Health freedom



Health freedom is the idea that people should be able to choose whatever medical treatment they want. It is a concept that seems intuitively good, but like many phrases introduced by groups or people with partisan political goals, is actually not really conductive to health of society.

"Health freedom" is often thrown around in libertarian circles, the idea behind it being that the government should not have a role in regulating or ensuring any quality control or public health in medicine. Thus, crank sites like NaturalNews that try to profit off lax government regulations will tend to promote libertarian candidates and libertarian outlets like those run by Lew Rockwell, and libertarians will reciprocate by giving a platform to quacks. There are also hard right organizations like AAPS that adopt this philosophy.

In 2015, the anti-vaxxer organization known as the Australian Vaccination-skeptics Network took the (as described in this article, already cranky) concept of health freedom just a few steps further, by founding an overtly fake church in order to try to bypass Australian laws requiring minimum standards of health and safety for young children through appealing to religious freedom.

What's so bad about "health freedom"?
Presumably, most people who walk into a drugstore want to make sure that the medications they pick out and/or are prescribed do pretty much what it says on the package and won't make them horribly, horribly ill when they weren't expecting it. To do that, in the United States for example, medications are subject to a rather elaborate testing and regulatory framework to make sure they are, in the classic words of the United States Food and Drug Administration, "safe and effective". The process is complex and time consuming, and occasionally corrupted by drug company pressure, and it does occasionally let through a bad drug like or allow gross overuse of a drug like  But it's the best we have right now.

Similarly, medical journals and interest groups spend a great deal of effort making sure that medical knowledge works, that procedures and devices are safe, and that as much is known as possible about the human body, and that the people who practice medicine stay within the bounds of what is known to work. These bodies inspect hospitals and nursing homes to make sure that their conditions are suitable for patient care, and accredit medical schools to make sure that prospective doctors are getting the best education that money can buy. Some of them also make sure that well-trained doctors are sent out into places where modern medicine is not available to make sure that even the poorest get the best medical care they can get. These principles are known as evidence-based medicine and are our best insurance against returning to the days of bullshit medicine such as bloodletting and the four humours.

There are those who think the above is a bad idea. For them, we have the concept of "health freedom".

The problem with blanket "health freedom"
"Health freedom" is a typical example of emotional appeal and argumentum ad populum — rather than try to prove that their nostrums actually, you know, work, alties and quacks advance the notion that people should have the right to choose whatever medical care they wish without regard for regulatory authorities or evidence. Immense amounts of effort have been expended by such people to get the authorities off their back, generally using libertarian and free market principles to argue that bad medicine will ultimately be shaken out of the market or appealing to conspiracy theories about the Medical Establishment and Big Pharma. To someone concerned about freedoms and uninformed and/or hopelessly cynical about medicine, this all sounds very good.

It should be pointed out that this freedom is not intended to be universal. If you ask an altie if they would be happy for Big Pharma to market drugs with the same lax regulation the alties demand for themselves, the answer is of course "no". What they want is a level playing field with one end higher than the other, and them always playing downhill. And ideally the other team not allowed on the pitch until they have brought the right shrubbery.

But are there any real downsides?
So what's the harm? More freedom is better, right? Welllll…

To a point. But freedom implies the ability to make informed decisions, and part of the point of the medical regulatory establishment is to make that information available. The existence of information contrary to alties' claims is inconvenient for them. Attacks on the medical establishment, imperfect as it is, are often no more than thinly veiled demands for a complete free-for-all where snake oil vendors get free rein alongside (or, more often, instead of) pharmaceutical companies and informed consent goes by the wayside. Sooner or later, the consumer must ask whether they are getting all the information they need, and for some quack to be selling toxic or injurious drugs or treatments while trying to suppress (by lawsuit or smear campaign) negative results impairs the consumer's ability to be informed. It's easy to go to drugs.com and get scads of information from multiple sources on any drug, including dosage, adverse reactions, and even chemical makeup. It's not so easy to get that information from an herbalist, who may not even know what the active component of a particular herb is. It's certainly not that easy to get it from someone like Kevin Trudeau, who is a known con man who plays off people's fears of the medical establishment but will give you nothing if you don't pay for it.

And at the end of the day, these people who promote "health freedom" (at least those who aren't hypocrites) will suffer the same diseases you get, only some of them will suffer much more due to avoiding vaccinations, chemotherapy, psychotropics, and the like in favor of herbal and homeopathic nostrums and highly questionable practices. They may suffer nutritional deficiencies from questionable diets. Their kids will be at risk of preventable infectious diseases due to lack of vaccines, and due to things like Herd immunity, they put everyone else's kids at risk, too; a baby isn't protected against diseases that it has yet to be vaccinated against.

Remember, then, when you hear the term "health freedom", that's not the whole story — there's a lot going on under the surface. Like US Christian fundamentalists' attempts to bleed the public school system dry by siphoning federal and local money off through vouchers for private religious schools, "health freedom" advocates want unfettered, uninformed access to the doctors and patients in the world without any interference from authorities and experts.

And in fact the "freedom" that health freedom activists want appears to be of a restricted sort. When asked if they think that "Big Pharma" should be free to sell its products without regulation, the answer is a resounding "no". This is justified by the appeal to nature: the products advocated are natural and therefore safe. Consider  or ebola, all of which are natural and thus obviously quite harmless.

So as with most such exercises in political framing, health freedom is in reality just special pleading. It's an attempt to free quacks, charlatans, frauds, and people playing doctors from the unwelcome attention of regulators and the reality-based community.