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Healthcare provision seeks to embrace prayer treatments

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. While not mentioning the church by name, it would prohibit discrimination against "religious and spiritual healthcare." [...]

About 90 years ago, private insurance companies began paying for Christian Science prayer treatments, but more recently, managed-care insurers declined reimbursements, insisting on paying for care that produced proven medical results.

The Internal Revenue Service allows the cost of the prayer sessions to be counted among itemized medical expenses for income tax purposes -- one of the only religious treatments explicitly identified as deductible by the IRS. Some federal medical insurance programs, including those for military families, also reimburse for prayer treatment. [...]

Dr. Norman Fost, a pediatrician and medical ethicist at the University of Wisconsin, said the measure went against the goal of reducing healthcare costs by improving evidence-based medical practices. "They want a special exception for people who use unproved treatments, and they also want to get paid for it," he said. "They want people who use prayer to have it just automatically accepted as a legitimate therapy."

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23 Responses:

  1. lafinjack says:

    Sounds good to me. People who go that way will die quicker, costing the system less money in the long run.

    • fnivramd says:

      Ain't necessarily so. This is the mirror of the standard argument for early intervention by single payer systems. By curing my cancer (with expensive drugs and radiation) when I found a lump, the state (in my case, the British government via the NHS) gets probably 30-40 more productive tax-generating years out of me AND saves on the critical care cost if I'd been admitted to a hospital dying from the late stages of said cancer.

      Most people who initially use "alternative" medicine for a disease that's not self-limiting will eventually seek proper (evidence-based) care and since they waited the treatment may be less effective and probably no cheaper, so in effect they cost _everyone_ more money anyway, even if you don't pay for the prayers, the sugar pills, or the E-meter sessions.

      • Yes, it only works if they have true faith and only go to Christian Scientist healthcare providers. If they wuss out at the end and try to get conventional healthcare, we will probably lose money, but I doubt we will lose more than if we don't cover Christian Scientist healthcare. They don't charge much (at least at the moment) and the people who are likely to use them are going to use them instead of conventional healthcare anyway.

        The major benefit of funding their choice is that we might be able to get hard data out of the providers about their success rates. The insurance companies are not required to reimburse these charges, they are required to consider reimbursing them. If I were in charge of an insurance company, I would shoot myself in the head require them to provide detailed, anonymous data about the treatments and outcomes before covering them

    • pavel_lishin says:

      Who says that dying of, say, cancer over a period if years is cheaper than treatment?

  2. gryazi says:

    This also covers Rastafaris, the Native American Church, and whoever's doing the ayahuasca sacraments, right?

    I'm starting to think my metaphysics are more gnostic than agnostic - something made the universe happen and we still can't be sure if it was some old white bearded guy sneezing or what.

    • gryazi says:

      ...and some of their most potent healing ceremonies can only be conducted at the Lagrange points. (Yeah, maybe separating church and state would be easier. And you can only get reimbursed after the services are rendered, right?)

    • merovingian says:

      My new faith says that video games and road trips will cure diseases. I'll plan to bill my carrier for those.

  3. cattycritic says:

    I don't see why taxpayers ought to pay for any "medical" treatments unless they have undergone the exact same approval process as every other medical treatment, regardless of the origin of the treatment.

    If and when I want spiritual care while I'm in the hospital, I certainly don't want some insurance company telling me I have to go to a preferred rabbi in their network. Watch, hospitals will start restricting access only to spiritual whatevers on their list of providers. Then one day I'll be in the hospital, they'll be right out of rabbis, and they'll make me see a Hmong shaman. This just sounds dumber all the time!

    (that was a joke, there.)

    • loic says:

      Unfortunately most of our "western medicine" doesn't actually have a great scientific basis. For example it's almost impossible to do double blind control trials of surgery.

      Surely there should already be insurance providers targetting people who want religious treatment. Why are Jehovas Witnesses paying premiums to cover blood transfusions they'll never want? And Christian Scientists want coverage for prayer but not much else. Isn't this what our faboulus free market is supposed to have delivered already?

      • fnivramd says:

        You can't double-blind such trials, but you can randomise patients into one arm or the other after an intention to treat decision. This is less fool-proof (the patient knows from the tiny scar that they got assigned the new keyhole method, and that could influence subjective outcomes), but it still gives us excellent reason to believe in the results, particularly when there's an objective outcome like reduced mortality, patients can't fake that.

        • They can't fake reduced mortality, but they can live longer due to the placebo effect, which is amazingly powerful. Of course, a finding that a treatment is due to the placebo effect should really be followed up by research to determine how cheaply and easily we can evoke that effect. Otherwise, people are still doing more poorly than if they'd had the "ineffective" surgery...

      • shannonwells says:

        Double-blind control trials, while they are considered an ideal, are not the only way to prove effectiveness of a treatment. Such a qualitative statement that "...most of our 'western medicine' doesn't actually have a great scientific basis" is impossible to prove, so I simply don't agree with it. Even so, new medical treatments are obviously not necessarily required to pass double-blind control trials before they are approved, so this is not an argument against my proposal that all medical treatments the taxpayer would have to pay for should be subject to federal approval.

        If we're going to force insurers to spend more money, I'd rather have private insurers be prevented from canceling people's coverage in the midst of cancer treatment because they've gone below full time hours (due to their illness!!). That's a real life example. I thought we were supposed to be worrying about how to pay for all this. Why throw in coverage that is demonstrably medically unnecessary?

      • You could conceivably teach a surgeon two new techniques, and not tell them which is expected to be more effective. There are good reasons never to do this.

        Some studies of non-critical surgeries (e.g., physical rehab) do use sham surgery, so everyone gets equally anesthetized and cut up. You can also have the person assessing outcomes blind to what the physician did, which gets you most of the way to double-blinding.

        And Christian Scientists want coverage for prayer but not much else. Isn't this what our faboulus free market is supposed to have delivered already?

        The problem is that our society has a pretty strong commitment to not letting people choke to death on their own blood in the middle of the sidewalk. If someone without insurance that covers real medicine chickens out and decides they don't want to die in the Christian Scientist prayer-based hospice, we're going to end up giving them care anyway. The argument that they made a bad decision and deserve to die horribly doesn't get much traction, though as you point out, it's a tricky situation.

  4. solarbird says:

    Does that include praying for the sweet release of death panels?

  5. hadlock says:

    Can someone explain what exactly the patient is paying for in a "prayer treatment"? AFAIK priests pastors rabbis etc do hospital calls for free. Their time and travel expenses are paid for by the church, which is in turn paid for by the congregation. Is the church asking that the state/insurer pay for their travel costs, or do they actually want money for the prayer service itself? If they're getting paid for the prayer service, where can I sign up to get a certification to practice prayer service under a priest or whatever (similar to a physician's assistant)? That sounds like a pretty decent gig.

  6. kou says:

    If I can claim that shinto purification (harai) will make me better after getting the swine flu or something, perhaps I could get my insurance to pay for a quick trip to Japan :P...

  7. bifrosty2k says:

    So awesome!
    Yes, this is the magic of letting bureaucracy decide whats treatment and whats not.

    • merovingian says:

      Yeah, I sure am glad there's no bureaucracy in health care right now.

    • I don't think legislative actions count as bureaucratic. It's a deliberate and explicit decision by identifiable elected individuals. Once the law is passed and you have unelected government employees deciding how to enforce it, that's bureaucratic.