A year on and Covid quackery remains a potent force in global public health discourse. We should not be surprised by this as quackery of all sorts suffuses the history of medicine in America and abroad. The recent mass exodus of public health officials from their jobs, however, is so unprecedented that it challenges Murray Rothbard’s Second Law: “No one ever resigns.” What the flight of the Covid quacks portends, however, remains unclear.
Quackery is a derisive term often used by medical establishments to denigrate competitive approaches to health and wellness but it can, and has, also been used to question the expertise of recognized health authorities. Those who engage in quackery are called quacks and by definition push their own scientifically untested curatives and preventatives in lieu of available alternatives in order to enrich or empower themselves at the expense of their patients and medical science.
Objectively, then, quacks put profits or power ahead of the scientific method and hence the interests of their patients. They break the Hippocratic Oath to “do no harm” in order to sell a system or nostrum.
Widespread quackery provides the only justification for the formation and continued existence of the FDA. But like similar government “watchdogs,” the FDA is subject to capture and other forms of manipulation. Moreover, it is painfully slow and hence especially ineffective during a fast-evolving situation like a pandemic. Yet many Americans assume that it protects them from all forms of quackery even though the last year has proven that it does not.
The FDA did not, and indeed cannot, protect Americans from two types of quacks extraordinaire, the legacy mass media and the government itself. The most powerful bulwark between patients and quacks is not journalism or public health officialdom but long-term relationships with “good” doctors. By “good” I mean both skilled and moral enough to follow the Hippocratic Oath to perpetrate no harm on their patients.
Good doctors speak with patients rather than at them, know their patients’ medical histories, and craft individualized treatments plans, be it for cancer or Covid. Thankfully, millions of Americans still have access to good doctors skilled enough to parse politics from scientific discussions of the costs and benefits of hydroxychloroquine, ventilators, and vitamin D and to apply that knowledge to the needs of individual Covid patients.
Remember that a large majority of people hospitalized with Covid recover (now over 95% for people with private insurance); most fatalities occur among the aged and ill, i.e, the most difficult cases to treat.
So why are public health authorities dropping like bees in a hive suffering from colony collapse disorder? Specifically, nine top health officials in New York recently quit and nationwide at least 49 have resigned or been fired since April 2020, a churning of top personnel never before seen in this country.
The journalists covering that unprecedented exodus point to facile explanations like limited resources, low morale, pandemic stress, political pressures, and so forth. But the deeper answer is that politicians have induced public health officials to engage in quackery by severing the intimate link between doctor and patient with one-size-fits-all prescriptions like lockdowns and mandatory masking. Instead of getting medical advice from the only person really qualified to give it to them, their doctors, Americans have been getting information, often unscientific generalities, from billboards and talking heads on television mimicking what they hear from the CDC and state health officials.
I suspect that many of the officials who quit, or allowed themselves to be put out to pasture, were haunted by questions like
- “How many people died of Covid because we made it seem like wearing a mask and social distancing was enough to protect them even though we knew that in specific instances it was not?”Whether public health officials convinced themselves of the efficacy of lockdowns, an unprecedented policy response rejected by all public health policy experts until March 2020, or faced political pressures to “do something,” even if that meant breaking their oaths to uphold the Constitution or the Hippocratic ideal, the guilt must be overwhelming.
- “What if we had encouraged everyone to help protect the vulnerable instead of issuing irrational orders to shut down restaurants and bars?”
- “Am I really a scientist if I support curfews as a public health measure in response to an infectious disease?”
- “How many of the people who committed suicide in 2020 did so at the margin because of the quack social remedies that my office advocated?”
This is not the first time that quackery has been ascendant in this country and I fear that without major healthcare reforms, like the ones that Sean Masaki Flynn, John C. Goodman, myself, and others have outlined, it will not be the last. The root problem is not medical, but economic. Only properly incentivized doctors will individualize the best available preventatives and treatments.
Readers probably know that in the eighteenth and early nineteenth centuries, trained and licensed medical doctors tried to cure their patients by feeding them poisons like mercury or calomel and draining their blood. Such treatments sometimes worked, or at least did not kill the patient, but often they failed and the doctor’s bill appeared as a charge against the deceased’s estate.
The failure of mainstream medicine led people like New Hampshire farmer Samuel Thomson (1769-1843) to search out alternative treatments. In the early nineteenth century, eclecticism, homeopathy, hydropathy, chrono-thermalism, osteopathy, and chiropractic, Christian Science, and sundry hygiene “cults” arose as alternatives to poisoning and blood purging. In the 1820s, Thomsonianism emerged as the most important alternative torture/treatment scheme.
By age four, Thomson was already learning about the medicinal properties of plants and was especially taken by the powerful emetic properties of Lobelia inflata, a poisonous herb with a pretty purple flower also known as “Indian tobacco.” As he grew, he managed to cure/not kill a number of family members and neighbors by torturing them with doses of lobelia sufficient to make them puke their guts out, and presumably their ailments away.
As Thomson’s fame grew, the mainstream bloodletting torturers/doctors tried to shut him down. He responded by obtaining patents for his various concoctions and going national with an advertising blitz and the hiring of agents well incentivized to spread the word that vomiting was better than bleeding. When detractors noted that his purges worked/didn’t kill patients only some of the time, Thomson developed additional tortures/therapeutics including alternating steam and cold baths supplemented with frequent enemas.
Such treatments, Thomson explained, were designed to rebalance the four main elements in the human body: earth, air, fire, and water. [For details, see James O. Breeden, “Thomsonianism in Virginia,” Virginia Magazine of History and Biography 82, 2 (Apr. 1974): 150-80.]
It would be nice to report that soon after doctors figured everything out and Americans all lived happily until dying of old age. But such was not the case. In early twentieth century South Dakota, for example, a Catholic priest turned doctor named William Kroeger diagnosed patients with doses of radiation so massive and indiscriminately applied that he ensured himself repeat customers. Although the small prairie town where he tortured/treated his patients and brewed his patent concoctions was called Epiphany, nobody seemed to have had one about the cure causing the disease. Kroeger died a rich man of the cloth. [For details, see Robert E. Wright, Little Business on the Prairie: Entrepreneurship, Prosperity, and Challenge in South Dakota (Sioux Falls: Center for Western Studies, 2015), 187-88.]
Doctors and other HCPs still bleed people (therapeutic phlebotomy), induce vomiting (although it is no longer recommended after poison ingestion), inject patients with poisonous chemicals (chemotherapy), blast them with radiation and electricity, and so forth. Techniques have improved with technology, but the big difference between medical practice and malpractice, treatment and torture, Dr. House’s brilliance and quackery, remains the doctor-patient relationship.
Quacks like Thomson and Kroeger had incentives to treat everyone with their own snake oils and treatment plans. Sometimes their nostrums matched patient needs, leading to cures that they publicized far and wide. Most often, though, patients would have been better off receiving other treatments, or none at all. While all people share enough traits that some elements of health are universal — nobody should ingest raw sewage, for example — most aspects of health are not “public,” they are private and highly individualized.
At some level, even the most statist public health official completely oblivious to Hayekian critiques of central planning must know, deep down, that issuing general medical orders from on high is quackery. They now flee in great flocks but what will it matter if other quacks replace them? We don’t need new public health officials. We need a reformed healthcare model with incentives more carefully aligned to individual needs.
Reprinted with permission from American Institute for Economic Research.