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Michael L. Millenson

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Can Strong Prayer Bend the Medical Cost Curve?

Posted: 02/29/2012 9:44 am

In a provocative essay entitled, "Randomized God," internationally renowned psychiatrist David Healy lays out a blueprint for a clinical trial to test the healing power of prayer. Putting aside the spiritual benefits of supplication, a more pressing secular question might be phrased this way: Can strong prayer bend the medical cost curve?

Anecdotally, appealing to the Almighty offers awe-inspiring economic potential. In the Bible, both Moses and Jesus heal lepers, who are suffering from what today we would call chronic disease, while the prophet Elisha practices acute-care medicine by bringing a Shunammite woman's dead child back to life. Think what they could do with diabetes or cancer!

Unfortunately, the key element seems to be not just these healers' faith in the Lord, but also the Lord's faith in them. For example, Moses speaks to God "face to face," Jesus is God's only begotten Son and Elisha is chosen by God as the successor to Elijah. Alas, our current medical groups, hospitals and health plans are overwhelmingly non-prophet institutions.

Still, the question remains whether prayers by ordinary people can produce an equivalent clinical impact. Healy, author of books such as "Let Them Eat Prozac" and "Pharmageddon," offers a methodology for testing prayer that is no less intriguing for its firmly tongue-in-cheek underpinnings. As a scientist and progenitor of a website called Data-Based Medicine, he begins by citing three studies that have shown an effect, albeit a weak one, for cardiac patients who were prayed for versus those who were not. He then lays out a series of methodological issues for "Theo-therapeutics" more suited -- quite deliberately -- to a trial of a new drug than a trial of faith.

The first issue is who is doing the praying. For example, could stronger effects be obtained if those praying for healing were a purer population sample (e.g., children or monks)? Might Muslims, Jews or Hindus at prayer have more impact than Christians who pray and, if so, "could Christians resort to hiring Hindu Prayers while remaining Christian?" Would hospitals then have to hire accredited Prayers or risk legal liability?

Then there are the actual prayers being prayed. A careful study would look at a variety of confounding factors; e.g., the relative benefits of the more ritualized prayers in Catholicism and Orthodox Judaism versus "the more spontaneous approach found in Protestantism or Sufism." If the benefits do derive from specific prayers, "some form of patent protection might be needed for companies hoping to develop better products," Healy continues. Government or organized religion might want to patent prayer products "already in common use to ensure that the labor of millennia is not lost to the communities who did the work."

Finally, there's the delicate issue of the number of "sins" of the ill person as a possible impediment to prayer effectiveness. These could be measured in the Prodigal Son Rating Scale "to establish whether any effects occur in proportion to an individual's history of sin." Adds Healy, "We may have a real therapeutic crisis if it turns out [specific prayers and those praying] work better for sinners than for the virtuous." That kind of effect could also prompt an economic crisis, as the paradoxical "wages of sin" prompt insurers to offer lower co-pays to alcoholics and gamblers.

Given Healy's background as a pharmaceutical industry critic, his main intent seems to be poking fun at the way many physicians and patients have embraced psychotropic drugs based on studies no more sturdy than those he cites in support of faith healing. (For rhetorical purposes, he calls them "recent," but the latest is from 2001 and subsequent research has provided no confirmatory evidence for prayer efficacy.) Nonetheless, Healy's implicit call for intellectual rigor in therapeutics raises equally valid questions about the reimbursement of a whole ranger of complementary and alternative medical practices. Advocates' assertions that these are "cost-saving interventions" often owe more to enthusiasm than evidence.

In addition, Healy raises uncomfortable questions about the capitalistic nature of our health care system. If, indeed, certain prayers could be shown to shorten the course of illness, would not American religious institutions rush to patent and license them, just as many of our (non-profit) universities have done with research on the human genome? Would not these same universities hope to reap a harvest of government grants by creating what Healy calls "departments of ethnosupplicantology"?

Over the course of history, self-anointed healers have included magicians, mediums, apothecaries, barbers and priests. The archbishop of Canterbury was legally able to award medical degrees in England as late as 1840. But even in our modern era, the precise confluence of therapeutic and personal factors that causes one individual to successfully fight off disease and another to flag and fade often remains a mystery. In health care, the equivalent of the wartime plea, "Praise the Lord, but pass the ammunition" would seem to be coupling faith in providence with full funding for the Patient-Centered Outcomes Research Institute.

"God heals, and the physician sends the bill," advised an old aphorism. For now, any attempt to systematically enlist God's power to help cut that bill remains only a prayer.

A version of this blog appeared on Forbes.com.

 
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04:30 AM on 03/25/2012
When one is inflicted by disease, one can take action in ANY direction, say rest, diet adjustment, medication and so on. And just leave and watch. Leave and watch is not an activity, it is an understanding. It is the gap, unknown between your action and outcome that is the healing factor. But you can not control it. You can just be with it.
It is not a formula. It is an understanding. When you take action in ANY direction, say any treatment-you have to just to forgo the comfort of controlling the outcome. Suddenly, whole energy is concentrated here only. You are attuned to wonder.
Y V Chawla
http://www.fundamentalexpressions.com
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soma77
Author, Speaker, Retreat Facilitator
09:34 PM on 03/20/2012
Yes, if we get off our knees after and vote the Republicans out of office.
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Catriona
Wha daur meddle wi me?
04:24 PM on 03/04/2012
Ok. If I find you with a bisected femur I'll say a prayer instead of calling for assistance.
10:28 AM on 03/04/2012
It has been proven over and over again that the collective will of the people is stronger than the will of god.
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tholin
05:11 PM on 03/03/2012
This is quite possibly the most inane article on the subject of intercessory prayer that I have ever read.

The quoted authors name is Dr. Healy ? Really ?

I was quite certain this was poor satire, unredeemed by comedic value.
09:44 AM on 03/04/2012
From the article:

"Given Healy's background as a pharmaceutical industry critic, his main intent seems to be poking fun at the way many physicians and patients have embraced psychotropic drugs based on studies no more sturdy than those he cites in support of faith healing. "
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lletaa
end war/healthcare for everyone
05:09 PM on 03/03/2012
I've been praying for single payer, universal cover all healthcare like Canada where the only prerequisite for care is being sick. I hope my prayers are answered because our complicated for profit nightmare of insurance company healthcare is killing me and alot of others.
09:02 PM on 03/03/2012
Let's have Single Payer, not Single Prayer.. Ironically the Prayer People still ultimately expect help from the Science-trained medical professionals whose base of knowledge comes from an evolutionary framework....we all deserve help whether we pray or not!
TomMartin
Freedom and equality.
11:06 PM on 03/03/2012
The Canadian single payer system has too long waits. Better to have a multiple-payer universal insurance system like they have in Germany or France.
09:45 AM on 03/04/2012
Could be! The Canadian system also spends much less per patient than the American system. A middle ground is easily imagined, but very difficult to put into place.
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Indigo1941
Time traveler.
01:22 PM on 03/03/2012
Using "strong prayer" to "bend the medical cost curve" sounds like Voodoo. If it's gotta be Voodoo, I expect rattles and drums and really big scary masks, doggone it!
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George Genung
01:19 PM on 03/03/2012
I am always amazed at believers who will tell you that their deity loves them with unconditional love.
Then go on to tell me of the conditions I must meet to receive that love.
That is what is going on with prayer and healing. Beg the deity enough, or get enough beggars and you might get some results. Or, as an earlier poster stated, turn your life over to the deity, and you might get cured. All conditions demanded by a apparently ego driven deity.
10:29 AM on 03/03/2012
A strong placebo effect has been proven to work. You can't tell the patient and they must believe whatever treatment works. Prayer is one that helps in this regard. Shamans have used the placebo effect with their traditions for tens of thousands of years. More recently, Christian religions have used it. Yes, by all means, use prayer. It helps, if one believes.
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11:31 PM on 03/03/2012
Actually, in one study, people who knew they were being prayed for actually had poorer recoveries than those who did not know they were being prayed for.
07:25 AM on 03/03/2012
Faith is good for healing.

Looking at it scientifically, faith induces placebos which have positive health effects. Also faith in the long term is healthy.

But that rating scale thing was just plain awkward.
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eddy joe
welcome to the machine
06:56 AM on 03/03/2012
Lack of prayer can result in more illness.
10:30 AM on 03/03/2012
That is a pretty ugly thing to say. A placebo effect can come from many things and it doesn't have to come from prayer. Your post is not helpful and worse.
ThinkCreeps
Seriously, it's time.
06:07 PM on 03/03/2012
Gee, Eddy. Got any evidence to support that?
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TheRoosterman
Crazy Texan
07:15 PM on 03/02/2012
What's that prescription of prayer going to cost me? Will insurance cover the costs?
ThinkCreeps
Seriously, it's time.
02:09 AM on 03/03/2012
Your mind, and self respect.
07:26 AM on 03/03/2012
Didn't do Einstein any harm.
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David Weidner
Ask me about my narcissism!
03:30 PM on 03/02/2012
Prayer has proven to be absolutely worthless, time and time again. Sending telepathic requests to nobody, doesn't do anything for anyone. Ever.
03:07 PM on 03/02/2012
I know of several examples of people who were fighting long illnesses and not being relieved. One particular example was a pastor's wife who was suffering from tuberculosis. She and her husband prayed often to God for relief but none came. Finally, she gave up asking for relief. She turned her life entirely over to God to do with her what He willed. One day after church, her husband hurried home to find her waiting for him at the bottom of the stairs in the house. She had the look of good health. Her husband reminded her that if she had turned everything over to God, she would have been cured much earlier. Sometimes we need an example like that to make us realize that if we turn to God and let His will prevail, we will be relieved of all illness and difficulties. That was a hard lesson for me to learn. Hopefully, I am up to it.
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04:14 AM on 03/04/2012
Clearly, she switched gods and that is why her prayers were finally answered. She started secretly praying to the FSM.
02:05 AM on 04/12/2012
That's one of the most ridiculous stories I've ever heard. People with tuberculosis must comply with treatment under the Public Health Act or face involuntary confinement for treatment. Treatment for TB in Canada anyway means nine months of medication given under the direct supervision of a health professional.
02:33 PM on 03/02/2012
Matthew 9:22 - Jesus turned and saw her. 'Take heart daughter', He said, 'your faith has healed you'. And the woman was healed.

Matthew 9:29-30 - Then He touched their eyes, saying, 'according to your faith, let it be done to you'. And their eyes were open.

- www.deathandlife.org/healing.html