At his “Miracle Ranch” in California, Robert O. Young would charge up to $5,000 per day to treat cancer patients. As part of his recommended six-week stay, the father of the alkaline diet would analyse the blood of patients, make them veggie smoothies, and supply a range of pH-branded supplements. He would also offer a treatment of baking soda solutions, injected into the veins.

As you may have guessed, Young is no doctor. But for 25 years, up until his most recent arrest in the summer of 2022, the retired pro-tennis player from Utah peddled his life-threatening cures to sick and desperate Americans. He is not alone. Far beyond the familiar landscape of yoga, chiropractics and aromatherapy lies a Wild West of supposed cure-alls, many of them driven by small-scale entrepreneurs who hope to parlay a unique product or brand into a sprawling business empire. Such characters have always floated around the margins of America’s healthcare scene, but right now, fringe practitioners are having a moment. The alternative-medicine lobby that backs them has never been more powerful.

The story of its rise to power begins in the mid-Nineties, around the same time that Young first started dabbling in alternative health: pairing tennis-related diet and exercise advice with a line of branded dietary supplements. The supplement industry was going through a sea change, thanks to the nascent alternative healthcare lobby, which scored a massive and improbable victory in the halls of Congress in 1994. The Dietary Supplement Health and Education Act broadened the definition of a food supplement to include almost any vitamin, mineral, plant or hormone. It also, critically, shifted the burden of proof away from manufacturers to the federal Food and Drug Administration, which had to identify dangerous products on a case-by-case basis, a resource-intensive prospect that allows tens of thousands of quacks to sell shady products with relative impunity.

This lax regulatory environment made selling supplements far more profitable. Between 1994 and 2002, the US supplement industry mushroomed from $4 billion in annual sales to $18.7 billion, and the number of dietary supplements advertised grew too, from 4,000 to 29,000. Bolstered by the efforts of its Republican Senator, Orrin Hatch, the supplement industry was centred in Utah, which became a sort of Silicon Valley of suspect health claims.

This was the ideal environment for Young, who rose to fame after publishing a bestselling book on the importance of an alkaline diet, The pH Miracle Diet, in 2000. The book was innocuous enough — it recommended exercise and a plant-heavy diet, and offered a blend of American can-doism and hucksterism that is tolerated, or even looked upon fondly, by the American public. This is where Young might have stayed, had his fantastical beliefs not led him down a much darker path.

The problem was that Young thought he had made a paradigm-shifting discovery: that germs were a myth, and that all diseases were caused by the body becoming overly acidic. When he began treating cancer patients at his upscale resort, a former grapefruit and avocado ranch in Valley Centre, he took his groundless theory even further. His de-acidifying treatments denied patients the chance to seek proper healthcare: Naima Houder-Mohammed, a 27-year-old captain in the British military with advanced breast cancer, drained her family’s finances to raise more than $77,000 (£62,700) to fund a visit to the Miracle Ranch.

Young might never have gone so far had the healthcare profession maintained its integrity. In the early days, there was a fairly clear division between people like Young and licensed medical doctors, a division that was enforced by state laws and various gatekeeper institutions — public health agencies, medical universities, and legacy media outlets, none of which would consider Young’s medical theory to be worthy of consideration.

But the alt-health lobby, swelling with profits and energy, began seeking ways to bypass these gatekeepers and make unfettered health claims directly to consumers. By 2005, supplement manufacturers were partnering with libertarian lobbyists to aggressively court small businesses in the alt-health community. Lobbyists held hundreds of Health Freedom Expos, where fringe practitioners gathered to hear them out. Their sales pitch focused on an appealing libertarian message: medical freedom. Instead of convincing the established gatekeepers of medical science that, say, herbs could treat cancer, practitioners should instead convince the public and their elected representatives that Americans had a fundamental right to buy the medicine of their choosing, whether it worked or not.

It was an ingenious strategy. By 2010, Americans were spending $34 billion out of pocket for alternative healthcare, and industry analysts estimate that spending increased by more than 50% between 2010 and 2020. An estimated 72 million American adults now use some form of complementary and alternative medicine (CAM).

The political makeup of CAM users shifted too. In 2003, it was extremely progressive Leftists who favoured alternative medicine, a hangover from America’s hippy movement. Twenty years on, it is mainly Conservatives, particularly when it comes to taking dietary supplements. A 2019 industry survey found that the American South has higher rates of supplement use than anywhere else in the country, while a 2008 survey found Republicans were twice as likely as Democrats to be heavy users of supplements.

How did a culture known for peace, love, happiness, marijuana and socialism transform into a hotbed of gun rights, anti-vaccine conspiracy theories and nationalism? The answer lies in the “medical freedom” movement, which very quickly found synergy with Republican politicians in the early 2010s, after 18 House Republicans, led by Georgia’s Tom Price, first floated the Medical Freedom Act. Not only were Republicans loathe to decry freedom in any form, but presidential candidates including Newt Gingrich, Mike Huckabee and Herman Cain also found that they could monetise their campaign email lists to sell quacky medical products to their supporters. At the same time, Right-wing media personalities including Tucker Carlson, Alex Jones and Ben Shapiro began promoting supplements and other alt-med products.

It wasn’t long before millions of conservative Americans found themselves bombarded with glowing sales pitches about herbal Viagra, brain-enhancing pills, pendants to ward off electromagnetic frequencies, and handheld lasers that could cure cancer. The pandemic only hastened this trend, as medical freedom lobbyists touted their miracle health cures and rail against mandatory mask-wearing and vaccines.

Of course, not all alt-med users are poor Conservatives. The field tends to be associated with well-to-do urban women, who spend significant amounts of money on Gwyneth Paltrow-style toxic cleanses and reiki therapy. And it’s true that, among white women, the more money they make, the more likely they are to use mild alternative therapies (mostly mind-body medicine such as yoga) — but that’s alongside routine visits to their private doctors.

Instead, the real victims of the alt-med lobby are poor Americans who struggle to pay for proper healthcare, and who are far more likely to seek out alternative cures for serious diseases. A National Health Interview Survey found that having unmet needs in medical care or having delayed care due to cost were associated with a higher chance of CAM use.

And as long as America’s justice system remains ill-suited to combatting the problem of medical misinformation, that looks unlikely to change. Despite serving several months in jail in 2017 and being ordered by a judge to pay out $105 million in damages to a single patient in a civil lawsuit in 2018, Young has refused to give up his operation. In May 2022, he was hit with further criminal charges related to his treatment of a patient, including that he had committed “wilful cruelty” to an elderly woman suffering from liver and thyroid disease.

It is unclear whether this will lead to a penalty that finally puts Young out of business — but, either way, the alt-health movement is unlikely to disappear soon. In the years since the pandemic motivated many Republicans to oppose Covid vaccines and mask mandates, Florida’s Governor Ron DeSantis has brought other aspects of the medical freedom movement out of the libertarian fringe and into the conservative mainstream. He has emboldened Republican state lawmakers across the country to introduce hundreds of public health bills this year in the name of liberty: critically, they go beyond targeting Covid-specific mask and vaccine mandates by weakening evidence-based care.

Under the DeSantis agenda, Florida’s proposed medical freedom laws would give doctors and insurers the freedom to refuse treatment to vulnerable Americans and force doctors to inform patients of alternative Covid treatments, regardless of FDA approval. As other red states follow Florida’s lead, America’s alt-health lobby will continue to prey on the poorest in society. They have created a world we cannot escape: where Left is Right, medicine is poison, and the doctor’s white coat is a harbinger of death.

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