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Wednesday, April 25, 2007

How not to reform the FDA
First of all, don't take advice from people who don't believe in regulation in the first place. Yes I realize that means we have to totally ignore the WSJ editorial page as well as much of the faculty of the University of Chicago (possibly excluding Richard Thaler). But the fact is they're operating on a dangerous and repeatedly rejected economic model of how the market acts. Whether or not you agree with Richard Epstein in specific cases like creating incentives to report adverse events (I don't really see that helping but it won't hurt), we should all be able to see the giant flaw in his concluding paragraph.

But neither Congress nor the FDA has mastered the fundamental lesson of risk analysis. Keeping drugs off the market deprives all informed patients the opportunity to correct FDA errors. Letting new drugs on the market leaves individual patients the option to decline their use. In the long term, Congress must wean the FDA from its misapplied "first, do no harm" principle, which causes far more harm than it prevents.


Umm, wait a minute. First of all, what kind of complete ignorance does one need of pharmacological regulation to not know that this is an impossible expectation for consumers and the market? Even lay readers should remember Vioxx. How would the market or consumers have detected a 1% increase in cardiac side effects? Even if people were given this information, does anyone seriously believe that scientific information provided at high speed or in tiny text will affect consumers more than the irrational advertisements they see of happy old people getting out of their wheelchairs and dancing?

This is called the myth of the omniscient consumer. It has been disproven, again and again, that the market or consumers as a whole make rational decisions. One of the scienceblogs in particular the Frontal Cortex lately has done a good job at reporting on how neuroeconomics has done a lot better job describing why humans, as individuals or as groups, make decisions than this failed rational actor theory. At the risk of stating the libertarian economics position as a false tautology, it seems to me that they are saying because the market provides something it is good, and it is good because the market provides it.

Now in our personal lives I'm sure we've all encountered things that the market has provided that were decidedly awful. Personally, I find battery-operated turning lollipops to be a sign of end times, a better general example would probably be the total failure of energy deregulation to save consumers money (and instead leading to disasters like the California energy crisis and Enron). But in terms of specifics, when people actually study economic decision making in humans we find people are actually terrible at making rational choices(for a great lecture on this listen to this one by Daniel Gilbert). Take for instance something as simple as the bandwagon effect in music purchases - people can't even figure out what music they personally like rationally. Think of all the products that are exceedingly successful that are on the market that are entirely based on irrational consumers. If people made rational economic decisions why does the gambling industry exist? Are people buying altie meds based on rational choices? Do you think that there is a rational and compelling reason for consumers to buy Enzyte? And these are the people you expect to somehow detect problems as subtle as those of Vioxx? Or rationally determine that drugs like Ketek cause idiosyncratic liver failure? How is it, especially given the desire of the market not to lose products that make money despite being worthless or dangerous, do we expect self-regulation or market forces to detect rare adverse events - by far the most common reasons for pulling drugs these days?

I'm afraid that, as I've said before, the invisible hand of the market is attached to a retarded monkey. I reiterate: don't trust people who don't believe in any regulation to give you advice on how to regulate.

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Monday, March 26, 2007

WSJ and the Quonset Hut
The WSJ just can not stand Al Gore, and environmentalism in general. For those with strong stomachs check out today's op-ed Al Gore's Lightbulbs.

The main thing I'll point out, is that they repeat what I call the "Quonset Hut Canard". That is, in order to be a real environmentalist, you have to go live in a quonset hut, eat nothing but berries, wipe with poison ivy and make love to itinerant bears. Or something.

Ever since Al Gore was elevated to celebrity with his movie "An Inconvenient Truth," the political world has been murmuring about a possible bid for the 2008 Democratic Presidential nomination. Those murmurs rose to a low roar on Wednesday, when he granted an audience to two Congressional panels on climate change.

Mr. Gore -- who, if his personal lifestyle matched his rhetoric, would be carrying his possessions in a hobo bindle and sleeping in a boxcar -- at least had the good sense to arrive at the Capitol in a hybrid. "The Goracle" was greeted by throngs of cheering fans and media adulation.


This smear was killed weeks ago but the denialists at the WSJ continue to bleat about energy use as if all energy were equivalent. I could use 1 million killowatts of solar and the environmental impact would be essentially nil, or I could use 10,000 kW of coal and it would be an entirely different beast. The man uses carbon offsets, buys from green suppliers, and does what he can to offset his impact. His whole point is that we shouldn't have to live in quonset huts to be environmentalists, we just need to change the way we use and buy power, not go back to the stone ages.

What a tiresome old load of BS from the WSJ editorial page.

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