give incentives to people to seek prayer for their diseases?  As I said, I cannot imagine a politician deliberately pandering to voters endorsing a useless intervention that demonstrably kills and maims. Unless.

There must be a reason.  And the only reason I can think of is that the conspiracy wackaloons are right.  The government is out to get us.  Costs are going up in health care and the best way to save money is to encourage people into worthless treatments that will lead to their early deaths.  That is the surest way to keep health care costs down.  So it makes sense for the government to encourage people to use alternative medicine and pay for Christian Science.  Worthless therapies offer far more promise to thin the herd than the H1N1 pandemic or HIV.  And they sponsors look like they are being good guys in the process.  It is absolutely diabolical.

And yet.

The government, in its occasionally schizophrenic approach, is also funding comparative effectiveness research as away of improving care and decreasing costs by demonstrating what works. Given the current track record of alternative therapies, if comparative effectiveness research bears any fruit, it will probably be the death knell for alternative therapies.  In the end alternative therapies will not have a prayer.

I have shaved my goatee.  We are returned to the previous time continuum.


  • Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, since 1990. He is a founder and  the President of the Society for Science-Based Medicine where he blogs under the name sbmsdictator. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His growing multi-media empire can be found at edgydoc.com.

Posted by Mark Crislip

Mark Crislip, MD has been a practicing Infectious Disease specialist in Portland, Oregon, since 1990. He is a founder and  the President of the Society for Science-Based Medicine where he blogs under the name sbmsdictator. He has been voted a US News and World Report best US doctor, best ID doctor in Portland Magazine multiple times, has multiple teaching awards and, most importantly,  the ‘Attending Most Likely To Tell It Like It Is’ by the medical residents at his hospital. His growing multi-media empire can be found at edgydoc.com.