It's become something of a trope I've used on a number of hit-and-run altie trolls: When they whine about Big Pharma being in control, I bring up my experiences with a subtype of alties: They want the non-zero amount of trust I put into the big pharmaceutical company's products, but they aren't willing to jump through the various hoops my fellow skeptics and I want enforced on all medical claims.
Some alties claim that proper clinical trials are too expensive for the Yoder's Good Health Recipe Ma & Pa business, therefore they should be exempt from those standards. The problem is that a lack of capital doesn't insulate one from self-deception, confounding factors, bias, and all the other cognitive failings we're subject to as mere mortals. An emotional appeal to poverty isn't going to prove your product works. Either you have it tested and know, or you haven't tested, and therefore, don't know if it works. If I had a health product I wanted to sell, I would have it tested well before applying the first price tag. If I don't test my product under rigorous conditions, that means I don't know whether or not it really works.
The first big question in this post: Why should I buy a product if the manufacturers don't know if it works?
The big pharmaceutical companies usually, but not always, go through the hoops of clinical trials, carefully documenting the tests. Yes, there have been instances of results being manipulated or outright falsified, but at least with a paper trail and post-market testing, there's a way to find out if fraud occurred. From what I've seen, no altie has ever operated under a system like that: They've only made excuses as to why they shouldn't go through the testing process.
Here's another big, important question: Why should I judge the pharmaceutical companies under one set of standards, and so-called "alternative medicine" under an entirely different set of standards?
It doesn't make sense to me to draw a line between medical claims of "mainstream" pharmaceuticals and the medical claims of things like herbs and supplements. Medical claims are medical claims. I don't even accept that there is such a thing as "alternative medicine": It's a false distinction created by a subculture to make excuses for not being treated like other medical claims. For the average altie I encounter, it's not about truth, it's about "Us versus The Other" with successful pharmaceutical companies as The Other.
Of course, people like me get lumped in with The Other because I don't accept the false dichotomy. Instead of arbitrary labels of "mainstream" and "alternative," I base my acceptance of a treatment on its ability to pass scientific trials: Some treatments have been shown to work. Some have been shown not to work. Some have not been properly tested, but look promising. Some have not been properly tested, but do not have any reasonable expectation to work.
The easiest way to market a failed treatment, as well as treatments expected to fail tests, is to label it "alternative." Those who buy into the false dichotomy between "mainstream" and "alternative" will likely give that treatment special consideration, instead of caring about what the clinical tests say.
Of course, one of arguments they bring up is for us to "try it ourselves." If we could determine causation based off of one observation, we wouldn't need the scientific method. If we weren't capable of self-deception, we wouldn't need double-blinding. We are flawed beings, and we have to work hard to counteract those flaws with good experimental design. Anecdotes may be good for generating hypotheses, but all the flaws we have, alongside the complexity of our bodies and the surrounding universe makes them worthless for testing those hypotheses. I know that if I get sloppy, I'm perfectly capable of fooling myself. We've all done it before. Why should I expect that to change when performing an inherently sloppy piece of self-experimentation?
In short, the big problem I have with alties is that they're asking me to be unfairly biased in their favor by demanding that I make special exceptions for them, and yet they so easily accuse me of being unfairly biased towards certain people who can demonstrate and document their competence. They're like children who say the teacher's out to get them, and yet it was their choice not to do their homework.