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36 sats \ 7 replies \ @optimism 4 Sep \ on: Trust the science, but I'm gonna manipulate you with emotion and sentiment Politics_And_Law
Do you have some links to literature about this so I can understand your view better?
Not the point of my post, I hesitated to even include it. Its nothing special. Just the basic idea of market based review organizations. I don't have links handy but there are privately ran journals that often over many years have been quicker to approve both new treatments and recommend the ceasing of other treatments.
First off, if you don't recognize the problem of a monopoly group of politically motivated individuals making decisions that affect millions of people and the huge incentives that exist to manipulate and control such a group then I'm not sure if you will be open to anything else.
Currently we have a centralized monopoly that decides what should and should not be allowed. They make mistakes. That's not a crime. They are human. But if you have multiple groups that make recommendations and the technology we have today to compare their track records against one another I think we'd have a better picture of risk vs. reward. One that isn't so easily politicized and co-oped.
I'm NOT saying there wouldn't be the same incentives but rather that it would be more clear and that there would be competition. That doesn't solve the issue but it helps a ton in my opinion.
I think one of the biggest issues is the seemingly blind trust in institutions as if there are not subject to politics and manipulation by industry. The fact that these institutions have so much power is one reason they are so targeted for control.
What we are seeing now is RFK pissing off the pharma industry and the politicians they own. We are also seeing many people that still have trust in the system manipulated into a panic. Not accepting the fact that they have been trusting a system that could have been lying to them for decades. They would never know it. The average person has to be more skeptical. The world is a mess of complex things and if you decide you are gonna just trust the industry paid science and the government shills that push it you are at their mercy.
I don't think everyone down the line is corrupt. I don't think every doctor is a paid pill pusher. But some are and enough people just trust authority that its not hard to see how a system could be corrupted by monopoly and greed.
Maybe I'm wrong. Maybe there is another way this could be done but the status quo is not good. Personally, I would trust competitive agencies that were recommendation based only. Provided the companies were not protected against torts as they are today.
Hope that helps.
These books cover a more broad area but they have good resources related to this idea.
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I largely agree with the rest of your post but I honestly never think too much about the status quo; prefer to look forward. That's why I asked about this particular sentence. I think it's clear what you're trying to relay for the rest of your post.
These books [..]
Thanks! Put "Primal Prescription" on my list!
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Here's a more short and sweet version.
For many services today we have review sites.
- Yelp
- Open Table
We all know they have flaws. Some are better for one thing than others. These also exist for things like supplements which are largely unregulated by the US gov.
Labdoor is the one I'm most familiar with.
The idea would be that there would be a massive market for consumer directed review sites for treatments. There would also be a huge market for a resource like this for medical professionals. The idea that something so important is best done by the state is absurd to me, but I realize it isn't to most people. I didn't always see it this way.
It might be hard to imagine but in a less centralized world I can see how companies could compete for doing testing and review or products. Today we know how quickly the market turns on a company that acts poorly. Cancel culture is toxic but the truth is that companies try to avoid bad press where they can.
I think people should trust the FDA and CDC about as much as they would trust a private company. So I'm not saying I would blindly trust the private industry. I'm saying it would be better to have options. Multiple groups competing for trust.
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review sites
Ah! Yes that could work, but I have 2 issues with this:
- I'm a bit skeptical of reviews because many are gamed 1
- it's a surveillance nightmare
I feel we'd need something with a precise audit trail that doesn't involve people self-doxxing their medical issues. I know many good, morally grounded physicians and specialists that aren't in it for the gains, maybe there ought to be a role for them? Augmented with proper expert systems, maybe? Idk.
The idea that something so important is best done by the state is absurd to me, but I realize it isn't to most people. I didn't always see it this way.
For me personally, the problem starts with too many people, including many my age (Gen X), are expecting government to basically fix everything for them, because they voted so now fix my shit. But, as you say, the problem is often that government policy actually incentivizes much of what is wrong today, so "more government" isn't going to fix it, and "different people in government" is unlikely to either. But you or I can't make people let go of that idea, they'll have to do it themselves - I've decided long ago that all I can do is free myself from it, talk to people about it, but this won't be fixed in my lifetime. 2
I didn't see it like this in my early 20s either. I've learned a lot since.
Multiple groups competing for trust.
Or competing for results! The main issue may be the protection under the law, that's something that RFK iirc wanted to do something about.
Footnotes
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One of my friends has a sidegig as a "professional reviewer": getting hired by manufacturers to test and write a great review, and get free products on top. You write a bad review, you're less likely to get hired. The incentives are off there too. ↩
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I might get China-trolled once more now, as happens any time I write something about governance, but so be it. ↩
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My description was in broad strokes. I'm sure people smarter than me would figure it out. You problems with it are valid. Obviously it would way different from simple review sites. My point is that it's not impossibly to imagine a different non-monopoly way.
The "review" sites would likely be testing / study based. Just done by an series of independent groups. Not imagining some surveillance based system on patients.
Anyway, the market has a way of coming up with creative solutions to problems.
100% agree with you on the problem. Government is expected to fix stuff a different the idea of voting to fix stuff is pretty homeless. Not sure I'd single out gen x there though. Multiple generations have had this idea.
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lol, I can't type on my phone. Such a boomer
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Its funny. Right after I wrote this, a relevant podcast popped up. Worth a listen.
Bob Murphy Show: Ep. 441 Ray March on RFK's Disappointing Use of AI in Health Reform
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