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Comment by forestrywat | Hacker News Reader

Because tests aren't completely innocuous? Because tests lead people to make significant medical decisions?

Look at the supplements world, where grifters are shilling chemicals that cause harm and make radical claims for absurd markups. Or gas station pills. You want those companies making Alzheimer's tests? People going in to a 7-11 and buying a "all illness test card" that tells people they do or don't have degenerative diseases?

No, it's very very important to ensure tests are actually indicative and ensure they are well made. To do that, a regulating body needs to be involved.

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Their doctor should be qualified to make that judgment without a government bureaucracy evaluating the efficacy of the test on their behalf, unless you want to completely destroy the rate of medical breakthroughs. If there's no potential harm from the procedure itself, the government shouldn't be involved at all.

Imagine if every new AI model had to be "cleared" by a government regulator. The role of government in healthcare evaluation needs to be simplified and streamlined. The liability needs to be shifted to doctor, and if it's a case of charlatanism, that liability should include a lengthy prison sentence.

There is potential harm. That's the point.

So we should just let companies flood doctors with potential treatments and then hope they have enough time to figure out whats relevant for their patients?

Seems much better use of time and money to have people developing tests meet a pre-defined standard and after that point they're allowed to flood doctors with marketing for the tests.

What use is future medical advancements if it can't meet low bars like proving it works?

The problem is the FDA's pathetic throughput times. It takes them decades to approve drugs. Blood tests take 1-2 years on average. It's a huge bottleneck. If they could turn these things around faster and work iteratively, it would be different.

October[1] to August[2] isn't even a single year.

Definitely longer than I'd expect for "cleared" considering everybody involved should have to be licensed and pretty sure you pay a fee to the FDA so that should cover the cost of FDA hiring employees to just call each person involved to verify the submission is accurate.

Although IIUC, they were already allowed to do 50yr+ people and the recent clearance is just for 40yr+ so I'm not actually sure how uh impactful this is (a bit more confused why it takes 10 months to drop the age by 10 years).

[1]: https://precivityad.com/news/c2n-submits-us-fda-regulatory-f...

[2]: https://c2n.com/news-releases/bg2ziqcz39o3wxf5uc04u279ziw0yv

> "If there's no potential harm from the procedure itself"

There is potential harm from the procedure itself because of https://en.wikipedia.org/wiki/Opportunity_cost and https://en.wikipedia.org/wiki/Budget_constraint and because sticking needles in people and drawing blood carries inherent medical risks.

Some doctors absolutely would abuse this. I used to date someone whose sister was an endodontist and there was another endodontist in the building who was making over $1m a year. She ended up seeing one of that endodontist’s patients and realized that the other doctor had been making all that money by giving people medical procedures they absolutely did not need.

But only another medical professional would know that; the patients were completely oblivious. I said she should blow the whistle but she “didn’t want to rock the boat”. It definitely changed how I feel about doctors. There’s a massive level of trust there, which most doctors will honor but a few will exploit.

As long as we make examples out of the few that exploit, it will be a-ok.

Citation very much needed. Society today is full of people in power who exploit others. Cops, ceos, spouses, etc. Very rarely are they "made an example of", and when they are it doesn't seem to change the intuitions.

> Their doctor should be qualified to make that judgment without a government bureaucracy

This is like saying AI developers should be qualified to evaluate the effacy of a model without testing the model.

You're assuming that everyone has access to a doctor, and that people who do have doctors will visit them instead of just looking at their phone.

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