If you have any choice in how you are treated, you will make your best judgement based on information available to you, such as by the recommendation of a friend, or a Yelp review. This is the same process you use to make any important purchase.
Before you have work done on your car, do you fly to China to inspect the part factory? You don't, because the relatively low risk you perceive that these parts will fail doesn't justify the expense of travel.
Do you perceive low risk because a government agency put a stamp of approval on the part? Probably not. Most likely, your risk assessment is based on information you've gathered about the final product, the auto shop -- that it is well-reviewed, and that your mechanic seems knowledgeable.
Furthermore, only you really know your exact needs. An expensive high-performance car part might provide you some marginal benefit, but not so much benefit that you're willing to buy that part at the expense of something else that's important to you, like your electric bill. A race car or Uber driver might make a different decision and choose a different part to suit their needs.
Medicine is like car parts. Bad ones can kill. But through the free market, a system of feedback is established that tends toward a wider variety, and higher quality, of parts overall.
When politicians prioritize some drugs over others, they interfere with this system, and money is spent on drugs and research that people don't necessarily want or need. You can imagine race car drivers getting together and lobbying politicians to subsidize high performance parts. Because these subsidies are funded by taxes, money is effectively taken from individuals who might prefer a different part. Now, those individuals who are not race car drivers have less purchasing power, and fewer choices overall.
You're correct that this is more or less the libertarian perspective, but I find it in no way extreme. I find it principled, direct, and humane. In our society, where nearly everyone has a smart phone and may conduct research at any time, I can't imagine a more effective system. I'm sure it was much easier to criticize the free market in a time when people couldn't read, or didn't have a global information database accessible on their person at every waking moment.
Man, if only there were some way we could run an experiment where we could see how the industry would react if drugs were not required to be vouched for by a regulatory agency.
Wait, there is: the health supplement industry. You know, the people who can't be bothered to even put in their claimed active ingredients because it's all placebo anyways?
The FDA was set up literally because of these snake oil situations, and modern evidence suggests that snake oil still thrives wherever the FDA is banned from setting foot.
What upsets you about other people using their own money to buy placebos, other than the fact that you can't understand why? At this very moment, millions of people across the globe are buying things for themselves you would never buy for yourself.
Has it occurred to you that the health supplement buyer is in a much better position to decide how to allocate their money than you are? You have limited, aggregate information; they have a total view of their own finances and life situation, and are willing to devote their own time to research their personal decision to buy. For example, they might discover through research that a supplement generally regarded as a placebo has a benefit under circumstances known only to the them.
When you limit the choices of others, based only on general information or your personal perspective, you limit the set of choices others may take. If you do this long enough, you might find yourself some day prohibited from buying something you desperately need, because your situation is an exception to some general rule that nobody ever considered.
The FDA might have made sense at a time when most people were illiterate and information was hard to come by. Now that most (at least in the US) are literate, and own smartphones, taking away choices for the benefit of some hypothetical illiterate serves only to worsen the life of the average person.
> The FDA might have made sense at a time when most people were illiterate and information was hard to come by.
The FDA was established at a time when virtually the entire population of the US was literate [1]. While I don't have the heart to look up statistics, I suspect that the US at the time had the highest (or at least among the highest) newspaper penetration of any country, and that newspaper penetration would have been quite higher than today. Public libraries and schools would have been in full flourish too, by that time. My grandparents grew up on farms on the edges of the High Plains--where you would expect to find the most bumpkin of country bumpkins--and illiterate and ignorant they were not.
For someone whose argument is that the federal agency is necessary only because of public ignorance, you sure seem to be modelling that ignorance you think no longer exists. The problem with your argument is that you neglect to reason that both information and misinformation are incredibly easy to come by, and most people are unwilling or unable to differentiate between them.
[1] It is worth pointing out that, if you measure literacy by the ability to read in your native language, Western Europe has been majority literate for over a millennium.
You're right, that last paragraph is a flawed argument. I retract it, and your findings compel me to assert that I think there was probably never a good reason for the FDA.
But it's the second, and weaker, of the two arguments I made. The argument I develop in my first three paragraphs stands.
Nobody is arguing that the population of the US was illiterate when the FDA was established. The argument is that it might have made sense at a time when the US population was illiterate, but now that everyone has access to a world of knowledge in the palm of their hand 24x7x365 the FDA does not make sense.
The argument was that the FDA never made sense, not even when it was first established in America, and for precisely that reason -- Americans were not illiterate.
Creating medicines is nothing like creating car parts. At all. There's not a single aspect of drug discovery, manufacturing, or distribution logistics that in any way resembles something as crude as producing unregulated widgets for automobiles.
You're simply highlighting how poorly you understand the pharmaceutical industry with this line of argumentation.
I think it's an inane and inept comparison. The manner in which defects arise in each type of product, and the manner in which failure modes manifest are so different as to be incomparable.
I don't see how you can contest that they're both products and that they can both kill people if they're defective. To me these two similarities are plainly true, and it is only these two similarities that are material to my argument.
I might misunderstand, but the direction your argument seems to be heading is that the free market is somehow incompatible with products that have complex failure modes or that can be defective in subtle ways, and that the FDA is thus necessary. Is that right?
Before you have work done on your car, do you fly to China to inspect the part factory? You don't, because the relatively low risk you perceive that these parts will fail doesn't justify the expense of travel.
Do you perceive low risk because a government agency put a stamp of approval on the part? Probably not. Most likely, your risk assessment is based on information you've gathered about the final product, the auto shop -- that it is well-reviewed, and that your mechanic seems knowledgeable.
Furthermore, only you really know your exact needs. An expensive high-performance car part might provide you some marginal benefit, but not so much benefit that you're willing to buy that part at the expense of something else that's important to you, like your electric bill. A race car or Uber driver might make a different decision and choose a different part to suit their needs.
Medicine is like car parts. Bad ones can kill. But through the free market, a system of feedback is established that tends toward a wider variety, and higher quality, of parts overall.
When politicians prioritize some drugs over others, they interfere with this system, and money is spent on drugs and research that people don't necessarily want or need. You can imagine race car drivers getting together and lobbying politicians to subsidize high performance parts. Because these subsidies are funded by taxes, money is effectively taken from individuals who might prefer a different part. Now, those individuals who are not race car drivers have less purchasing power, and fewer choices overall.
You're correct that this is more or less the libertarian perspective, but I find it in no way extreme. I find it principled, direct, and humane. In our society, where nearly everyone has a smart phone and may conduct research at any time, I can't imagine a more effective system. I'm sure it was much easier to criticize the free market in a time when people couldn't read, or didn't have a global information database accessible on their person at every waking moment.