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I'm just curious to see if NOT delivering any pill (pretending that the drug is not yet available) might have a positive effect comparable to giving a fake pill (placebo effect), in clinical trials - or to boost ROI for health insurance companies, by pretending that the drug will be available only in several weeks. And from an experimental design point of view, how do you perform such a test - no pill vs. placebo vs. real pill, to see what works best, based on medical issue, patient and drug?

I believe it depends on the patient - it works for me because with no pills, I know I need to fight the disease / health condition myself alone (possibly with some crowdsourcing help), and it makes me stronger and not worried as I no longer have to listen to scary pronostics. This strength built up over several years, thanks to US healthcare and how it works, for example:

  • Having to wait 3 hours in an emergency care facility, leaving after being told about the waiting time, and being cured automatically without any drug or medical advice.
  • Having to wait 3 weeks for a drug, and by the time the drug was available, I was cured and did not pay for it (maybe it's a trick used by health insurance companies to reduce costs, as I was told by the drugstore that the health insurance company would paid in 3 weeks; it worked well, and makes me want to pay the cheapest tax-proof (IRS-proof) health insurance, even if it means lying about my age / gender / smoking or whatever status - it does not matter since I don't use it (I also have a note in my wallet saying that I won't pay for medical procedures performed without my consent - so it's not like I'm going to get free healthcare). Indeed, I could buy a very expensive plan, just like I could buy a Ferrari. But for the same reason that I don't purchase a Ferrari car because I think these cars are very over-priced, I don't purchase US health insurance (except the absolute minimum required by law), for the same reason. 
  • I had a chalazion (eyelid bump) for 2 months. I went to visit a doctor who said that I should get it removed sooner rather than later (requiring a medical procedure, general anesthesy, and incision in eyelid). The next day it got much better, and I decided to not do the operation (though I believe the improvement might be due to external factors, not just the fact that I healed automatically after being scared by the doctor, and it could just be temporary).

However, I believe this reverse-placebo effect does not work for most patients, maybe it works just for 10-20% of all patients. Should we identify who could benefit from such low-cost (zero dollar) healthcare?

Obviously no pharmaceutical company is ever going to finance such clinical trials due to conflict of interests, and maybe everyone who react like me (reverse-placebo) already spend very little to nothing in official healthcare, so there's no gain to do some research that would convince us that we can do better with less official health care. What do you think?

To summarize, not using any drug (claiming the drug is not yet available) might have a better effect than placebo, possibly a better effect than the real drug, depending on the patient and medical condition (especially for medical conditions that are stable over time). In short, how do you identify combinations of patient types / drugs / medical conditions where, in terms of effect, produce the following: placebo < drug < no drug?

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Interesting conjecture, but I doubt it would be approved by an human subjects review board.

Actually, most routine medical "problems" will resolve themselves in 2-4 weeks without treatment in the average person of reasonably good health. The body's immune system and natural healing abilities will take care of it just fine without external intervention. It'd be interesting to see if nothing vs something would pan out to prove that doing nothing is better than intervention in most cases.

The biggest factor in most maladies is related to stress, poor diet, and lack of exercise. Boring - we've all heard it before, but it's true. If we reduce our stress, eat healthier foods, and just go for a daily walk we'll all feel much better, lead happier lives, and be a more successful human being. We tend to want to be lazy and just take a pill instead.


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