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Oil from Snakes: Health Fraud in the Age of Information

Part One: Health Fraud in the United States

The 2020s have so far been defined mainly by public health catastrophes on a global scale. The coronavirus pandemic has led people all across the United States and the world at large to seriously begin reconsidering their personal health, the medicines they take, and their healthcare systems, as well as the ways in which they engage with those systems. The conclusion that many have arrived at is one of disillusionment and fear, a realization that the structures upon which we have come to rely have failed to protect us from severe threats to both our lives and our financial well-being. Government measures to prevent the spread of disease are delayed by bureaucracy, medical practitioners are given perverse incentives to exploit their patients for their own personal benefit, and even when the built-in inefficiencies and insufficiencies of healthcare systems are minimized, human error and/or ignorance often causes people to suffer and die anyway. Meanwhile, the United States remains—and seems as though it will continue to remain—the only developed nation without any form of universal healthcare. Amidst this near-unprecedented crisis of health, many people have chosen to turn away from conventional medicine and have instead begun seeking out other solutions to their medical issues, in the hopes that less insidious avenues to good health exist.

When people decide to begin searching outside of the realm of accepted medicine, however, opportunities arise for bad actors to enter the picture. Alternative medicine, sometimes referred to as complementary, holistic, or integrated medicine, encompasses a wide range of treatments, from those which may have some validity despite not having yet been fully vetted by the medical community, all the way to treatments that have no medical worth whatsoever and that are actually harmful to the patient, or intended to treat non-existing conditions.  For the purposes of this article, I will be discussing treatments that fall along the latter end of that spectrum—those constituting health fraud—though it should be noted that any treatment which cannot be readily supported by medical science ought to be regarded with at least some level of skepticism.

Health fraud, sometimes called quackery, is the promotion of medical practices which are ineffective in treating conditions and/or the diagnosis of conditions that do not exist or which the patient does not suffer from. Health fraud takes on many forms, with one of the most recognizable in the present day being the promotion of high-priced and ineffective “miracle cures” for conditions ranging from cancer to asthma and various other chronic illnesses. The recently invented myths that ivermectin or hydroxychloroquine could treat or even cure COVID-19 were trademark examples of this type of health fraud. It even has a name of its own, “snake oil,” a term that tends to conjure amusing images of mustache-twirling villains selling bottles of herb-laced mineral oil to gullible townspeople in the Wild West. 

Snake oil, however, can be deadly serious. Over 1 million people have died from COVID-19 in the past two and a half years in the United States alone, many of whom chose not to receive vaccinations due not to a lack of access (which was catastrophic early in the pandemic), and not to hesitancy about the trustworthiness of a rushed vaccine (a concern which was at least somewhat reasonable even if it didn’t prove accurate), but rather to the belief that through some type of home remedy or alternative cure, they could prevent or treat the coronavirus without the help of a vaccine. 

In fact, the general sense of vaccine hesitancy now prevalent in the United States stems from a single instance of health fraud that occurred nearly 25 years ago. The modern anti-vaccine movement was sparked in 1998 by a now-discredited study authored by then-doctor Andrew Wakefield alleging a relationship between the MMR (measles, mumps, and rubella) vaccine, inflammation of the colon, and autism. This study’s findings were knowingly fabricated, and Wakefield went on to stoke the flames of a medical scandal whose repercussions we are still experiencing today, all in order to boost the sales of an alternative vaccine and contribute to a fraudulent lawsuit against vaccine manufacturers. Wakefield is no longer a licensed medical practitioner, but despite this, his following is massive—as is the number of people who subscribe to some version or another of the anti-vaccine conspiracy theory.

In the face of such far-reaching and unethical cases of medical fraud, our first instinct may be to blame the people who seek out and fall for these false “treatments.” We are inclined to shame them, to simply laugh at their perceived gullibility, and though some of us might try to educate them about the medical science behind an issue, many more of us will, in some way, sneer and move on. This approach, however, is flawed in that it allows the real perpetrators of health fraud to go free, and denies compassion to those who use these treatments and who are, after all, the true victims of these practices. 

As mentioned above, many of those who turn to alternative practices and find themselves the victims of health fraud are people who have been failed by our healthcare system, and by society as a whole. People who attempt to find “miracle cures” for chronic illnesses often do so because they have not been properly diagnosed or treated by real doctors, or because ableist structures in our society do not allow them to live with their illnesses contentedly. Many (though not all) of those who choose not to take vaccines make that choice because they have had some negative experience with the medical system which has left them unable to trust doctors in the way that receiving an inoculation requires, some even having racial trauma related to discrimination or outright racism within the medical system. Even those who freely choose to pursue alternative avenues to medicine, rather than having been forced into that choice by the systemic shortcomings and inequities within the healthcare system and within society at large, should not be blamed for being victimized by a deeply predatory and deceptive industry.

The health fraud industry is not a universal constant, not some natural disaster to bemoan but accept; it is an industry controlled by human beings, which feeds off the same perverse incentives that fuel our entire health care system. The first victims of health fraud only turned to alternative medicine because the established medical system, which promised to help them, only took their money and pushed them aside. While our health care system remains for-profit and inaccessible, while hospitals remain underfunded and poorly managed, and while doctors are taught inaccurate and even racist medical science, we will never be free from those who advertise cheaper and more appealing treatments whose only drawback is that they never really work.

Part Two: Health Fraud in New Jersey

The history of health care fraud in New Jersey is expansive, and has gone through some noteworthy phases. In a Senate hearing in 1964 before the Subcommittee on Frauds and Misrepresentations Affecting the Elderly, a subcommittee of the Special Committee on Aging, Senator George Smathers of Florida testified that during a time in which his family was living in New Jersey, his father was prescribed such dubious treatments for arthritis as being stung by bees, being overheated in a large metal cylinder, and walking with coins in his shoes. Later, in the 1980s, according to a New York Times article by nutritionist Laufey V. Bustany, the state was nearly overrun by a wave of faux doctors with degrees from unaccredited universities prescribing fraudulent and sometimes deadly nutritional supplements to patients, including one case in which a woman suffering from systemic lupus erythematosus, a serious type of arthritis, was prescribed vitamin C in such high doses that she passed away from acidosis. And in the 1990s, Gorayeb Seminars, Inc., based in Rockaway, New Jersey, offered two-hour hypnosis seminars which it guaranteed would stop the urge to smoke and assist in weight loss. Owner Ronald Gorayeb later settled out of court with the FTC.

But the history of health fraud in New Jersey only provides half of the picture. Quackery and health care fraud are still virulently persistent in the state. At time of writing, a statement has just been released by the U.S. Attorney’s Office, District of New Jersey, about the confession of Saurabh Patel, of Woodbridge, New Jersey, who was charged with conspiracy to commit health care fraud. Patel conspired with a family member, who allegedly prescribed unnecessary compound medications to patients without a license, which Patel would then fill in order to collect insurance payments. Patel has not yet been sentenced at time of publication, but he is not the only such fraudulent medical practitioner in recent years and months in New Jersey. In fact, in Princeton itself, a lawsuit only ended last year against Princeton Pathology Services, which, according to the contention of the government, submitted several requests to Medicare without written substantiation in their records, defrauding the government of significant amounts of money that would otherwise have been paid to citizens in need of medical care.

 With all of this context of health care fraud, you may be wondering how to spot health care fraud when presented with it, so that you can then avoid and/or report it. Fortunately, there are several methods available to help recognize these schemes for what they are.

 The first of these tools, and the most important of all, is to trust your gut. As cliché as it might sound, you will almost certainly have some inkling as to how legitimate a medical practice is when you first come across it. In fact, many of these fraudulent schemes will be designed specifically to be obvious, as counter-intuitive as that might seem. According to “Why do Nigerian Scammers Say They are from Nigeria?” a paper by Cormac Herley, it turns out that scams are most effective when they’re obvious, because it makes sure that the only people who will even look into them are the people gullible enough to give money to them. As a result, many instances of health care fraud explicitly state that they are not supported by the medical establishment, so that only people credulous enough (or suspicious enough of the medical establishment) to buy in will read further. Beyond this, however, there are several other key warning signs:

Lack of informed consent

Informed consent, the practice of informing patients what procedures they are going to undergo, is a bedrock of ethical medicine. If a practitioner does not fully elaborate what procedures they will be performing, what those procedures consist of, and exactly what risks are involved, or does not obtain your written consent after informing you about this, they are not properly obtaining informed consent and are not an ethical practitioner. This also goes for prescriptions of medicine or equipment like braces.

Advertising “Eastern medicine”

This tactic trades on two beliefs. The first of these, the more justified, is the belief that Western hegemony has historically discounted the medical practices of other cultures, even when they are, in fact, useful and effective (an example being the synthesis of a similar drug to aspirin by indigenous Iroquois and Seneca communities in North America). The second of these, however, is the belief that “Eastern” cultures have some essential superiority in medical practices, or even some mystical power, a blatant example of Orientalism. There is no “Western” vs. “Eastern” medicine, there is real and fake medicine. Vaccines are used in East Asia just as much as they are in America!

Scapegoating conventional medicine

The medical system in America has many flaws, as discussed in the first article of this series. Medicine itself, however, is vital, and if a practitioner is casting aspersions on the efficacy of vaccines, surgery, or other essential parts of the modern medical canon, their own professionalism likely leaves much to be desired. This especially goes for “Doctors hate this simple trick!” advertisements, in which a particular alternative practice is lauded as a threat to the medical establishment and/or licensed doctors are accused of suppressing a more effective treatment.

Relying on mystical thinking

Religion and spirituality are extremely important to many people, and likely even to you in many aspects of your life. But when it comes to your own physical health and your money, don’t allow yourself to rely solely on faith and practices that can’t be replicated by the medical community at large. Terms you can associate with mystical thinking can include overtly mystical ones like “sacred geometry,” but they can also include ones that invoke more scientific-seeming concepts (quantum physics will never play a role in the curing of chronic pain).

Dodgy credentials

Have you ever wondered why doctors have their degrees on the walls of their offices? It’s because that helps you verify their credentials and medical training. If your doctor doesn’t have theirs up, you should ask them where they went to medical school (and if they didn’t, you should get out quickly!), but even if they do, if you’re unsure of the doctor’s legitimacy, look up their school to find out if it’s a degree mill or not. Many of the most successful medical fraudsters and quacks have “PhDs” from schools whose medical program consists of one book and a quiz that goes ungraded.

With all of this said, it is worth a reminder that the underlying problem of medical fraud does not lie with these charlatans. As outlined in my previous article in this series, these practices can only succeed as they do because the American health care system is morally bankrupt, and we remain the only fully-developed nation in the world with no universal health care. While it is crucial that you follow the guidelines in this article to keep yourself safe and healthy via reliable means, and it is helpful if you take political action against health care fraud, ultimately, the only way to finally defeat this parasitic industry is to fight to ensure that valid medical care is available for everyone who needs it, so that nobody has to resort to betting on snake oil.

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