(This copies a comment I left on Derek Lowe’s blog at Science Magazine.)
I was the foundational theorist of open-source software development back in the 1990s, and have received a request to respond to your post on open-source pharma.
Is there misplaced idealism and a certain amount of wishful thinking in the open-source pharma movement? Probably. Something I often find myself pointing out to my more eager followers is that atoms are not bits; atoms are heavy, which means there are significant limiting factors of production other than human attention, and a corresponding problem of capital costs that is difficult to make go away. And I do find people who get all enthusiastic and ignore economics rather embarrassing.
On the other hand, even when that idealism is irrational it is often a useful corrective against equally irrational territoriality. I have observed that corporations have a strong, systemic hunker-down tendency to overprotect their IP, overestimating the amount of secrecy rent they can collect and underestimating the cost savings and additional options generated by going open.
I doubt pharma companies are any exception to this; when you say “the people who are actually spending their own cash to do it have somehow failed to realize any of these savings, because Proprietary” as if it’s credulous nonsense, my answer is “Yes. Yes, in fact, this actually happens everywhere”.
Thus, when I have influence I try to moderate the zeal but not suppress it, hoping that the naive idealists and the reflexive hunker-downers will more or less neutralize each other. It would be better if everybody just did sound praxeology, but human beings are not in general very good at that. Semi-tribalized meme wars fueled by emotional idealism seem to be how we roll as a species. People who want to change the world have to learn to work with human beings as they are, not as we’d like them to be.
If you’re not inclined to sign up with either side, I suggest pragmatically keeping your eye on the things the open-source culture does well and asking if those technologies and habits of thought can be useful in drug discovery. Myself, I think the long-term impact of open data interchange formats and public, cooperatively-maintained registries of pre-competitive data could be huge and is certainly worth serious investment and exploration even in the most selfish ROI terms of every party involved.
The idealists may sound a little woolly at times, but at least they understand this possibility and have the cultural capital to realize it – that part really is software.
Then…we see what we can learn. Once that part of the process has been de-territorialized, options to do analogous things at other places in the pipeline may become more obvious,
P.S: I’ve been a huge fan of your “Things I Won’t Work With” posts. More, please?
Let’s search the linked post for “FDA”… nope.
I think that’s really the biggest difference: open source software is possible because no government agency insists on $800 million – $1 billion in tests before a piece of software can be sold (or even given away). Big Pharma, and the current process of drug development, doesn’t prevent somebody in a garage lab from discovering a cheap cure for cancer or heart disease or dementia, but the FDA prevents that discovery from being legally distributed. Big Pharma grew as a result of Big Government, and they’re the only entity with the financial resources to get past the official gatekeepers.
>Big Pharma grew as a result of Big Government, and they’re the only entity with the financial resources to get past the official gatekeepers.
I agree, but I think it’s orthogonal to what Lowe was trying to address.
If drugs were developed with the same pragma as open source software how many would be dropped before silly amounts of money had been spent on them? It is the cost of all the failures on the way which hike the cost of the successes but if there was better peer review and cross fertilization of problems would the cost of failures be reduced. http://www.bbc.co.uk/news/health-27130098 gives a very nice overview of the current model.
Open collaboration allows more eyes with different expertise to review software and the end product is improved as a result?
That is when we can keep to a stable functionality rather than just ‘improving for improvements sake’ :)
This isn’t something I firmly believe, just kind of a vague suspicion:
We have a situation where the FDA over-regulation has created a huge barrier to pharmaceuticals. In this system, the only practical way to turn a profit, after paying to jump through all the clinical trials/other regulations is to extract monopoly rent from the patent on the new drug IP. With a really unhealthy market, it seems like it’s very much to your advantage for your competition to rat-hole a bunch of resources in exploratory research, to confirm what you already know doesn’t work.
But even if ESR’s suspicion is true, and it’s just a case of corporations over-estimating the value of secrecy, it’s a wide-spread culture used to making money (only) by extracting rent. In the history of the open-source software movement, there were always people around who remembered not caring about protecting trade secrets. In pharmaceutical research, there might be very few people who can even imagine making money in a manner other than rent-seeking.
The negatives in the author’s statement assumes that R&D costs are high because R&D is expensive. Creating and researching a new drug isn’t that expensive. FDA approval testing is what is expensive.
Don’t be a chucklehead. Without FDA “over-regulation” we’d have boondoggles like thalidomide, causing untold wreckage in countless human lives. Requiring proof of efficacy and long-term safety before drugs are brought to market is one thing the U.S. regulatory apparatus actually does fairly well, and of course conservatives want to scupper it, putting lives and public health at risk.
If anything the FDA is too lenient; anything they deem a “nutritional supplement” is essentially unregulated, and they let Vioxx through.
According to Scott Alexander, the real impact of the FDA is not to prevent unsafe drugs from getting on the market, but to certify that drugs *are* safe, so that pharmaceuticals are safe from biologically unsound litigation as soon as someone on a drug has an unrelated issue, such as liver failure.
Here is the link: http://slatestarcodex.com/2015/03/21/list-of-passages-i-highlighted-in-my-copy-of-machinery-of-freedom/
Grep for ‘no no no no no no no no’ in the page.
Lambert, I think that’s an argument for reforming the tort system as well, not for keeping the FDA in its present form. Maybe just allow people to buy and use cheaper, unapproved drugs at their own risk if they sign away their right to sue, with a fixed and limited liability schedule of payments for injuries or death.
Oh, dear.
I work for a tech company who’s primary IP is in software. We use version control. At the top of every file is a notice of Copyright BigCorp $InitialYear – $LatestYear.
Every check-in must update the copyright notice to reflect the current year, if applicable. This means for the first month of every year, pretty much every code review contains a notice that somebody forgot to update the copyright notice.
Now, you’d think that a revision control system would be far better at keeping track of dates of creation and edits, and you’d be right. However, then the lawyers get involved, and I’ve had a multi-year discussion with them over this issue which has led to them being even more ornery.
I pointed all of the technical solutions and things which make sense.
The lawyers came back and said that without them it’s much harder to sue for willful infringement if somebody isn’t made aware of the copyright status of the document, and somebody might get only a portion of our codebase and not a the notice if it isn’t in every file. They insisted that there was case law, though refused to cite it to me.
Corporate lawyering is basically being a professional pessimist.
Well, let’s see. The trouble I see with tort reform stems from the tremendous complexity of human biology, and the real expenses of diagnosis.
A patient takes Sumdrugsadil and later develops a liver problem. Was it due to Sumdrugsadil? Not immediately obvious either way. How do we find out? We run tests. How much do those tests cost? Hundreds or thousands of dollars, and none of the tests will conclusively answer the question; they only suggest yes / no.
It feels like one could resolve this through some sort of risk calculation – 30% chance Sumdrugsadil caused the problem * $100,000 for the liver treatment = $30,000 to the patient plus arbitration costs, done and done – except the actuaries have no way of knowing whether it’s 30%, 25%, or 100%. Even if they tracked liver incidents over time, the probabilities would quickly multiply as the actuaries tried to control for factors like diet, genetic markers, etc.
All this smacks of unknowability of the market to me. Which suggests my tentative proposal for tort reform: you can sue, but they can countersue. The problem there boiling down to resources available. A pharma corp has a lot more money to spend on litigation than a typical patient does, so that will have a chilling effect on patients moving any farther than simply considering a suit. Class action suits would be the logical remedy to this; not sure how well that would work in practice.
Ah; that Derek.
I like his Boom posts so much I want to see then in a book, as I mentioned once in a comment:
“Sand Won’t Save You This Time:
Chlorine Triflouride and other delightful chemical compounds I want no part of”
Garrett: It very much is, and that was the fundamental theory behind IMG’s Mark MacCormick’s second book, titled (in my favorite printing) “The Terrible Truth About Lawyers: What I Should Have Learned At Yale Law School”.
In short: it is the job of corporate counsel, at any size, to tell you what not to do to minimize risk.
It is the job of the executives to decide what is acceptable risk, and do it anyway in furtherance of business.
When your company gets too big for executives to overrule lawyers: it’s too big.
It’s easy to point to deaths and injuries caused by approved drugs. It’s much harder to count the deaths and injuries caused by delays and non-approvals of drugs. That toll is likely much, much larger. That’s the game theory problem the FDA faces, which skews their bias toward non-approval: nobody gets in trouble for saying “no.”
@Baylink:
I suppose the situation for IT security is the same, except they never overrule the executives.
I find the assertion that drugs are safer today due to the efforts of the FDA somewhat silly. It has far more to do with the fact that we now know what questions to ask. The FDA offers little more than an illusion of safety; they’re as bad as the TSA.
Atoms are heavier than bits, but worse the interactions between them are far more complex and accurate simulation is intractable. Also, the dependencies are hellish, and there’s no version control.
All this ranting about the FDA or Big Pharma ignores one basic fact.
Drug discovery is extremely hard.
A drug works by interacting with the chemical processes of living systems. Living systems are orders of magnitude more complex than any software. Every process is entangled with many other processes, and there are layers upon layers of regulators, enablers, and antagonists, all of which were added to the system by random chance.
Making a software product is a fairly straightforward process. You know what you want the product to do, you know how to do that thing, and development is the process of putting the how into code. Most of the time, your product can do what it does without reference to what other products are doing at the same time. Computer and software architecture is designed to keep tasks and processes separate from each other, except as specifically intended.
The software analogy to drug development would be like this. Imagine a 10M line program which provides all IT functions for a huge enterprise – everything from factory process control to e-mail services to point-of-sale to ERISA to word processing to VOIP to RAID management. It was written over thousands of man-years by a small army of programmers working in parallel with no understanding of structure, documentation, or code style. Many different instances of the program are running at any given moment, and it is in fact unusual for any two instances to be running from the same source code.
You’re trying to make a patch for an intermittent problem whose cause you don’t know, working largely from debugger dumps and decompiled bits of machine code.
That it can be done at all is amazing. Doing it on the cheap, or by informal processes, seems right out.
>That it can be done at all is amazing. Doing it on the cheap, or by informal processes, seems right out.
I’m not under any illusions about that.
What can be done, and should be done, is to minimize process friction and maximize the benefits of sharing information rather than keeping it in a proprietary vault. And I mean “maximize the benefits” in a hard economic way – if we can plausibly promise to reduce every party’s cost base enough, we can motivate reciprocal altruism.
There is absolutely no way to know whether a drug works in humans nor whether it is safe without extensive tests. As the information assymetry is almost absolute, the consumer knows next to nothing about the substance, this is the classical case of a lemon market.
https://nl.m.wikipedia.org/wiki/The_Market_for_Lemons
If you make even the slightest effort, you will find countless numbers of cases where countries with weak FDC’ ratified ineffective drugs. People using ineffective drugs will not seek effective treatment. Every country knows examples of people dying because they prefered homopathy or excorcism. Companies can produce fake drugs faster than consumers can learn to avoid them. The FDC’ of the world were set up to make an end to the sale of quack drugs.
In short, without a strong FDA, there will be no effective drugs, let alone safe drugs.
>In short, without a strong FDA, there will be no effective drugs, let alone safe drugs.
A claim falsified by history before the FDA.
I have a certain hunch that there is an inherent connection between IP or closed-source and doing business as a corporate person, a legal, non-natural entity ran by an employee CEO, as opposed to doing business as a personal, private entrepreneur, a natural person.
I cannot really give strong evidences for this hunch. The closest I get is “legal fictions tend to like other legal fictions”. I guess, without IP, in open source, you must realy on human resources, most often yourself, to make money, basically selling your talent, your knowledge. But without a personal entrepreneur and without a team personally loyal to him, a corporation cannot rely on it. Everybody is replacable. Hence, the corporation needs to _reify_ the knowledge and talent of their people, to be able to make money off it even when the people leave.
I am a firm believer of the idea that even hobby economists should speak the language of accounting. And the issue from that angle is, you can put IP on a balance sheet, but people not. I.e. a private entrepreneur can raise capital from venture investors simply due to the investors seeing his talent, his ability, and that of his personally loyal team, and fork over the money just due to this trust. But an impersonal corporation with an employee-CEO cannot really argue “we happen to employ some really smart folks”. They employ them today, and they may quit tomorrow, that is not a firm basis to invest, to buy shares. Thus, they “reify” the knowledge of their current people, turn it into IP and put that on a balance sheet.
The crucial thing to understand IP is that it is, yes, a legal fiction, but far more than that and far more importantly than that, an accounting fiction. “Intangible assets”.
ESR, you are rather famous at selling open source software to such corporations. The issue is, I think, that they tend to be hardware corporations. Not software. (Or service providers, media providers like Reddit, whatever – not software sellers.)
The only potential solution I see here is either somehow promote personal, natural entrepreneurs over corporations (fat chance), or try to find that X where pharma relates to X the same way as software to hardware or to service and then you can have open source pharma. If hospitals, medical service providers would do the pharma research…
@esr
“A claim falsified by history before the FDA.”
That is because there was already regulation in place far before the USA was even conceived. The FDA and its brethren only developed after horrible scandals (Thalidomide). They grew with the industry.
http://www.who.int/medicines/technical_briefing/tbs/Drug_Regulation_History_Present_Future.pdf
And there were many drugs that were ineffective. Another horrible example was DES which proved to have both horrible side effects and be ineffective.
http://www.cdc.gov/des/consumers/about/effects.html
It took well into the 1960s before effectiveness was tested, and that lead to quite a number of “drugs” removed from the market.
http://www.fda.gov/AboutFDA/WhatWeDo/History/Overviews/ucm304485.htm
>That is because there was already regulation in place far before the USA was even conceived.
I quote “In short, without a strong FDA, there will be no effective drugs, let alone safe drugs.” You were wrong, so you changed the subject. You do that a lot.
Your second change of subject was from “effective” to “safe”.
@esr
The FDA is not perfect, by far. But its failings to ensure that all drugs are effective show where the market would go without testing:
THE SALE OF INEFFECTIVE DRUGS
http://www.culturalsurvival.org/publications/cultural-survival-quarterly/united-states/sale-ineffective-drugs
And here is a list of drugs withdrawn after being approved because of mandatory post-market surveillance:
https://en.wikipedia.org/wiki/List_of_withdrawn_drugs
@esr
“I quote “In short, without a strong FDA, there will be no effective drugs, let alone safe drugs.” You were wrong, so you changed the subject. You do that a lot.”
OK, indeed my fault. Filling in the blanks of the logic:
The FDA was installed because previous government regulations were proving ineffective. Government regulation is necessary to obtain safe and effective drugs.
I must grant that there were effective drugs around before the FDA was put into place. Even before there was testing on effectiveness (e.g., antibiotics). I was a little too extreme on that. That is mostly because I have witnessed many wranglings in medical research to establish whether treatment regimes were actually effective. This is much more difficult than people think.
@esr
“Your second change of subject was from “effective” to “safe”.”
I realized that, see my previous comment. The second link in my earlier comment was to a large review in the 1960 that removed a large number of ineffective drugs from the market.
My emphasis
One of my comments in in the moderation queue.
How many effective treatments aren’t available, even to informed individuals willing to balance risks, because of the immense costs involved? Most European countries have a cheap, highly effective exposure treatment for seasonal allergies available, but it’s illegal in the US. I’d very much like to avail myself of it, but my betters have decided I’m too stupid to be allowed to.
As many posters have pointed out, the need for clinical trials precludes the open-source software model to serve as a template for open-source pharma. However, there are many ideas from open-source software that apply to pharma and can be used to design effective open-source pharma models. In one of the earliest papers on open-source pharma published nearly 10 years ago (http://www.nature.com/nrd/journal/v5/n9/abs/nrd2131.html), I argued that drug discovery activities lend themselves to open-sourcing, while drug development is better handled through outsourcing. However, a combination of the two can produce alternative drug R&D models that can develop drugs more economically. One should also note that the open-sourcing/outsourcing idea has found its way in various novel drug R&D models such as virtual companies, public-private partnerships for neglected diseases (e.g., Medicines for Malaria Venture or Global TB Alliance), and the multiple open-source portals that adorn big pharma websites.
@esr
And China is a nice showcase as both “traditional” and “Western” medicine is available. With quite interesting results, even given that almost all traditional treatments are ineffective:
http://aeon.co/magazine/health/james-palmer-traditional-chinese-medicine/
Without a serious attempt to prove the effectiveness of traditional medicine, most traditional treatments are more like placebos. I seriously doubt that popular Tradition Chinese Medicine like ground furniture and the balls of large carnivores are effective against diseases and ailments.
Example:
Ibogaine is quite literally a cure (often after a single dose) for heroine/opiate addiction without the risk of withdrawal. In the US, because of the FDA, they use the much, much more dangerous methadone, which doesn’t actually cure the addiction but become a substitute drug, that you have to take for years.
We’ve been discussing locating plaintiffs to bring suit on the issue of Brad Spengler of GRSecurity once he closes his derivative work (with some new discussions):
https://soylentnews.org/article.pl?sid=15/09/07/040206 http://pipedot.org/pipe/KPRX
http://8ch.net/tech/res/346860.html http://pipedot.org/pipe/K33M
If you’ve not been taught the law, don’t try to debate the legal merits of the case and show yourself to be a lay fool, please.
@DocMerlin
“Ibogaine is quite literally a cure (often after a single dose) for heroine/opiate addiction without the risk of withdrawal. ”
Aside from the usual problems in the USA to act rationally with respect to substance abuse, Ibogaine is not exactly an “easy” drug.
http://ibogalife.com/ibogaine-side-effects/
Furthermore, I have serious doubts about anything that claims to be a single dose cure for opiate addiction. The psychology and physiology of addiction is much more complex than what can be expected to be treated with a single dose of any substance.
For instance, I read a study about drug abuse in the Netherlands (sorry, pre-internet, no link) that found that around a third of illegal drug users uses them as self-medication for severe mental problems. Another third had severe personality problems, e.g., antisocial personality disorder (ASPD), or were emotionally immature. For what it is worth, the last third were recreational users with temporary problems that tended to sort themselves out.
Only the last third would be amenable to any “pill” that would cure addiction. The others would fall back to some kind of substance abuse under any circumstances. That last third, would get off their addiction anyhow. For the rest, the best “cure” would be simply to prescribe heroin. They did that in Switzerland with amazing results.
https://en.wikipedia.org/wiki/Heroin-assisted_treatment
Although I am not a fan of the FDA, in fact I think it is responsible for more deaths than perhaps any other government agency besides the military, I think it is a huge mistake to hang all the costs of drug development on them. Certainly getting past them is very expensive, but the intrinsic cost of testing drugs is extremely high irrespective of any regulatory costs.
At the most basic level though, the real problem is that someone gets to choose your risk reward tolerance. Some bureaucrat gets to decide that, and decides it the same for everyone. The FDA in particular is notorious for setting the risk/reward ratio extremely biased in favor or very low risk, irrespective of rewards. There are many known examples of people months from death who have their last request for an experimental drug denied because it is too risky. There are many drugs that were delayed for a decade in the USA that saved thousands, millions of people with their earlier approval in other countries.
And really, as far as I can see the real power of the FDA comes from the thalidomide incident. For less than two years various international regulatory agencies allowed this drug, a powerful anti-emetic, for pregnant women, who by a terrible coincidence tend toward emesis due to the impact of pregnancy on their body, and by another terrible coincidence that emetic tendency occurs early in pregnancy when fetuses are most vulnerable to damage. And of course we all know the terrible toll that took on tens of thousands of babies born with horrible birth defects.
The FDA was the exception. Not, as far as I can see, due to any diligence but to bureaucratic delay. Not due to skill or care, but due to sloth and neglect. However, their sloth and neglect in this particular case was beneficial since American women were denied this drug and spent their early pregnancy with their head in a toilet instead. This “success” seems to be the genesis of the FDA doctrine of safe and effective, or to put it another way a very high preference for safety over benefit; or to put it even differently, a preference for invisible mortality and morbidity over visible mortality and morbidity.
Having said all that, open source pharam is surely very different than OSS. Ultimately you need to put drugs into humans to tell if they work, and before that into animals from bacteria through to higher mammals. This need is intrinsic, and it is also very expensive. Pharm demands rent to pay for it.
The question of IP in drugs is perhaps the most interesting one or all. I have no doubt we would all be better off without it. However, to understand why you need to get out of the narrow box in which most companies and most people think of IP. It like all things has both pros and cons from a purely amoral economic measure irrespective of the general immorality of something like intellectual “property”.
Winter: would the FDA’s process of clinical trials actually have caught the side effects of thalidomide before that drug was put on sale? I see good reasons to doubt it. Clinical trials can provide good evidence that a drug does what its discoverers think it does (efficiacy), because it’s obvious what to look for. But it’s much harder to notice effects of a drug that are not what the discoverers intended (safety) – especially when, as with thalidomide, the best science of the day claimed that the dangerous side effect was impossible, so nobody would even think of looking for it. (IIRC the thalidomide scandal is the reason why drug companies test on pregnant animals at all.)
>Winter: would the FDA’s process of clinical trials actually have caught the side effects of thalidomide before that drug was put on sale?
Almost certainly not. A forgotten detail about this drug is that it only caused birth defects in mothers with B12 deficiency. That’s a kind of confounder trials are very bad at spotting.
This also implies that a Thalidomide plus B12 combination would be safe even for pregnant women. But, of course, the theory under which FDA regulations are written forbids this. One of the seen-vs.-unseen effects is all the deaths and side effects from tranquilizers that are far less safe.
@Michael Brazier
“Winter: would the FDA’s process of clinical trials actually have caught the side effects of thalidomide before that drug was put on sale?”
There were some novel aspects on this drug. Thalomide comes in two forms (enantiomers)
https://en.wikipedia.org/wiki/Thalidomide
One was the “active” form, the other the dangerous form. Also, it was not (widely) known then that unborn children were that sensitive to drugs. First tests were done with the “good” form, whereas the drug contained both forms. After this disaster, drugs for pregnant women needed special tests to look for birth defects.
What would have made a difference would be a rule that would have forced post-market surveillance. Which is now in place.
What made this case so “special” was the way the producer of Thalomide was able to obstruct the legal system and intimidate those who pointed out the adverse side effects. Modern rules make this much more difficult.
http://www.bmartin.cc/pubs/08nd.pdf
“What would have made a difference would be a rule that would have forced post-market surveillance. Which is now in place.”
A rule requiring after-market surveillance for dangerous side effects cannot possibly catch a side effect before a drug goes to market. So you’ve basically admitted that the modern FDA’s clinical trials would not have kept thalidomide off the market.
Attempts by Chemie Grünenthal to deny culpability afterward have nothing to do with the question of whether the FDA’s process for approving drugs is well designed.
Let me fix this statement for you:
The question is, can there be an open source approach to both sides that reduces the costs?
@Garrett on 2015-09-08 at 16:30:10 said:
# > at January 01 /home//repos/tools_repo/update_copyright/update_copyright.py
@Winter:
If you evaluate people as they enter treatment, and if they *want* treatment you can help most of both the first and third groups that way–with the first group you replace the opiate with a molecule more specific to their problem that is less or non-addictive[1] and with some counseling and you’re going to help a lot of them become, if not exactly productive citizens, at least not societal sea-anchors.
The second group, at least the “immature” aren’t going to want help.
[1] In this we differentiate between “addiction” and “habituation”.
> I quote “In short, without a strong FDA, there will be no effective drugs, let alone safe drugs.” You were wrong, so you changed the subject. You do that a lot.
It’s certainly poorly worded, but you’re smart enough to know that what he meant isn’t something that can be so easily falsified by an existence proof of drugs that happen to be effective/safe in spite of a failure to make sure that consumers know which ones they are.
>It’s certainly poorly worded, but you’re smart enough
…to not let a self-described Communist get away with a propagandistic argument. Yes, I am.
> This also implies that a Thalidomide plus B12 combination would be safe even for pregnant women. But, of course, the theory under which FDA regulations are written forbids this. One of the seen-vs.-unseen effects is all the deaths and side effects from tranquilizers that are far less safe.
And with no FDA, are you proposing this would have happened, rather than them continuing to sell it as-is and attack anyone who attempts to publicize the dangers?
>And with no FDA, are you proposing this would have happened, rather than them continuing to sell it as-is and attack anyone who attempts to publicize the dangers?
Yes. Because B12 is cheap and who wants a lawsuit?
This might be true also of 3D printing and milling machines.
Things are changing. If I need a gear, a flange, or something, I don’t need to have one that has very high setup costs for injection molding or factory production. I can just print or mill it, at least if it is opensource. Same with circuitry – electronic hardware and designs. It is hard to see because there are stocks and a supply chain so it is still more convenient to order it.
We don’t have “home” or small biohacking quite yet. But are getting close. Makerspaces can now produce nearly anything physical or electrical for those who can’t afford to have it at home.
Biohacking is a few years away, and remember we’ve been breeding, creating hybrids, and selecting for most of human history. Too few people live near farms and ranches.
I think that gets at the heart of the problem and also clarifies it a good deal. On one hand, there are important parts of the pharma industry that really are ‘just bits’. They include the biochemical knowledge of how each drug affects the human body, as well as the chemical-engineering knowledge of making it. These are all good candidates for being produced and published in a fashion akin to Open Source. And they already are! It’s called “the scientific process”.
On the other hand, when you take a tour of an actual factory in which all this knowledge is implemented — and you should, it’s fascinating! — you can’t help feeling overwhelmed by all the stuff it takes to turn knowledge into actual medicine. There’s huge buildings, with tons of special-purpose equipment built in to control the environment in which the drugs get mixed, synthesized, and filled into capsules. These environments may or may not be totally different from each other, and from the environment that workers need to work in. You need added machinery to keep them all apart. And in turn, the mixing, synthesizing, and filling of the drugs is itself driven by a seemingly-endless chain of special-purpose machinery. I don’t see how Open Source would be useful for this part of producing pharmaceuticals. You can’t just throw such a factory, let alone its workers, into a Xerox machine and expect a new factory to come out.
With all this in mind, this buzz-term “open-source pharma” bothers me because it’s vague and overbroad. If one wants to demand more transparency in industry research, fine! If one wants to explore quicker patent expirations so that cheap generics can get into the market sooner, fine! But why not just say it like that? Why shoehorn one’s demands into a buzz concept they don’t really fit into?
On the third hand, isn’t all this a great problem for Eric to have? When you’re a memetic engineer and others try to muscle their own memes into your memes’ memeplex, chances are you have done something right.
> a self-described Communist
Here, in A&D? Who?! I know some are progressives… but communists?!
I’m going to go a bit off topic here and I apologize. Everyone is talking about the implications of drug development and research so I’m going to throw a curveball.
Big Pharma has grown larger than it really needs to be. We do not need more drug development and research in the areas of heart disease, some forms of cancers, hypertension, diabetes type II, etc(althought it would be nice to know the mechanisms for the sake of science). There is a vast amount of research showing that lifestyle changes such as exercising everyday(at least 30min walking a day) and especially eating a plant based diet(a diet centered around plants) can reverse many of our top killers.
Utilizing plant based diets to treat diseases is nothing new. It has been demonstrated more than half a century ago that some of our chronic diseases that are plaguing the nation are reversible. People like our founding fathers and hippocrates himself approved nutrition as a safe and viable way to treat diseases. It seems that we have long forgotten that we don’t need all these drugs to treat our leading killers. It’s mostly due to the fact that in medical school, students don’t receive adequate amounts of nutrition training. In most cases, nutrition is neglected(so be wary of asking doctors for nutritional advice). Plant based nutrition is the best weapon to combat western diseases but so many people don’t know about this. This is mostly due to the fact that there’s no money in telling people to eat plants rather than take certain drugs. Drugs contain all sorts of undesirable side effects while plants are just food that we eat which hardly contains any side effects.
Here’s a website that I recommend for learning about nutrition: nutritionfacts.org
The information is free to the public. Just wanted to share this.
@esr
“…to not let a self-described Communist get away with a propagandistic argument. Yes, I am.”
Which is why I corrected my words when it was pointed out.
The point with thalidomide is that you should get the correct form. Anyhow, people are much more careful now with pregnant women. Telling that they should take enough vitamin B12 is not exactly the right amount of care given the horrible effects when you get it wrong.
@esr
“Almost certainly not. A forgotten detail about this drug is that it only caused birth defects in mothers with B12 deficiency. That’s a kind of confounder trials are very bad at spotting.”
I never claimed the FDA could have captured the side effects at the time. And no one ever claims that tests will capture every harmful side-effect. That would be ludicrous. That is why there is post-market surveillance.
However, a FDA “bureaucrat” did insist on getting all the evidence and that all tests would be performed by Grünenthal. That saved a lot of grieve in the US. And the FDA was strong enough to oppose the intimidation of the producer. The weaker the national variant of the FDA was, the more harm was done by Thalidomide (e.g., Spain).
@William
“replace the opiate with a molecule more specific to their problem that is less or non-addictive[1] and with some counseling and you’re going to help a lot of them become,”
I am all for it. But I must admit that I am not current on this field. I know that anything that affects the reward system enough to mess with an addiction might need some careful study in and of itself.
But I also know that the USA (and others) are very schizophrenic when mind altering substances are involved. I can see them making the wrong decisions for ideological/religious reasons.
To be clear, I am not necessarily arguing that the FDA should simply be abolished, but at the very least it needs reform. Perhaps there should be different levels of FDA approval, with one or two lower ones that signify “We know this is unlikely to kill you outright, but take it at your own risk.” The current all-or-nothing system can lead people to believe that every approved drug is safe and effective for everyone, which is not the case.
Winter needs to read a little Bastiat. His argument is a classic example of “the seen and the unseen”: he sees the lives saved by the FDA, but he doesn’t see the lives lost and the other costs.
> …to not let a self-described Communist get away with a propagandistic argument. Yes, I am.
Nice try.
I’ll be more explicit, then. As far as I know, “history before the FDA” clearly does not actually bear out a claim that the market of that era wasn’t filled with poisons and snake oil, so my understanding of your argument is that you are simply pointing out that legitimate medicines existed alongside them, in an excessively and maliciously literalistic reading of Winter’s statement as claiming that they did not.
>an excessively and maliciously literalistic reading of Winter’s statement as claiming that they did not.
Since when is it a bad idea to be “malicious” towards people who advocate the massive initiation of force against others? Since when is it a bad idea to hold them accountable for what they say? After the totalitarian-statist horrors of the 20th century, how could it possibly be a good idea to concede statists and avowed communists the benefit of any doubt?
Would you ask a Jew to be forgiving in argument with a Nazi arguing for the extinction of inferior races? The Gricean maxims go out the window when the other side’s argument implies and sanctions an overwhelming threat of force. I make no apology. I would be remiss in my duty if I behaved otherwise.
I doubt that. Pharmaceutical plants are immensely capital-intensive, require that you sink immense up-front costs before they produce anything, and are subject to steeply increasing returns to scale. (One big manufacturing site in pharma is usually more productive than a hundred tiny ones, other things being equal.) Adding all this up, I would expect that Pharma would be just about as Big under Anarcho-Capitalism as it is in today’s mixed economies.
PS: Since I disagree with most of you guys here on politics but do agree with you on epistemology, here’s a suggestion for falsifying my hypotheis: For all developed countries in the world (the OECD countries, say), plot the size of their respective government against the size of their respective pharmaceutical sector (or the average size of their pharmaceutical companies, depending on what you mean by “Big Pharma”). If you do find a significant positive correlation, I stand corrected. (I expect this to be a weekend-project in applied statistics, which is more than I can do myself right now. But it’s definitely feasible for anyone seriously interested in this kind of question.)
> Yes. Because B12 is cheap and who wants a lawsuit?
Okay, then why didn’t they do that in the first place instead of suppressing information about the existence of side effects. If they didn’t know that B12 was the issue, why didn’t they perform their own investigations to find out once the side effects were brought to light, with a recall in the meantime to prevent pregnant women from taking it until they got to the bottom of the issue?
The problem is there is nothing in the actual history to suggest that they would have done anything voluntarily, or even allowed normal market forces (like publication of negative information about their product) to act.
>The problem is there is nothing in the actual history to suggest that they would have done anything voluntarily, or even allowed normal market forces (like publication of negative information about their product) to act.
If you think that’s true, what you should be aiming for is to help “normal market forces” work better, so that the corporations cannot suppress negative information about their products. That would be a much-better solution than a waaay overpowerful FDA, which has a massive “things unseen” problem in exactly Frederic Bastiat’s sense.
The “totalitarian-statist horrors of the 20th century” were initiated by tyrants with unusual charisma and cult of personality — not social democracies. Germany has gone for seventy years without backsliding into totalitarianism; during most of that time it has had a more comprehensive state apparatus than the USA and yet remains farther from totalitarian horror than the USA.
As for Winter being an avowed communist, we’ve covered this before: his “yeah, I’m a commie” statement was facetious and reflective of the fact that political views derided as “commie” in the United States could be center-right in Europe.
>The “totalitarian-statist horrors of the 20th century” were initiated by tyrants with unusual charisma and cult of personality — not social democracies.
In every case except the first one – the Armenian genocide – the tyrants relied on communist and socialist ideology to operate. This is not an accident; Marx himself explicitly advocated the use of revolutionary terror and mass slaughter. We should not be surprised that his adherents faithfully carried out the program.
Two questions.
> …a massive “things unseen” problem in exactly Frederic Bastiat’s sense.
1. I’ll play the Devil’s advocate: what would you reply to a non-libertarian who argued that the whole “things unseen” concept is unscientific because we should only talk about what can be observed, or because it’s unfalsifiable, or something like that?
2. Regarding “statists and avowed communists” (and possibly straying too far off-topic): do you feel a moral dilemma about consuming works of art created by such people? Maybe if we pirate those works, thus giving the commies no money…
>what would you reply to a non-libertarian who argued that the whole “things unseen” concept is unscientific because we should only talk about what can be observed,
We don’t have only one society to look at, and the same society can change over time in relevant ways. In many cases we can verify a “things unseen” assertion by looking at a different experiment.
>do you feel a moral dilemma about consuming works of art created by such people?
Yes, I do. I found it quite crushing to learn that Dorothy Sayers was a Stalinist.
“Unseen” in the Bastiat sense does not mean “unobservable,” it just means “not immediately apparent.” It’s there if you look for it.
Also, this point bears repeating: it’s a bit silly to decry a person as an extreme statist when a strong state is the only thing preventing that person from getting real wet real fast. Winter has not shown any tell of having political views that are anything but mainstream in the Netherlands.
@esr
“Since when is it a bad idea to be “malicious” towards people who advocate the massive initiation of force against others?”
It seems you mean me when you say “people”. Could you point out where I advocated the massive use of force against others?
But maybe you mean levying taxes as “massive initiation of force against others”? In that case I am in the company of most of your countrymen.
@esr
“Would you ask a Jew to be forgiving in argument with a Nazi arguing for the extinction of inferior races?”
And what do you think is my connection to the holocaust? Do you really assume I have any sympathy with fascist idealogies or racism?
Would it not be a better debating technique to stick to market forces in health care and drug development?
>But maybe you mean levying taxes as “massive initiation of force against others”? In that case I am in the company of most of your countrymen.
Most of my countrymen don’t “joke” about being communists. That is, they do not knowingly associate themselves with radical evil – give it cover, give it respectability.
@esr
“If you think that’s true, what you should be aiming for is to help “normal market forces” work better, so that the corporations cannot suppress negative information about their products.”
And how eould such a system look?
The FDA was founded as the end point of a long history of disasters in drug marketing. Even now, with strong legal rules and enforcement, companies try to outwit the FDA by hiding bad results and gaming research publications.
I assume you can point out examples where a truely FDA free, free market of drugs lead to good medical drugs?
Must be possible because there are many developing countries with very weak regulations.
My recollections are that people get sold lemons:
– Growth hormones adverticed for malnourished children
– Formula io breast feeding in areas with unclean water
– Antibiotics given to “cure” viral infections
– Tylenol injected io pills
And then we have the homeopathy and traditional Chinese medicin quack stuff.
But I am sure you can point out success stories of free markets in pharma?
>And how eould such a system look?
How do crowdsourced review systems look now?
>But I am sure you can point out success stories of free markets in pharma
Many of our most important drugs were invented before the FDA got a death grip on approvals in the U.S. It isn’t responsive to point at the incidence of quack medicines in a free market, because the FDA is not effective at suppressing those; they simply get relabeled as “supplements” or for non-medical use.
@Jeff Read
“Also, this point bears repeating: it’s a bit silly to decry a person as an extreme statist when a strong state is the only thing preventing that person from getting real wet real fast.”
In a sense, I am a “strong statist”. I share that ” ideology” with a large majority of West Europeans and a fair number of East Europeans, Asians and North Americans.
And the large waves of people moving around the Middle East towards Europe are not exactly crying out for less nation state and smaller government.
On the other hand, I really wish the libertarians luck with founding their utopia. It would be really great if they would be able to create a free industrial society without taxes and oppression.
It is just that I cannot make myself believe it would work. In the contrary, I fear it would devolve into a genuine nightmare.
I can confirm this fact, being a German who has been living in America for over seven years.
@esr
“That is, they do not knowingly associate themselves with radical evil – give it cover, give it respectability.”
Most communists in Western Europe were (and are) decent people who had no intention of creating a new Stalinist tyrany. Most of the people those from the US call communist are actually socialists who support democracy. Many communist political leaders in Europe were respected by their political opponents.
And the canard of claiming the fascists were really communists/socialists is something few Europeans will tolerate in a discussion. Most certainly not the victims of these regimes.
I grew up among people who had lived through the Nazi rule. Both in and outside Germany. I think I weigh their stories and opinions more than those of armchair ideologists from the other side of the globe.
>Most communists in Western Europe were (and are) decent people who had no intention of creating a new Stalinist tyrany.
But the effect of their “decency” was to repeatedly enable hideous crimes. They get no pass. They sided with evil by choice, and should get no more forbearance than a Nazi claiming not to be like those bad Nazis.
@esr
“How do crowdsourced review systems look now?”
Experimental? They tend to break down when large amounts of money are involved. Think astroturfing.
@esr
“Many of our most important drugs were invented before the FDA got a death grip on approvals in the U.S.”
I never said the FDA is perfect. Far from that. But a medical treatment must show it is safe and effective. I think everyone should be very happy that he can have a level of trust that anything sold as medicin is both safe and effective.
It is also a truism that safety and effectiveness are tradeoffs. You can argue that the FDA makes the wrong tradeoff. But when you abolish the approval process, you do not abolish the tradeoff. You only hand it to different people.
Handing off the tradeoff to the companies means profits will rule the balance. If you hand it to the consumers, ignorance and superstition will rule. A lemon market will develop. Or more likely, a snake oil market.
@esr
“It isn’t responsive to point at the incidence of quack medicines in a free market, because the FDA is not effective at suppressing those; they simply get relabeled as “supplements” or for non-medical use.”
People are free to believe whatever they want. The FDA has only to make sure that consumers who want proven effectiveness get what they want. All others can buy whatever snake oil they want.
But that’s not what Dutch people (correct, WInter?) joke about when they say “yeah, I’m a Commie” to an American. Rather, the joke is about the lazy, ignorant, yet widespread habit among conservative and libertarian Americans of throwing Social Democrats in the same pot as Stalinists and Maoists.
Winter, I don’t think it’s unfair to put, into the same category, political movements that are revolutionary, totalitarian, socialist, anti-capitalist, anti-religious, dismissive of the rights of individuals, and which slaughter millions. The fact that one variety tended to slaughter millions of political opponents, and the other slaughtered (many fewer) millions of people of certain ethnicities and political opponents, is a distinction without much of a difference.
Thomas Blankenhorn: I think you’re correct, but of course Europeans (and many on the left) have a tendency to lump together conservatives, Republicans, libertarians, the KKK, the Nazis….
And rightly so (that they get no pass, I mean). So in your judgement, does the Social Democratic Party of Germany get a pass for being the only party in the Reichstag to vote against suspending the German constitution and handing absolute power over to the Nazis? I’m asking because this seems to be a fairly clear-cut case against throwing Social Democrats and Communists in the same pot.
>Social Democratic Party of Germany get a pass for being the only party in the Reichstag to vote against suspending the German constitution and handing absolute power over to the Nazis?
No. The only thing Communists and Socialists actually disliked about the Nazi dictatorship was that it wasn’t their dictatorship. They weren’t voting for liberty, they were voting against a power grab that was somebody else’s.
(It was studying the Nazi revolution in detail that made me into an anarchist.)
@esr
“But the effect of their “decency” was to repeatedly enable hideous crimes”
When did French or Italian communist enable hideous crimes post WWII? These countries had strong communist movements. Still have. Whenever they were in power nothing hideous happened.
And to go further, when did West European Social Democrats enable hideous crimes? British Labour?
>And to go further, when did West European Social Democrats enable hideous crimes? British Labour?
Funny you should mention them. MI5 discovered that a covert group roughly coinciding with what was later called the “Red tendency” in British Labor made plans for a violent Communist coup that involved bizarre tactics like spreading contact poison on the floors of Westminster.
In 1973.
Yes, it was hushed up. Only came out in some officers’ memoirs decades later.
That is, unfortunately, correct. But two wrongs don’t make a right.
@Thomas Blankenhorn
Yep, that is right.
@PapayaSF
“have a tendency to lump together conservatives, Republicans, libertarians, the KKK, the Nazis”
Not the Nazis. But I admit my fellow countrymen might have some difficulty sorting these all out.
@esr
“MI5 discovered that a covert group roughly coinciding with what was later called the “Red tendency” in British Labor made plans for a violent Communist coup that involved bizarre tactics like spreading contact poison on the floors of Westminster.”
Your clasping at straws here.
A “Libertarian” blew up a federal building in Oklahoma. The Italian pseudo freemason lodge P2 with connections to the Vatican planned a violent right wing coup. Belgian right wing police officers planned a coup (probably linked to the Gang of Nijvel). I can go on and on.
Neither Labour nor their continental counterparts have supported anti democratic actions by anyone.
Hmm. I notice the above examples include several groups espousing philosophies Eric is at odds with, and one group expressed in quotes, presumably because the individual did not actually ascribe to the philosophy espoused by that group.
@esr
“and one group expressed in quotes, presumably because the individual did not actually ascribe to the philosophy espoused by that group”
Just as the members of labour were at odds with those among them plotting murder. You cannot judge a whole polirical movement by the actions of a few, at one time, plotting in secret.
But this whole argument is silly. Social democrats have been in power in every West Eurooean country. That has never lead to coups or concentration camps or widespread censorship. In all cases, the people went to the polls in due time and gave them another term or not. No violence, no crimes against humanity.
So arguing the Social Demicrats are a force of evil equivalent to Stalin or Hitler is plain silly.
> You cannot judge a whole polirical movement by the actions of a few, at one time, plotting in secret.
You can when their plot is perfectly consistent with the expressed premises of the larger movement.
I’m amazed that the US hasn’t exploded into a morass of people voting with the firearm/high explosive of their choice multiple times in the last decade. And by morass i don’t mean a small group that is quick to be demonized, i mean a new american civil war.
@esr:
Since we’ve generally devolved into a political discussion here, is there a particular subculture or platform within anarchist politics with which you would generally identify? I am myself mostly an agorist, but find describing myself as “believing in post-Westphalian models of governance” helps people who haven’t studied anarchist philosophy better anticipate my stance on the various issues than stating a more traditional-slash-accurate affiliation.
>is there a particular subculture or platform within anarchist politics with which you would generally identify?
You’d be pointing in the right direction to describe me an anarcho-capitalist of the Friedmanite tendency.
I was a friend of SEKIII for many years before he died. The differences between Friedmanite anarcho-capitalism and his agorism are inconsequential, mainly matters of rhetorical style.
> As far as I know, “history before the FDA” clearly does not actually bear out a claim that the market of that era wasn’t filled with poisons and snake oil
You’ve not answered this.
That the market of that era was filled with poisons and snake oil is what he meant, what you knew he meant, and what you still haven’t provided even an unambiguous statement of disagreement, let alone evidence against.
>That the market of that era was filled with poisons and snake oil is what he meant, what you knew he meant, and what you still haven’t provided even an unambiguous statement of disagreement, let alone evidence against.
Stop pretending you can read my mind. When he said “effective”, I took him to mean what he said.
Of course the pre-FDA market was full of poisons and snake oil. Rather like … today’s market. Unless you think all those “nutritional supplements” are bottled magic? And that he toxic effects of nonprescription drugs like, oh, I don’t know, aspirin, have somehow vanished by government fiat?
Thus, when I have influence I try to moderate the zeal but not suppress it, hoping that the naive idealists and the reflexive hunker-downers will more or less neutralize each other. It would be better if everybody just did sound praxeology, but human beings are not in general very good at that. Semi-tribalized meme wars fueled by emotional idealism seem to be how we roll as a species. People who want to change the world have to learn to work with human beings as they are, not as we’d like them to be.
Until someone invents a drug that *makes* humans how they’d like them to be. :P
> Most of my countrymen don’t “joke” about being communists. That is, they do not knowingly associate themselves with radical evil – give it cover, give it respectability.
No, instead they give it cover and respectability by associating their moderate opponents’ views with it.
This might be true also of 3D printing and milling machines.
Things are changing. If I need a gear, a flange, or something, I don’t need to have one that has very high setup costs for injection molding or factory production. I can just print or mill it, at least if it is opensource. Same with circuitry – electronic hardware and designs. It is hard to see because there are stocks and a supply chain so it is still more convenient to order it.
My own humble contribution along these lines: http://www.thingiverse.com/thing:962350
A MATLAB/Octave (if you don’t have MATLAB, Octave works fine) script to generate involute gear STL files.
Even supposing you were right about the SPD’s motives (which you’re not): Wouldn’t you prefer a party to cast the right vote for the wrong reasons rather than doing what Germany’s two classical-liberal parties did (DDP and DVP)? They both ‘voted for liberty’ by unanimously affirming Hitler in the role of dictator, above the constitution and any laws under it.
>Wouldn’t you prefer a party to cast the right vote for the wrong reasons rather than doing what Germany’s two classical-liberal parties did (DDP and DVP)?
Pretty much nobody with power in that stretch of history behaved like other than a villain or a coward. How else do you think I became persuaded that even constitutional democracy is fatally unstable in the direction of tyranny?
Over-prescription of antibiotics in infants and young children has resulted in an epidemic of unintended chronic illnesses by critically distorting an individual’s microbiome at this early stage of natural development. As such, a lot of new drug development is aimed at remedying these problems, but ignores the root cause. This is a vicious cycle with a very long latency cycle, and consequently may never by broken. Some forms of high tech are anti-evolutionary.
@esr:
> How else do you think I became persuaded that even constitutional democracy is fatally unstable in the direction of tyranny?
I don’t think you take it far enough: Even anarchy is fatally unstable in the direction of tyranny. *Humanity* is fatally unstable in the direction of tyranny.
That said, while I agree that constitutional democracy (like everything else) is unstable, I don’t think the collapse of Weimar Germany, used as an example in your linked article, is the best example, as the founding circumstances of the Weimar democracy would have set it up for failure even if democracies were, in general, stable.
>I don’t think you take it far enough: Even anarchy is fatally unstable in the direction of tyranny. *Humanity* is fatally unstable in the direction of tyranny.
This might be so. But studying history persuades me that the least ineffective thing we can do is deny would-be tyrants the ideology and machinery of oppression that is statism. I am not alone in this; the constitutional minarchists who founded the U.S. attempted this. And, sadly, failed.
Your argumentation is sliding from silly to ridiculous. Bit there is pattern in your “madness”. You resort to rhetoric when your ideology is involved.
@esr
“You can when their plot is perfectly consistent with the expressed premises of the larger movement.”
Here you claim that Labour and their continental counterparts are part of a larger movement prone to commit hideous crimes. Guilt by association. This flies in the face of 70 years of history where these political movements were often in power without any of the hideous crimes even attempted by any these parties. I think you will be very hard pressed to present actual evidence that the Social Democrats have in any way worse than their conservative compatriots.
The pattern in your insistence on their evil is that you are certain the left is the incarnation of evil. Therefore, you do not have to bother with actual behavior. Guilt by (any type of) association is all you need.
@esr
“Rather like … today’s market. Unless you think all those “nutritional supplements” are bottled magic? And that he toxic effects of nonprescription drugs like, oh, I don’t know, aspirin, have somehow vanished by government fiat?”
Again, the pattern is the same. The FDA are a powerful representative of the state, states are evil, therefore, the FDA is evil. No real evidence is needed, just rhetoric.
So you feel you do not have to stoop down to look at what the task of the FDA is, i.e., separating safe and effective medical drugs from safe foodstuffs from dangerous stuff. The task of the FDA is most certainly not prohibiting people from drinking green tea or following homeopathic advice because they believe this is beneficial to their health.
The aspirin argument is completely absurd. All medical treatments and drugs are harmful. That is even why they work. It is just that some of the side effects are beneficial when you are ill (e.g., it kills the germs or cancer cells before it kills the patient). The task of the FDA is to balance the risks against the benefits. Where to put the balance and whether the FDA do a good job is subject to discussion. But that is their job.
Somehow, my comments disappear in a black hole.
@esr
” But studying history persuades me that the least ineffective thing we can do is deny would-be tyrants the ideology and machinery of oppression that is statism.”
Ideologies don’t kill people, people do.
(short comments work, my longer comment seems to be gone forever)
>Ideologies don’t kill people, people do
Would you seriously claim to a Jew about to be machinegunned into a trench that Nazi ideology had no causal power in his death? And would you deny that he was killed by the machinery of the state?
>If you think that’s true, what you should be aiming for is to help “normal market forces” work better
Curetogether.com is a good example. Seriously, this site helped me immensely.
The complicity of Eurocommunists and Eurosocialists in Red atrocities is considerable, though not universal.
As regards the Sozialdemokratische Partei Deutchslands, it was in power in 1918-1920 and 1928-1930 without becoming a dictatorship. OTOH the Kommunist Partei Deutschlands was explicitly opposed to democracy, like the Nazis. The Weimar Republic fell when between them they had a majority of the Reichstag. And the stooges who ran East Germany for the Soviets were local Communists.
Eurocommunists generally were supportive of the USSR, opposed to NATO, and opposed to any resistance to Communist attack elsewhere. They often provided academic and cultural cover for Soviet propaganda, and helped organize anti-American protests (the so-called “peace movement”).
As regards British Socialists: Sidney and Beatrice Webb were among the Labour Party’s most prominent intellectual advocates, and also enthusiastic apologists for Stalin. Another was Hewlett Johnson, the “Red Dean” of Canterbury. George Bernard Shaw visited the USSR and reported there was no famine. There is, to this day, a “Stalin Society” in Britain, whose members have included important Labour Party activists and trade unionists such as Arthur Scargill (head of the coal miners union during the conflict with Thatcher). To be fair, in 1950 the Labour government joined the U.S. in defending South Korea against Communist attack.
In the 1970s to the 1990s, the Labour Party had a “Militant Tendency” of Trotskyites, who had to be purged by an “icepick brigade” of party enforcers.
>They often provided academic and cultural cover for Soviet propaganda
As a concrete example: we know a lot about the mechanics of Soviet dezinformatsiya during the later Cold War because the man who was the Soviet station chief in London around 1980 was fully debriefed on this after 1992. A favorite tactic when Moscow Center wanted to float a legend was to use socialist (not avowedly Communist, but socialist) newspapers in France and Italy to do it.
Of course this hinged on the socialist newspapers being controlled by KGB and GRU agents of influence. Which they were, along with pretty much everything else the “democratic socialists” did. If he and other sources are to be believed, the Soviets thought Western naivete about this was hilarious. And exploited it ruthlessly.
Most people delegate their thinking, and thus the determination of their actions, to ideology. This is why controlling rhetoric has always been a key aim of anyone seeking power: Make an idea either literally unthinkable or so taken for granted that no one questions it, and then you can demand action based on it. See, for current examples, “rape culture”, and the labeling of any criticism of climate alarmism (particularly including “Why should I believe your current predictions if your past predictions have been wildly inaccurate?”) as “denialism”, implying that there is no possible honest room for disagreement.
@esr
> Of course the pre-FDA market was full of poisons and snake oil. Rather like … today’s market. Unless you think all those “nutritional supplements” are bottled magic? And that [t]he toxic effects of nonprescription drugs like, oh, I don’t know, aspirin, have somehow vanished by government fiat?
Eric, this is pretty thin.
When your conclusions are so obviously shrouded in ideology you should probably revisit your assumptions.
>Eric, this is pretty thin.
Don’t know why you say that. The phony nutritional supplements are a perfect example of why the FDA cannot in fact do the job it was chartered to do – not merely does not, but cannot. All it takes is a few phone calls to congresscritters and the “effectiveness” criterion goes out the window.
@esr
“Of course this hinged on the socialist newspapers being controlled by KGB and GRU agents of influence.”
We saw the same with newspapers controlled by the CIA et al.. That does not say anything about the people reading the newspapers. Often, this was even kept hidden from the “owners” of the newspaper. Just like the CIA tended to infiltrate left wing publishers. On the contrary, simply the fact they the Soviet operatives had to do it secretly shows that the people reading the newspapers did not want to follow them.
@esr
“Would you seriously claim to a Jew about to be machinegunned into a trench that Nazi ideology had no causal power in his death?”
The ideology was already pretty old, and was at the time pretty widely spread over Europe (pogroms were common practice all over Eastern Europe). Still, only the Germans did the genocide thing, and even they had to do it mostly in secret (although that seem to be disputed) by special forces (the SS).
I seem to be unable to respond anything beyond a few lines. Everything else disappears. Anyone who has an idea what is wrong?
Do you have ‘legal highs’ in the US? Drugs which purport to mimic banned ones but due to ‘the strict letter of the law’ manage to avoid being illegal. Should the law be better written or is it impossible since what ever you legislate someone will ‘invent’ a way around it? Then even when something is marked ‘not for human consumption’ some idiots will take it …
@esr
“The phony nutritional supplements are a perfect example of why the FDA cannot in fact do the job it was chartered to do – not merely does not, but cannot.”
You seem to believe that your government already surpassed Stalin and should see a need for trying to forbid people to eat or believe in “health foods”. That is a kind of tyranny you do not often find in human history.
Why should the FDA care what people believe? They only want to make sure that when it claims to be medication, it actually is medication.
If I want to ensure that foods labeled to contain no salt do, in fact, not contain salt, there is no reason to forbid the sale of foods containing salt.
Back on topic. Here is another blog post on Open Source Pharma from Andy Updegrove
http://www.consortiuminfo.org/standardsblog/article.php?story=20150904123645851
@TomM, @Random832:
What is your stance regarding the use of “off-label” prescriptions, ie. not for the formally approved purpose? Is this an acceptable practice within medicine (the role of the approval process is to help ensure drugs do no harm), or problematic (should be considered a ‘snake oil’ placebo when there are no studies to prove efficacy)?
As may be implied by my parenthetical asides, neither of you have stated a clear enough position in this discussion to allow me to predict which conclusion you might favor. (I also recognize the example reasoning given are not mutually exclusive predicates, which also confounds such predictions.)
@ Christopher Smith – “Most people delegate their thinking,”
All living things are creatures of habit, and homo sapiens are unique in that our use of complex language allows for wetware reprogramming of our brains (and hence thinking habits). Memetics is the science of this phenomenon and political indoctrination is one of the applications. Hijacking of fundamental social indoctrination tools (think early childhood education or religious training) is one of the ways to enable a tyranny.
@Winter Do your comments happen to include the word “Social-ist”?
@ESR I don’t know why your CSS is defined to suppress bold tags in comments. I tried to emphasize the “cial-is” part in the above comment to point out *why* that word gets blocked by the spam filter.
Not the ones controlled by the CIA.
@Random832:
I also have a comment currently held in moderation. It does not appear to contain any spam-like language, has zero links or other formatting, and isn’t extremely long (or extremely short) compared to others in this discussion. I’m not sure what is triggering the moderation queue, but it’s rather mysterious.
@Random832
“@Winter Do your comments happen to include the word “Social-ist”?”
Quite likely.
@Winter
> It is also a truism that safety and effectiveness are tradeoffs. You can argue that the FDA makes the wrong tradeoff. But when you abolish the approval process, you do not abolish the tradeoff. You only hand it to different people.
This Winter is exactly the point. I doubt anybody here objects to the idea of an organization, preferably several organizations, determining the safety and effectiveness of drugs or other medical devices. What I, and I suspect many object to, is the idea that if one agency determines that it doesn’t meet the standard they have set that you get thrown in jail for using a drug without their approval.
Make the FDA advisory. Decide your trade-off yourself with the help of your doctor. Change your trade off at different times in your life. It is INSANE to thing that the same risk reward ratio is appropriate for everyone at every time.
For example, currently in the USA there is a very serious shortage of coral snake antivenin. There is lots of it in Mexico, but almost none in the USA, and most of it is expiring. Why? Because there aren’t too many coral snake bites in the USA, and going through the FDA approval process to set up a manufacturing plan for a drug that has already been used for a hundred years is just too darned expensive.
So if you are getting bit by a coral snake, you’d better hope it happens in a third world country like Mexico. They can treat you there with their backward medical system. In the USA? Better to die a horrible death that take the risk of an unapproved medicine.
My God! Let people choose their own medicines with the help of the doctor! Sure generate information about them. Gather test results. Make M&M analyses of the drugs in production.
But whatever you do, don’t get bit by a coral snake in modern day America.
@Winter Just to spell it out more explicitly – “Cial-is” [with no hyphen] is the name of a drug that is commonly advertised in spam. It’s been noticed in the past that the spam filter here does not respect word boundaries.
@Jessica
“you get thrown in jail for using a drug without their approval.”
Please confirm that I read this right. A patient gets thrown in jail for using a non-approved drug?
I am pretty sure that is not so in Europe.
@Random832
“@Winter Just to spell it out more explicitly”
I got it. Fun with False Positives.
Winter> Please confirm that I read this right. A patient gets thrown in jail for using a non-approved drug?
If somebody makes the drug for distribution to humans without FDA approval, it’s a felony. If you take the drug (either off-label by getting it from a Vet or bringing it across the border or in you basement chemistry set) it’s a felony. And if a doctor recommended it, it’s a felony (and automatic loss of FDA script privileges, which basically means he’s not a doc any more even if he beats the charges).
So, are you starting to see why we hate the FDA over here now? It’s not just a matter of they say “You shouldn’t use drug X because it’s snake oil.” It’s because “Drug X is snake oil until you can prove it’s not, and no you can’t do trials until you prove it’s not snake oil.”
It’s hard to be for an agency when they have a press conference saying something like, “We’ve studied this drug for 10 years to determine it was safe and effective, and now that we’ve approved it we believe it will save 1 million people per year.” So, 10 million people died why you made the inventors jump through hoops? And I’m supposed to be HAPPY about that???
BTW, Jessica, I think I’d disagree with you about the military causing more deaths than the FDA at this point. I’m pretty sure we’re past the tipping point on that body count.
@ esr
> Yes, I do. I found it quite crushing to learn that Dorothy Sayers was a Stalinist.
Sorry, I don’t know her. But I was thinking mainly about music; it seems to me that most musicians are leftist. If we boycott them, what’s left? (No pun intended.) In additions to our recent conversations on music, I’ve seen old threads in which you praised quite a few musicians (especially guitar virtuosi). With all due respect, are you sure none of them is a statist of some sort?
And speaking of musicians you’ve mentioned (or rather not mentioned): given your love of jazz fusion, I’m surprised you never discussed – at least on your blog – certain luminaries of the genre, such as Miles Davis and Jaco Pastorius. Do you feel they’re overrated?
> I was a friend of SEKIII for many years before he died.
I didn’t know you were friends with Konkin. I’m sorry for your loss.
@Winter
> Please confirm that I read this right. A patient gets thrown in jail for using a non-approved drug?
Eh, yes. To use one high profile example, Steve Kubby, LP Candidate for Governor of California. Of course it doesn’t happen a lot because the FDA has got the supply locked up, and the suppliers get thrown in jail a lot too (or sometimes suffer massive fines and loss of their business.) If people actually had access to these life saving meds it would happen a lot more because the worst crime in America is disrespecting the government.
Denying people access to drugs of their choice by throwing their suppliers in jail amounts to the same thing.
@Jessica
I am not sure about the exact laws, so this should be taken as an impression from the country I live in.
I think consumers can take whatever substance they can put their hands on, legally. This holds for illegal drugs (in the Netherlands). Posession for personal use, the same. I have never heard of someone jailed for consuming any substance.
However, distributing or posessing unapproved, or off-label substances is a different matter. That is more like the US I think.
There are provisions for off label use, but I do not understand that situation.
Btw, for every life saver hold up in testing there are several where untested use would have ended badly. This too is a balance.
But I understand the FDA: There must be rules, and the rules must be applied blindly and without thinking.
I read “The death of common sense” in the 1990s. That book explained a lot about the USA to me. Although I still get surprised by the blind idiocy with which rules are written and applied in the US.
The earlier remark about German “Grundlichkeit” transplanted to the US makes sense. But I know from experience that the Germans can be quite reasonable too.
@Don
> It’s because “Drug X is snake oil until you can prove it’s not, and no you can’t do trials until you prove it’s not snake oil.”
Perhaps the worst part of the FDA is the futility of the whole thing. I have done development under the yoke of the FDA. It involves masses and masses and masses of utterly pointless busywork and forests full of paper. I’m sure they do some valid and useful things, but you have NO idea how much BS is involved until you sit in the room full of stacks of paper, or go through the meetings where people argue endlessly and utter ephemera just because they have nothing better to do that show their own putative importance. I worked for Baxter Healthcare for a while. They have vaults the size of a large church full of shelves and shelves of books that nobody ever reads.
I have done it once before, you could not pay me $10,000 an hour to do it again.
…
OK, maybe $10,000 an hour. But I wouldn’t do it for long and I would definitely drink heavily. (Which is obviously a good thing from the people doing your life critical stuff.)
@ Jessica Boxer
Yep. I’ve spent the last 2.5 years learning the joy of working for a contract pharma manufacturer. The ridiculousness of hoops that must be jumped through to satisfy regulators (and the arbitrariness of the regulatory rules) is amazing.
On the plus side, coming from small shops, it’s the first job I’ve had where pay raises are mostly automatic, reviews happen (and on a schedule!), and compared to my last six jobs, I work so little it’s like being on vacation every day. I’m thinking about getting another job to do while I’m at work so I can be busy :).
I guess where you’re at kinda depends on where you come from ;).
Off-label use is essential for a lot of critical things. For example, the use of naloxone to reverse opioid overdoses is approved via IM and IV routes. However, the route which is being used by all of the members of the public and first responders is intra-nasal administration. This isn’t approved by the FDA. This also means that it can’t be sold in a single device for IN administration. The result is that you have to buy the drug in one cartridge, and then an atomizer as a second unit which the end user has to piece together.
Apparently, an open source variant of the Pharma model is already in practice and appears to be upsetting the apple cart.
http://chimera.labs.oreilly.com/books/1234000002036/ch02.html
Yes, I do. I found it quite crushing to learn that Dorothy Sayers was a Stalinist.
Say what!!!!
Dorothy Sayers was a devout Catholic and an eloquent Christian apologist. She was also a scholar of medieval languages and IIRC a friend of J.R.R. Tolkien and C. S. Lewis.
I haven’t read all her works, just the mysteries and her translations of Dante and the Chanson de Roland. There isn’t a visible trace of “Stalinist” sentiment in the mysteries – but there is considerable ridicule of Communists and other “modernists”.
Are you sure you haven’t got her confused with someone else?
>Say what!!!!
Sorry. Brain fart. I meant Dorothy Parker. The humorist.
To be more on topic that (as I see) vast number of comments: there are quite a bit of trying to crowdsource fragments of scientific process, with programs and games such as FoldIt and EyeWire (both medical-related, in medicine as science). Though from what I browsed they are edu-free freeware, not opensource, unformtunately (well, except those that use web standards, like WebGL – by necessity they include sources).
Jessica has hit on the key problem. If the FDA would confine itself to assuring that medical professionals and consumers get as much information as possible to make good decisions, but refrained from “banning” anything outright, it wouldn’t be the problem that it is. The FDA could require that doctors inform patients and obtain specific consent (“I understand that ${Drug} has not been approved by the FDA for the purpose for which ${Practitioner} has prescribed it, and accept the risks that it may produce unknown side-effects and/or be ineffective in treating ${Disease}…”) before an unapproved drug can be prescribed. That’s a fairly minimal bar.
Agencies like the FDA take credit for improving the quality of medicines that properly goes to the scientists who advanced medical science to the point where it’s even possible to evaluate the safety and efficacy of drugs.
Re: spam-trap. The trick in using the word “socialist” is to insert an HTML Entity such as “‍” into the word so that it no longer contains the name of that drug.
>Re: spam-trap. The trick in using the word “socia?list” is to insert an HTML Entity such as “” into the word so that it no longer contains the name of that drug.
As this post demonstrates, “socialist” does not cue the spam trap.
Good, it still works:
socia‍list => socialist
socia‍lism => socialism
etc.
Fail.
socia‍list => socialist
socia‍lism => socialism
etc.
> I think consumers can take whatever substance they can put their hands on, legally.
> This holds for illegal drugs (in the Netherlands). Posession for personal use, the same.
Wikipedia begs to differ with you:
https://en.wikipedia.org/wiki/Drug_policy_of_the_Netherlands
As did the tour guide I overhead discussing last Sunday when I was sitting in O’Reilly’s pub.
Now, they *do* have a “we won’t prosecute” policy for small amounts of pot, and yeah, parts of the CBD smelled a lot like Denver (or like that shit-head in the car next to me this morning), but the tour guide made it fairly clear that you *could* get arrested (especially @Schiphol) or when traveling around the Netherlands if you were holding.
It is also clear from looking around a bit that the Netherlands has a rather rigorous policy regarding “hard” and prescription drugs used without a prescription. Again they may have a more rational policy on how to treat addicts/users (putting them in jail is pointless, treatment of underlying issues is probably a more useful option). However here in the states we *rarely* put people in prison for possession of small amounts, especially Pot.
You must remember that in the US Progressivism (which is an umbrella that covers Communism, Socialism, Nazis and Fascism movements) grew out of, or was based from Christian churches, and the goal very much was to improve man and society. Christianity in the US was always of the more schismatic kind, and often based on the folks Europeans drove out for being too strict/nuts. Hence the Quakers, Calvinists, etc.
In many ways Progressive thought (in the US) IS the union of Church and State, but it’s been so long since the Progressives were really Christian that they’ve forgotten why they do these things. It’s just doctrine now.
But this is why *we* do these things. People like Teddy Roosevelt and others of that ilk took the position that if Man wouldn’t “do the right thing”, we’d make him. And they tried to.
And, like the rest of what has become the Progressive mindset, it’s an utter failure and in many ways makes things worse.
The way it works in the US is that once a drug has been approved FOR ANY USE, it can then be prescribed for *any* other use, even if that use has not been approved.
Note that as the Bush-era IRS fairly pointed out, Congress sets the rules, and the agencies allegedly implement them. Don’t blame the FDA for the role it’s cast in; blame your critters.
Eric, what do you think will be the equivalent of Apache (the web server) for open-source pharma?
Specifically, Apache was where you went when you didn’t want to buy a web server, didn’t want to write your own from scratch, but didn’t mind that you might have to fix bugs or add new features in order to get exactly what you wanted.
Also, how is open-source pharma different than researchers publishing papers about their research (in journals or otherwise)?
>Eric, what do you think will be the equivalent of Apache (the web server) for open-source pharma?
I don’t think I know yet. I haven’t studied the problem closely enough.
> Sorry. Brain fart.
“Brain fart”? Didn’t know that term. But I now see it’s in the Jargon File.
> I meant Dorothy Parker. The humorist.
Oh. I don’t know her, either.
Anyway, I just realized that in my previous comment I wrote “in additions to”. You must have hated that; but I assure you it was unintentional, not the result of a misconception (which would be stupid even for my standards). And it cannot have been a typo, either, since the S key is adjacent neither to the N key nor to the space bar. Therefore, it counts as a *brain fart*, doesn’t it? :-)
Also, how is open-source pharma different than researchers publishing papers about their research (in journals or otherwise)?
A separate topic: But can anyone access those journals where the “free exchange of scientific ideas” is “published” without million dollar university library subscriptions? The DRM (and ITAR and export restrictions) on scientific papers is pretty extreme.
My university recently decided that all data/files generated during our stay belong to the university. We are to upload everything to a central server prior to leaving and the hard drives we bring in are to be wiped, so that we don’t “illegitimately” retain any copies of our own work. It’s unenforceable, but the intent is noxious.
@petro
“I beg to differ”
“It is also clear from looking around a bit that the Netherlands has a rather rigorous policy regarding “hard” and prescription drugs used without a prescription.”
The link you gave tells it. Users dot not get procecuted for using any substance. Users also do not get procecuted for the possesion of small amounts for personal use. That does not hold for whomever sells the stuff. And most certainly not for people trying to take any amount in or out of the country.
@petro
“And, like the rest of what has become the Progressive mindset, it’s an utter failure and in many ways makes things worse.”
So US conservatism is a brand of fatalism? The believe that we live in the best of all possible worlds. Any attempt to improve it is futil and leads to disaster.
That is indeed the believe of the religious fundamentalist.
The evidence betrays this believe. The world is a better place now than it was in the 19th century. And a lot was by design by progressivists.
Is it even theoretically possible for a moderator to get put in the spam trap?
I replied to ESR questioning his logic. That reply got put in the mod queue.
>I replied to ESR questioning his logic. That reply got put in the mod queue.
I have pretty much given up trying to figure out why Akismet (the stock WordPress spam filter) behaves strangely in edge cases. Statistical fiterung is like that sometimes. It’s nothing I am doing.
Didn’t think it was, explicitly. Just noting that your rationale seems to be off, and that quoting your “see, this works” comment was enough to trigger the filter. The complaints about the political sobriquet seem to be justified.
This is a test of the theory that “socialist” triggers the spam filter for other users, but not for moderators. If this does not end up in the mod queue, then “socialist” does not trigger the filter. If it does, Eric, please approve and quote this post. If your quote is blocked, then you are subject to the spam filter and some other factor than the word “socialist” is triggering the filter. If your quote is not blocked, then it is most likely that you are not subject to the filter and “socialist” is triggering it.
I made the following test post, with “the s word” replaced with the word suspected to trigger the spam filter. It went to the moderation queue. So now we wait to see if Eric’s quote of the post will be blocked.
This is a test of the theory that “the s word” triggers the spam filter for other users, but not for moderators. If this does not end up in the mod queue, then “the s word” does not trigger the filter. If it does, Eric, please approve and quote this post. If your quote is blocked, then you are subject to the spam filter and some other factor than the word “the s word” is triggering the filter. If your quote is not blocked, then it is most likely that you are not subject to the filter and “the s word” is triggering it.
This post is to test whether the spam filter is filtering words that contain the names of drugs with *ahem* “certain functions” as substrings.
“The Union of Soviet Soviagrat Republics no longer exists.”
>“The Union of Soviet Soviagrat Republics no longer exists.”
This one didn’t pass the mod filter. So it’s probably not the word “socialist”.
If that word is triggering the spam filter, it’s probably due to the six-letter substring beginning with the third letter.
Oh, looks like The Monster already pointed that out.
@esr Er, just what exactly do you think he was testing with “so-VIAGRA-t”?
Ah, memories of a stupidly naive “profanity blocker” keylogger I encountered in my youth that would block the last four letters of the phrase “has hit”, but which was clueless enough that using the arrow keys or mouse to reposition the cursor defeated it.
Christopher Smith,
That’s one for the ages — a true clbuttic.
@esr:
>This one didn’t pass the mod filter. So it’s probably not the word “socialist”.
It’s not the word “socialist” itself, but the fact that “socialist” contains “cialis” as a substring. Substituting “viagra” for “cialis” in “Union of Soviet Socialist Republics” triggers the filter as well, which indicates that strings of the form so[$APHRODESIAC]t trigger the filter.
As this post contains the words “viagra” and “cialis” , I figure it is almost certain to end up in moderation.
Eric, I want to go back to something you wrote in the OP:
> It would be better if everybody just did sound praxeology, but human beings are not in general very good at that.
Are you talking about praxeology in the Misesian sense or in some more general sense? In any case, what’s your prescription for becoming good at it?
>Are you talking about praxeology in the Misesian sense or in some more general sense?
The Misesian sense.
>In any case, what’s your prescription for becoming good at it?
Well…I know how I got good at it – by thinking about microeconomics and libertarian political theory for a long time. But I’m far from sure that would work for most people.
Before the comments on this post close, I would like to share my thoughts on the subject of OSPharma.
First an anecdote, which shows my vested interest. My daughter, while studying at Vassar College (at the age of 22), suffered a stroke. While she was physically very healthy until this point in her life, we can only assume that this stroke was caused by a birth control pill. As I understand it, after much therapy she is almost back to normal with the exception of some residual left side restricted movement. Further, I understand that she was included in a class action against the manufacturer. Whilst I have been able to track down some of the info about the case, most is filed under seal, and she doesn’t (can’t) talk about it. Not speaking to one’s ex for 14 years doesn’t help.
Hence my interest in seeing some sort of transparency, especially in the areas of FDA approval, the availability/publication of the research, testing procedures, and test results (animal and human) of both approved and unapproved drugs, and the chemical composition(s) of such drugs. As I understand it, the US patent system is there to teach – and as a result of pharma’s sharing of their discoveries, they are granted a monopoly over the manufacture and sale of the products that they discover. So it would be fair game for a OSPharma database to include all the specifics of each and every past, present and awaiting approval pharmaceutical patent application. It is not as though a searchable database is going to start manufacturing drugs out of bits and bytes!
While I hate to say it (because it grates): If a drug manufacturer has a patent and FDA approval, they ‘have nothing to fear, if they have nothing to hide’. Going back to my anecdote, they must surely have tested said pill for clotting attributes (i.e. the cause of the majority of strokes). Whether such testing is sufficiently thorough to cover genealogical and physical variances in the intended users of their drugs, is an unknown that should be known – and potential users should be warned of the percentage possibility of ill effects. If the FDA approval process is unable to make such determinations, then it is a load of crock. And as a result the vast expense, claimed by Big Pharma, of R&D and testing a patent waste.
I have read through the comments above, and the 55 comments on Eric’s Google+ post, and find that 90% entirely miss the point. They mainly argue for and against the profitability and R&D and manufacturing costs incurred by Big Pharma, while I believe that the positive impact on the quality and cost of drugs that could be achieved by a OSPharma searchable database would be enormous. If all the data, from both failures and successes, of the R&D and testing were consolidated then it should be possible to look up the chemical components of my daughter’s birth control pill and correlate them across the board with all the other drugs that contain the same elements, and either issue warnings and/or severely restrict the use thereof.
If such data were readily available (worldwide?) then an enormous amount of time, money and effort would not be fruitlessly wasted reinventing the wheel (i.e. doing the same research that someone else has already done). This should be a boon for Big Pharma, (as well as university labs, startups, etc.), in that their failure rate, which is bandied around as a 10:1 would be greatly reduced.
I have not mentioned academic and scientific journals and papers above, since I don’t know how to slot their ‘knowledge’ into the proposed OSPharma database/repository, and I have no clue as to how to overcome the IP issues in getting them into the Public Domain, so that they can be shared and searched, in order to benefit mankind now or in the future.
Perhaps it is time to think outside the box, give it a good shake, check whether the cat is alive or dead, count to 42, and build something as prolific and earth shattering as the OSPharma project portends. Crowdsourcing rules.
It’s tempting to go from the evidence that humans don’t always behave in a ways explainable by praxeology – that is, some of their behavior, even economic behavior, is reflexive rather than purposeful – to the belief that when they don’t, a free market will yield a less desirable result than one where some humans are simply told what to do. The ol’ “Social Security exists because you’re too shortsighted to save for your own retirement” argument.
That said, some people do, in fact, appear to act against their own economic interest. Free market advocates note that free markets tend to penalize such actions. Free market opponents apparently are worried they’ll act irrationally anyway.
Paul Brinkley,
As Quentin S. Crisp observed: “It has been found that the only people who really fit the simplified mathematical model of self-interested rational behaviour at all times are economists and psychopaths.”
We do not need to hypothesize on what a United States with a truly free market would look like. We have an example from history — the late nineteenth and early twentieth century. The Gilded Age. The era of robber barons. Free and unfettered markets made a select few rich while most of the working class struggled to make ends meet, working long days in grueling and unsafe conditions and often sending their children to do likewise to supplement the family income. From this environment came strikes, unionization, leftist activism (no KGB agents of influence then because no Soviet Union!) and demands for labor and occupational safety laws, which were eventually implemented.
The free market has been a disaster for this country. Government regulation is one of the most effective tools we have to correct or prevent catastrophic market failures. It remains so to this day. Future generations may enjoy less skin cancer risk than my generation must deal with because of the Montreal Protocol banning CFC use. In less time than it would take for the market to figure out what the most economically rational course of action is (provided the market has instruments that account for the long-term externalities of CFC use), government stepped in and did the job.
>. Free and unfettered markets made a select few rich while most of the working class struggled to make ends meet
That’s as historically insane as Winter’s belief that Naziism didn’t kill any Jews. The Gilded Age in the U.S. saw more human beings achieve middle-class purchasing power than any era in any place before it, and normalized for population size no time period of comparable size has done as well since. Only the immediate post-WWII period even comes close.
@Paul Brinkley
“That said, some people do, in fact, appear to act against their own economic interest.”
This assumes that we are able to reduce all our “interests” into a single dimension where we can add a monotonic value (price) to each “interest”. It is not entirely clear why this should be possible. And even less reason to assume humans can do this reliably.
One approach would start with the observation that people have to make “emotional” judgements (will I be happy in this house?) ass well as “rational” judgements (will I be able to pay the mortgage given expected interest rates change in relation to my future income?). There is no reason to assume that the emotional valuation uses the same “currency” as the “rational” valuation. If these two are out of sync, people will make “irrational” choices.
@Paul Brinkley
“Free market advocates note that free markets tend to penalize such actions. Free market opponents apparently are worried they’ll act irrationally anyway.”
Lets talk computing. This is also a computational problem: How many strategies can I compute over what time depth to select the “optimal” solution? We do know people have a limited time horizon. Hence the two retirement problems: People save too little for their retirement, but when they have money, they do not spend it before they die.
So, even in a perfectly free market, people’s abilities are limited so they will have a limited time horizon and a lack of information. Even if they could act rationally, they simply lack the information and capacities to find the optimal solution at any given moment in life.
That people in Africa and the Middle East can find thousands of dollars (that seems to be the currency of choise?) to pay traffickers to get them to Europe in the mistaken believe they will have better health care and a better life just reinforces that. Only this weekend Germany has finally realised THEY are adding to the problem by saying they will take everyone, while the UK has always tried to help support the camps closer to home in a hope that the millions of refugees can at some point move back to where they want to be. In those camps better health care is being provided than they got at home, funded by ‘overseas aid’ but as I have said before, the whole system is broken when minorities can take control and displace the vast majority of the lawful population? Making a few more drugs more generally available is a bit of a futile gesture?
@Lester Caine
“That people in Africa and the Middle East can find thousands of dollars (that seems to be the currency of choise?) to pay traffickers to get them to Europe in the mistaken believe they will have better health care and a better life just reinforces that.”
Actually, I think the refugees are making a rational decision. If they reach Germany or the UK, their future and that of their children will look very, very much brighter than when they stay in the refugee slums in Lebanon or even the war zones in Syria. What they might not factor in well enough are the risks of getting there. But when you run the actual numbers, trying to make the journey might still be a well founded rational choice.
Whether they will be happy in Germany is another question. But being unhappy is still better than dead.
@Lester Caine
“In those camps better health care is being provided than they got at home, funded by ‘overseas aid’”
You might want to update your information on that. Especially in Lebanon. Also, there is inadequate schooling and no work.
@Lester Caine
“but as I have said before, the whole system is broken when minorities can take control and displace the vast majority of the lawful population?”
So there is a distinction between “minorities” and “lawful” people? We have a bad history on this going back many centuries.
Totally agree, but 4 million Syrian’s are living in camps rather than at home, and we can’t provide proper housing in Europe for all of them. Most WANT to go home … their own home … so what should be done? Start building Hospitals, Schools and Homes where they are billeted currently?
Tangentially related issue (of open access): should Wikipedia top editors use ScienceDirect accounts donated by Elsevier? It may lead to better sources, but it may lead to more reliance on paywalled closed-access sources…
http://arstechnica.com/science/2015/09/wikigate-raises-questions-about-wikipedias-commitment-to-open-access/
Side-note: WTF. ScienceDirect articles are so horrendously expensive, instead of “iTunes song” cheap (0.99 $)???
@Jeff Read:
If you google for “Economic statistics for the us 1800-1900”, the first result has a table (on pg. 15 of the PDF) showing nominal wages for the gilded age. Their base year, 1850, is indexed at 100 and show that by the end of the 19th century, farm labor wages increased 35% and non-farm labor by over 50%, even before we account for any inflationary aspects.
Checking statistics for inflation, the Fed’s CPI estimates for the same time period shows a predominance of year-to-year cost reduction. Even if wages had remained stagnant in the post-Civil War era (1865-1900), the buying power of those wages would have approximately doubled.
When you claim that “The free market has been a disaster for this country”, upon what basis do you ground your belief? The statistics I can find covering the “Gilded Age” point to a massive improvement of the quality of life for all Americans, not just the top 1%.
>When you claim that “The free market has been a disaster for this country”, upon what basis do you ground your belief?
That’s easy. He bases that belief on propaganda written by Marxists. Duh!
Jeff Read’s complaint reminds me of a possibly apocryphal story. A Gilded Age radical managed to get into the office of a rich man, and gave his speech about how the man’s wealth should be redistributed to the workers of the world. The rich man did some calculations and called in secretary to pay the radical “his share” of his wealth, which amounted to… about a dollar.
@ Paul Brinkley – The ol’ “Social Security exists because you’re too shortsighted to save for your own retirement” argument.
The federal Social Security program has never been a substitute “retirement savings” option that corrects a deficiency in the population of US workers. It has always been a supplemental mandatory tax that feeds additional funding into government’s general spending habit and thereby acts to encourage the growth of government in all aspects. It is fundamentally a Ponzi scheme that inevitably must go bust at some time in the future.
Encouraging large scale Ponzi schemes under the guise of altruism is anti-evolutionary.
>The federal Social Security program has never been a substitute “retirement savings” option that corrects a deficiency in the population of US workers. It has always been a supplemental mandatory tax that feeds additional funding into government’s general spending habit
Much as I would love to agree with this, I did the research and it’s not true. SS was in fact designed as a forced-savings option; it didn’t become a feeder for the general spending habit until Al Gore’s “lockbox” in the 1980s.
@Jakub
“should Wikipedia top editors use ScienceDirect accounts donated by Elsevier? It may lead to better sources, but it may lead to more reliance on paywalled closed-access sources…,”
Free Open Access papers get more citations hence better impact factors. That starts to bite.
@ esr
> The Misesian sense.
Thanks.
BTW, I’ve become skeptical about the Austrian school of economics after reading this short article and part of this longer document.
I might land on the Chicago school; after all, Milton Friedman predicted the phenomenon of stagflation. However, leaving the Austrian school probably means I’ll have to deal with equations sooner or later, and that’s a problem for me (the “tolerable subhuman” and all that). But I must pursue the truth, right?
Still, that school was probably my “gateway drug” into libertarianism; the resources at mises.org were certainly illuminating.
I may be pushing it, but… do you agree with the Mises Institute’s stance on the American Civil War? I guess you don’t, since you mention Lincoln along with Washington and Jefferson in your Gun Nut Page. But is there at least some truth to it?
@ Jeff Read
> Future generations may enjoy less skin cancer risk than my generation must deal with because of the Montreal Protocol banning CFC use. In less time than it would take for the market to figure out what the most economically rational course of action is (provided the market has instruments that account for the long-term externalities of CFC use), government stepped in and did the job.
That reminds me of a problem I have with some proponents of laissez faire, despite my general agreement with it. In “The Toxicity of Environmentalism”, George Reisman – who is an Objectivist – writes: “if there were in fact to be some reduction in the ozone layer, the appropriate response … would be to be sure that there were more sunglasses, hats, and sun-tan lotion available.” That strikes me as criminally irresponsible; I feel prevention is preferable (especially since I dislike the contact with sun-tan lotion… yuck).
In his Libertarianism FAQ, our host says there are minarchists who would accept “special powers for environmental enforcement”. I guess I could accept that; but IMHO, the ideal way to protect the environment would be some arrangement that involved the civil society and which perhaps would be grounded in polycentric law.
>BTW, I’ve become skeptical about the Austrian school of economics
Some skepticism is reasonable. Austrian economics has some historical baggage attached to it that it probably shouldn’t, leading to mispredictions. On the other hand about half of the critique in that short article is based on a what seems to me a rather obvious and tendentious misunderstanding of what the Austrians actually say.
I can handle equations, but I nevertheless like the Austrian style of thinking qualitatively about economics – it avoids the temptation to over-mathematicize from scanty and noisy data.
>do you agree with the Mises Institute’s stance on the American Civil War?
I have no idea what that position is.
but I nevertheless like the Austrian style of thinking qualitatively about economics – it avoids the temptation to over-mathematicize from scanty and noisy data.
Indeed, I’ve mostly followed your advice form N years ago to use both and not get too caught up in the doctrinal differences. I have noticed that many people who go hardline Austrian (as distinct form the Austrian thinkers themselves) tend to soak up too many religious-like patterns in their thinking. Too willing to condemn all corporations, while glossing over the fact that the one and only source of corporate power is government. This may simply be the influence of the Rothbardian MORALS UBER ALLES CONSEQUENCES UNTER ALLES! view however…
hmmm, maybe Rothbard reincarnated as Stallman :D
> the Fed’s CPI estimates for the same time period shows a predominance of year-to-year cost reduction. Even if wages had remained stagnant in the post-Civil War era (1865-1900), the buying power of those wages would have approximately doubled.
Interesting. This came as a something of a mild shock to me, so I dug into the details a bit. I went into this research expecting to find that the gilded age / “robber barons” were a net win for the country, albeit at the cost of terrible working conditions for unskilled workers, until the legal protections caught up and made unskilled working-class life more bearable.
Looking at these (and other) statistics, it looks like during much of the gilded age, the standard of living for unskilled workers stayed roughly constant (higher wages, but mostly eaten up by higher cost of living) and skilled workers’ standard of living shot up by roughly 50%. So, if someone claims that the gilded age represents “unrestrained capitalism”, I’m calling that a solid win for unrestrained capitalism.
What seems to confound the issue is the rise of labor unions/movements at the time. At face value, it doesn’t seem entirely unreasonable to claim that rise of labor unions and associated legal reforms helped increase workers’ quality of life.
Problem with this theory: the rise of labor unions slightly trailed the standard of living increases in time. It might be the case that the initial standard of living increases were due to an economic boom resulting from the end of the Civil War, then continued improvements thanks to the legal labor reforms, but that requires something of an interesting coincidence. Alternatively, productivity finally just became high enough to make implementing various labor reform laws possible.
Another confounder: high-tariffs. I don’t have a good grasp on how much tariffs encouraged large monopolies/trusts, but I bet it’s not trivial.
Conclusion: the gilded age is moderate, albeit not conclusive evidence, that Laissez-Faire “unrestrained” capitalism works pretty well.
@ ESR – “Much as I would love to agree with this, I did the research and it’s not true.”
Perhaps a comparison will clarify. Today, as in 1935, a private US citizen can voluntarily save some of their income during their working years and then use these funds to support themselves during their retirement years (or leave it to heirs if they die early). You could do this by putting cash under the mattress, deposit it into a bank savings account (and earn some interest), or invest it in a myriad of financial instruments (e.g. modern day 401k). In this option, individuals control and manage their own money.
By contrast, the federal Social Security program (and other the similar programs) have always been mandatory taxes collected by the IRS. These funds (like all federal revenues) have always been placed into special Treasury accounts managed by government officials. For the first four decades of Social Security, the FICA tax income exceeded the current year SS disbursements and government accountants represented that the “SS Treasury account was in surplus.” This was then (and is today) purely an accounting gimmick. The asset represented by this “surplus” account has been used continuously by the federal government to borrow against in order to fund other needs. In the early years, this borrowing was indirect and well concealed. Subsequent to the 1969, the subterfuge was dropped and the borrowing became direct and obvious.
> Much as I would love to agree with this, I did the research and it’s not true. SS was in fact designed as a forced-savings option; it didn’t become a feeder for the general spending habit until Al Gore’s “lockbox” in the 1980s.
Isn’t there an argument that it was obviously inevitable from the beginning, so the fact that it would end up happening would therefore have been known to those originally designing it, so the distinction of when it “actually” happened is academic?
>Isn’t there an argument that it was obviously inevitable from the beginning, so the fact that it would end up happening would therefore have been known to those originally designing it, so the distinction of when it “actually” happened is academic?
Yes, there is. Unfortunately, you can easily spot the minority of people in the habit of applying that kind of institutional-incentive analysis systematically; they’re called “libertarians”.
Austrian economics has some historical baggage attached to it that it probably shouldn’t
And yet another item gets added to the infinitely long list of Things That ESR Needs To Blog About In His Copious Free Time.
The earlier talk about praxeology had me mulling it overnight. The implication is that assuming people will act purposefully, rather than reflexively, is a good habit to engage. Eric caveated this with “sound”, meaning there’s a way to do it wrong. So I ended up imagining what it would look like if someone overdid it, and it occurred to me: it would look like a conspiracy theory.
Then I thought, well, some conspiracy theories only look that way to some people, look dry plausible to others, and it can be sometimes hard to tell the difference.
Several ways I could carry this football from here.
@Paul Brinkley – Most conspiracy theorists don’t actually stop at “The reason why X did (thing that it is universally agreed that X in fact did) was an evil plan to benefit themselves”; they’ll invent actors and events whose existence isn’t in evidence at all.
For example, one 9-11 truther claim is that demolition charges were more or less openly pre-planted (with claims that when asked the designers asserted that it was no big deal and just something that was trendy) when the WTC was first built. Of course, there’s no actual evidence of this outside the truther reality distortion bubble.
@ESR re:Austrian Economics: the basic problem is with Rothbard and his strongly black-or-white, good-vs-evil, my-way-or-the-highway, almost cultish way of thinking. The LvMI and its president, Lew Rockwell, who seems to got a bit deranged when his good friend and idol Rothbard died, turned it into a Rothbard cult and gave it a bad name. And today, the Internet fame of AU is almost entirely up to the LvMI. And given that although far less than Rothbard, LvM himself was a bit dogmatic…
To get good AU without the cult vibe you have to rely on sources as far from the LvMI as possible. Which will not be that famous today. Who is your favorite? Henry Hazlitt? Ludwig Lachmann? Israel Kirzner?
BTW my primary beef with AU is that they are so rigid at not giving in a millimeter to socialists is that they deny the possibility of a recession being caused by a general lack of demand due to employers depressing wages. This is seriously bad, as even a simple island model type of a toy thought experiment simulation shows it is possible and when one wants to oppose political solutions to problem, desperately denying that the problem exists is not really a smart move.
>Who is your favorite?
I’ve learned the most from Hayek, Hazlitt and von Mises. I would say Hayek if I had to pick a single favorite.
I”m aware of the the LvMI but have never had anything to do with them. And I always disagreed with Rothbard’s deontic moralizing.
“BTW my primary beef with AU is that they are so rigid at not giving in a millimeter to socialists is that they deny the possibility of a recession being caused by a general lack of demand due to employers depressing wages.”
It seems to me that, while such a thing could theoretically happen, it would require a cartel including all the employers in an economy – and cartels have a natural tendency to crack up, because each member of the cartel benefits by breaking the agreement as long as the rest stick to it. Further, the more parties there are in a cartel, the faster it breaks.
In this case, if employers in general agree to pay lower wages, those employers who don’t do so attract the best workers, making them more productive and more profitable than the rest. Once this is noticed, employers in the cartel start leaving it by raising wages, and the artificial recession comes to an end, if it ever started.
@Michael It would require a cartel only to depress wages below marginal productivity, not to depress wages below where consumer demand starts lagging. These two are not necessarily related. One interesting thing you can see is that countries have an economic boom whenever they find export markets, such as the rebuilding after WW2. What does that suggest? If workers, getting paid as per marginal productivity, produce enough goods that they themselves can afford and also can export, then their wages are clearly not consumer demand clearing.
You should check the book “Bad Pharma” [0] if you are interested in learning how bad FDA and EMA (European equivalent) actually are in reality (hint: unpublished trial data is at the heart of the system, trials are not done according to scientific methods, and if you belong to the club you can get useless drugs easily approved). They are nothing more than a “security theater” in the pharma industry. If companies had published full data on trials to public, it could have been verified by independent researchers (and even by the people who needs the drugs, you know, ones whose life depend on making the best choice) and we would have better information on which ones work and which ones don’t.
I also disagree with the notion that drug discovery is harder than software. Underlying systems (like human brain) might be more complex than many of the software we use, but our understanding of them is nowhere near that level. People discovered drugs in BC years just by trying random herbs. Current process is just more streamlined and has additional test steps before human trials to reduce the suffering. It might be a hard and unfruitful process but not as complicated as software.
[0] http://www.amazon.com/Bad-Pharma-Companies-Mislead-Patients/dp/0865478007
> > do you agree with the Mises Institute’s stance on the American Civil War?
>
> I have no idea what that position is.
Dunno if this thread’s still active, but I’ll try. Sorry for the delay. :P
The Wikipedia entry on the institute attributes the following to Lew Rockwell himself: “We have published revisionist accounts of the origins of the Civil War that demonstrate that the tariff bred more conflict between the South and the feds than slavery”.
And then there’s the description page of one of their courses, where many strong accusations are hurled at Lincoln.
Disclaimer: I’m not asserting that all members of the institute adhere to that position on Lincoln and the Civil War. (It does seem to be the prevailing view, though.)
>“We have published revisionist accounts of the origins of the Civil War that demonstrate that the tariff bred more conflict between the South and the feds than slavery”.
Wow. That takes some sort of prize for using what is in a narrow technical sense the truth in a grossly deceptive way. My respect for the Institute just took a serious hit.