6 ms·

Beyond "Abolish the FDA"

23 points by gHeadphone 3y ago

jdasdf 3y ago
[flagged]
- cj 3y ago
  > Companies will put whichever labels they feel are required because they are still liable for the problems their products cause. This is basic and standard tort law, no change Are we sure about this? On instagram I’m getting blasted with GPL-1 weight loss prescriptions and testosterone prescriptions (even though I’m in my 30’s, athletic, not overweight… I think? But these ads make me question even that…) If it weren’t for the “talk to a doctor” barrier and you could just click “get free sample” for wegovy or testosterone or whatever other drug, there will be a lot of abuse. Companies, especially startups, will skirt the law. They already do it and they don’t get in trouble. But the advertising industry + prescription drugs is a deadly combo. 1) convince people they have ailments that require treatment, 2) sell them an unneeded treatment. Maybe I would benefit from Wegovy / GPL-1? According to these instagram ads I will. And add in testosterone because, why not.
- cwillu 3y ago
  If your plan for abolishing the FDA is “and also abolish every other relevant arm of government at the same time”, you don't have a plan. “Full abolition of the FDA would have domino effects on every other part of healthcare. You would have to reform the insurance system, the War on Drugs, the medical evidence system, the malpractice system, and the entire role of doctors. All of these other things are terrible and should probably be reformed anyway. But you’d have to do it all at the same time, and get it all exactly right.”
  - ceejayoz 3y ago
    Nor much understanding of history. There’s a reason “snake oil salesman” is a term we have.
  - closewith 3y ago
    The libertarian fantasy is that they'll be the heroes of their own rugged individualism story, not the victim of contaminated drinking water and counterfeit medication.
- SmallDeadGuy 3y ago
  > If it's truly something consumers value... You're acting like consumers of medication have a choice. They _need_ certain medication and if the only option doesn't include safety inspections then they can't exactly just pick a different medication, they have to put their trust in a profit-driven company's hands or suffer and maybe die. Healthcare isn't something that should be sold as people are forced to buy it to survive. That allows crazy levels of exploitation, leading to insane prices like the U.S already has for medication, treatments, and medical insurance.
  - nickpp 3y ago
    > put their trust in a profit-driven company's hands Every single company making products and services we all use is profit-driven. > Healthcare isn't something that should be sold as people are forced to buy it to survive Healthcare is far from being the only essential good that I have to buy to survive. It's a merchandise like any other - the market rules still apply. Maybe emergency care is different (since I could be unconscious when buying it) but that's what insurance is for. That's what I use in countless other domains as well: car emergency assistance, travel emergency, etc.
    - sjsdaiuasgdia 3y ago
      >Maybe emergency care is different (since I could be unconscious when buying it) but that's what insurance is for. Hope the hospital your unconscious self is taken to happens to be in your insurance network, and that your insurance provider doesn't decide that what you went in for wasn't really an emergency.
      - nickpp 3y ago
        Also hope I will not lose my consciousness in the middle of the desert where there is no hospital. Yes, there are risks in life and you cannot protect yourself from every possible danger. Life is harsh.
        sjsdaiuasgdia 3y ago
- croes 3y ago
  Companies sell products which literally kills their customers and you think without any control that would get better? You won't find effective medication in the mass of snake oil that would hit the market.
  - ekianjo 3y ago
    > Companies sell products which literally kills their customers and you think without any control that would get better The FDA is killing people on a daily basis by being so slow and bureaucratic to review life saving drugs. But its the dog that does not bark so people are completely oblivious to it.
    - croes 3y ago
      The FDA doesn't make the laws.
- developer93 3y ago
  The trouble with libertarianism is that it assumes everyone has perfect knowledge. Right now I don't need to do a ton of research about what drugs I'm taking, or the food I'm eating, come to that, because there are agencies making sure that things I buy which are labeled as such will nearly never kill me. I don't want to spend my evenings reading about esoteric stuff that I don't have to care about now, I want to watch streaming or play computer games. Even if I did, Covid has already shown us how bad most people are at recognising good research from propaganda. I just don't feel like it would end well.
  - nickpp 3y ago
    > it assumes everyone has perfect knowledge Nobody says that. Free markets are actually the best mechanism to deal with situations in which participants have partial/imperfect knowledge. > I don't need to do a ton of research about what drugs I'm taking I do, and I recommend all do. Just the other week my ear doctor gave me a prescription for an antibiotic that had as a side effect a significant chance of ligament fracture. I went back and he changed it to a milder, less aggressive medicine.
    - developer93 3y ago
      You don't generally have to check if your food is made with lead or carcinogens though right? And if inspections aren't compulsory some people are going to get lead poisoning before word gets around, or get cancer decades later and never know. Better to have someone qualified to check it before it gets to the shelves. Granted I'm using lead as a hyperbolic example, but I'm sure you get the point I'm trying to make. Why are free markets better at dealing with partial knowledge?
- hanselot 3y ago
  Watch as they come to downvote you for not welcoming more regulation and nanny state culture, while contributing nothing. There's a reason I leave dead comments on. It's where all the interesting things are. This place is the perfect hybrid between 4chan and reddit, but sadly the reddit side is obsessed with censoring dissenting thought into oblivion. Though I don't need to say that, that's the thing everyone will keep regurgitating as prime reason to stay here. What I don't understand is why we don't just colour code the opinions instead of hiding them. Simply make the thoughts of people that are considered alternative red and everything else green or something. Use an llm to assign the colours. I also don't understand why arguing in bad faith is unsupported. Bad faith actors are the people you need to convince, why would you need to convince the borg, you are already among them.
  - Propelloni 3y ago
    Oh, grandma, look! A dismissive person being angry about being dismissed.
- raverbashing 3y ago
  > Companies will put whichever labels they feel are required because they are still liable for the problems their products cause. This is basic and standard tort law, no change required here. Company gets sued because warning is missing, adds warning back, go back to square one (warnings are legally mandated). Mind that a lot of those warnings come about after drug testing and subsequent pharmacovigilance work. > Companies are welcome to have inspectors come in and certify that the drugs are safe, just like they do when ratings agencies rate their debts. Yes, because that works wonderfully. I'm sure all AAA bonds are solid (and that even with the SEC). Oh wait
- sjsdaiuasgdia 3y ago
  >Companies will put whichever labels they feel are required because they are still liable for the problems their products cause. This is basic and standard tort law, no change required here. A few problems here... It's hard to sue if you're dead. Yeah, your family can sue, but now they're dealing with that on top of you being dead. And there is nothing the court can do to un-dead you. In addition to not being able to un-dead you, the court can't fix the disability or other permanent issues you're now dealing with. Sure, the court can award you damages. While there are probably exceptions, most people would probably rather have their health and quality of life. Dealing with it through tort law alone means that the damage must go all the way through to occurring. That damage can often not be undone to any real degree, only kinda covered up with cash. That presumes the poison peddler hasn't protected themselves with an army of shell companies, or siphoned the funds off into another country, etc. Waiting until the damage happens for every single instance is sticking fingers in ears at societal scale.
  - darkerside 3y ago
    Also, who investigates wrongdoing? Police, FBI, FTC? Why would unenforced and rampant corruption not be the norm? Sure, you sue, and the pharma produces doctored evidence. How do you find out, and how do you confirm it, and how do you make sure they are punished? The FBI has a lot of other shit going on.
- LastTrain 3y ago
  >Don’t all reasonable people ignore labels because they’re useless? Sounds like once you're no longer obligated to put them in, the only ones left will be the useful ones. Come on this the very reason we have an FDA and its origin story - false labels were rampant before that and caused real harm.
- knome 3y ago
  we did 'caveat emptor'. we created the FDA because it was awful for everyone. no customer individually has the capacity or resources to figure out which of a hundred companies are the ones selling adulterated foods or simply lying about medicines working and throwing narcotics in all of them. I don't know if you're trolling or if you just don't care about anyone and would happily see millions poisoned for the sake of profits for liars and cheats.
  - starlevel003 3y ago
    This is HN, so the answer to that question should be very obvious.
- butterknife 3y ago
  Just watch a chain of pharmacies emerge from the ashes with advertised regulation that will eventually become a role model for competitors and they will all try to band together and establish a "neutral" administer of said regulation. Consumers will demand it.
ekianjo 3y ago
> Are we also eliminating factory inspections to make sure drugs aren’t contaminated? > Right now the FDA does this too Not really. They come and check and confirm your procedures are in line with a bunch of paper standards. In no way they can guarantee the lack of contamination.
- closewith 3y ago
  And yet following the introduction of those paper regulations, the amount of factory contamination fell to near-zero. What a coincidence.
  - ekianjo 3y ago
    How do you know it fell to zero? Are you personally overseing the testing of all drug batches and ensuring all equipment is calibrated at all times?
    - yosame 3y ago
      In Australia at least, you need to maintain records showing testing of each batch and equipment calibration. Government auditors can come at anytime to review the records, and will shut things down if records are missing/altered/or lacking. Pharmaceutical manufacturers aren't constantly shutting down, so we can assume contamination is fairly low.
      - MichaelZuo 3y ago
        Just because people write a very low or zero value in the records doesn't mean that's actually true for the product that physically is consumed. At best it can be said to imply what's likely the case in physical reality. But even assuming a very low corruption rate of 0.1%, that's still hundreds of bad record writers putting out bogus records.
- nick2k3 3y ago
  You clearly have never participated in an FDA audit as the party under scrutiny. They look into a lot of things, and their auditors have a lot of experience and know where to look for mistakes. Their m.o. is to keep digging: if they find something that is not quite right they start asking about who did it, who supervised it, what else that person has worked on... so on and so forth until they find something. It's pretty terrifying to witness..
drtournier 3y ago
Just read two paragraphs and sounded like someone asked ChatGPT to write this thing as a Joe Rogan podcast.
ekianjo 3y ago
Much of that post fails to adress the fact we lived thousands of years fine without the FDA and that the FDA commits some of the most egregious crimes by being wholly corrupt with a sliding door between corps and administrators and delaying life saying drugs for no reason. They have a huge amount of blood on their hands.
- closewith 3y ago
  > Much of that post fails to adress the fact we lived thousands of years fine without the FDA ...
- starlevel003 3y ago
  > we lived thousands of years fine without the FDA For those thousands of years our only medicine was "ground up unicorn toe".
  - ekianjo 3y ago
    I did not know that medecine was a 20th century science and that we lived in dark ages until the year 1899
    - RandomLensman 3y ago
      Pretty close, maybe more like mid-19th century as far as the "chemistry side" is concerned.
    - TeMPOraL 3y ago
      We effectively did. Look around where you are. Unless you're in the middle of a forest, pretty much every single thing you see is the result of scientific and technological advancements of the last 150 years. Half of it probably owes its existence to the oft forgotten chemical and petrochemical revolutions that started about 100 years ago. Before that? Before the tail end of 19th century, we knew fuck all about anything. Medicine, in particular, graduated from voodoo and aforementioned "ground up unicorn toe" into a proper science and profession, also about 100 years ago. It's really hard to overstate how different 20th century science and technology is from anything that came before. We've crossed a qualitative threshold there.
michaelt 3y ago
> Are we also eliminating the concept of prescription medication? [...] Do you also want all medications to be available without a prescription? A few years ago I watched a video of a debate among people seeking the Libertarian Party presidential nomination [1] where I learned that Libertarians honestly and earnestly believe you shouldn't need a license to drive a car. I am pretty sure a Libertarian would see no problem with offering cocaine, fentanyl and warfarin off the shelf in corner stores. Of course, how this intersects with the Ivermectin lovers of the Republican party I'm not sure. [1] https://www.youtube.com/watch?v=PcllE7fx8-I https://www.youtube.com/watch?v=PcllE7fx8-I
ekianjo 3y ago
> Or rather, there will be studies, but they’ll be much smaller. And the pharma companies will figure out ways to manipulate them. The only reason we have big, less-than-completely-manipulated studies is that the FDA demands it, and employs lots of experts to figure out which studies have been manipulated or not. LOL the blind trust that the author has for the seriousness of the FDA when it comes to clinical studies is absolutely laughable. The same FDA approved Vioxx and let Oxycontin ravage the US for years before moving any finger, and because of public pressure rather than anything else. Its failures speak volumes on how useless that agency is. Besides it is very easy to design clinical trials to make your drug look better than it actually is, and p hacking is still a thing. The FDA is the cargo cult of clinical science.
- nabla9 3y ago
  Pattern. Replace X with government agency if you are from the right. Capitalism if you are from the left. 1. X has huge positive impact overall. 2. Something bad related to X 3. Emotional rage quit. X is bullshit. Alternative. Try to think what is the total effect overall. Don't be emotional.
- 303uru 3y ago
  Of the thousands of drugs on market and thousands more the FDA has kept from market let's blow the whole thing up over a few anecdotes. Disregard that the true problem is not properly separating capital from scientific regulation. Instead propose a solution that turns the entire system of to capital. Great plan.
ethanbond 3y ago
Another important question: how will pharma companies even know whether their drugs work? It’s ridiculously, ridiculously hard to figure this out even if you’re not a bad actor and you do have a drug that works. The only reason to go through that effort is for FDA’s stamp.
- ekianjo 3y ago
  Insurers. They would set up their own monitoring systems to insure drugs that work even if the FDA did not exist.
  - RandomLensman 3y ago
    Why would drug manufacturers do that (instead of just using a limited corp per drug, for example)? Why would insurers take on some massive tail risk (and how would they get the capital for that)?
    - from-nibly 3y ago
      I think insurers would just put pressure on the companies. They would just not pay for the medication unless it was proven to not put their customers at risk, lest they have to pay for the treatment of the treatment.
      - RandomLensman 3y ago
        The health insurer might not be the same as the one taking the tail risk on the medication.
port515 3y ago
[flagged]
- closewith 3y ago
  I mean, by default this is true. They are federal and state agencies, after all.
jfasi 3y ago
Libertarianism is a two-part ideology that holds that first, despite all the clear signs around us, the world is simple. In a simple world, what is the point of regulation, policy, or any other collective action, for that matter? Why not abolish everything? On its face, this isn't an insane point of view. It's natural to look at the scope and complexity of government and as yourself "is all this really necessary?" While it'll never achieve mainstream status, some tinges of libertarianism contribute meaningfully as a counterweight to the tendency of government to grow beyond the point of diminishing returns to society. The problem is, the ideology has a second, usually unspoken tenet: anyone who suffers brought it upon themselves. Hacker stole your bitcoins? Should have used a hardware wallet. Hospital bills driving you to bankruptcy? This is what you get for not saving for a rainy day. Poisoned by shoddily produced medicine? Hey, you get what you pay for. It's an ideology of arrogance. Both intellectual arrogance, as its dunning-kruger afflicted adherents look over the vast and complex world and say "how hard could it possibly be?" to every challenge they perceive, and also of moral arrogance, as those same people cast their eyes over the depth of human suffering and inexplicably think "I've got mine, you all are on your own." The reason why libertarians always lose is because anyone who isn't a billionaire would spend their entire existence looking over their shoulder in terror at the infinite ways life can screw you. And even then they would probably fail. Any reasonable person would gladly hand over the right to sell medicine they mixed in their own basement in exchange for knowing they won't be poisoned when they need help themselves.
- deleted 3y ago
  [deleted]
- friend_and_foe 3y ago
  I think libertarianism is an ideology that says that people have the right to take responsibility for their own lives and make their own decisions for themselves without getting anyone's permission. That's what I see anyway. I could be hyperbolic and say something like "it's nice that you think human beings are stupid and need a mommy to make all their decisions for them" or "guard rails can be used to lead cattle to slaughter" but I think you just genuinely believe the second point you made. The world might not be simple, but I think humans are perfectly capable of navigating the complexity on their own. That's really the crux of this disagreement. It's an ideology that says human beings are very capable and good when left to their own faculties the vast majority of the time and that it is ineffective to take away their right to self actualize in a failed attempt to try to prevent the instances when that is not the case. Side note, dunning Kruger has been discredited as statistical bias, I only know because I see a post about it on this site almost once a week.
jmyeet 3y ago
Obligatory pointer to how libertarians were defeated by bears [1]. Libertarians and neoliberals at this point are essentially indistinguishable. Neoliberalism is just a thinly-veiled wealth transfer to the already-rich through deregulation and tax cuts, masquerading as "market-based reforms" at the altar of the "free market". The "free market" itself is a myth because a well-functioning market requires strong government. It requires regulation. So when you see something like regulatory capture, which is a real problem, and companies bypassing the very regulation that limits their excesses and thinking the solution is less regulation. It's nonsencial. [1]: https://www.vox.com/policy-and-politics/21534416/free-state-project-new-hampshire-libertarians-matthew-hongoltz-hetling https://www.vox.com/policy-and-politics/21534416/free-state-...
redeux 3y ago
> … are all medications freely available at the corner store? Does this include warfarin, where getting the dose slightly wrong makes you bleed to death? Does it include MAOIs, where eating cheese after use makes your blood vessels explode? Obviously you put these things on the label … Who puts these things on the label and why? I don’t understand what’s obvious about this in a laissez-faire system. The author seems to argue for the removal of medication safety regulation in one area (FDA) but imply that there would still be safety regulations in regards to labeling? This seems like a huge contradiction to me.
- 303uru 3y ago
  Congrats, you just speared the stupidity of the libertarian dream in a sentence. As a pharmacist, it's terrifying that anyone is even broaching the idea of ending the FDA and putting all medications OTC.
  - friend_and_foe 3y ago
    Well, prior to the modern age, people self medicated. All compounds were freely available in most countries. You didn't need anyone's permission to find them and take them. Was it better? I don't know. I doubt you'd have many of the extremely effective medicines that have been invented since then. But I also don't think restricting medications has done anything to help curb addiction for example, and in my opinion the situation we live in where people just assume something is safe just because it's on the shelf of a store is a bad outcome of outsourcing personal safety to a government agency. I'm very diligent about what I put into my body, and I think most people would also be if they realized they needed to be, most people have a false sense of security as an adverse side effect of governments taking the role of claiming something is safe. I like not having lead in my turmeric, I like being able to see what's in my food by looking at the label. But I don't like having to pay someone a few hundred bucks just to get permission to numb some acute pain I feel from time to time due to a chronic condition. I skirt that law using a "supplement", but I don't think I should have to. All in all I think there's room for improvement. A lot of room. I'm not quite ready to say the government shouldn't have anything to say about the way things are done but I am ready to say they should have a much less prominent role.
supriyo-biswas 3y ago
The list of warnings issued by the FDA[1] to pharmaceuticals should serve as a great reminder of what can happen without a regulatory agency. [1] https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/compliance-actions-and-activities/warning-letters https://www.fda.gov/inspections-compliance-enforcement-and-c...
derbOac 3y ago
There's echoes of the "defund the police" controversy in "abolish the FDA". I doubt abolishing the FDA will happen, and I'm not sure many people who argue for it really literally mean to completely abolish it. What they mean is something closer to "radically overhaul the FDA" or "abolish it in its current form and rebuild it in a different way". These types of political positions happen because serious problems get dismissed by the status quo and nothing changes. There's a kind of false equivalence that's implicit — "arguing that X is a problem with agency B means you want all these other horrible consequences of getting rid of B" so nothing happens. After awhile, with nothing changing, it seems like the only option is to argue against eliminating the agency because valid criticisms just get spun away politically, and opponents of real change seem to frame the choices that way. Even now, I suspect discussions like this about the FDA only exist in a small bubble like Scott's readership. Most of the US doesn't have these ideas in their consciousness probably, so the problems get swept aside, and only bubble up if calls for dramatic changes like abolishment are discussed as a kind of intellectual punching bag for entertainment, and as a distraction from making real, serious reform. I would have been more impressed with this post if it had offered solutions to the problems involved. What it offers as proposals aren't bad, but sidestep the real problems and in one case just obfuscate things more. I don't think the FDA should be abolished, but I do think its role should be restricted to labeling fraud, product purity testing, and enforcing transparency in product efficacy evidence. For me, the FDA is just one problem in a litany of problems with healthcare related to regulatory capture. The US desperately needs medical deregulation — or at least reregulation. Arguments against this in the form of fear mongering without offering reform proposala are starting to feel to me like they really mean the status quo is fine and nothing really needs to change.
fabiofzero 3y ago
This is such a stupid idea that I don't know why people are discussing it. On the other hand this is HackerNews.

23 points by gHeadphone 3y ago

jdasdf 3y ago

[flagged]

cj 3y ago
> Companies will put whichever labels they feel are required because they are still liable for the problems their products cause. This is basic and standard tort law, no change Are we sure about this? On instagram I’m getting blasted with GPL-1 weight loss prescriptions and testosterone prescriptions (even though I’m in my 30’s, athletic, not overweight… I think? But these ads make me question even that…) If it weren’t for the “talk to a doctor” barrier and you could just click “get free sample” for wegovy or testosterone or whatever other drug, there will be a lot of abuse. Companies, especially startups, will skirt the law. They already do it and they don’t get in trouble. But the advertising industry + prescription drugs is a deadly combo. 1) convince people they have ailments that require treatment, 2) sell them an unneeded treatment. Maybe I would benefit from Wegovy / GPL-1? According to these instagram ads I will. And add in testosterone because, why not.
cwillu 3y ago
If your plan for abolishing the FDA is “and also abolish every other relevant arm of government at the same time”, you don't have a plan. “Full abolition of the FDA would have domino effects on every other part of healthcare. You would have to reform the insurance system, the War on Drugs, the medical evidence system, the malpractice system, and the entire role of doctors. All of these other things are terrible and should probably be reformed anyway. But you’d have to do it all at the same time, and get it all exactly right.”
- ceejayoz 3y ago
  Nor much understanding of history. There’s a reason “snake oil salesman” is a term we have.
- closewith 3y ago
  The libertarian fantasy is that they'll be the heroes of their own rugged individualism story, not the victim of contaminated drinking water and counterfeit medication.
SmallDeadGuy 3y ago
> If it's truly something consumers value... You're acting like consumers of medication have a choice. They _need_ certain medication and if the only option doesn't include safety inspections then they can't exactly just pick a different medication, they have to put their trust in a profit-driven company's hands or suffer and maybe die. Healthcare isn't something that should be sold as people are forced to buy it to survive. That allows crazy levels of exploitation, leading to insane prices like the U.S already has for medication, treatments, and medical insurance.
- nickpp 3y ago
  > put their trust in a profit-driven company's hands Every single company making products and services we all use is profit-driven. > Healthcare isn't something that should be sold as people are forced to buy it to survive Healthcare is far from being the only essential good that I have to buy to survive. It's a merchandise like any other - the market rules still apply. Maybe emergency care is different (since I could be unconscious when buying it) but that's what insurance is for. That's what I use in countless other domains as well: car emergency assistance, travel emergency, etc.
  - sjsdaiuasgdia 3y ago
    >Maybe emergency care is different (since I could be unconscious when buying it) but that's what insurance is for. Hope the hospital your unconscious self is taken to happens to be in your insurance network, and that your insurance provider doesn't decide that what you went in for wasn't really an emergency.
    - nickpp 3y ago
      Also hope I will not lose my consciousness in the middle of the desert where there is no hospital. Yes, there are risks in life and you cannot protect yourself from every possible danger. Life is harsh.
      - sjsdaiuasgdia 3y ago
croes 3y ago
Companies sell products which literally kills their customers and you think without any control that would get better? You won't find effective medication in the mass of snake oil that would hit the market.
- ekianjo 3y ago
  > Companies sell products which literally kills their customers and you think without any control that would get better The FDA is killing people on a daily basis by being so slow and bureaucratic to review life saving drugs. But its the dog that does not bark so people are completely oblivious to it.
  - croes 3y ago
    The FDA doesn't make the laws.
developer93 3y ago
The trouble with libertarianism is that it assumes everyone has perfect knowledge. Right now I don't need to do a ton of research about what drugs I'm taking, or the food I'm eating, come to that, because there are agencies making sure that things I buy which are labeled as such will nearly never kill me. I don't want to spend my evenings reading about esoteric stuff that I don't have to care about now, I want to watch streaming or play computer games. Even if I did, Covid has already shown us how bad most people are at recognising good research from propaganda. I just don't feel like it would end well.
- nickpp 3y ago
  > it assumes everyone has perfect knowledge Nobody says that. Free markets are actually the best mechanism to deal with situations in which participants have partial/imperfect knowledge. > I don't need to do a ton of research about what drugs I'm taking I do, and I recommend all do. Just the other week my ear doctor gave me a prescription for an antibiotic that had as a side effect a significant chance of ligament fracture. I went back and he changed it to a milder, less aggressive medicine.
  - developer93 3y ago
    You don't generally have to check if your food is made with lead or carcinogens though right? And if inspections aren't compulsory some people are going to get lead poisoning before word gets around, or get cancer decades later and never know. Better to have someone qualified to check it before it gets to the shelves. Granted I'm using lead as a hyperbolic example, but I'm sure you get the point I'm trying to make. Why are free markets better at dealing with partial knowledge?
hanselot 3y ago
Watch as they come to downvote you for not welcoming more regulation and nanny state culture, while contributing nothing. There's a reason I leave dead comments on. It's where all the interesting things are. This place is the perfect hybrid between 4chan and reddit, but sadly the reddit side is obsessed with censoring dissenting thought into oblivion. Though I don't need to say that, that's the thing everyone will keep regurgitating as prime reason to stay here. What I don't understand is why we don't just colour code the opinions instead of hiding them. Simply make the thoughts of people that are considered alternative red and everything else green or something. Use an llm to assign the colours. I also don't understand why arguing in bad faith is unsupported. Bad faith actors are the people you need to convince, why would you need to convince the borg, you are already among them.
- Propelloni 3y ago
  Oh, grandma, look! A dismissive person being angry about being dismissed.
raverbashing 3y ago
> Companies will put whichever labels they feel are required because they are still liable for the problems their products cause. This is basic and standard tort law, no change required here. Company gets sued because warning is missing, adds warning back, go back to square one (warnings are legally mandated). Mind that a lot of those warnings come about after drug testing and subsequent pharmacovigilance work. > Companies are welcome to have inspectors come in and certify that the drugs are safe, just like they do when ratings agencies rate their debts. Yes, because that works wonderfully. I'm sure all AAA bonds are solid (and that even with the SEC). Oh wait
sjsdaiuasgdia 3y ago
>Companies will put whichever labels they feel are required because they are still liable for the problems their products cause. This is basic and standard tort law, no change required here. A few problems here... It's hard to sue if you're dead. Yeah, your family can sue, but now they're dealing with that on top of you being dead. And there is nothing the court can do to un-dead you. In addition to not being able to un-dead you, the court can't fix the disability or other permanent issues you're now dealing with. Sure, the court can award you damages. While there are probably exceptions, most people would probably rather have their health and quality of life. Dealing with it through tort law alone means that the damage must go all the way through to occurring. That damage can often not be undone to any real degree, only kinda covered up with cash. That presumes the poison peddler hasn't protected themselves with an army of shell companies, or siphoned the funds off into another country, etc. Waiting until the damage happens for every single instance is sticking fingers in ears at societal scale.
- darkerside 3y ago
  Also, who investigates wrongdoing? Police, FBI, FTC? Why would unenforced and rampant corruption not be the norm? Sure, you sue, and the pharma produces doctored evidence. How do you find out, and how do you confirm it, and how do you make sure they are punished? The FBI has a lot of other shit going on.
LastTrain 3y ago
>Don’t all reasonable people ignore labels because they’re useless? Sounds like once you're no longer obligated to put them in, the only ones left will be the useful ones. Come on this the very reason we have an FDA and its origin story - false labels were rampant before that and caused real harm.
knome 3y ago
we did 'caveat emptor'. we created the FDA because it was awful for everyone. no customer individually has the capacity or resources to figure out which of a hundred companies are the ones selling adulterated foods or simply lying about medicines working and throwing narcotics in all of them. I don't know if you're trolling or if you just don't care about anyone and would happily see millions poisoned for the sake of profits for liars and cheats.
- starlevel003 3y ago
  This is HN, so the answer to that question should be very obvious.
butterknife 3y ago
Just watch a chain of pharmacies emerge from the ashes with advertised regulation that will eventually become a role model for competitors and they will all try to band together and establish a "neutral" administer of said regulation. Consumers will demand it.

ekianjo 3y ago

> Are we also eliminating factory inspections to make sure drugs aren’t contaminated? > Right now the FDA does this too Not really. They come and check and confirm your procedures are in line with a bunch of paper standards. In no way they can guarantee the lack of contamination.

closewith 3y ago
And yet following the introduction of those paper regulations, the amount of factory contamination fell to near-zero. What a coincidence.
- ekianjo 3y ago
  How do you know it fell to zero? Are you personally overseing the testing of all drug batches and ensuring all equipment is calibrated at all times?
  - yosame 3y ago
    In Australia at least, you need to maintain records showing testing of each batch and equipment calibration. Government auditors can come at anytime to review the records, and will shut things down if records are missing/altered/or lacking. Pharmaceutical manufacturers aren't constantly shutting down, so we can assume contamination is fairly low.
    - MichaelZuo 3y ago
      Just because people write a very low or zero value in the records doesn't mean that's actually true for the product that physically is consumed. At best it can be said to imply what's likely the case in physical reality. But even assuming a very low corruption rate of 0.1%, that's still hundreds of bad record writers putting out bogus records.
nick2k3 3y ago
You clearly have never participated in an FDA audit as the party under scrutiny. They look into a lot of things, and their auditors have a lot of experience and know where to look for mistakes. Their m.o. is to keep digging: if they find something that is not quite right they start asking about who did it, who supervised it, what else that person has worked on... so on and so forth until they find something. It's pretty terrifying to witness..

drtournier 3y ago

Just read two paragraphs and sounded like someone asked ChatGPT to write this thing as a Joe Rogan podcast.

ekianjo 3y ago

Much of that post fails to adress the fact we lived thousands of years fine without the FDA and that the FDA commits some of the most egregious crimes by being wholly corrupt with a sliding door between corps and administrators and delaying life saying drugs for no reason. They have a huge amount of blood on their hands.

closewith 3y ago
> Much of that post fails to adress the fact we lived thousands of years fine without the FDA ...
starlevel003 3y ago
> we lived thousands of years fine without the FDA For those thousands of years our only medicine was "ground up unicorn toe".
- ekianjo 3y ago
  I did not know that medecine was a 20th century science and that we lived in dark ages until the year 1899
  - RandomLensman 3y ago
    Pretty close, maybe more like mid-19th century as far as the "chemistry side" is concerned.
  - TeMPOraL 3y ago
    We effectively did. Look around where you are. Unless you're in the middle of a forest, pretty much every single thing you see is the result of scientific and technological advancements of the last 150 years. Half of it probably owes its existence to the oft forgotten chemical and petrochemical revolutions that started about 100 years ago. Before that? Before the tail end of 19th century, we knew fuck all about anything. Medicine, in particular, graduated from voodoo and aforementioned "ground up unicorn toe" into a proper science and profession, also about 100 years ago. It's really hard to overstate how different 20th century science and technology is from anything that came before. We've crossed a qualitative threshold there.

michaelt 3y ago

> Are we also eliminating the concept of prescription medication? [...] Do you also want all medications to be available without a prescription? A few years ago I watched a video of a debate among people seeking the Libertarian Party presidential nomination [1] where I learned that Libertarians honestly and earnestly believe you shouldn't need a license to drive a car. I am pretty sure a Libertarian would see no problem with offering cocaine, fentanyl and warfarin off the shelf in corner stores. Of course, how this intersects with the Ivermectin lovers of the Republican party I'm not sure. [1] https://www.youtube.com/watch?v=PcllE7fx8-I https://www.youtube.com/watch?v=PcllE7fx8-I

ekianjo 3y ago

> Or rather, there will be studies, but they’ll be much smaller. And the pharma companies will figure out ways to manipulate them. The only reason we have big, less-than-completely-manipulated studies is that the FDA demands it, and employs lots of experts to figure out which studies have been manipulated or not. LOL the blind trust that the author has for the seriousness of the FDA when it comes to clinical studies is absolutely laughable. The same FDA approved Vioxx and let Oxycontin ravage the US for years before moving any finger, and because of public pressure rather than anything else. Its failures speak volumes on how useless that agency is. Besides it is very easy to design clinical trials to make your drug look better than it actually is, and p hacking is still a thing. The FDA is the cargo cult of clinical science.

nabla9 3y ago
Pattern. Replace X with government agency if you are from the right. Capitalism if you are from the left. 1. X has huge positive impact overall. 2. Something bad related to X 3. Emotional rage quit. X is bullshit. Alternative. Try to think what is the total effect overall. Don't be emotional.
303uru 3y ago
Of the thousands of drugs on market and thousands more the FDA has kept from market let's blow the whole thing up over a few anecdotes. Disregard that the true problem is not properly separating capital from scientific regulation. Instead propose a solution that turns the entire system of to capital. Great plan.

ethanbond 3y ago

Another important question: how will pharma companies even know whether their drugs work? It’s ridiculously, ridiculously hard to figure this out even if you’re not a bad actor and you do have a drug that works. The only reason to go through that effort is for FDA’s stamp.

ekianjo 3y ago
Insurers. They would set up their own monitoring systems to insure drugs that work even if the FDA did not exist.
- RandomLensman 3y ago
  Why would drug manufacturers do that (instead of just using a limited corp per drug, for example)? Why would insurers take on some massive tail risk (and how would they get the capital for that)?
  - from-nibly 3y ago
    I think insurers would just put pressure on the companies. They would just not pay for the medication unless it was proven to not put their customers at risk, lest they have to pay for the treatment of the treatment.
    - RandomLensman 3y ago
      The health insurer might not be the same as the one taking the tail risk on the medication.

port515 3y ago

[flagged]

closewith 3y ago
I mean, by default this is true. They are federal and state agencies, after all.

jfasi 3y ago

Libertarianism is a two-part ideology that holds that first, despite all the clear signs around us, the world is simple. In a simple world, what is the point of regulation, policy, or any other collective action, for that matter? Why not abolish everything? On its face, this isn't an insane point of view. It's natural to look at the scope and complexity of government and as yourself "is all this really necessary?" While it'll never achieve mainstream status, some tinges of libertarianism contribute meaningfully as a counterweight to the tendency of government to grow beyond the point of diminishing returns to society. The problem is, the ideology has a second, usually unspoken tenet: anyone who suffers brought it upon themselves. Hacker stole your bitcoins? Should have used a hardware wallet. Hospital bills driving you to bankruptcy? This is what you get for not saving for a rainy day. Poisoned by shoddily produced medicine? Hey, you get what you pay for. It's an ideology of arrogance. Both intellectual arrogance, as its dunning-kruger afflicted adherents look over the vast and complex world and say "how hard could it possibly be?" to every challenge they perceive, and also of moral arrogance, as those same people cast their eyes over the depth of human suffering and inexplicably think "I've got mine, you all are on your own." The reason why libertarians always lose is because anyone who isn't a billionaire would spend their entire existence looking over their shoulder in terror at the infinite ways life can screw you. And even then they would probably fail. Any reasonable person would gladly hand over the right to sell medicine they mixed in their own basement in exchange for knowing they won't be poisoned when they need help themselves.

deleted 3y ago
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friend_and_foe 3y ago
I think libertarianism is an ideology that says that people have the right to take responsibility for their own lives and make their own decisions for themselves without getting anyone's permission. That's what I see anyway. I could be hyperbolic and say something like "it's nice that you think human beings are stupid and need a mommy to make all their decisions for them" or "guard rails can be used to lead cattle to slaughter" but I think you just genuinely believe the second point you made. The world might not be simple, but I think humans are perfectly capable of navigating the complexity on their own. That's really the crux of this disagreement. It's an ideology that says human beings are very capable and good when left to their own faculties the vast majority of the time and that it is ineffective to take away their right to self actualize in a failed attempt to try to prevent the instances when that is not the case. Side note, dunning Kruger has been discredited as statistical bias, I only know because I see a post about it on this site almost once a week.

jmyeet 3y ago

Obligatory pointer to how libertarians were defeated by bears [1]. Libertarians and neoliberals at this point are essentially indistinguishable. Neoliberalism is just a thinly-veiled wealth transfer to the already-rich through deregulation and tax cuts, masquerading as "market-based reforms" at the altar of the "free market". The "free market" itself is a myth because a well-functioning market requires strong government. It requires regulation. So when you see something like regulatory capture, which is a real problem, and companies bypassing the very regulation that limits their excesses and thinking the solution is less regulation. It's nonsencial. [1]: https://www.vox.com/policy-and-politics/21534416/free-state-project-new-hampshire-libertarians-matthew-hongoltz-hetling https://www.vox.com/policy-and-politics/21534416/free-state-...

redeux 3y ago

> … are all medications freely available at the corner store? Does this include warfarin, where getting the dose slightly wrong makes you bleed to death? Does it include MAOIs, where eating cheese after use makes your blood vessels explode? Obviously you put these things on the label … Who puts these things on the label and why? I don’t understand what’s obvious about this in a laissez-faire system. The author seems to argue for the removal of medication safety regulation in one area (FDA) but imply that there would still be safety regulations in regards to labeling? This seems like a huge contradiction to me.

303uru 3y ago
Congrats, you just speared the stupidity of the libertarian dream in a sentence. As a pharmacist, it's terrifying that anyone is even broaching the idea of ending the FDA and putting all medications OTC.
- friend_and_foe 3y ago
  Well, prior to the modern age, people self medicated. All compounds were freely available in most countries. You didn't need anyone's permission to find them and take them. Was it better? I don't know. I doubt you'd have many of the extremely effective medicines that have been invented since then. But I also don't think restricting medications has done anything to help curb addiction for example, and in my opinion the situation we live in where people just assume something is safe just because it's on the shelf of a store is a bad outcome of outsourcing personal safety to a government agency. I'm very diligent about what I put into my body, and I think most people would also be if they realized they needed to be, most people have a false sense of security as an adverse side effect of governments taking the role of claiming something is safe. I like not having lead in my turmeric, I like being able to see what's in my food by looking at the label. But I don't like having to pay someone a few hundred bucks just to get permission to numb some acute pain I feel from time to time due to a chronic condition. I skirt that law using a "supplement", but I don't think I should have to. All in all I think there's room for improvement. A lot of room. I'm not quite ready to say the government shouldn't have anything to say about the way things are done but I am ready to say they should have a much less prominent role.

supriyo-biswas 3y ago

The list of warnings issued by the FDA[1] to pharmaceuticals should serve as a great reminder of what can happen without a regulatory agency. [1] https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/compliance-actions-and-activities/warning-letters https://www.fda.gov/inspections-compliance-enforcement-and-c...

derbOac 3y ago

There's echoes of the "defund the police" controversy in "abolish the FDA". I doubt abolishing the FDA will happen, and I'm not sure many people who argue for it really literally mean to completely abolish it. What they mean is something closer to "radically overhaul the FDA" or "abolish it in its current form and rebuild it in a different way". These types of political positions happen because serious problems get dismissed by the status quo and nothing changes. There's a kind of false equivalence that's implicit — "arguing that X is a problem with agency B means you want all these other horrible consequences of getting rid of B" so nothing happens. After awhile, with nothing changing, it seems like the only option is to argue against eliminating the agency because valid criticisms just get spun away politically, and opponents of real change seem to frame the choices that way. Even now, I suspect discussions like this about the FDA only exist in a small bubble like Scott's readership. Most of the US doesn't have these ideas in their consciousness probably, so the problems get swept aside, and only bubble up if calls for dramatic changes like abolishment are discussed as a kind of intellectual punching bag for entertainment, and as a distraction from making real, serious reform. I would have been more impressed with this post if it had offered solutions to the problems involved. What it offers as proposals aren't bad, but sidestep the real problems and in one case just obfuscate things more. I don't think the FDA should be abolished, but I do think its role should be restricted to labeling fraud, product purity testing, and enforcing transparency in product efficacy evidence. For me, the FDA is just one problem in a litany of problems with healthcare related to regulatory capture. The US desperately needs medical deregulation — or at least reregulation. Arguments against this in the form of fear mongering without offering reform proposala are starting to feel to me like they really mean the status quo is fine and nothing really needs to change.

fabiofzero 3y ago

This is such a stupid idea that I don't know why people are discussing it. On the other hand this is HackerNews.