Scott Alexander’s recent post on the FDA raises the average level of discourse on the subject. He starts from the premise that the FDA deserves destruction but cautions against rash action. No political slogan can be implemented without clarification and “Abolish the FDA” is no different, but Scott’s objections aren’t strong reasons to stop short of a policy implementation that still retains the spirit behind the slogan.
I also thought that Scott fell into the fallacy of thinking something can't happen because he can't imagine the details. Markets solve lots of problems that individuals cannot or do not.
The problem with abolishing the efficacy requirement is that you remove the main incentive for drug companies to demonstrate that their drugs have a positive risk-benefit profile. Patients may have more choice, but they'll be making those choices on the basis of minimal (or nonexistent) data about whether drugs work. The arguments about abolishing the FDA tend to focus on patients and doctors, when I think the more relevant impact is how it changes the incentives and behaviour of the drug industry.
Medicines are too potentially dangerous for there not to be much strong research into their dangers. The opportunity cost of not treating serious disease effectively is too high for there not to be much strong research into their efficacy.
While consumers choose doctors to be their medical decision-makers, is is highly important that doctors make good decisions. The FDA serves to make it possible for individual doctors to make good decisions on drug prescribing. Doctors could never dream of doing all the research themselves. Even large hospital trusts and insurance providers would baulk at overseeing the research required to replace that directed by the FDA.
If the FDA were abolished, doctors would seek a body that provides the same services. They might choose the European Medicines Agency. They might choose a new body established by Google or Harvard or the Mayo Clinic. Such a new body would be very powerful, and would likely not limit it's scope in the way the FDA does.
Abolishing the FDA could easily lead to a bigger, bolder monopoly with a grip over the lives of nearly everyone in the world. I don't think this is ideal from a libertarian perspective.
It could also lead to two or three health advice agencies, with market forces keeping them serving the consumer well to an extent. But one need only look at the social media market and it's relationship to suicides and deaths-by-eating-disorder to see a similar market's balancing of profit and customer welfare.
The motor industry is an even better example. Few cars followed Volvo's seat belt innovation until governments forced them to. Car manufactures in a highly competitive market knew that if people died using their product, other people would blame factors other than the car. Why not focus innovation on the shape of a car's fins, or it's colour, or it's top speed? That's what the consumer was focused on.
This is not to say the FDA is ideal. But a democratic government is probably the best kind of organisation to own and oversee a body of it's type.
I also thought that Scott fell into the fallacy of thinking something can't happen because he can't imagine the details. Markets solve lots of problems that individuals cannot or do not.
The problem with abolishing the efficacy requirement is that you remove the main incentive for drug companies to demonstrate that their drugs have a positive risk-benefit profile. Patients may have more choice, but they'll be making those choices on the basis of minimal (or nonexistent) data about whether drugs work. The arguments about abolishing the FDA tend to focus on patients and doctors, when I think the more relevant impact is how it changes the incentives and behaviour of the drug industry.
Medicines are too potentially dangerous for there not to be much strong research into their dangers. The opportunity cost of not treating serious disease effectively is too high for there not to be much strong research into their efficacy.
While consumers choose doctors to be their medical decision-makers, is is highly important that doctors make good decisions. The FDA serves to make it possible for individual doctors to make good decisions on drug prescribing. Doctors could never dream of doing all the research themselves. Even large hospital trusts and insurance providers would baulk at overseeing the research required to replace that directed by the FDA.
If the FDA were abolished, doctors would seek a body that provides the same services. They might choose the European Medicines Agency. They might choose a new body established by Google or Harvard or the Mayo Clinic. Such a new body would be very powerful, and would likely not limit it's scope in the way the FDA does.
Abolishing the FDA could easily lead to a bigger, bolder monopoly with a grip over the lives of nearly everyone in the world. I don't think this is ideal from a libertarian perspective.
It could also lead to two or three health advice agencies, with market forces keeping them serving the consumer well to an extent. But one need only look at the social media market and it's relationship to suicides and deaths-by-eating-disorder to see a similar market's balancing of profit and customer welfare.
The motor industry is an even better example. Few cars followed Volvo's seat belt innovation until governments forced them to. Car manufactures in a highly competitive market knew that if people died using their product, other people would blame factors other than the car. Why not focus innovation on the shape of a car's fins, or it's colour, or it's top speed? That's what the consumer was focused on.
This is not to say the FDA is ideal. But a democratic government is probably the best kind of organisation to own and oversee a body of it's type.