4 ms·

I found all of that remarkably prescient except for this: >To reach that age you'll need to know enough to make more complicated medical choices: Do I want to

• WalterBright 6y ago
  > Why do we always seem to wildly overestimate progress in medicine? Because we dismiss the role the FDA regulations have in greatly retarding innovation.
  • rswail 6y ago
    Or maybe it's because the human body is an incredibly complex mechanism and our analysis skills for determining the impact of making changes to that mechanism are yet to reach the levels we need.
    • WalterBright 6y ago
      Or maybe it's the regulations. See "Regulation of Pharmaceutical Innovation" by Sam Peltzman.
  • Apocryphon 6y ago
    The FDA is not the enforcer of the laws of physics preventing the invention of medical nanites.
  • elil17 6y ago
    If it was the FDA's fault, you'd see scientists regrowing limbs and testing nano-bots in rats. The FDA actually has a great system of emergency and compassionate use authorizations that allow early testing of experimental drugs and devices. These systems came into place because of a long history of medical disasters: see thalidomide, Elixir sulfanilamide, and so many more.
    • WalterBright 6y ago
      I'm not arguing the reason for the regulations. I'm pointing out that the regulations greatly slow down and increase the cost of medical innovations.
      • thombat 6y ago
        True, but it isn't the case that we know how to repair blood vessels or regrow limbs in other vertebrates. Medical regulations haven't retarded basic research, it's just that biology is fundamentally very complex and most medical progress amounts to diligent iteration of inspired guesswork and observation.
        • WalterBright 6y ago
          People are not likely to invest in research and development without a corresponding probability of making money off of it. The regulations make that very difficult.
          • elil17 6y ago
            That’s why the government provides drug research grants and 20-year drug monopolies (aka patents)
            • WalterBright 6y ago
              Nowhere near enough to compensate for the costs and delays of the regulations, unless it is a blockbuster drug. Government research grants are doled out by a bureaucratic committee unwilling to take risks - so the grants are for safe, incremental, conservative, political gains. (After all, the committee has to answer to whoever their oversight bureaucrats are.) This is not where game-changing innovation comes from.
        • smabie 6y ago
          It's pretty hard to know the path not taken. I used to work at the FDA, and let me tell you, they're basic reason for existence is to slow down innovation. Many think it's worth it, but I personally believe that their risk aversion has hurt much more people than it has helped. But from a political perspective, it's the right move because no one is going to blame you for hypothetically preventing some life-saving wonder drug from existing; they're going to blame you for approving some drug that kills a bunch of people. In the first case, the harm is almost impossible to quantify or even reason about, in the second case the harm is direct and known.
  • adrianN 6y ago
    Do you want to go back to the days of snake oil salesmen or what alternative do you propose to a regulating body for medicine?
    • WalterBright 6y ago
      I propose that legally consenting adults can get whatever treatment they want, provided they are willing to sign a clear contract that the treatment has not been approved by the FDA. Approval by the FDA would also come with legal immunity from lawsuits if the treatment is later found to be defective. Those who are fearful of snake oil can choose to stick with only FDA approved treatments.
• excalibur 6y ago
  > More than 200,000 centenarians will inhabit the United States in 2020— why shouldn't you be one of them? Because I wasn't 80 when you wrote that?
• asveikau 6y ago
  People are optimistic that those problems can be solved. They also fear death.