4 ms·

You start going in the right direction by talking about the cost of the FDA process, but then veer off into the weeds with a solution from extreme Libertarianis

by orev 6y ago

You start going in the right direction by talking about the cost of the FDA process, but then veer off into the weeds with a solution from extreme Libertarianism. History has shown over and over and over again that this type of hands-off approach and “let the consumer decide” mumbo jumbo absolutely does not work. It’s just as debunked as the trickle down economics theories. They have been tried so many times and failed every time. If I’m in the ER am I supposed to stop and check every single drug they give me before having emergency surgery? Is the hospital? Would we give the right for every citizen in the country to inspect the premises of every drug manufacturer? So now anyone must be allowed to walk into any factory whenever they want to see what’s going on? How should any layperson be expected to have the knowledge and expertise to even perform an evaluation? I can imagine some kind of review site where people post 1-star reviews like “took drugs, died anyway”. How many bad reviews/people dead would you say should be enough for a company to be removed?

wooby 6y ago
If you have any choice in how you are treated, you will make your best judgement based on information available to you, such as by the recommendation of a friend, or a Yelp review. This is the same process you use to make any important purchase. Before you have work done on your car, do you fly to China to inspect the part factory? You don't, because the relatively low risk you perceive that these parts will fail doesn't justify the expense of travel. Do you perceive low risk because a government agency put a stamp of approval on the part? Probably not. Most likely, your risk assessment is based on information you've gathered about the final product, the auto shop -- that it is well-reviewed, and that your mechanic seems knowledgeable. Furthermore, only you really know your exact needs. An expensive high-performance car part might provide you some marginal benefit, but not so much benefit that you're willing to buy that part at the expense of something else that's important to you, like your electric bill. A race car or Uber driver might make a different decision and choose a different part to suit their needs. Medicine is like car parts. Bad ones can kill. But through the free market, a system of feedback is established that tends toward a wider variety, and higher quality, of parts overall. When politicians prioritize some drugs over others, they interfere with this system, and money is spent on drugs and research that people don't necessarily want or need. You can imagine race car drivers getting together and lobbying politicians to subsidize high performance parts. Because these subsidies are funded by taxes, money is effectively taken from individuals who might prefer a different part. Now, those individuals who are not race car drivers have less purchasing power, and fewer choices overall. You're correct that this is more or less the libertarian perspective, but I find it in no way extreme. I find it principled, direct, and humane. In our society, where nearly everyone has a smart phone and may conduct research at any time, I can't imagine a more effective system. I'm sure it was much easier to criticize the free market in a time when people couldn't read, or didn't have a global information database accessible on their person at every waking moment.
- sithadmin 6y ago
  >Medicine is like car parts Creating medicines is nothing like creating car parts. At all. There's not a single aspect of drug discovery, manufacturing, or distribution logistics that in any way resembles something as crude as producing unregulated widgets for automobiles. You're simply highlighting how poorly you understand the pharmaceutical industry with this line of argumentation.
  - wooby 6y ago
    I mean only to say that they are both products, and that they may both result in injury or death if they are produced irresponsibly. Would you not agree with those two points of comparison?
    - sithadmin 6y ago
      I think it's an inane and inept comparison. The manner in which defects arise in each type of product, and the manner in which failure modes manifest are so different as to be incomparable.
      - wooby 6y ago
        I don't see how you can contest that they're both products and that they can both kill people if they're defective. To me these two similarities are plainly true, and it is only these two similarities that are material to my argument. I might misunderstand, but the direction your argument seems to be heading is that the free market is somehow incompatible with products that have complex failure modes or that can be defective in subtle ways, and that the FDA is thus necessary. Is that right?
- jcranmer 6y ago
  Man, if only there were some way we could run an experiment where we could see how the industry would react if drugs were not required to be vouched for by a regulatory agency. Wait, there is: the health supplement industry. You know, the people who can't be bothered to even put in their claimed active ingredients because it's all placebo anyways? The FDA was set up literally because of these snake oil situations, and modern evidence suggests that snake oil still thrives wherever the FDA is banned from setting foot.

by orev 6y ago

wooby 6y ago

If you have any choice in how you are treated, you will make your best judgement based on information available to you, such as by the recommendation of a friend, or a Yelp review. This is the same process you use to make any important purchase. Before you have work done on your car, do you fly to China to inspect the part factory? You don't, because the relatively low risk you perceive that these parts will fail doesn't justify the expense of travel. Do you perceive low risk because a government agency put a stamp of approval on the part? Probably not. Most likely, your risk assessment is based on information you've gathered about the final product, the auto shop -- that it is well-reviewed, and that your mechanic seems knowledgeable. Furthermore, only you really know your exact needs. An expensive high-performance car part might provide you some marginal benefit, but not so much benefit that you're willing to buy that part at the expense of something else that's important to you, like your electric bill. A race car or Uber driver might make a different decision and choose a different part to suit their needs. Medicine is like car parts. Bad ones can kill. But through the free market, a system of feedback is established that tends toward a wider variety, and higher quality, of parts overall. When politicians prioritize some drugs over others, they interfere with this system, and money is spent on drugs and research that people don't necessarily want or need. You can imagine race car drivers getting together and lobbying politicians to subsidize high performance parts. Because these subsidies are funded by taxes, money is effectively taken from individuals who might prefer a different part. Now, those individuals who are not race car drivers have less purchasing power, and fewer choices overall. You're correct that this is more or less the libertarian perspective, but I find it in no way extreme. I find it principled, direct, and humane. In our society, where nearly everyone has a smart phone and may conduct research at any time, I can't imagine a more effective system. I'm sure it was much easier to criticize the free market in a time when people couldn't read, or didn't have a global information database accessible on their person at every waking moment.

sithadmin 6y ago
>Medicine is like car parts Creating medicines is nothing like creating car parts. At all. There's not a single aspect of drug discovery, manufacturing, or distribution logistics that in any way resembles something as crude as producing unregulated widgets for automobiles. You're simply highlighting how poorly you understand the pharmaceutical industry with this line of argumentation.
- wooby 6y ago
  I mean only to say that they are both products, and that they may both result in injury or death if they are produced irresponsibly. Would you not agree with those two points of comparison?
  - sithadmin 6y ago
    I think it's an inane and inept comparison. The manner in which defects arise in each type of product, and the manner in which failure modes manifest are so different as to be incomparable.
    - wooby 6y ago
      I don't see how you can contest that they're both products and that they can both kill people if they're defective. To me these two similarities are plainly true, and it is only these two similarities that are material to my argument. I might misunderstand, but the direction your argument seems to be heading is that the free market is somehow incompatible with products that have complex failure modes or that can be defective in subtle ways, and that the FDA is thus necessary. Is that right?
jcranmer 6y ago
Man, if only there were some way we could run an experiment where we could see how the industry would react if drugs were not required to be vouched for by a regulatory agency. Wait, there is: the health supplement industry. You know, the people who can't be bothered to even put in their claimed active ingredients because it's all placebo anyways? The FDA was set up literally because of these snake oil situations, and modern evidence suggests that snake oil still thrives wherever the FDA is banned from setting foot.