The Question Is, Who is Defrauding Whom?

CBC National News anchor Peter Mansbridge was filled with the appropriate level of indignation introducing the story of insurance fraud on the April 16, 2010 edition of the National. Unfortunately, the CBC’s pro alternative-medicine bias (examples of which are searchable on this site) placed the CBC in a position where they couldn’t quite get it straight as to who is defrauding whom.

The “investigative journalistic report” came complete with hidden cameras, disguised microphones and undercover journalists posing as customers. In reality, what we got was a public relations exercise posing as journalism.

Here is the story. The CBC ‘uncovered’ that beauty-spas are billing health insurance companies for a virtual cornucopia of complementary and alternative medicine  services such as acupuncture, message therapy, osteopathy, naturopathy and chiropractic where where in fact, the beauty spas were only providing cosmetic services. For example, a beauty spa provides hot rock ‘therapy’, and claims it as message therapy. The hot rocks treatment is listed on an bill as massage therapy, signed by a  registered massage therapist, and then submitted to the insurer for payment. It was reported that one spa representative offered to cover $2,000 worth of cosmetic services with fake receipts.

Alistair Forsythe, a senior researcher and spokesperson at the Canadian Health Care Anti-Fraud Association, that represents the health insurance industry, was quoted in the CBC report as saying: “We call that theft at the end of the day.”

Well, the Canadian Health Care Anti-Fraud Association should know.

It wasn’t all that long ago that the health insurance industry refused to pay for alternative medical treatments and therapies on the quite sensible grounds that there was no evidence that such treatments were in any way effective. Insurance companies didn’t want to pay for therapies that didn’t work.

That attitude changed when the bean counters (primarily in health care insurance companies in the United States) pointed out that whether the treatments worked or not was irrelevant. All that mattered was the comparative cost of an alternative medical practitioner to a real doctor and the subsequent impact on corporate profits. By covering alternative treatments, insurance companies could save themselves a fortune. So what if the treatment is cosmetic or bogus? Better to pay $250 for worthless treatments (that could see the patient become seriously ill or worse) than pay $4,000 (for a treatment that may actually do some good).

The beauty of this real insurance scam is that it can be promoted as providing freedom of choice. Mrs. Smith, you can go through a long and painful chemotherapy treatment in which you will loose your hair and suffer terribly or you can stretch out here in our therapy spa and have someone gently massage your back with parsley, sage, rosemary and thyme. It’s a false choice of course – no one ever says: You can live or you can die. Turns out, honesty is bad for profits.

Insurance coverage of alternative medical practices was a cynical attempt by health insurance companies to reduce costs by replacing costly but effective treatments with cheaper ineffective treatments – the patient be damned – literally.

Of course, the insurance industry was warned of this slippery slope. Once you start funding scientifically useless treatments, there will be no end to it. Pretty soon, you will be funding everything. That is exactly what is happening now. You reap what you sow.

For example, benefit plans in Canada often  include ‘massage therapy‘, but don’t distinguish between what parts of massage constitute the therapy, and what parts just make you feel good. This is not surprising. The distinction can’t be made because there is no evidence to support the claim that massage therapy has any therapeutic effect.  Therapy has become anything that makes you feel good regardless of effectiveness.

Which means there is no fraud, at least on the part of beauty spas. Spas submitting claims for massage therapy, signed by a massage therapist, are not committing fraud and certainly no fraud the insurance industry wasn’t willing to tolerate when it was saving them money.  Now that it is costing the insurance companies,  they are calling it theft.

Hmmmm. The alarm expressed by insurers seems to be doing little more than covering up the real fraud, the fraud in which people can pay with their lives. That’s the fraud of alternative and complimentary medicine. Perhaps one day, the  CBC will investigate that, and its own role, and those of the insurance companies, in promoting worthless treatments to the naive and desperate.

CONFLICT OF INTEREST

In the meantime, a mea culpa. I have a personal interest in this story.  My wife has a benefit plan that includes coverage for many of these phony alternative medical practices, including massage therapy. Three or four times a year she trots down to the spa at the Hyatt Hotel in Calgary and treats herself to a day of indulgence courtesy of her benefits plan insurer and Alberta taxpayers.

She reports that the spa at the Hyatt is terrific, comes home feeling great and without any delusions concerning therapeutic effects. The phrase we use at our household is . . .  Hey, if they are dumb enough to pay for it. I like it when my wife is happy and feeling spoiled, especially when someone else pays.  So I would definitely like this to continue.

Further to this, as a Reiki Master, I am still working on my holistic Margarita Therapy (1/3 tequila, 1/3 orange liquor and 1/3 freshly squeezed lemon or lime juice over ice).  No word yet on insurance coverage but I promise to keep you all posted. It’s homeopathic – I swear!

Is Intelligent Design Leading Alberta Science Policy?

Dr. Marvin Fritzler, who holds the holds The Arthritis Research Chair in the Faculty of Medicine, has been appointed Chair of the Alberta Science and Research Authority (ASRA). The ASRA’s mission:

is to enhance the contribution of science and research to the sustainable prosperity and quality of life of Albertans. The ASRA functions as the senior science and research body of the Government of Alberta and works collaboratively with government departments and agencies and other stakeholders to maximize the effectiveness of science and research as an integral component to the success of the province in the global economy.http://www.fp.ucalgary.ca/bmb/news/news.html

Having an institution such as ASRA seems like a good idea. There ought to be an opportunity for somebody to represent science in the halls of government, and here in Alberta, Canada, that somebody is Dr. Marvin Fritzler. Dr. Fritzler is also a signatory to A Scientific Dissent From Darwinism, which is part of a public relations campaign to have Intelligent Design taught in science class.

Discovery Institute Propaganda

A Scientific Dissent From Darwinism is the handiwork of the Discovery Institute, a lobby group (although they describe themselves as a ‘think-tank’) attempting to have Intelligent Design (ID) taught in schools as an alternative to Evolution. ID is a load of pseudo-scientific nonsense — a thinly disguised effort to have religion taught in the classroom — as science. These efforts have included recent involvement with some school boards in Kansas to have science standards in education changed so that ID could be presented as part of the science curriculum.

This lobbying effort has also included the Discovery Institute sponsoring A Scientific Dissent From Darwinism. It is a petition or declaration of sorts, the intent of which was pure propaganda — obtain the signatures of a large number of scientists calling Evolution into question and use this as evidence that there is some large scientific controversy concerning modern Evolutionary theory. This would be used to support the Discovery Institute’s teach the controversycampaign designed to get ID into science classrooms. As the Discovery Institute states:

the long list may help to answer the contention that “virtually all reputable scientists in the world” support Darwin’s theory.

The petition was a spectacular — failure. It did get some press, especially from the more gullible members of the media. However, despite the best efforts of the Discovery Institute, only about 100 (so called) scientists signed on — a truly pathetic number that only reinforced the contention that virtually all the world’s reputable scientists in the world do indeed support Darwin’s theory. Actually, the petition did turn out to be a relatively handy, if crude way, to separate reputable scientists (those that didn’t sign the petition) from those best classified as granola scientists (defined as nuts and flakes).

To drive home this point, mainstream science responded to the Discovery Institute’s initiative with a somewhat tongue in cheek initiative of their own. Entitled Project Steve (in honor of the evolutionary biologist Stephen Jay Gould) only signatures of scientists named Steve or Stephanie (which is estimated to be less than 1% of scientists) were sought in support of the following statement:

Evolution is a vital, well-supported, unifying principle of the biological sciences, and the scientific evidence is overwhelmingly in favor of the idea that all living things share a common ancestry. Although there are legitimate debates about the patterns and processes of evolution, there is no serious scientific doubt that evolution occurred or that natural selection is a major mechanism in its occurrence. It is scientifically inappropriate and pedagogically irresponsible for creationist pseudo-science, including but not limited to “intelligent design,” to be introduced into the science curricula of our nation’s public schools.

So far those signing on number more than 600 — far outpacing the Discovery Institute’s numbers and providing ample evidence that virtually all reputable scientists do indeed support Darwin’s theory.

The bottom line here is that ID is pseudo-science. The Discovery Institute’s efforts, including gathering signatures to A Scientific Dissent From Darwinism, is little more than an exercise in anti-scientific propaganda.

The Inmates and the Asylum

Which brings us back to Dr. Marvin Fritzler. As Chair of the Alberta Science and Research Authority (ASRA) it is his job to help the organization fulfill its mandate as the senior science and research body of the Government of Alberta. It is difficult to see, however, how Dr. Fritzler can do this job effectively when he has signed on to a declaration sponsored by the Discovery Institute in pursuit of what is described by the scientists of Project Steve as “scientifically inappropriate and pedagogically irresponsible” objectives.

Numerous phone calls were placed the Alberta Science and Research Authority over a period of three weeks to obtain their perspective on the matter. Two questions were put to ASRA (and the group identified as representing ASRA on the public relations front — Alberta Innovation and Science). These two questions were:

1. Can you confirm that the Dr. Marvin Fritzler that signed the Discovery Institute’s petition is the same Dr. Fritzler that is current Chair of ASRA?

2. If this is indeed the same Dr. Fritzler, do you think ASRA’s credibility is in anyway compromised by the fact that Alberta’s leading science and research body is led by someone that has signed on to A Scientific Dissent From Darwinism?

After a lengthy exchange of phone calls and e-mails, ASRA and Alberta Innovation and Science refused to answer indicating they didn’t know if this was the same Dr. Fritzler or not. Alberta Innovation and Science confirmed that the Chair of ASRA was a Dr. Fritzler, but couldn’t (or wouldn’t) confirm if this was the same Dr. Fritzler that signed A Scientific Dissent From Darwinism. They suggested I contact Dr. Fritzler at ASRA to find out. I placed subsequent calls to ASRA and they in turn asked for copies of A Scientific Dissent From Darwinism to aid them in answering my questions. I complied twice and gave up when asked a third time.

I guess we shouldn’t be surprised at the response given the Alberta Government’s history of support for pseudo-scientific nonsense — think school boards in Kansas but on a much larger scale. In Alberta, the inmates are definitely in charge of the asylum.

Of course, so far as I am aware, none of this impacts Dr. Fritzler’s ability to actually practice science. Most of science does not require an acceptance of Evolution. However, it seems to me that having someone so clearly out of step with the scientific mainstream providing policy and related advice on matters of science to the Alberta Government, is a concern — and a big one. Makes you wonder who actually appoints the Board and Chair of the Alberta Science and Research Authority. I thought it might be some collection of Alberta scientists. Wrong. According to the Minister’s office, it turns out the Board and Chair are appointed by an Order in Council, which means they are, not surprisingly, political appointments.

It Gets Scarier

Of course the cynics might ask what difference it makes who runs ASRA when the Alberta Government’s science policy has proven so anemic anyway. One answer might be that an anemic science policy is a function of the leadership in Alberta and ASRA.

There is, however, another reason to be concerned. One of ASRA’s three priorities is the Life Sciences. In fact, ASRA has just completed a major initiative entitled Growing Our Future: A Life Sciences Strategy for Alberta. Presumably this will set the Government’s strategy on all elements of the life sciences from genetic research to biotechnology and from agricultural research to human health. In short, this is a strategy that has everything to do with biology.

Yet, Nothing in biology makes sense except in light of evolution. This was the title of an essay written in 1973 by famed geneticist and evolutionary biologist Theodosius Dobzhansky (1900-1975). It’s title accurately reflects the consensus of science today. As Dobzhansky stated in that essay:

Let me try to make crystal clear what is established beyond reasonable doubt, and what needs further study, about evolution. Evolution as a process that has always gone on in the history of the earth can be doubted only by those who are ignorant of the evidence or are resistant to evidence, owing to emotional blocks or to plain bigotry. By contrast, the mechanisms that bring evolution about certainly need study and clarification. There are no alternatives to evolution as history that can withstand critical examination. Yet we are constantly learning new and important facts about evolutionary mechanisms.

So, was the life science strategy of Alberta, to use Dobzhansky’s words, a product of, ignorance, emotional blockages or plain bigotry? And even if the strategy was untainted, where is the credibility of ASRA given that the Chair is so completely out of step with the biological sciences (and such organizations as the American Association for the Advancement of Science) on what is emerging as one of the most important issues of science and society?

ASRA is a public institution funded with public money. As a citizen and taxpayer, I think I have the right to be concerned with the quality of representation science is getting.

Rebuttal

In a final (and desperate) act to confirm whether the Dr. Fritzler that signed A Scientific Dissent From Darwinism was the same Dr. Fritzler that Chaired ASRA, I e-mailed copies of initial drafts of this article to the Dr. Fritzler at the University of Calgary.

Dr. Fritzler responded at length confirming that he signed A Scientific Dissent From Darwinism and was also the Chair of ASRA. He also made it clear (in a later e-mail) that ASRA’s credibility or capability is not in any way affected by his position on Intelligent Design.

The response initiated a series of e-mail exchanges between the two of us. These called into question some of the statements made in the original draft of this page and I have made corrections where I was in agreement with Dr. Fritzler’s criticisms.

I also offered to post Dr. Fritzler’s responses to ASkepticRTN — allowing people to read Dr. Fritzler’s concerns, criticisms and position on all this. He rejected the offer.

The Nature of Nonsense: Dr. David Suzuki has got a whole new show

In 1960, the CBC launched the Nature of Things as a half-hour science series. It was a good idea. People wanted to hear about science and the Nature of Things gave it to them. The CBC describes it as Canada’s longest running documentary television series.

Notice that the word science is not in the description.

That’s because the Nature of Things is not about science anymore, or at least, not just about science. Now it is equally about the increasingly flaky, pseudo-scientific nonsense promoted by the program’s star, Dr. David Suzuki. I remember when Dr. Suzuki first joined the program 30 years ago. He shattered the image of scientist as nerd and presented science in a way that I thought was magic. He was just so cool.

Things have changed. Now, Dr. Suzuki is trying to sell magic as science.Literally. Take a recent example. On May 13, the Nature of Things presented: Blue Buddha: Lost Secrets of Tibetan Medicine. The documentary follows Tuvan Lama, Tibetan Monk and traditional healer, as he treats patients, engages in traditional rituals, and passes on this vast medical heritage to the next generation.

Dr. Suzuki’s overly earnest narration provides a nice contrast to the nonsense on the screen. For example, Dr. Suzuki tells us:

  • ancient Tibetan medicines are only mixtures of ingredients and are ineffective until they are prayed over using special ancient Tibetan rituals and incantations,
  • ancient Tibetan medicine is recognized and accepted as a comprehensive medical system,
  • Tibetan medicine understands how the mind affects the body and how our personal energy fields can be used to help the body heal itself.

This is only a small sample of the stupidity presented. There is much more, as it takes a lot of nonsense to fill an hour of television, but I can’t remember it all. I do remember one scene though. It concerns an unfortunate elderly woman who is dying of stomach cancer. She comes to see Tuvan Lama and telling him of her condition, she asks for any help he can provide.  Tuvan Lama takes her hand, and after a deep spiritual moment, asks her if her stomach hurts?!!  He then provides her with some special medicine that has been prayed over (because you know, you like need that) but reminds her to get right with the Buddha, because evidently, she is going to die anyway.

Wow, this is the kind of medicine we need in the west, especially in Alberta. We have got way too many people going to hospitals for things like cancer and it’s costing us a fortune. We could bring Tuvan Lama and other monks practicing these ancient healing arts over here. That way, our cancer victims could die much faster and at less cost. (Patient: I have Leukemia. Monk: Better get right with the Buddha because you’re toast. That’ll be $100. Next!)

It’s sad to see a what was a great program like The Nature of Things, slide so far downhill.  In my view, it is  a betrayal of those that originally put the program together so many years ago. They wanted to explain and develop an appreciation for science among their fellow Canadians. Now, the Nature of Things is trying to sell Canadians that mysticism and magic are science and feed the ego of its host in the process.

It turns out, Dr. Suzuki has created a whole new show: The Nature of Nonsense.  Weekly on, where else, the CBC.

Acupuncture study reveals new desperation on the part of NCCAM

Plus, the usual media gullibility

Starting with a provocative statement and finishing with nonsense worthy of Lewis Carroll, the headline in the September 11 Calgary Herald read; Acupuncture helps relieve headache, back pain, whether placebo effect or not: study. 

According to the article, “The new analysis was published online Monday in Archives of Internal Medicine. The federal government’s National Center for Complementary and Alternative Medicine paid for most of the study, along with a small grant from the Samueli Institute, a non-profit group that supports research on alternative healing.” Researchers with Memorial Sloan-Kettering Cancer Center in New York and several universities in England and Germany wrote that the results ‘provide the most robust evidence to date that acupuncture is a reasonable referral option,’ . 

Archives of Internal Medicine, researchers led by Andrew Vickers, an epidemiologist and biostatistician at Memorial Sloan Kettering Cancer Center, report that stated that; “The effects of acupuncture are statistically significant and different from those of sham or placebo treatments,” says Vickers. “So we conclude that the effects aren’t due merely to the placebo effect.”

Dr. Vickers may be an epidemiologist and biostatistician, but clearly,  needs to go back and take an introductory course on statistics. This is a first year statistics students error, misinterpreting  statistical significance as meaning practical importance. Statistical significance means the difference was detectable by the measurements system (including things like the sample size, sensitivity of the measuring instrument). Differences in telephone numbers are statistically significant. The question is whether these differences are important.

Confusing statistical significance as a measure of practical importance is a sign of incompetence or worse, the desperate act of researchers to get something, anything,  published. Or perhaps it’s just desperate act of NCCAM (the black hole of pseudo-scientific research at $2.0 billion and counting) to actually produce a finding.  In essence, Dr. Vickers and his team, are making a pun, switching the statistical meaning of significance (detectable) with the everyday meaning (important) in the hope that; (i) you won’t notice, and (ii) you will believe this statistical con-game for real science. Either way, the joke is on anyone believing it and American taxpayers paying for it.

The actual results showed a decline from a baseline pain level of 60 (on a scale of 0 to 100), to 30 for those receiving acupuncture, to 35 for those receiving fake acupuncture (the placebo), and 43 for people receiving the usual care and no acupuncture. From 35 to 30–are you kidding me? Like loaded guns, some people shouldn’t be left alone with a statistical software program.

Equally bad is the level of journalism involved. Close to 500 words on the subject of which about 40 are dedicated to the voice of reason from Dr. Stephen Barrett. A few more words from the good doctor, who actually knows what he is talking about, wouldn’t hurt. Where’s the journalistic balance?

The author, Lindsey Tanner, is supposed to be a “Medical Writer” for The Associated Press, although, here again, clearly not a very good one. A health writer, should actually understand what a placebo is. Ms. Tanner clearly doesn’t. She is too busy selling pseudo-scientific nonsense as science. Perhaps she should be the “Alternative-Medical Promoter” for Associated Press. Now that would fit.