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Comment by qwerty456127 | Hacker News Reader

This is because the only place for progress in America seemingly is within yet-nonexistent unregulated areas. As soon as something gets regulated in the US it mostly is doomed to lag decades behind the rest of the developed world (because American policymakers apparently are not fond of updating existing laws/rules and the bureaucracy is not flexible enough, often prioritizing the letter of the law). Of course there are exceptions (let alone particular regulations which do much more good than harm) but this seems to be the rule.

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Metamizol (Novalgin) is probably one of the biggest examples of this I know. It's a non-NSAID, non-addictive painkiller that was discovered over 100 years ago and banned in the USA in the 60s. It has a similar danger profile to Diclofenac (Voltaren), which is now prescribed like candy. And it is still widely used in Germany and Switzerland, so there is lots of data on 'modern' populations. But since nobody can patent it, there's no motivation to get it reapproved in the US, so everyone get opioids instead.

To be fair, the Netherlands has very tight controls on metamizol as well, and for no clear reason except small-c conservatism, and also a tremendous reluctance for doctors here to give out painkillers.

No, I have never asked for painkillers myself, so it isn't personal! However, if God–forbid I came down with pain issues that were treatable by painkillers, you better believe I would be on the dark markets PDQ.

(My RSI is no fun, but I deal, and it isn't amenable to painkillers except in mind-numbing doses.)

Myself and everyone I knew took metamizol countless times, for every minor sickness (the way people use Tylenol in the US) when I was a child. And side effects were unheard of. So I don't understand why does anybody care to control it more strictly than paracetamol (which is really deadly by the way) or ibuprofen. People should just be taught to consider their unprescribed meds conservatively and avoid taking NSAID like candies.

When addressing the root cause of pain is lobbied against by billion dollar corporation (for instance, Big Food -> inflammation and obesity), the current system is the outcome.

In addition, any GP that might normally have a chance of breaking people out of the disease-food feedback loop is bought out by the healthcare cartels (maybe getting a part of the symptomatic treatment profits).

Here is a link of videos made by a non-profit, with a plethora of references for each video.

https://nutritionfacts.org/topics/industry-influence/

> My RSI is no fun, but I deal, and it isn't amenable to painkillers except in mind-numbing doses.

Just a warning - trying to ignore the pain (by bearing it or hiding it with painkillers) is what is likely making your RSI worse. Please try and address the actual cause of the pain, than just taking pain killers.

While it's widely prescribed in Germany, it is actually pretty restricted, too, but there seems to be a lot of off-label use. It's only supposed to be prescribed for strong pain, or for fever only if other medications don't work. There is a risk of agranulocytosis, which is low, but the reason for the restriction in various countries.

Yes, it's not a paracetamol replacement, more like an option as a combination with paracetamol and ibuprofen to treat pain that would otherwise require opioids.

I expected this to be a rant about bureaucracy and it turned out to be a nuanced and rational discussion of the failure of American government. Good stuff.

I would only add that this isn't an accident - https://en.wikipedia.org/wiki/Regulatory_capture

For a large company, draconian regulations can be to their distinct advantage, as them very size allows them to handle the cost and complexity, while smaller companies cannot - or they can simply cheat, and if caught, swallow penalties that would destroy a small company.

Nah. A lot of it is is protectionism. For example, european cars came with significantly better headlights in the US but they put less light above the road, which didn't meet a standard designed for non-reflective road signs.

The manufacturers tried to get the standard updated, but the US auto industry blocked it, which resulted in car companies having to make US-specific, shittier, headlights - at significant expense - because GM and Ford didn't wanted more competitive advantage.

A big part of the problem is our ongoing and increasing legislative gridlock. When one of the two major political parties has as their stated goal preventing the other from getting anything done, and undoing anything they do (leaving aside their open efforts to replace democracy with autocratic fascism), it's very, very difficult to make any meaningful progress.

The funny thing is I actually can't tell which party you're referring to. All of those accusations can and have been leveled against each party by the other. I think that actually says a lot about the real cause of the legislative gridlock you're referring to: when each side insists the other is a bunch of fascists that they simply can't work with, well... they won't work with them, and this is the result.

Then you haven't been paying attention.

The Democratic Party has advanced actual legislative agendas, tried to govern, and supports democracy.

The Republican Party has openly stated their goal to "make Obama a one-term president", frustrate Democratic legislation simply because it is Democratic legislation, and is actively working to subvert democracy and both prevent and overthrow the results of free and fair elections.

If you genuinely can't tell the difference between these things in 2022, either you have been living under a rock, or you are refusing to see what's objectively clear because it upsets your worldview.

> The Republican Party has openly stated their goal to "make Obama a one-term president"

That’s a very trashy hot take. Doing everything possible to demonize and replace a POTUS is American tradition dating to the Peggy Eaton affair and has contributed to a United States civil war. In recent times, Democrats objected to the Trump presidency, elected though he was, and sought to block his every move. In fact, when Trump announced the COVID vaccine initiative, the Democratic Party held congressional hearings decrying it as a dangerous waste.

Yeah, no; you can't "everyone does it, it's always been like this" your way out of this.

There's a big difference between "we need to be able to defeat the other side in order to enact our goals, which are X, Y, and Z" and "our only stated goals are to defeat the other side and hold power". Also see 2020, when the Republican Party released no official platform aside from, effectively "we support Trump, whatever he says goes".

There's a big difference between every (modern*) Democratic president and Trump, who has, since even before he was elected, derided and eroded our democracy, actively promoted racism and white supremacy, and relied upon Big Lies[0] as fundamental parts of his campaign and governance strategy.

* To differentiate from the era prior to the Dixiecrats flipping to the Republican Party, in response to the Democratic Party officially supporting civil rights.

[0] https://en.wikipedia.org/wiki/Big_lie

I was just thinking about this. At some point, it seems like companies that want to innovate will just have to break laws and hope public support for a new, better product gets them off the hook somehow. Sounds crazy, but the thought arrived in the context of "how do we do health insurance better?"

I was picturing something like what we've seen with marijuana, where laws change at the state level while DC looks the other way.

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