First, do no harm.

Have I got a miracle drug for you. Proven effective in hundreds of studies, it costs nearly nothing. Despite that, enterprising entrepreneurs have already made millions on it. It's called placebo.

Placebo is sometimes known as a sugar pill — a medication purposely designed to have no biological effect. It's indispensable to medical research though, because if people think they are getting a pill or treatment with some medical benefit, they surprisingly often do get a benefit. That benefit is the placebo effect, a mixture of expectation, faith and the power of your mind to deceive your body.

For millennia, placebos were about all the medical profession had to offer. With no clue about what actually caused diseases, doctors were forced to rely on a comforting touch, a sympathetic demeanor and the knowledge that most of the time people get better on their own. It isn't clear how much of the placebo effect is due to that comforting touch and sympathetic demeanor and how much to expectation. One study a few years back found that people got better pain relief when given a placebo they were told cost $2.50 per pill than when given the same placebo and told that a pill cost only 10 cents. In the placebo business, you get what you pay for.

Another study made me want to meet the researchers. It asked people with painful arthritic knees — so painful they would consider surgery — to take part in a placebo-controlled study. A placebo in this case is a fake surgery. Imagine the conversation. “Now, Mrs. X, I'd like you to help me out in a new study. I'm going to anesthetize you, drill some holes in your knee, and then I may or may not do the rest of the actual surgery which everyone up to now believes will relieve your pain.” Of course, it turned out that those getting the pretend surgery got just as much pain relief as those getting the real surgery, so it wasn't such a bad deal after all.

Placebos as treatments for aging have a rich and amusing history. In fact, the vitamin and supplement industry might be said to be built on the placebo effect.

Anti-aging treatments weren't always placebo-safe though. I mentioned in a previous column, John R. Brinkley, who became fabulously wealthy during the Great Depression by implanting goat testicles into men and goat ovaries into women. We know he killed more than a few of these people, but some of the survivors must have felt younger and more vigorous, otherwise how did he keep getting new customers? Around the same time, radium water — yes, radioactive water — became a popular health treatment. Industrialist Eben Byers was a three-bottle-a-day enthusiast of Radithor, water containing radioactive radium and thorium. In the end it didn't turn out well for Byers though, who was famously memorialized in the 1932 Wall Street Journal headline, “The Radium Water Worked Fine Until His Jaw Came Off.”

I've been thinking of how we could harness the placebo effect to save our health care system and make me fabulously wealthy like Dr. Brinkley. I think I have it. No matter what the legislative future of health care, everyone agrees that its cost is going to skyrocket. So how about this? For treating any of the conditions known to respond to the placebo effect, every third pill or treatment will be a placebo instead of the real drug or treatment. That reduces costs by a third. Then, because placebos are more effective the more expensive they are, we increase the charge for any medications containing placebos by a third. Now we're talking real savings or real profit, depending on who's paying and who's getting paid. The government saves money, the health insurance companies' profits soar. I just need to get in on the action somehow. Enterprising entrepreneurs thinking about following up on this, you know how to contact me.
