Homeopathy in the United States

Homeopathy is more prominent in Europe than it is in the United States. In the United Kingdom, for example, the Royal Family has long used homeopathic remedies, and the Prince of Wales advocates for the practice. Homeopathy is also paid for under the UK’s National Health Service (as it is by several other national health services in continental Europe), although the UK House of Commons Science and Technology Committee has recommended that this be reviewed.

In the United States, some states license homeopathic providers along with other groups, such as chiropractors, but Medicare, the largest single payer in the United States, rejects charges for homeopathic treatments as “not medically necessary.” Some private health insurance plans cover homeopathy under modest “complementary medicine” benefits, such as Blue Cross plans offering a small annual maximum benefit ($500) for alternative services such as homeopathy, herbal medicine, ayurvedic treatments, or naturopathy. But private insurances often limit such benefits with a cap on numbers of visits and a deductible that is even higher than the maximum benefit.

The US Food and Drug Administration recognizes homeopathic remedies for marketing, but concerns itself mainly with their presence in the homeopathic register and with details of labeling. (The FDA lightly monitors a number of treatments that were already common before it began its assessment programs.) FDA exemption of homeopathic remedies from expiration dating and other labeling requirements reflects the safety (lack of toxicity) of compounds without active ingredients. The FDA has published information for consumers about homeopathy in the past, but its current FDA For Consumers website does not return any results for searches on homeopathy.

The US National Institutes of Health has recently begun complementary medicine programs, including funding some studies to test complementary treatments. Its NCCAM (for complementary and alternative medicine) program is controversial in some quarters, criticized as promoting worthless therapy. But it publishes fairly straightforward (ok, yeah, a little bit too “neutral”) information about homeopathy, the general thrust of which is that the efficacy of homeopathic drugs is not established, but the placebo effect can be helpful. For people considering using homeopathic remedies, the NCCAM’s very first recommendation is, “Do not use homeopathy as a replacement for proven conventional care or to postpone seeing a doctor about a medical problem.”

If this all seems a bit dull and plodding, then I confess: that’s how it feels to me. Homeopathy has never been particularly visible in my life, even though I live in the Sam Francisco Bay Area and understand that this area is home to many medical denialists—people who don’t want to vaccinate their children, for example, or who swear by raw milk as not merely safe but universally beneficial. These are educated, middle-class people who are simply privileged enough that they (and their parents) can’t remember a time when vaccine-preventable diseases stalked the land in great numbers, let alone the way that the increasing urbanization of Americans created a special challenge for distributing milk safely over longer distances. Still, as foolish as privileged people are willing to be on their own dimes, it seems like the people writing the checks and making the standard-of-care recommendations are on the right page with this one.

Tomorrow, I promise, I’ll link to something tart and British on the subject.

(If you can’t wait [for tart and aren’t holding out for British], then go to YouTube and watch this bit from Dara O’Briain on alternative medicine. He’s a bit harsh about “nutritionists,” which here are as likely to be mainstream providers working side by side with physicians in diabetes and genetics clinics, but he’s certainly got homeopathy pegged.)

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