Actually, I’m one of those true believers who thinks that markets never fail. So, my a priori answer to this Sino-American conundrum is that we don’t have a free market in medicine and the Chinese probably don’t withhold cheap, harmless therapy that seems to work even though scientific evidence is less than certain.
I only recently came across this English-language review of the Chinese medical literature on the subject of hyperbaric oxygen for the treatment of cerebral palsy and my supposition about Chinese medical policy, at least, was born out. This particular review confined itself to neonatal ischemic patients and the researchers, though from England, had an obvious command of the Chinese language. The authors found 20 Chinese-language reports of randomized, or what the authors called quasi-randomized, studies; quite a few other hyperbaric oxygen studies for cerebral palsy did not meet the authors’ inclusion criteria and had to be excluded from the analysis.
Overall, the patients treated with hyperbaric oxygen fared better than the ones who did not receive hyperbaric oxygen. Here are the authors’ conclusions in their own words:
“Treatment with hyperbaric oxygen possibly reduces mortality and neurological sequelae in term neonates with hypoxic-ischaemic encephalopathy. Because of the poor quality of reporting in all trials and the possibility of publication bias, an adequately powered, high quality randomised controlled
trial is needed to investigate these findings. The Chinese medical literature may be a rich source of evidence to inform clinical practice and other systematic reviews.”
This conclusion is hard to quibble with: Maybe hyperbaric oxygen works and more study is needed to say for sure. But I find it curious that the Chinese are willing to treat their brain-injured babies with hyperbaric oxygen whereas the American government–or at least Medicare and Medicaid, for the most part–refuses to pay for hyperbaric oxygen treatment of brain injury.