Beyond "Abolish the FDA"

https://www.astralcodexten.com/p/beyond-abolish-the-fda

by gHeadphone • 3 years ago

23 42 3 years ago

ekianjo7• 3 years 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.

closewith2• 3 years ago

And yet following the introduction of those paper regulations, the amount of factory contamination fell to near-zero. What a coincidence.

ekianjo7• 3 years 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?

nick2k3• 3 years 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• 3 years ago

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

ekianjo7• 3 years 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.

closewith2• 3 years ago

Much of that post fails to adress the fact we lived thousands of years fine without the FDA

...

starlevel003• 3 years ago

we lived thousands of years fine without the FDA

For those thousands of years our only medicine was "ground up unicorn toe".

ekianjo7• 3 years ago

I did not know that medecine was a 20th century science and that we lived in dark ages until the year 1899

renegade-otter• 3 years ago

We've lived for thousands of years without the National Transportation Safety Board. Why do we need it? What it do? Planes not falling out of the sky? Meh. Boring.

This libertarian "burn the government down" bullshit is exhausting. REALLY itching to eat some bad meat and croak? Because this is what happened before. Then the responsible people said "maybe we should have someone checking that so that our citizens don't get sick and die".

It's called a Civilization. Welcome.

Maybe the answer is to fix it, not destroy it? Is the FDA a revolving door? Yes. Many regulatory agencies are.

The politicians who complain the most are the ones most ok with the government being a corrupt dumpster fire. Helps the narrative, and the rubes are eating it all up.

michaelt• 3 years 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

ekianjo7• 3 years 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• 3 years 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.

303uru2• 3 years 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• 3 years 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.

ekianjo7• 3 years ago

Insurers. They would set up their own monitoring systems to insure drugs that work even if the FDA did not exist.

RandomLensman3• 3 years 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)?

jfasi• 3 years 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.

friend_and_foe3• 3 years 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• 3 years 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-...

redeux• 3 years 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.

303uru2• 3 years 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_foe3• 3 years 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.

bonzini• 3 years ago

Who puts these things on the label and why

I guess because otherwise you could be sued? Not that it makes this any more viable.

friend_and_foe3• 3 years ago

If you'd continued reading, this is addressed in the very next paragraph. The article doesn't argue for the abolishing of the FDA, the article is making a similar point to the one you're making.

supriyo-biswas• 3 years 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-c...

derbOac• 3 years 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• 3 years ago

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

Beyond "Abolish the FDA"

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