Anybody who deeply scrutinizes the FDA will find opportunities for reform. For instance, when the economists Daniel B. Klein and Alex Tabarrok applied their scrutiny, the result was http://www.fdareview.org/

What is surprising and exciting about the possibility of Balaji's appointment is not that he has identified opportunities for reform, it is that he may be appointed despite the fact that reform is his primary motivation!

He has no political motive, no personal motive, he does not "hate" the FDA (he is not the kind of person to be driven by hate)... he simply sees the FDA's mandate as an incredibly important one which it could do a better job of fulfilling. This should inspire optimism.