Senator Tom Harkin: NCCAM has “fallen short” because it hasn’t validated enough woo

Senator Tom Harkin (D-Iowa) owes me a new irony meter.

I’ll explain in a minute, but first you have to know why I even give a rodent’s posterior about Harkin. As you may recall, no single legislator in the U.S. has done more to damage the cause of science- and evidence-based medicine than Tom Harkin. It was through his efforts that the National Institutes of Health, despite the fact that its scientists were not agitating for it, had the National Center for Complementary and Alternative Medicine (NCCAM) rammed down its throat, first as the Office of Alternative Medicine (OAM) and then, when NIH Director Harold Varmus tried to place OAM under more scientific NIH control in 1998, by elevating OAM to a full and independent Center within the NIH.

I’ve complained many times about how NCCAM funds studies of pseudoscience and quackery and even more about how it promotes unscientific medical practices. I’ve said time and time again that there is nothing that is funded by NCCAM that wouldn’t better be dealt with by other Centers or Institutes within the NIH. I’ve also pointed out Harkin and other CAM-friendly legislators created and promoted NCCAM not for the purpose of rigorous scientific evaluation of CAM practices, but rather to promote CAM and ultimately “integrate” it with scientific medicine. At this they have been enormously successful.

At “proving” that CAM works, not so much, so much so that Senator Tom Harkin is very, very unhappy with NCCAM and said so recently, as pointed out by Majikthise. On Thursday, Harkin told a Senate panel that he was disappointed that NCCAM had disproven too many alternative therapies. The video can be viewed here. In addition, Harkin’s statements have also been posted to his Senate blog:

I am pleased to co-chair this morning’s hearing with Senator Mikulski. And I am eager to hear our distinguished witnesses’ ideas on using integrative care to keep people healthy, improve healthcare outcomes, and reduce healthcare costs.

It is fashionable, these days, to quote Abraham Lincoln. So I would like to quote from his 1862 address to Congress – words that should inspire us as we craft health care reform legislation. Lincoln said, “The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty . . . . As our case is new, so we must think anew, and act anew. We must disenthrall ourselves, and then we shall save our country.

Clearly, the time has come to “think anew” and to “disenthrall ourselves” from the dogmas and biases that have made our current health care system – based overwhelmingly on conventional medicine – in so many ways wasteful and dysfunctional.

I note that on the video, Harkin does not say “conventional medicine.” Rather, he says “conventional allopathic medicine.” And, as any regular reader of this blog knows, anyone who uses the term “allopathic” in such a contemptuous manner to describe conventional scientific medicine has clearly drunk the Kool Aid. But, consistent with how I’ve warned that CAM advocates would do their best to hijack any effort on the part of the Obama administration to reform the health care system by trying to link all manner of unscientific woo to “prevention,” Harkin goes on to do just that:

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

“It is time for America’s health care system to emphasize coordination and continuity of care, patient-centeredness, and prevention.

“And it is time to adopt an integrative approach that takes advantage of the very best scientifically based medicines and therapies, whether conventional or alternative.

“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.

Note the false dichotomy. It is not necessary to embrace pseudoscience in order to reform the health care system to emphasize coordination, continuity of care, and prevention. Nor, I would argue, is it necessary to use placebo medicine to reduce costs, and, let’s face it, that’s what the vast majority of the hodge-podge of unscientific and pseudoscientific practices that fall under the rubric of CAM are: Placebo medicine.

Most tellingly, Harkins makes the following remarks about NCCAM. Harkins first prefaces his remarks by explaining how he decided he wanted to write the legislation that brought into existence the OAM and, later, NCCAM. Not surprisingly, it was based on an anecdote about a friend of his from the House of Representatives who had a serious illness, tried “alternative” approaches, and supposedly got better. Then, Harkins makes a startling admission:

One of the purposes of this center was to investigate and validate alternative approaches. Quite frankly, I must say publicly that it has fallen short. It think quite frankly that in this center and in the office previously before it, most of its focus has been on disproving things rather than seeking out and approving.

Note what Harkin first says here. He doesn’t say that the purpose of NCCAM was to investigate alternative approaches and determine if they work or not. Rather, he says that the purpose of NCCAM was to investigate and validate alternative approaches. That’s why he’s so disappointed that the vast majority of the studies coming out of NCCAM are actually negative. Moreover, he doesn’t understand science. Hypothesis testing involves designing experiments or clinical trials that can be falsified; i.e., “disproved.” That’s how the scientific method works. But Tom Harkin does not want NCCAM to work by the scientific method. Not really. Or, at least, he said he did in the beginning until the studies performed by believers even under conditions most optimized to produce “positive results” have failed to do so. Now he’s unhappy, and his new strategy is to “integrate” these therapies that have failed thus far to stand up to scientific scrutiny with scientific medicine. In fact, he makes it very clear that he plans on yoking any health care reform that President Obama tries to pass through the Congress to the addition of integrative medicine:

Since 1992 the field has evolved and matured. Today, we are not just talking about alternative practices but also the integration between conventional and alternative therapies in order to achieve truly integrative health. We need to have practitioners talking with each other, collaborating to treat the whole person. And this is the model we intend to build into our health care reform bill.

On several occasions, I have laid down a public marker, saying that if we pass a bill that greatly extends health insurance coverage but does nothing to create a dramatically stronger prevention and public health infrastructure and agenda, then we will have failed the American people.

Well, this morning, I want to lay down a second marker: If we fail to seize this unique opportunity to adopt a pragmatic, integrative approach to health care, then that, too, would constitute a serious failure.

That, my dear readers, is what we are dealing with. A balder statement of what purveyors of pseudoscientific medicine plan I cannot imagine.