No Coercion

I want to talk about how the U.S. Food and Drug Administration (whose motto appears to be, “Protecting and promoting your health”) hurts people. I’ll first say that I’m fully aware that many people who go to work for the FDA are good people and do so because they honestly believe the agency does what its motto claims. Unfortunately, they’re mistaken. Also, I’m not one of those people who thinks the FDA can be made to effectively ‘promote our health’ by reforming it. The very idea of a single agency that has the power to approve or deny new drugs, medical devices, treatments, etc., is fundamentally unsound, bad for health care in America, and morally wrong.

Let’s look at the example of a new drug for curing multiple sclerosis. The government (the FDA) claims that it’s keeping patients safe by withholding approval of the drug until the manufacturer has met all the FDA requirements (testing, clinical trials, labeling, etc). That can take many years and cost hundreds of millions of dollars. In the meantime, many MS patients have suffered, and some have died, without even having the option of trying the new drug.

Did the FDA’s actions keep people safe? Well, even if we assume that the drug was dangerous and ineffective at curing MS, the FDA has still interjected itself between potential willing buyers and sellers and thus violated one of the basic tenets of a free society. And if, on the other hand, the drug was both safe and effective, then the FDA is responsible for harming the people who would have obtained that drug during the time taken by the FDA approval process.

Supporters of government pharmaceutical regulation argue that there’s no way to know whether a new drug is safe or effective ahead of time, so we have no choice but to violently prevent (since that’s what government regulation boils down to) our neighbors from even having the option of trying a new drug until it’s been thoroughly vetted by no less noble a group than the very thugs whom we’ve hired to initiate force against our neighbors on our behalf.

But they’re wrong. The multitude of voluntary interactions in the free market can quickly and non-coercively identify safe and useful drugs. It happens all the time in other industries. Consider the early adopters–the small group of people who are the first to try a new product. If a new drug for MS is introduced in a free market (i.e.  no FDA), most MS patients aren’t desperate enough to jump on it right away. But a smaller group of patients are suffering to such a degree (maybe having tried everything else) that it’s worth it to them to risk the unproven drug, even if there is concern it could kill them. As more of these early adopters move in, data starts to come in (picture something like Consumer Reports for pharmaceuticals or discussion forums on MS sites) indicating the level of the drug’s safety and effectiveness.

As more information comes out from the early users of the drug, the uncertainty starts to diminish, and (if the results are positive) those who are suffering a great deal (but not enough to be in the early adopter group) choose to try the drug (since their personal cost-benefit analysis has shifted based on the new information). This produces even more ‘user data,’ thus continuing the trend of increasing numbers of people using a drug that’s helping them and thus eliminating a great deal of suffering. And it’s all done quickly and voluntarily, with no one having options artificially kept from them by force.

In addition, the manufacturer, not being hamstrung by FDA rules, would be able to constantly improve the formula based on patient results, thus reducing suffering even more.

None of this can happen when a group of people with guns gets to say which drugs are approved. Those who want to improve health care and reduce it’s cost could start by calling for abolishing the FDA and allowing free markets to bring us new health care products the same way they bring us new cell phones–with rapidly advancing functionality and plummeting prices.

Update: the comments that ensued when I posted this to a discussion forum at one of my local network affiliate’s sites reminded me of another good point. The FDA has not proven itself particularly good at approving only safe medications. One of the leading causes of death in the U.S. is adverse reactions to drugs approved by the FDA. Part of the problem is that the FDA is subject to massive corruption by large pharma companies, something that would be nonexistent or minimal under a free market in which multiple drug testing and reporting companies were competing to be known as the most effective at researching drugs.

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