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by pizza234 715 days ago
They're even covered by some insurance plans.

A friend of mine is an orthopedic surgeon, and they explained to me that for mild problems, which would normally heal on their own, it's cheaper to cover a placebo rather than real medication.

4 comments

While I hear this argumentation a lot, I still struggle with this:

If you have "mild problems, which would normally heal on their own", buying no medication at all would be even cheaper.

And from an ethical point of view, the idea of financing a whole (homeopathic) industry that uses your money to produce fake science, even with a single cent, should make one shudder, shouldn't it?

> If you have "mild problems, which would normally heal on their own", buying no medication at all would be even cheaper.

But placebos actually outperform no intervention.

Okay, fair point.

But then, why prescribe the most expensive placebos where you co-finance societal harmful behavior, rather than just prescribing the "harmless" placebos that are not homeopathy, which are usually even cheaper and don't have any ideological overhead?

I'm not aware of any research along these lines, but I suspect that all placebos are not equally effective.

It's a psychological effect, so things like price or flavor or packaging likely affect its strength.

Yea there is research into it, and you're correct

Color matters: placebo colored pills work better than white pills.

Delivery mechanism matters: placebo injections work better than pills.

Idk about price, packaging, or flavor specifically. But delivery mechanism, color, number of pills, etc I remember from a study.

The 2008 Ignobel Prize in Medicine was awarded for a paper that showed that higher-priced placebos are more effective than lower-priced placebos [0].

[0] https://en.wikipedia.org/wiki/List_of_Ig_Nobel_Prize_winners...

There is a lot of over-the-counter and even some prescription medicine that don't do much at all for what people take them for, and homeopathy is cheaper and less harmful for the same placebo effect. Cold medicine in particular is known for its dubious efficiency.

No medication is even cheaper, but the placebo effect works, so if people were to take something, might as well have them take something cheap and harmless. In my opinion, it doesn't justify supporting homeopathy, but health insurances may see it differently.

Placebos are an interesting ethical issue. Doctors are not supposed to deceive you, they are people you trust with your life and very personal issues and they are therefore held to very high standards. But even if it is for your own good, the placebo effect is based on deception, so is it ethical for a doctor to give you a placebo? And is fake science that still help people ethical? The consensus seems to be "no" for both and I tend to agree, but I still think it is worth debating.

Here we have an article that claims that even when people are told they are getting a placebo, they still felt better after taking it.

https://www.health.harvard.edu/blog/placebo-can-work-even-kn...

> If you have "mild problems, which would normally heal on their own", buying no medication at all would be even cheaper.

American culture loathes the idea of not treating a disease. Problems are expected to be dealt with, even if it harms society (see overprescribing antibiotics or opioids).

When confronted with people that don't understand the impacts of medicine, it's easier for an insurance company to give them fake medication than nothing at all.

To those who downvoted: Would you dare to explain your disagreement?
Indulging without argument a patient's harmless fantasies economizes on physician time, and that is surely the most precious resource.
This is basically how TCM came to be!

The Chinese Communist Party had billions being raised out of incredible poverty and that populace started demanding medical care. There was no possible way to supply enough clinics, doctors, nurses, etc - and not just because Mao whipped the Red Guard into an anti-intellectual froth than then slaughtered much of China's academic/scientific community.

So Mao waved his hands and invented TCM, which basically said "oh yeah, most of these traditional Chinese medicines work. We did some research and figured out which ones and how to apply them!"

Hilariously people argue TCM doesn't work not because it's complete bullshit, but because it's a modified, corrupted version of actual Chinese medicine...

Sometimes I get into conversations with TCM advocates.

"If you get into a car accident in China," I say, "an ambulance will take you to a hospital where they will treat you with western medicine. Why do you think that is?"

It’s even cheaper to offer nothing. Some humans are just quite something.