61 ms·

Adderall anyone? There's a panoply of legal ways to obtain amphetamines, but the US medical system is far less competent at customer service than the black mark

Adderall anyone? There's a panoply of legal ways to obtain amphetamines, but the US medical system is far less competent at customer service than the black market due to regulatory capture. I think it's critical to appreciate that Physician Regulations, the AMA, etc. are the main culprits here. How they avoid getting properly blamed for things like the opioid epidemic, I have no idea.

brookst 4y ago
I suspect that most people who understand the role AMA plays in prohibition and drug abuse also aren’t super interested in focusing on blame. The whole thing is a complicated system of perverse incentives and counterproductive policies. It doesn’t really matter if the AMA is 20% or 60% to blame.
- alpineidyll3 4y ago
  Blame is a poor choice of words. Ideally we could stop letting physicians write their own regulations, and instead have at least one mechanism with incentive to promote national health, rather than the medical industry complex.
  - starkd 4y ago
    Traditionally, doctors, as men of science, have been given wide latitude to prescribe, since there is no one treatment that is good for everyone. Unfortunately, that seems to be changing, as doctors are expected to adhere to a standard regimen of treatment options. It is the dangers of institutionalization of our healthcare.
    - alpineidyll3 4y ago
      Calling doctors men of science is extraordinarily generous. Scientists do things like collect data to test hypotheses. The ama lobbies aggressively against national medical record standardization etc. At the end of the day, it's about whether the person making decisions has good incentives. And that's not the case in the present system.
      - starkd 4y ago
        I was being a bit facetious in using the term, but that was the image given to doctors once upon a time. Nevertheless, my point is that doctors are not mere technicians applying handbook remedies. They are generally given wide latitude to try novel ideas when appropriate. Unfortunately, that appears to be changing.

brookst 4y ago

I suspect that most people who understand the role AMA plays in prohibition and drug abuse also aren’t super interested in focusing on blame. The whole thing is a complicated system of perverse incentives and counterproductive policies. It doesn’t really matter if the AMA is 20% or 60% to blame.

alpineidyll3 4y ago
Blame is a poor choice of words. Ideally we could stop letting physicians write their own regulations, and instead have at least one mechanism with incentive to promote national health, rather than the medical industry complex.
- starkd 4y ago
  Traditionally, doctors, as men of science, have been given wide latitude to prescribe, since there is no one treatment that is good for everyone. Unfortunately, that seems to be changing, as doctors are expected to adhere to a standard regimen of treatment options. It is the dangers of institutionalization of our healthcare.
  - alpineidyll3 4y ago
    Calling doctors men of science is extraordinarily generous. Scientists do things like collect data to test hypotheses. The ama lobbies aggressively against national medical record standardization etc. At the end of the day, it's about whether the person making decisions has good incentives. And that's not the case in the present system.
    - starkd 4y ago
      I was being a bit facetious in using the term, but that was the image given to doctors once upon a time. Nevertheless, my point is that doctors are not mere technicians applying handbook remedies. They are generally given wide latitude to try novel ideas when appropriate. Unfortunately, that appears to be changing.