As medical care costs inexorably rise, a particularly perplexing problem is how to treat destitute patients whose illnesses are largely self-inflicted. What do you do with those who gorge themselves into diabetes while unable to pay a nickel for treatment? Current policy provides government-supplied medical care even if the sick person continues the unhealthy behavior. For better or worse, punitive measures, let alone denying treatment altogether, are unthinkable—taxpayers pay the bills regardless. Clearly, such generosity is a recipe for bankruptcy.
Let me suggest a solution to this tribulation: offer the ill the option of government-paid traditional, folk medicine or, to use today’s faddish vocabulary, non-Western alternatives. Not only are such “cures” dramatically cheaper than science-based medicine, but these options are already popular among the poor unable to afford expensive doctors and hospital care. For millions, an herbal potion far outshines colonoscopies and other invasive procedures. No doubt, public subsidies would encourage millions to skip expensive ER visits and prescription medications.
Those who might doubt the allure of non-Western medicine should visit New York City’s Chinatown and observe the countless stores offering traditional Chinese treatments for almost every illness imaginable, including deadly cancers and psychosis. Popular herbal remedies include baizhu, chaihu, guizhi, rougi and haunglian (for a more complete list, see here). Indeed, according to one compilation, there are over 100,000 medical recipes in ancient Chinese literature and the popularity of these high-rent Chinatown outlets attests to the market. The penchant for non-traditional cures is hardly limited to the Chinese. New York City also has a large Dominican population where herbal and extract medicines are also exceedingly popular.
It would be a snap to promote government subsidized non-Western medicine, and to take just one example in detail, consider what can be done to help African Americans. To be sure, given the enormous variation within sub-Saharan Africa, there is no one single model of “African medicine” but there are common themes that could guide an American version. Besides the familiar reliance on herbs, plants and animal parts, central to African medicine is the belief that illness is not a results of chance occurrences, e.g., catching the flu, but results from social, spiritual or social imbalances. According to one analysis, good health is a result of harmony among a person’s physical, spiritual, moral and social balance, and the healer’s role is to bring these forces into harmony. Moreover, unlike doctors in Western medicine, African healers occupy roles of high priests, diviners, and others religious-like figures. In many instances, putative cures would alarm university-trained doctors– applying the fat of a boa constrictor to cure gout and rheumatism but many Africans (even African Americans) might likewise be skeptical of high-tech Western cures (and at least some are as useful as boa constrictor fat).
While European rulers attempted to stamp out traditional medical practices, often labeling it as “witchcraft,” the older techniques have nevertheless have returned to post-colonial Africa. In one South African hospital, for example, older, more spiritual techniques are mixed in with Western style medicine. It is also arguable that previous approaches are more practical in societies lacking electricity or clean water. They may also offer positive placebo benefits. Remember that some modern medicines, e.g., quinine, owe their origins to “primitive” herbal remedies.
With the legitimacy of African folk medicine established, the next step is to build institutional arrangements to secure government financial support. Perhaps a National Academy of African Healthcare which would then would certify Doctors of African Medicine (DAM) to oversee clinics comparable to convenient care Western-style facilities Note well, government funding of non-traditional, even initially suspect medicine is hardly new. Over decades medical cures that scientists once deemed quackery are now covered by insurance, including Medicare. If scientific proof were the only criteria for public funding, talk-based psychotherapy might vanish. Acupuncture has evolved from an exotic procedure to one that is mainstream, clinically proven and popular. The mainstreaming of chiropractic medicine is another useful parallel.
The current system of Medicare or Medicaid, even private insurance, would just be extended. So, as of January 1, 2014 (with some state variation), payments for healthcare would be given for all adults with incomes at or below 138% of the federal poverty level. The Children’s Health Insurance Program (CHIP) would cover all children from low-income families. Meanwhile, the elderly and disabled could avail themselves of Medicare. It is quite likely that business would boom at African based Medical clinic that advertised “we accept Medicare, Medicaid and other insurances.”
Especially important would be for universities and college with African American students to provide non-Western student healthcare. It is even conceivable that many white administrators would turn to African cures to demonstrate solidarity with medical multiculturalism. Hard to imagine a university president refusing African-based herb-based treatments for his arthritis.
No doubt, the (largely white) medical establishment would criticize Afro-centric medicine as witchcraft or voodoo that puts patients at risk from make-believe doctors applying untested methods and potentially dangerous drugs. But, keep in mind that nobody is forced to use this alternative and if no cure is forthcoming, patient can certainly opt for traditional Western, science-based treatment. All that is being proposed is an option for those who reject “white” science-based health care and instead trust in remedies derived from traditional, usually long-standing African approaches that have survived centuries of colonial efforts to repress them. To repeat, it is the perfect option for those who condemn America’s toxic European whiteness.
This is a win-win solution to a current medical crisis whereby millions of poor patients soak up expensive medical care for preventable illnesses. Such “culturally sensitive” medicine, of which African-based treatment is just one example, will surely outshine previous cost-cutting initiatives like enhanced healthcare education or preaching the mantra of preventive care. The savings will, guaranteed, be in the billions—just compare the cost of a neighborhood-based shaman to an ER physician let alone the cost of powerful herbs versus a prescription drug. This approach will also bring thousands of decent-paying healthcare jobs to African Americans plus opportunities for black-run manufacturing and retail businesses to join the booming healthcare industry.
With any luck this government insurance-based model will find favor among other groups possessing a strong history of folk medicine. Haitian, like the Chinese and Dominicans (among countless other ethnic groups), have a long history of using plant and animal medicinal material to cure illnesses; the only change would be that government would now subsidize these treatments. It is also likely that patients will feel more at home with their “culturally competent” healers versus having to deal with largely white university-trained professionals unfamiliar with patient lifestyles. The expansion of medical options should also delight free-market conservatives.
In short, it is a bit more than a little ironic that traditional non-Western medicine that rejects science-based medicine will bring financial solvency to our out-of- control healthcare system.