L. Neil Smith's
THE LIBERTARIAN ENTERPRISE
Number 305, February 6, 2005
"An Unhealthy Obsession"
Hey FDA! Lead, Follow, or Just Go Away
Exclusive to TLE
"Some Gene Research Just Isn't Worth the Money", say two esteemed medical researchers in a New York Times essay.
"How should we set priorities in medical research? Officials at the National Institutes of Health will grapple with this question as they allocate billions of dollars from the agency's budget this year." they go on to say.
True enough. But whose priorities? Doctors? Mine? Yours? The government's, university's, private lab's, big or small pharma's?
The trouble with this approach is that the people the doing the work (the doctors) seem to like the rare, exotic, Nobel Prize-worthy "cool stuff". But, the public health community (governments mainly, but some NGO's as well) goes for a utilitarian approach. In their view, a vaccine against breast or prostate cancer, which would help many, many more people, has greater utility than some exotic treatment for a rare disease. Pharmas want "cures" for baldness, anti-aging remedies, acne medicine and the likeproducts that will sell like crazy. Viagra, Levitra, Cealis, and other big moneymakers come to mind here.
So who gets to pick? Glad I asked.
The large pharma corporations have the brainpower and the money to do what they want, but are checked by the power of the government and the pressure groups that control them. The FDA and the rest prefer Pharma to engage in research for "societal priorities" rather than the "fast buck" as the bureaucrats and their masters sneeringly put it.
Baldness or impotence doesn't seem so bad if you have prostate cancer. But who gets to decide? The FDA and the rest of the government, in the set-up we have now.
If I want to research Ibogaine to see if it is a worthwhile treatment for smoking cessation, or drug and alcohol addiction, I'll have to go to Mexico or some other place without all the government snoops looking over my shoulder continually.
I think that if the government just got the hell out of the drug regulation business entirely it would improve things enormously. How is that you say?
Without the FDA, there might be a few Thalidomide tragedies or quack remedies that don't work as advertised or even at all. But, the market being what it is, private testing and certifying firms would no doubt emerge. What would keep these firms objective and honest? The marketplace, that's what.
If I wonder whether a drug will help the arthritis in my knee or ward off the common cold, to whom do I turn for advice? A firm that independently tests and evaluates drugs and publishes the results, that's who. Firms like Consumers Reports, or the old Good Housekeeping Seal of Approval, and Underwriters Labs. The viability of these firms is predicated on the belief that they give honest answers and opinions. In a truly free market context, that is all you need, too.
Rating firms in whatever category that taint test results, skew data, or take money to influence their findings, they go away. Because the only asset a rating company has is their reputation and track record. If the FDA screws up or lies, we can't fire them. All we get is a "My bad. So sorry." from them, a few people get fired, congress makes some noises, and editorial boards rant and rave, and then it is back to business as usual.
That is why a private system would be better, cheaper, and easier to use for most people, and would severely downsize the influence of the current major players. Probably why the entrenched beneficiaries of the present system cling to it so hard, eh?