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Comment by collyw | Hacker News Reader

Alternative medicine with proof that it works becomes convetional medicine.

For a large category of stuff: no it doesn't, unless it's patentable. Simply because there's no drive and funding to get it through the trials. It's "not invented here" on a societal scale.

And for a lot of alternative medicine, the hit rate is quite low; it seems there are elements of matching the treatment to the patient that the RCT has trouble with.

This is especially bad for chronic low-level conditions that conventional medicine is bad at even bothering with. Minor aches and pains, fatigue, that kind of thing.

>For a large category of stuff: no it doesn't, unless it's patentable. Simply because there's no drive and funding to get it through the trials.

We have no shortage of very cheap and totally free solutions that are nonetheless accepted by conventional medicine.

>And for a lot of alternative medicine, the hit rate is quite low; it seems there are elements of matching the treatment to the patient that the RCT has trouble with

Or it's just that the "alternative medicine" hit rate is just the statistical noise from random healing, placebo and self-recovery.

Ironically, vaccines, which are probably the greatest bang for the buck in human history (and ridiculously cheap even at an absolute level) are currently the most attacked medicine.

And the attacks come from the same people peddling the $40 sugar pills.

I think trash collection, indoor plumbing and refrigerators/freezers have done much more to improve the public' health.

I agree that those have bigger bangs, but the "buck" part for vaccines is extremely small. Good plumbing and sewers have probably saved a lot more lives, but the cost per person is orders of magnitude higher.

For example, the cost of eradicating smallpox was about $1-2 billion (in 2017 dollars), and saves around 2 million lives per year. (This is a rare example of a one-time investment that pays off forever with no additional action on our part, which is pretty nice.) This is about what New York City spends annually to maintain city water and sewer infrastructure.

For one, those are still way more expensive than vaccines. With $100 for vaccines (whose research costs have long been absorbed anyway) you're settled for life, but you'd be paying for trash collection, indoor plumbing and refrigerators/freezers for your whole life.

(Plus those are not medicine, which is the context we were discussing here).

Do you have any examples of effective treatments that are not considered "medicine" merely because they're unpatentable?

Oatmeal?

Do you have any basis for considering this to be effective, besides that one person's experience?

Indeed! The issue isn't snake oil, the issue is that clinical trials are slow and expensive.

Very little appreciation for the fact that alternative or conventional at some point someone has to make the leap and try something unknown and see if it has any impact.

I'm not sure that selling that to tons of people at a high price without funding real trials is a good way to check if it has impact.

That last part being the key. If you make the leap and see if it has an impact, you're doing good. If you make the leap and sell it for $60/bottle without ever checking to see if it works, you're selling snake oil.

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