Beyond "Abolish the FDA"
astralcodexten.com
astralcodexten.com
Who puts these things on the label and why? I don’t understand what’s obvious about this in a laissez-faire system. The author seems to argue for the removal of medication safety regulation in one area (FDA) but imply that there would still be safety regulations in regards to labeling? This seems like a huge contradiction to me.
Was it better? I don't know. I doubt you'd have many of the extremely effective medicines that have been invented since then. But I also don't think restricting medications has done anything to help curb addiction for example, and in my opinion the situation we live in where people just assume something is safe just because it's on the shelf of a store is a bad outcome of outsourcing personal safety to a government agency. I'm very diligent about what I put into my body, and I think most people would also be if they realized they needed to be, most people have a false sense of security as an adverse side effect of governments taking the role of claiming something is safe.
I like not having lead in my turmeric, I like being able to see what's in my food by looking at the label. But I don't like having to pay someone a few hundred bucks just to get permission to numb some acute pain I feel from time to time due to a chronic condition. I skirt that law using a "supplement", but I don't think I should have to.
All in all I think there's room for improvement. A lot of room. I'm not quite ready to say the government shouldn't have anything to say about the way things are done but I am ready to say they should have a much less prominent role.
I guess because otherwise you could be sued? Not that it makes this any more viable.
These types of political positions happen because serious problems get dismissed by the status quo and nothing changes. There's a kind of false equivalence that's implicit — "arguing that X is a problem with agency B means you want all these other horrible consequences of getting rid of B" so nothing happens. After awhile, with nothing changing, it seems like the only option is to argue against eliminating the agency because valid criticisms just get spun away politically, and opponents of real change seem to frame the choices that way.
Even now, I suspect discussions like this about the FDA only exist in a small bubble like Scott's readership. Most of the US doesn't have these ideas in their consciousness probably, so the problems get swept aside, and only bubble up if calls for dramatic changes like abolishment are discussed as a kind of intellectual punching bag for entertainment, and as a distraction from making real, serious reform.
I would have been more impressed with this post if it had offered solutions to the problems involved. What it offers as proposals aren't bad, but sidestep the real problems and in one case just obfuscate things more.
I don't think the FDA should be abolished, but I do think its role should be restricted to labeling fraud, product purity testing, and enforcing transparency in product efficacy evidence.
For me, the FDA is just one problem in a litany of problems with healthcare related to regulatory capture. The US desperately needs medical deregulation — or at least reregulation. Arguments against this in the form of fear mongering without offering reform proposala are starting to feel to me like they really mean the status quo is fine and nothing really needs to change.
It’s ridiculously, ridiculously hard to figure this out even if you’re not a bad actor and you do have a drug that works. The only reason to go through that effort is for FDA’s stamp.
[1] https://www.fda.gov/inspections-compliance-enforcement-and-c...
On its face, this isn't an insane point of view. It's natural to look at the scope and complexity of government and as yourself "is all this really necessary?" While it'll never achieve mainstream status, some tinges of libertarianism contribute meaningfully as a counterweight to the tendency of government to grow beyond the point of diminishing returns to society.
The problem is, the ideology has a second, usually unspoken tenet: anyone who suffers brought it upon themselves. Hacker stole your bitcoins? Should have used a hardware wallet. Hospital bills driving you to bankruptcy? This is what you get for not saving for a rainy day. Poisoned by shoddily produced medicine? Hey, you get what you pay for.
It's an ideology of arrogance. Both intellectual arrogance, as its dunning-kruger afflicted adherents look over the vast and complex world and say "how hard could it possibly be?" to every challenge they perceive, and also of moral arrogance, as those same people cast their eyes over the depth of human suffering and inexplicably think "I've got mine, you all are on your own."
The reason why libertarians always lose is because anyone who isn't a billionaire would spend their entire existence looking over their shoulder in terror at the infinite ways life can screw you. And even then they would probably fail. Any reasonable person would gladly hand over the right to sell medicine they mixed in their own basement in exchange for knowing they won't be poisoned when they need help themselves.
Side note, dunning Kruger has been discredited as statistical bias, I only know because I see a post about it on this site almost once a week.
LOL the blind trust that the author has for the seriousness of the FDA when it comes to clinical studies is absolutely laughable. The same FDA approved Vioxx and let Oxycontin ravage the US for years before moving any finger, and because of public pressure rather than anything else. Its failures speak volumes on how useless that agency is.
Besides it is very easy to design clinical trials to make your drug look better than it actually is, and p hacking is still a thing.
The FDA is the cargo cult of clinical science.
Replace X with government agency if you are from the right. Capitalism if you are from the left.
1. X has huge positive impact overall.
2. Something bad related to X
3. Emotional rage quit. X is bullshit.
Alternative. Try to think what is the total effect overall. Don't be emotional.
Libertarians and neoliberals at this point are essentially indistinguishable. Neoliberalism is just a thinly-veiled wealth transfer to the already-rich through deregulation and tax cuts, masquerading as "market-based reforms" at the altar of the "free market". The "free market" itself is a myth because a well-functioning market requires strong government. It requires regulation.
So when you see something like regulatory capture, which is a real problem, and companies bypassing the very regulation that limits their excesses and thinking the solution is less regulation. It's nonsencial.
[1]: https://www.vox.com/policy-and-politics/21534416/free-state-...
> Right now the FDA does this too
Not really. They come and check and confirm your procedures are in line with a bunch of paper standards. In no way they can guarantee the lack of contamination.
At best it can be said to imply what's likely the case in physical reality. But even assuming a very low corruption rate of 0.1%, that's still hundreds of bad record writers putting out bogus records.
Their m.o. is to keep digging: if they find something that is not quite right they start asking about who did it, who supervised it, what else that person has worked on... so on and so forth until they find something.
It's pretty terrifying to witness..
A few years ago I watched a video of a debate among people seeking the Libertarian Party presidential nomination [1] where I learned that Libertarians honestly and earnestly believe you shouldn't need a license to drive a car.
I am pretty sure a Libertarian would see no problem with offering cocaine, fentanyl and warfarin off the shelf in corner stores.
Of course, how this intersects with the Ivermectin lovers of the Republican party I'm not sure.
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For those thousands of years our only medicine was "ground up unicorn toe".
Look around where you are. Unless you're in the middle of a forest, pretty much every single thing you see is the result of scientific and technological advancements of the last 150 years. Half of it probably owes its existence to the oft forgotten chemical and petrochemical revolutions that started about 100 years ago.
Before that? Before the tail end of 19th century, we knew fuck all about anything. Medicine, in particular, graduated from voodoo and aforementioned "ground up unicorn toe" into a proper science and profession, also about 100 years ago.
It's really hard to overstate how different 20th century science and technology is from anything that came before. We've crossed a qualitative threshold there.
Nevermind the thousands of plants with verified therapeutical effects across the world for centuries.
But yeah, old societies were completely clueless and a bunch of idiots and surely we have learnt nothing from them.
Yes, they were, in comparison. They had neither predictive theoretical models, nor the tools to confirm and refine them - hell, for most history, they didn't even understand they need those things in the first place. Please appreciate that the period starting in late 19th century brought all the pieces together - the theoretical foundations, the observations, communications, precision manufacturing, the philosophy of science - they all added up to exponential growth across all scientific disciplines, and all occupations.
That's not to say we didn't learn anything from them. They did accumulate knowledge. But the sum of all knowledge humanity accumulated since beginning of recorded history is just a rounding error compared to what humanity accumulated in the last 100 years. That's the exponential growth at work.
Nobody is saying that. What we're saying is that the application of science to medicine and nutrition had an absolutely enormous effect, and before that, we didn't really have explanations- just empirical observations- of the effect of medicines.
Now? Though still rare, it's just another thing you can have transplanted if you need it.
This libertarian "burn the government down" bullshit is exhausting. REALLY itching to eat some bad meat and croak? Because this is what happened before. Then the responsible people said "maybe we should have someone checking that so that our citizens don't get sick and die".
It's called a Civilization. Welcome.
Maybe the answer is to fix it, not destroy it? Is the FDA a revolving door? Yes. Many regulatory agencies are.
The politicians who complain the most are the ones most ok with the government being a corrupt dumpster fire. Helps the narrative, and the rubes are eating it all up.