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Coincidentally, I've just heard Milton Friedman talk about "Health Care in a Free Market". Fascinating and eloquent. He argues that the FDA did more harm than

by air7 7y ago

Coincidentally, I've just heard Milton Friedman talk about "Health Care in a Free Market". Fascinating and eloquent. He argues that the FDA did more harm than good, and that society would be better off without a governmental supervision for health care in general. -- https://www.youtube.com/watch?v=-6t-R3pWrRw https://www.youtube.com/watch?v=-6t-R3pWrRw btw, in the end he makes a strong argument for negative income tax. This surprised me, as my model of his world-view was apparently more simplistic that it ought to be.

anthony_doan 7y ago
I disagree. FDA have set guidelines for clinical trials and moral standards to it. For an example you cannot experiment on a person without their consent and you have to state out what your trials is doing. It all lay out. It's because of Tuskegee syphilis experiment that we have IRB and FDA. FDA also love stating that they prevented a drug that causes birth defect a while back unlike Britain. Another example of government regulation working is cars. Death relating to car crashes have fallen every year with safety regulations. It's not perfect but there are many cases that it works and there are laws and rules set in place. The free market is not the panacea for everything.
- will4274 7y ago
  Falling car crash rates don't prove regulation is successful. Consumers shop for safety too. It's difficult to compare the counterfactual, but to make this claim, you need to at least compare the rate of change of crashes in unregulated countries or times to regulated countries or times.
  - kube-system 7y ago
    For both auto safety and pharmaceutical safety there is a large degree of consumer information disparity, information unavailability, and disincentive for the individual to protect the public interest. It takes a lot of resources to test those products, and consumers don't really have the resources to do it themselves. In some cases, insurers could possibly foot the bill (eg. IIHS), but that model still has a couple of big weaknesses: consumers may not be informed enough to parse the results, consumers might prioritize short-term needs over public health, and an insurance body may still have some incentives working against public benefit. Things like truck under-ride guards likely wouldn't be on commercial trucks if they weren't regulated. Consumers aren't going to all voluntarily coordinate to buy vehicles which have crash-compatible bumper heights. Antibiotic misuse would be even more out of control if it weren't regulated. Mexico is a good example for road regulations. They do not have the same crash regulations as the US, and many old model vehicles are still legal for sale there. Things like the 1950's VW Beetle were still sold there into the 2000s. They have the highest death rate per distance traveled in the world.
- sseveran 7y ago
  The Tuskegee syphilis experiment was run by US Public Health Service which is currently part of the HHS. The FDA was founded in 1906, although it has earlier origins, which is well before the study was begun.
dTal 7y ago
Ah yes. This is why, before we had the FDA, everything was fine, and why nobody saw the need for the FDA in the first place </s> The Libertarian capacity for ignoring Chesterton's Fence is nothing short of astonishing. Free markets require free information - the FDA was created in large part to enforce accurate labeling.
- ikeboy 7y ago
  https://www.fdareview.org/issues/theory-evidence-and-examples-of-fda-harm/ https://www.fdareview.org/issues/theory-evidence-and-example... It turns out we can directly compare pre-1962 FDA with the current FDA and find strong harms outweighing any benefit of the current regime. If all the FDA did was "enforce accurate labelling", they wouldn't be responsible for hundreds of thousands of deaths from delayed approval of drugs. Maybe that's not the part people are complaining about.
  - dTal 7y ago
    That might be a valid point if the parent comment had been similarly nuanced. But it said "no government supervision", not "roll back to 1962". I find this kind of motte-and-bailey stuff ubiquitous in discussions with libertarians, as the "philosophy" amounts to anarchy which most people realize is bad.
    - ikeboy 7y ago
      Note that I'm not the one who posted the parent comment. Anyway, the Milton Friedman talk linked explicitly mentions the same beta-blockers example as my link discusses and cites it as causing tens of thousands of deaths. He says it's been a disaster over "the last 20 years" - the talk was in 1978, so this is roughly the 1962-1978 period. And the "governmental supervision for health care" mentioned is broader than the FDA.
- dnautics 7y ago
  You don't talk to libertarians much, do you? I don't know many libertarians that would argue that accurate labelling shouldn't be enforced by the law. Drugs quality testing could also conceivably be performed by a non-government regulatory agency (e.g. Underwriters Labs)
vincnetas 7y ago
As a recipient of free healthcare, i would never ever like to see "free market" near my "paid by government" healthcare.
hannob 7y ago
So what you're saying is because FDA isn't enforcing rules strictly enough we should leave it to free markets and have no rules at all? Libertarian logic I guess...
- allovernow 7y ago
  Consumers unload responsibilities onto regulatory bodies. When the regulators function appropriately, the result is better than no regulation. When regulatory agencies are captured by industry and better serve commercial rather than citizen interests, it is unlikely that citizens will recognize that their government is no longer working for them. At this point it may be better for consumers to be forced to pay more attention to the product. And this creates multiple points of competition, unlike regulation which is somewhat anticompetitive. Transparency, efficacy, cost, reviews in the age of the internet, all combine as a form of emergent regulation which may outperform explicit agencies in some cases.
  - UnFleshedOne 7y ago
    If the state of online reviews is any indication, things would devolve into a clusterfuck of disinformation. Committees Of Concerned Citizens On The State Of Toothpaste will pop up and dissolve like mushrooms, some of them funded by this or that corporate interest, some being incompetent to evaluate state of anything, and the rest drowned in all the noise. Emergent anything only works if there is an explicit external force pushing things towards a specific organization or a set of laws of nature that produce outcome you happen to find satisfactory. I guess your point was that current state is worse than that already, and that's a valid point, although I don't think this is the case.
aalleavitch 7y ago
This would be a nightmare, the average consumer has absolutely no capacity to make informed judgments on their own healthcare, they would get eaten alive, and historically they have been.
jcranmer 7y ago
The general consensus of many workers in the industry is that the FDA's regulation is about right, rather than being either too tight or too lenient. It is willful or reckless ignorance to believe that the absence of the FDA will not have serious consequences. There already exists a segment of the drug industry that is nearly completely unregulated by the FDA, as a matter of law. I am of course speaking of the health or dietary supplements. And the experience here does not bode well: there are a sheer number of "miracle" pills and cures that come out of it, unhelpfully promoted by snake oil salesmen like Dr. Oz. And investigations have found that many companies can't even be bothered to put the active ingredients into their products.
- ikeboy 7y ago
  There's another area that's unregulated - off-label uses. See https://www.fdareview.org/issues/theory-evidence-and-examples-of-fda-harm/ https://www.fdareview.org/issues/theory-evidence-and-example... for a discussion of the evidence from off-label uses of approved drugs.
  - loceng 7y ago
    From my own experience with the Canadian health system, mentioning it as basically a single payer system, not allowing off-label use causes problems - at least the lack of and ability to initiate in a cascading process to initiate research for off-label use is a problem.
- loceng 7y ago
  It can be argued both ways. Another option without FDA would be people will self-regulate: determine who they trust - individuals, organizations, or networks - and who they don't trust based on hearing word of mouth experiences being spread vs. people being manipulated via bombardment of shallow, cheap advertisements - allowing a functional mechanism of Darwinism while preventing regulatory capture and squashing of drugs that were known to provide great benefit - but couldn't be patented so were controlled - like marijuana, MDMA, psychocybin, etc; presumably anything that kept in circulation in the black market was providing individuals with benefit, and arguably things like opiates kept and pumped into the public market did far more harm than even perhaps the total of harm caused by the black market drugs. Edit: Just to clarify, I'm not arguing for or against here, I just stated another option - so thanks for that downvote whoever the lazy person was did it.
tehjoker 7y ago
Naomi Klein on Milton Friedman: https://www.theguardian.com/commentisfree/cifamerica/2010/mar/03/chile-earthquake https://www.theguardian.com/commentisfree/cifamerica/2010/ma... Friedman and the "Chicago Boys" advised Augusto Pinochet in Chile and used his dicatorial powers to ram through changes into the Chilean economy. I don't think Friedman is someone to admire.
Angostura 7y ago
Welcome to GoopTV!

by air7 7y ago

anthony_doan 7y ago

I disagree. FDA have set guidelines for clinical trials and moral standards to it. For an example you cannot experiment on a person without their consent and you have to state out what your trials is doing. It all lay out. It's because of Tuskegee syphilis experiment that we have IRB and FDA. FDA also love stating that they prevented a drug that causes birth defect a while back unlike Britain. Another example of government regulation working is cars. Death relating to car crashes have fallen every year with safety regulations. It's not perfect but there are many cases that it works and there are laws and rules set in place. The free market is not the panacea for everything.

will4274 7y ago
Falling car crash rates don't prove regulation is successful. Consumers shop for safety too. It's difficult to compare the counterfactual, but to make this claim, you need to at least compare the rate of change of crashes in unregulated countries or times to regulated countries or times.
- kube-system 7y ago
  For both auto safety and pharmaceutical safety there is a large degree of consumer information disparity, information unavailability, and disincentive for the individual to protect the public interest. It takes a lot of resources to test those products, and consumers don't really have the resources to do it themselves. In some cases, insurers could possibly foot the bill (eg. IIHS), but that model still has a couple of big weaknesses: consumers may not be informed enough to parse the results, consumers might prioritize short-term needs over public health, and an insurance body may still have some incentives working against public benefit. Things like truck under-ride guards likely wouldn't be on commercial trucks if they weren't regulated. Consumers aren't going to all voluntarily coordinate to buy vehicles which have crash-compatible bumper heights. Antibiotic misuse would be even more out of control if it weren't regulated. Mexico is a good example for road regulations. They do not have the same crash regulations as the US, and many old model vehicles are still legal for sale there. Things like the 1950's VW Beetle were still sold there into the 2000s. They have the highest death rate per distance traveled in the world.
sseveran 7y ago
The Tuskegee syphilis experiment was run by US Public Health Service which is currently part of the HHS. The FDA was founded in 1906, although it has earlier origins, which is well before the study was begun.

dTal 7y ago

Ah yes. This is why, before we had the FDA, everything was fine, and why nobody saw the need for the FDA in the first place </s> The Libertarian capacity for ignoring Chesterton's Fence is nothing short of astonishing. Free markets require free information - the FDA was created in large part to enforce accurate labeling.

ikeboy 7y ago
https://www.fdareview.org/issues/theory-evidence-and-examples-of-fda-harm/ https://www.fdareview.org/issues/theory-evidence-and-example... It turns out we can directly compare pre-1962 FDA with the current FDA and find strong harms outweighing any benefit of the current regime. If all the FDA did was "enforce accurate labelling", they wouldn't be responsible for hundreds of thousands of deaths from delayed approval of drugs. Maybe that's not the part people are complaining about.
- dTal 7y ago
  That might be a valid point if the parent comment had been similarly nuanced. But it said "no government supervision", not "roll back to 1962". I find this kind of motte-and-bailey stuff ubiquitous in discussions with libertarians, as the "philosophy" amounts to anarchy which most people realize is bad.
  - ikeboy 7y ago
    Note that I'm not the one who posted the parent comment. Anyway, the Milton Friedman talk linked explicitly mentions the same beta-blockers example as my link discusses and cites it as causing tens of thousands of deaths. He says it's been a disaster over "the last 20 years" - the talk was in 1978, so this is roughly the 1962-1978 period. And the "governmental supervision for health care" mentioned is broader than the FDA.
dnautics 7y ago
You don't talk to libertarians much, do you? I don't know many libertarians that would argue that accurate labelling shouldn't be enforced by the law. Drugs quality testing could also conceivably be performed by a non-government regulatory agency (e.g. Underwriters Labs)

vincnetas 7y ago

As a recipient of free healthcare, i would never ever like to see "free market" near my "paid by government" healthcare.

hannob 7y ago

So what you're saying is because FDA isn't enforcing rules strictly enough we should leave it to free markets and have no rules at all? Libertarian logic I guess...

allovernow 7y ago
Consumers unload responsibilities onto regulatory bodies. When the regulators function appropriately, the result is better than no regulation. When regulatory agencies are captured by industry and better serve commercial rather than citizen interests, it is unlikely that citizens will recognize that their government is no longer working for them. At this point it may be better for consumers to be forced to pay more attention to the product. And this creates multiple points of competition, unlike regulation which is somewhat anticompetitive. Transparency, efficacy, cost, reviews in the age of the internet, all combine as a form of emergent regulation which may outperform explicit agencies in some cases.
- UnFleshedOne 7y ago
  If the state of online reviews is any indication, things would devolve into a clusterfuck of disinformation. Committees Of Concerned Citizens On The State Of Toothpaste will pop up and dissolve like mushrooms, some of them funded by this or that corporate interest, some being incompetent to evaluate state of anything, and the rest drowned in all the noise. Emergent anything only works if there is an explicit external force pushing things towards a specific organization or a set of laws of nature that produce outcome you happen to find satisfactory. I guess your point was that current state is worse than that already, and that's a valid point, although I don't think this is the case.

aalleavitch 7y ago

This would be a nightmare, the average consumer has absolutely no capacity to make informed judgments on their own healthcare, they would get eaten alive, and historically they have been.

jcranmer 7y ago

The general consensus of many workers in the industry is that the FDA's regulation is about right, rather than being either too tight or too lenient. It is willful or reckless ignorance to believe that the absence of the FDA will not have serious consequences. There already exists a segment of the drug industry that is nearly completely unregulated by the FDA, as a matter of law. I am of course speaking of the health or dietary supplements. And the experience here does not bode well: there are a sheer number of "miracle" pills and cures that come out of it, unhelpfully promoted by snake oil salesmen like Dr. Oz. And investigations have found that many companies can't even be bothered to put the active ingredients into their products.

ikeboy 7y ago
There's another area that's unregulated - off-label uses. See https://www.fdareview.org/issues/theory-evidence-and-examples-of-fda-harm/ https://www.fdareview.org/issues/theory-evidence-and-example... for a discussion of the evidence from off-label uses of approved drugs.
- loceng 7y ago
  From my own experience with the Canadian health system, mentioning it as basically a single payer system, not allowing off-label use causes problems - at least the lack of and ability to initiate in a cascading process to initiate research for off-label use is a problem.
loceng 7y ago
It can be argued both ways. Another option without FDA would be people will self-regulate: determine who they trust - individuals, organizations, or networks - and who they don't trust based on hearing word of mouth experiences being spread vs. people being manipulated via bombardment of shallow, cheap advertisements - allowing a functional mechanism of Darwinism while preventing regulatory capture and squashing of drugs that were known to provide great benefit - but couldn't be patented so were controlled - like marijuana, MDMA, psychocybin, etc; presumably anything that kept in circulation in the black market was providing individuals with benefit, and arguably things like opiates kept and pumped into the public market did far more harm than even perhaps the total of harm caused by the black market drugs. Edit: Just to clarify, I'm not arguing for or against here, I just stated another option - so thanks for that downvote whoever the lazy person was did it.

tehjoker 7y ago

Naomi Klein on Milton Friedman: https://www.theguardian.com/commentisfree/cifamerica/2010/mar/03/chile-earthquake https://www.theguardian.com/commentisfree/cifamerica/2010/ma... Friedman and the "Chicago Boys" advised Augusto Pinochet in Chile and used his dicatorial powers to ram through changes into the Chilean economy. I don't think Friedman is someone to admire.

Angostura 7y ago

Welcome to GoopTV!