It’s nice to get the occasional good news, to know that there are other people out there who respect facts and science. The Spanish government announced that it plans to ban alternative medicine from state health centers. This is a bold move, and completely justified. In fact, any other approach is nothing short of outrageous.

In Spain there is a robust state health system, which covers all people living and working in Spain – about 90% of the population use public health care. About 19% use private health care to some extent. Spain is considered to have one of the best health care systems in the world, and has the life expectancy to go with it.

Now they want to make their health care system even better by purging it of harmful and wasteful pseudoscience. They have not yet provided a comprehensive list of what they consider “alternative” but gave homeopathy and acupuncture as examples (a good place to start). The Guardian reports:

The proposal, unveiled by the science and health ministers, aims to avoid the “potential harmful effects” of the practices when they are used as an alternative or a complement to treatment that is itself based on “proof and scientific rigour”, the government said in a statement.

At its core it is a simple and even obvious standard – provide health care that the best available scientific evidence says is safe and effective, and is the best option available, provided by licensed professionals. I have yet to hear even a semi-reasonable argument against this basic approach. The “alternative” is to use treatments that are not safe, not effective, or have been inadequately tested, provided by those who are not legitimate experts or professionals.

It is amazing that we even need to fight for this, but the snake oil industry has done remarkably well at rebranding themselves and essentially gaslighting the world into thinking that pseudoscience is reasonable medicine. They have done this in a number of ways. Politically they make it about freedom – the freedom of the consumer to get access to whatever health care they want. Really, however, it is about the freedom of charlatans and snake oil peddlers to sell pseudoscience without regulation.

They have also attacked the scientific basis of medicine itself, arguing at various times that we don’t need science to know what works, mainstream medicine is not all that scientific itself, and science is all a conspiracy anyway. They have tried to change the rules of science, and water down the standards of evidence. They have successfully hamstrung regulations, and even infiltrated academia and hospitals (usually with huge grants of money or the promise of providing an additional revenue stream).

They have also vigorously attacked their critics – anyone who would bother to point out that it’s probably a good idea if we don’t treat patients with nonsensical potions, magic spells, and rank pseudoscience. They try to make it seem that we are the fanatics, or that we are in the pocket of “Big Pharma”, and if that doesn’t work, they sue us. Unfortunately, all the money is on the side of selling snake oil, not defending rigorous standards of science in medicine.

As a result of this propaganda, and general negligence by academia, over half the population thinks there is something to homeopathy (which is just water). One review of surveys breaks it down this way:

We found that we could split the public into three groups. The first, who we called the “disaffected”, comprise just under 30%. They are generally pessimistic about medicine, don’t see the value of science education and don’t believe in the efficacy of homeopathy either. A second “conventional” group, accounting for just over 30% of citizens, are likely to be supportive and trusting of conventional medicine, reject CAM and value science education. The third and largest group (just over 40% of the population) is the most interesting. This group is likely to have used CAM and to think that homeopathy is effective. Yet they are overwhelmingly trusting of medical doctors, value science education and are optimistic about medical advances.

So less than a third of the public takes and essentially science-based approach to thinking about medicine. The same amount distrust science, and some of them even think alternative medicine is better. Most essentially don’t care, and will try anything. This approach is often sold by misinterpreting placebo effects. It used to be that if a treatment worked no better than placebo, that meant it didn’t work (this is still, of course, true, but most people are now confused about it). Alternative medicine proponents have convinced the public that placebo effects are real, and even if a treatment has only placebo effects, that’s good enough.

That’s quite the scam – they have actually convinced a majority of people that it’s OK if their product has no effect, because they will be fooled into thinking it works anyway, and really being fooled into thinking something works is just as good as if it really works.

So good for Spain for taking a strong stance. I hope it works out. Expect massive push back from the gurus and snake oil peddlers – they will cry oppression, they will say it is unfair, and they will say it is anti-consumer. It is they, however, who are anti-consumer. If public funds are going to be used to provide health care to everyone, then the government has a responsibility to ensure that the money is spent on medicine that actually works, that the standard of care is met, and that the funds are not used to promote pseudoscience or abuse patients by selling them false hope.

Hopefully Spain’s plan to ban alternative medicine from the public health service will be fulfilled, and the EU will follow their lead, and the rest of the world will follow also. We are long past the time where things like homeopathy should simply be banned as an obvious dangerous fraud.