How TCM may actually be saving Taiwan's NHS a bundle

The most recent Skepdic newsletter contains mention of a report by the BBC on an intriguing scheme being undertaken by Northern Ireland's NHS involving referral of some patients to practitioners of complementary and alternative medicine with the NHS picking up the tab. While it may sound like a load of bollocks on the surface, the scheme promises to drastically reduce the amount of money spent needlessly on people who are not really all that sick, or who may benefit just as well from the placebo effect as from a costly drug.

Scott Sommers recently lamented on Kerim's blog that "no one who is truly ill uses [Taiwan's NHS]" and in another comment suggested that folk remedies available on the NHS represent additional costs. After reading about the scheme in Northern Ireland it struck me that the availability of traditional Chinese medicine on the NHS in Taiwan may actually be saving the government a bundle. Rather than over-prescribing prozac and other expensive pharmaceuticals of dubious efficacy, how's about a packet of dried fungus or a harmless session with an acupuncturist at a fraction of the cost? The patient feels better, the government saves money and the NHS remains in less debt than it would have been otherwise. Many Taiwanese use TCM almost exclusively for minor illnesses and non-illnesses. This is a good thing. The last thing we want is for them to be over at the real hospital being pointlessly prescribed pricey drugs. I never thought I'd hear myself say this but let's hear it for TCM on the National Health Service !

Update (2 March, 2009): This article describes some of the findings from the experiment in Northern Ireland. Eight-one percent of patients reported improvements in physical health after the treatments. So what if it's the good ol' placebo effect? It's saving money and people are happy! "The researchers concluded: 'Not only has this project documented significant health gains, but also the potential economic savings likely to accrue from a reduction in patient use of primary and other health care services, a reduction in prescribing levels and reduced absenteeism from work."

Traditional Chinese Medicine and cancer

My mum sent me this news story about a traditional Chinese medicine called Aristolochia fangchi which has been banned in the UK since 1999 because it can cause kidney failure and cancer of the urinary system. Nice stuff. (By the way, it seems to be spelt wrong in the Yahoo article. More info from Wikipedia here.) There is also the danger that this herb may be used as a substitute for other herbs. The Aussie government has a fact sheet listing the herbs which are most likely to contain Aristolochia used mistakenly - or accidentally-on-purpose - as a substitute.

It made me wonder whether this ancient herb is still available here in Taiwan. Unlikely, but the very fact that you can get TCM on the National Health Service, it's not inconceivable. Afterall, in Taiwan we effectively have state-sponsored snake-oil (figuratively and quite literally - snake oil is available as a Chinese medicine here) provided to the masses alongside so-called Western medicine. I say "so-called" because what that really means is "evidence-based" medicine.

And while I'm ranting why don't we just do away with coy words like complementary/alternative and conventional medicine, and Chinese and Western medicine, and say instead what skeptical minds are thinking anyway, namely: "medicine that works" and "medicine that doesn't work"? I'm of the view that we should only be taking and paying taxes for medicine that works and not be taking medicine and paying taxes for that which hasn't been proven to work, but hey that's just me talking crazy again. Yes, I know some Chinese medicine works - that's when we should stop calling it Chinese medicine and call it simply medicine. You see my point? OK, back to Aristolochia: wouldn't that be a mind-bender - a known carcinogen prescribed by TCM doctors on the National Health System? I just hope it isn't so.