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Put yourself in the position of an FDA official charged with approving or disapproving a new drug. You can make two very different kinds of serious mistakes:
1. Approve a drug that turns out to have unanticipated side effects resulting in death or serious impairment of a sizable number of persons.
2. Refuse approval to a drug that is capable of saving many lives or relieving great distress and has no untoward side effects.
If you make the first mistake, the results will be emblazoned on the front pages of the newspapers. The finger of disapproval, perhaps even of disgrace, will point straight to you.If you make the second mistake, who will know it? The pharmaceutical firm promoting the new drug…will be dismissed as greedy businessmen with hearts of stone…. The people whose lives might have been saved will not be around to protest. Their families will have no way of knowing that their loved ones lost their lives when they did only because of the [in]action of an unknown FDA official.
— Milton Friedman
This is baked into the FDA pie – every process reflects this central approach to risk. The consequence is that tests of efficacy that should take days or weeks (in the case of Corona) will take, according to the government, many months. Vaccines cannot be “proven” for a year or more.
So we have this central tension right now. The FDA is institutionally incapable of sticking their necks out to support rapid tests or hydroxychloroquine or any other treatment. There are too many unknowns and they are paralyzed. The only thing the bureaucrats are sure of is that they should not make any mistakes by acting too fast. That, and anything Donald Trump supports is probably a bad idea, so they should reflexively oppose it. Can you imagine the opprobrium in the Beltway if the FDA is seen to help the President end a crisis?
So now we have the spectacle of Rudy Giuliani interviewing Zelenko and presenting the findings directly to the American people. The President has to engage in asymmetrical warfare against the Deep State in order to do his job.
If this goes as I would like it to, the FDA ends up being so discredited that its role is reduced to a purely advisory one going forward (seals of approval for medicines and devices, but no veto power). That would be a happy result, indeed! Milton Friedman would be thrilled.Published in