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The issue is that there are too many barriers to commercialisation and the current stakeholders have too much power. The profitable fields like medicine strictl

The issue is that there are too many barriers to commercialisation and the current stakeholders have too much power. The profitable fields like medicine strictly limit the number of people accepted (the official explanation is that there aren't enough residencies, the unspoken reason is that the American Medical Association wants to keep salaries up) and FDA drug approval laws err on the side of caution; better to have 10 people die due to disease and lack of access to treatments than to have one person die due to a faulty drug that the FDA let through. This attitude and approach means that the time to market is huge and highly resource intensive. The COVID vaccines were designed in less than a day. It took a year to reach market even under the ridiculously accelerated approval pace.

earhart 6y ago
A close friend of mine made a career out of shepherding drugs through the FDA approval process. They’ve stated multiple times that in their professional experience, every single regulation is there because some asshat tried to cut corners so they could profit from snake oil. Additionally, the RNA vaccines were somewhat novel. In the future, maybe (hopefully!) we’ll be able to speed up the process, but for now, do you really want to give the entire population an experimental substance, with no tracking, with our woeful medical system, and see how it turns out, hoping to get lucky? Bearing in mind that the number of people you’d have to vaccinate for herd immunity is much larger than the number of people who’re likely to have a problem from Covid-19? I do grok that bureaucrats are incentivized to follow the precautionary principle, simply because people equate actions to responsibilities for outcomes and don’t tend to weight inaction so heavily. But overall, I’m really glad the FDA was so careful, and because of that care, I’ll happily get the shot once it’s available to low-risk people like myself; I’m very pro-vaccines, but even I wouldn’t have taken it a year ago.
phobosanomaly 6y ago
There's this loop in medical education where people come into it with lofty goals, but are then hit with $240k of tuition (excluding living expenses). They then take out loans on that, and then have to pay them back. So, when people talk about cutting salaries, there are all these new doctors that are going 'wait a minute, by this point I'm $300k (just on postgraduate training) in the hole after 4-years of hellish training, and I have to pay that back.' If we were able to take some of the debt burden out of medical education, you'd have people still lining up out the door to go to med school, they'd probably be willing to take lower salaries, and work in more underserved areas.
croissants 6y ago
> the unspoken reason is that the American Medical Association wants to keep salaries up I used to believe this, but the AMA claims that it's actually the US Congress that is keeping the number of residencies low [1]: > The American Medical Association (AMA) adopted policy at its Annual Meeting today to build upon its efforts aimed at modernizing and increasing funding for graduate medical education (GME). The new policy calls for the AMA to continue advocating for legislation that removes the caps on Medicare-funded residency positions, which were imposed by the Balanced Budget Amendment of 1997, to help ensure an adequate physician workforce to meet the nation’s growing needs for health care services. I'm not an expert on this though, so it's possible that this is all PR doublespeak. [1] https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...

earhart 6y ago

A close friend of mine made a career out of shepherding drugs through the FDA approval process. They’ve stated multiple times that in their professional experience, every single regulation is there because some asshat tried to cut corners so they could profit from snake oil. Additionally, the RNA vaccines were somewhat novel. In the future, maybe (hopefully!) we’ll be able to speed up the process, but for now, do you really want to give the entire population an experimental substance, with no tracking, with our woeful medical system, and see how it turns out, hoping to get lucky? Bearing in mind that the number of people you’d have to vaccinate for herd immunity is much larger than the number of people who’re likely to have a problem from Covid-19? I do grok that bureaucrats are incentivized to follow the precautionary principle, simply because people equate actions to responsibilities for outcomes and don’t tend to weight inaction so heavily. But overall, I’m really glad the FDA was so careful, and because of that care, I’ll happily get the shot once it’s available to low-risk people like myself; I’m very pro-vaccines, but even I wouldn’t have taken it a year ago.

phobosanomaly 6y ago

There's this loop in medical education where people come into it with lofty goals, but are then hit with $240k of tuition (excluding living expenses). They then take out loans on that, and then have to pay them back. So, when people talk about cutting salaries, there are all these new doctors that are going 'wait a minute, by this point I'm $300k (just on postgraduate training) in the hole after 4-years of hellish training, and I have to pay that back.' If we were able to take some of the debt burden out of medical education, you'd have people still lining up out the door to go to med school, they'd probably be willing to take lower salaries, and work in more underserved areas.

croissants 6y ago

> the unspoken reason is that the American Medical Association wants to keep salaries up I used to believe this, but the AMA claims that it's actually the US Congress that is keeping the number of residencies low [1]: > The American Medical Association (AMA) adopted policy at its Annual Meeting today to build upon its efforts aimed at modernizing and increasing funding for graduate medical education (GME). The new policy calls for the AMA to continue advocating for legislation that removes the caps on Medicare-funded residency positions, which were imposed by the Balanced Budget Amendment of 1997, to help ensure an adequate physician workforce to meet the nation’s growing needs for health care services. I'm not an expert on this though, so it's possible that this is all PR doublespeak. [1] https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...