I’ve restarted taking ivermectin, which along with A-BART, has lovely side effects like making me feel like there’s a spike through my hand, and it provoked some thoughts. We had some cousins down over the weekend, and one of them also has Lyme disease along with co-infections. Her case is like mine in origin (steroid treatment for a different problem let the illness out) but like Sarah, she’s disabled from the effects. Her case is at the level of Sarah’s at her worst- lots of mental fog and severe physical incapacitation (e.g. no fine motor control). A significant difference is that she and her husband were not well-off financially before this started, and of course this has made their situation much harder and more precarious. She receives medicaid, and that’s what brings me to the crux of the matter.
Medicaid, being a big government-run program, necessarily needs to have well-published standards about what’s covered and what’s not, and generally follows (trailing) medical consensus about appropriate treatments and the like.
Lyme disease (and a fortiori confections) are slippery, and the mainstream medical consensus about appropriate treatments largely fails to successfully treat those of us with bad cases. “Lyme literate” practitioners are uncommon, expensive, and generally function on an out-of-pocket basis. The A-BART is $89 per bottle, and is an extremely effective treatment, but is not covered. Nor are the oodles of supplements, probiotics, or supportive care therapies which allow me to continue functioning through my illness.
Now, providing medical care for the poor is a reasonable government goal, and while the decisions may not be perfect, at least they’re something. However, this problem also exists with the ACA, designed as a broad-based scheme to cover everyone.
In that case, “one size fits all” medicine is as problematic as “one size fits all” jeans- if you’re right for 99% of the population, you’re still wrong for millions of people, and 99% is a wildly optimistic number.
I think that a contributing factor here is the Dunning-Kruger effect, which causes the policy-makers to overestimate their ability to centrally plan people’s lives. Worse, some new research is showing that those folks who actually are smart overlook the flaws in their thinking.
All of this leaves me with the sense that central planning is something best left in the Soviet ash-bin of history. I sure hope the US Supreme Court agrees.