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scratch one quack doc…..

by Donald Prothero, Oct 19 2011

As skeptics, it is frustrating for us to see the con artists and snake-oil salesmen hammer us with their pitches about “herbal remedies” and “natural cures” and homeopathy and all the other false medical claims that are made on TV, on the Internet, and nearly everywhere you look (not to mention all the spam ads that promise penis enlargement or enhanced sexual stamina). Most of the time there seems to be no regulation or oversight on these obviously useless products that prey on desperate people and give them false hope for a “cure”—and no one seems to check whether these people have ever successfully cured anything. Even more frustrating is watching the flim-flam art of faith healing, where modern-day Elmer Gantry types prey on people exploiting not only their vulnerabilities from their poor health, but also their religious blinders. Most of us have heard about the time when James Randi exposed the crooked Rev. Peter Popoff on Johnny Carson’s Tonight Show. As this video shows, Popoff seemed to know amazing little factual details about  his flock as he “healed” them, and was making millions of dollars off them—until Randi  and his collaborators used their own radio receiver to pick up and record the transmissions that Popoff’s wife was sending to the Reverend’s tiny  hidden earpiece. She was prompting him with details that these same people had filled out on “prayer cards” just before the service, and Popoff promptly used this information to amaze and dupe his flock. You would think that Popoff would be completely discredited and his career finished after being exposed as a crook, but apparently not so. After going bankrupt and spending only a short time out of sight, he’s back and raking in millions again ($23 million in 2005 alone) doing the same thing. Now his con is selling little vials of “miracle water” and “prayer bracelets” and asking for donations with promises that God will bless you if you pay him. And his flocks are apparently unaware or uninterested in his previous exposure as a crook. (If you want a good laugh, take a look at this hilarious video of faith healer Benny Hinn recast as the evil Sith Lord and Emperor Palpatine in the Star Wars movies).

So it was with great joy that I saw in the Sept. 28 Los Angeles Times that one of these con artists had finally been caught and punished. Her name is Dr. Christine Daniel, and she ran a clinic in the San Fernando Valley not far from here. For years, she had been marketing her snake oil as “C-Extract”, “the herbal treatment”, and “the natural treatment”, and other bogus names, when it turned out  these products were no more than sunscreen preservatives and beef extract. She has a legitimate MD (Temple Med School, 1979) but is also a Pentecostal minister. She peddled her products on evangelical networks like TBN, promising both that these treatments would cure people with terminal cancer, and that she was doing God’s work. She charged her customers up to $6000 a week for treatments with completely ineffective substances. Apparently enough bilked patients were mad at her that the law finally took action last year. On September 27, 2011,  a federal jury convicted her of peddling expensive phony treatments to desperate patients, and sentenced her to 150 years in prison and a $5.5 million fine.

It’s nice to know that at least one sleazy doctor selling false hopes will go to the slam and never hurt another patient, but why does this case seem like the exception to the rule? Why don’t we hear of more faith healers being exposed and bankrupted like Peter Popoff, and how do con artists like Popoff manage to come back, even though their sordid past is easy to look up for anyone with a computer? Why are there not more prosecutions of “alternative medicine” peddlers and others who make demonstrably false claims, and who have left a trail of sick and dead patients behind them? Is it because such prosecutions are expensive and lower in priority than prosecuting violent criminals? Or is it because the “doctor”  needs to leave a long trail of angry ripped-off patients and dead bodies behind before the district attorney will take notice?

Even more disturbing, only a year ago one of the patients Dr. Daniel ripped off sued her in court, and apparently won. Her office was already under investigation for tax evasion, wire fraud, mail fraud, and tax evasion, all of which were part of her recent conviction. Yet if you Google “christine daniel md” you will get a whole bunch of sites which list different doctors, their practices, their patient satisfaction ratings, and any complaints or other charges against them (like malpractice). Not one of them mentions her long history of shady dealings. I guess I wouldn’t trust them if I wanted a recommendation for a doctor, because they clearly don’t bother to keep track of misconduct, but are simply shills to bring in more patients.

So I pose this question to those of you out there with medical and/or legal training: why don’t we see more prosecution of these doctors peddling false medicine? Why do faith healers seem to be immune to charges of fraud? Is it because of the expense of prosecution and the D.A.’s focus on violent criminals taking priority over con artists? How does a faith healer escape the same scrutiny when they too leave a trail of broken promises and unhealed people who were lied to, all in the name of religion?

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102 Responses to “scratch one quack doc…..”

  1. Other Paul says:

    Isn’t it simply because they’re just a relatively small subset of a much larger group – con-artists – who themselves don’t seem to figure as highly in prosecution stories as one might reasonably expect them to? Confidence tricksters don’t get prosecuted as much as one would expect, because by their very nature many victims don’t know they’ve been duped or, even when they do, are less willing to expose themselves as dupes. A small number of con-artists may run the risk of being punished by (cough) ‘extra-legal’ means (such as ending up in a pillar of a bridge somewhere) but that’s less of a risk for the snake-oilers and the like because they’re very publicly visible.

  2. Robo Sapien says:

    The problem is that very few charlatans are the truly dangerous kind, most are just selling BS and you are generally thought to be a moron if you buy their crap. Someone literally has to die before the light is put on them, and even that light fades with time. Faith Healers are also a special case, nobody in an elected seat wants to be accused of religious persecution so it gets swept under the rug.

    One would think that more of these quacks would end up getting assassinated by the people they swindle. Strange world.

  3. Somite says:

    Although prosecution is well deserved for these people, we are missing something more important. The FDA should be able to require efficacy and specific medical claims. Currently if your product is considered safe you can get away with ambiguous medical claims and efficacy does not have to be shown. However, in this country we have the problem of necessary regulations being framed as costly and “job-killing”. Never mind the pain and suffering of patients and their families.

    This is why I shudder when GOP candidates openly talk of limiting regulations by the EPA and FDA. It would prevent appropriate testing of new compounds but will also greatly promote pseudoscientific chicanery.

    • tmac57 says:

      That’s the problem with laissez faire thinking,they forget the step of first determining the location of the baby,before discarding the bath water.
      I am not opposed,in principle, to scrutinizing regulations and laws to see if they are appropriate or not,but you always have to ask yourself “Now why again did we create this?”, before tossing it aside for expediency.

    • CountryGirl says:

      The EPA has been hijacked by left wing radicals who are using it to push an anti-capitalist anti-constitution agenda. While I applaud your right to blindly hate the GOP I reject your belief that you will somehow benefit from an out of control Marxist-Leninist EPA. They have become too powerful and to radicalized.

      • Somite says:

        Because they use science to reach determinations of toxicity? This is the problem with science it might conflict with your political agenda.

        Can you provide a concrete example of what you allege?

      • CountryGirl says:

        I was tempted to create a list of the EPA’s “unscientific” misuse of our laws and the problems they created. But I realize that: 1)You are either unaware of this (ignorant) and probably cannot be cured of your ignorance, or 2)You are just as aware of EPA’s over zealousness as most of us are and thus are driven by your politics and won’t change. How can you not know of the crimes against democracy and the constitution that the EPA commits everyday???

      • Somite says:

        A credible link (not an ideological blog) will do.

      • tmac57 says:

        Ahhh…The old ‘If you don’t know what you did wrong,then I’m sure not going to tell you!’ gambit.
        Nice!

      • tmac57 says:

        Nice parody CountryGirl! You almost had me believing you were serious.

    • Miles says:

      Somite, I’m curious if you and those who share your trust in the FDA to do more good than harm believe that there are any drawbacks to the FDA? As someone who is skeptical of the FDA, I readily admit there are good things about it. I’m sure the FDA must have stopped some harmful drugs from reaching the market over the years and has likely saved lives. But at what cost? Do you and your ilk believe that there are any costs, or is it all sunshine and roses?I understand that you don’t agree with people like myself (and probably never will), but I think you’ll find a more mature view of people like me is not to assume that we don’t recognize the up-sides, but to recognize that we simply don’t think they outweigh the down-sides.

      • tmac57 says:

        Miles-The problem seems to be that the most vocal opponents of the FDA seem to be either CAM zealots or free market ideologues instead of sober critics.
        There is of course room for a fact based discussion over the benefits and negatives of the FDA.So as long as you stick to the facts,and acknowledge the good side of what the FDA has accomplished,then we can have a dialog.
        Question:Would you eliminate the FDA if you had that power?If yes,then what do you see as the benefits/risks of doing so?

      • Miles says:

        tmac57,

        Yes, I would phase out the FDA. The ultimate reason is because I value human life, and desire for the best healthcare possible to be available to most amount of people possible. You and I likely share the same goal, but disagree on how that is to be accomplished.

        I’ll quote the late Milton Friedman:

        “So that the record of history is absolutely crystal clear. That there is no alternative way, so far discovered, of improving the lot of the ordinary people that can hold a candle to the productive activities that are unleashed by a free enterprise system. ”

        When you think of what kinds of things have made the biggest impact on human well-being, what do you think of? Do you think of things like penecillin, GE crops, vaccines, electricity, etc.? Or do you think of things like bureaucratic processes, trade barriers, wise and benevolent rulers, and pages upon pages of regulations? Measuring exact numbers for these things will be next impossible. You will not be able to find hard stastics for these things, and any you do find can be shown to support either argument. That is the nature of statistics.

        Yet despite all that, I feel confident in claiming that human innovation and invention, trying new things, discovering new ways of doing things, has had the largest impact on human well-being. I have no numbers to prove my case. Yet I look at the life an average American lives today, and compare that to the standard of living of a wealthy person only a hundred years ago, and I am astonished. I’m astonished not by the advances in rules, leaders, and groups of people telling you to do things their way, but by the advances in human invention.

        All of this human innovation is more associated with free enterprise. Everywhere you look in history, you see the same story. Rules and regulations are loosened up, and innovation goes up too. More freedom happens, and suddenly more invention happens. People try and compete with each other to make a better product, and we get better products.

        How about some examples then? The industrial revolution is a good one. How about India? How about Hong Kong? How about any region in the world that drastically reduced the amount of rules and the strictness of their government? Every case in history you look to, you see growth. Hong Kong and India are two astonishing examples. India went from the equivalent to the dark ages to competing with modern economies in a span of 30 years.

        With pages and pages of rules and regulation, you get the exact opposite. Sure, there are bad people in the world. And if you have lots of checks and rules and restrictions, you can catch those people (or turn them into lawbreakers) and increase safety to a degree. But when everyone is free to invent, compete, innovate, and try new things, you unleash a level of innovation that leaves the previous gains from safety in the dust.

        With the way the FDA enforces drug testing and regulation right now, only a very small number of wealthy, politically connected groups have the money and power to compete and innovate. Get rid of all those rules and let people choose for themselves, and yes, some of those drugs will be dangerous. Some people will die of dangerous drugs (people still die of dangerous drugs even with regulation). But you also open yourself up to the Steve Jobs and Bill Gates characters of the world, who create amazing things in their basement when they are free to experiment and sell their inventions, changing the entire world as a result.

        The other great thing about free markets, is that they tend to do an amazing job at policing themselves. When you are worried about the safety of your car, or whether or not your mechanic is ripping you off, do you turn to government agencies to tell you what to buy? I don’t. There are government safety ratings cars, but I completely ignore them. I turn to Consumer Reports. When I want to know which restaraunt is good, I don’t demand that a government agency be created to make sure that restaraunt owners are making food that meets my minimum standards, I look them up on Yelp! When I want find the best doctor, I look at patient reviews and experiences. When I’m concerned about a drug or want to know more, I turn to ConsumerReportsHealth.org.

        So many of you who insist that government agencies are necessary to keep us safe, simply assume that if the government doesn’t test things for safety, nobody will. But that is and always will be wrong. When people desire a way to inform themselves about what is safe and what is not, the market will provide a solution. You assume that if the FDA did not exist, safety testing would not happen. It would. In fact, it already does get done by other private entities other than the FDA. Abolishing the FDA would only strengthen the incentives for private companies to compete with each other to fill the void that the FDA has left. And suddenly everybody gets a choice, and different solutions are avilable for different people who want different things.

      • Somite says:

        This is so naive. How do you identify a drug that will in the short term cures something but in the long term causes cancer? Do you think businesses that are only interested in next quarter profits will engage in full carcinogenicity testing for their compounds.

        The FDA exists to make sure pharma does the testing they should do anyway. Not more or less.

      • Max says:

        We already have drugs that aren’t FDA approved, only they’re called “dietary supplements.” Do you see Consumer Reports conducting rigorous reviews of expensive clinical trials to guarantee their safety and efficacy? At best, they meet USP standards of ingredient quality, and those are enforceable by the FDA.

      • Somite says:

        There is always room for improvement on any process. What FDA critics always fail is at pointing out what is exactly systemically wrong with the FDA. I work on the pharmaceutical regulatory industry (which by the way generates thousands of jobs) and every day we identify and characterize toxicities that would otherwise be identified first in humans.

        Again: what facts back the claim that there is currently something systemically wrong with the FDA and EPA?

      • Miles says:

        Somite, you are making the mistake of what Frederick Bastiat would describe as the “seen vs. the unseen.” He describes this problem eloquently in his famous “Broken window fallacy.” http://en.wikipedia.org/wiki/Parable_of_the_broken_window

        You can point to numbers and statistics of how many incidents of death have been recorded of drug toxicity or other safety concerns. But what can’t be measured, is how many people with terminal illness have died as a result of not having access to non-approved drugs which may have saved their lives. You also can’t measure what kind of innovative drugs might be available to us if it were easier for the private sector to get those drugs to the market. We will never know this number, and as a result, will never be able to do a comparison. You are guilty of looking at only one side of the equation and declaring victory: the benefits, absent the costs.

        The other thing you can’t measure, is the subjective value of safety. Lot’s of people die every year in car accidents. I would imagine many more people die each year in car accidents than die from drug toxicity. Should we ban automobiles? That might seem silly, but if more people die of accidents than drugs, why not?

        Individual people evaluate risk differently. Safety is not an on or off switch, but rather there are varying degrees of safety, as well as varying degrees of costs.

        You probably find it perfectly reasonable to allow each individual adult make their own choice as to whether or not they want to drive on a public road in a car and incur the safety risks that entails. But you will not allow individual adults make the same decision as to what to put into their own body. Instead, you advocate that there is one safety:risk ratio that should be the same for everyone, at least when it comes to drug testing standards.

      • Max says:

        Did you read the original post about the quack doc? Why would anyone spend billions on research to make effective medicine if they’re allowed to charge $6000 a week for snake oil?

      • Somite says:

        The mistake you are making is assuming the FDA does not take this into consideration already. Each drug is evaluated and its indicated indication and target population taken into consideration. The system as it exists maximizes safety and therapeutics.

        Again: what is your evidence that the FDA prevents the approval of treatments that would save patients due to undue regulation?

      • Miles says:

        @Max

        “Why would anyone spend billions on research to make effective medicine if they’re allowed to charge $6000 a week for snake oil?”

        Straw-man argument here. I never suggested that someone interested in fraud would want to spend money on FDA approval. Where did I ever say anything like this.

        In fact, I have admitted now, multiple times, that markets aren’t perfect. Fraud happens, and sometimes people will take advantage of each other.

        The point I was making, is that requiring a business to spend billions of dollars in testing before selling a products, keeps out the honest people who really do have drugs that could be highly beneficial to society. But they can’t, because they can’t afford the testing.

      • Max says:

        Miles,

        So, without the FDA, these honest people would claim that their drug works without proving it. How is that honest?

      • Miles says:

        @Somite

        “The system as it exists maximizes safety and therapeutics.”

        You cannot “maximize” safety. Safety is a preference. Did you get your brakes inspected for safety before you drove to work today? Will you get them inspected tomorrow? Safety is a cost-benefit decision that each individual person evaluates according to their own tastes, needs, and preferences. I am not accusing you of being a socialist, but believing that one level of safety is right for everyone, and they are not allowed to choose for themselves how much safety is right for them, is a socialist attitude. It does not work.

        To claim that the FDA has worked out a formula that is right for everyone, taking everything into account, dismisses the freedom for people to choose for themselves. Only *I* can decided what is right for me. Not the FDA, or anyone for that matter. The FDA can give me recommendations. The FDA can educate me on pros and cons, show me statistics, recommend testing procedures, etc. But only MILES can ultimately decide what is best for MILES.

        “Again: what is your evidence that the FDA prevents the approval of treatments that would save patients due to undue regulation?”

        These cases happen all the time. Penn & Teller did an episode of Bullsh*t where the interviewed several patients who were dying, but were not permitted to try experimental drugs because they were “unsafe”. These people were dying already!
        Here is another article: http://online.wsj.com/article/SB121944789005365195.html#printMode

        What, do you want me to do an Internet search and find every example of this? Just use Google if you want to find more.

      • Miles says:

        @Max

        “So, without the FDA, these honest people would claim that their drug works without proving it. How is that honest?”

        I’ve already answered this. I don’t know if you are intentionally trolling because you feel threatened, or if you are truly just ignoring most of the points that I’m making.

        As I’ve already stated, many times, safety is NOT an on/off switch. Even the FDA doesn’t rate drugs this way. Even the FDA doesn’t simply say, “yes, this drug is safe, no this drug isn’t.” They say things like “here are the known side effects, here are the trials we’ve run and they are below the thresholds we believe are adequate for safety standards”, or things like “only x% of patients experienced problems, which according to our standards is safe enough.”

        Why do you assume that businesses developing drugs would not do testing of their own to check for safety? They can still get sued or imprisoned if the commit outright fraud. I’m not advocating that we stop punishing people who knowingly commit fraud. I’ve already said this several times, but why do you assume that if the FDA doesn’t do any safety testing, that NO safety testing will get done from the private sector? That is absurd.

        Thirdly, and I’ve already pointed this out, other business tend to crop up that specialize in testing other products for safety. I’ve already mentioned Consumer Reports. They make money by testing other products for safety and quality, and making the published results available to consumers for the price of double-cheese burger. They do it for drugs as well.

        The FDA is a group of people. So are businesses. I am the one accused of being naive, but for some reason, you people portray things as if all of the human beings at the FDA are infallible, moral, upstanding humans who genuinely care about others and do their best, but those in business are greedy, evil, uncaring, and are interested in nothing other than lining their own pockets.

        The last time I checked, the people who work for government are no more angels than the rest of us. I don’t know why you guys keep on with that same old tired story.

      • Max says:

        Miles,
        “Why do you assume that businesses developing drugs would not do testing of their own to check for safety? ”

        I addressed this in my comment above, but I’ll repeat it here.
        http://www.skepticblog.org/2011/10/19/scratch-one-quack-doc/#comment-66215

        We already have drugs that aren’t FDA approved, only they’re called “dietary supplements.” Do you see Consumer Reports conducting rigorous reviews of expensive clinical trials to guarantee their safety and efficacy? At best, they meet USP standards of ingredient quality, and those are enforceable by the FDA.

      • Max says:

        Miles,

        You said: “The point I was making, is that requiring a business to spend billions of dollars in testing before selling a products, keeps out the honest people who really do have drugs that could be highly beneficial to society. But they can’t, because they can’t afford the testing.”

        You complained that regulations prevent honest people from selling products that they can’t afford to test. This implies that you’d prefer to let these people sell products without running expensive tests to prove they work. In other words, they’d claim their products work without proving it. How is that honest?

      • Miles says:

        “You complained that regulations prevent honest people from selling products that they can’t afford to test. This implies that you’d prefer to let these people sell products without running expensive tests to prove they work. In other words, they’d claim their products work without proving it. How is that honest?”

        Because in reality, an economy is not so binary. You make it seem as if the choice is either:

        A) Have the FDA require companies to spend 10+ years and billions of dollars in testing to sell any of their drugs to anyone.

        or

        B) Have a free market where people who can’t afford to test their drugs at all do not, and we have no idea how safe any of our drugs are as consumers.

        But in reality, markets provide a lot of different options and choices besides the most extreme.

        The first example, is that start-up phrama’s who might not have enough to money to do extensive testing, can leave it up to other businesses that specialize in testing drugs evaluate them independently. I’ve mentioned companies similar to consumer reports many times. As a consumer, I would have a choice of several different sources of information if I wanted to become informed about a particular drug. It could be something as simple and un-scientific as looking at what other consumers have said about a product (Yelp!), relying on an organization that specializes in safety testing drugs (some 3rd party business that makes their money this way), seeking professional advice from a physician, or simply trusting that if a drug has been on the market for 5+ years and there hasn’t been any significant recalls or reports about it being dangerous, that it is probably going to be ok.

        Some of these methods will obviously be safer than others. But there is no reason why the private business that fills the void created by a missing FDA necessarily has to be the same company who makes the drug. This opens the market to people who can leverage the expertise by other people in the marketplace, without having to pay all of the costs for that expertise themselves. I imagine that it wouldn’t be long before smaller pharmaceutical companies began to outsource their safety testing processes to other companies that do just as capable of a job in order to save costs.

        Now let me ask you. What if I told you that there is a medical industry in America, one that if performed irresponsibly or without care for safety could seriously kill or injure the patient, but nevertheless is an industry has is burdened by next to no government safety standards, regulation, or enforcement?

        What if I told you that despite almost no regulation, both quality and safety has increased dramatically over the years on its own, is considered a very safe procedure to have, and compared to government-run healthcare is dirt cheap for consumers?

        Would you believe me that such an industry could possibly exist? Because such and industry does exist. And if your view of safety regulation is correct, this industry should be rife with dangerous, irresponsible, profiteering corporations that throw safety to the wind in order to make a quick dollar out of the rest of us suckers. But it isn’t. And you can’t rely on government regulation to explain how it can possibly be safe.

      • Somite says:

        See my previous post about how the FDA does no testing. Testing is done like you describe, by 3rd party companies. The role of the FDA is to ensure testing is done appropriately and according to guidelines.

        “t could be something as simple and un-scientific as looking at what other consumers have said about a product (Yelp!)”

        Also you fail to understand the toxicity of drugs may be subtle, only noticed after years of administration or be outright lethal. Word of mouth is not sufficient to evaluate safety. And no, Miles can not determine if a drug is safe or not for Miles to take. This involves teams of scientists and large clinical trials that Miles by himself does not have the resources to pay for.

      • Miles says:

        @Somite

        See my previous post about how the FDA does no testing. Testing is done like you describe, by 3rd party companies. The role of the FDA is to ensure testing is done appropriately and according to guidelines.

        Sorry somite, I’m not going to take part in your comments any more until you make an effort to stop misrepresenting what I say like a cheap talk-show host.

      • Miles says:

        Somite:

        “what facts back the claim that there is currently something systemically wrong with the FDA and EPA?”

        Where do you want to start Somite? Let’s focus on one particular area of government, so that this thread doesn’t keep getting derailed. I don’t want to start talking about the FDA, only to have you respond by talking about the EPA for example.

        You obviously want to debate me on the evidence of the pros/cons of a particular area of government controlling the market. You shall have your debate, and I’ll leave it up to you to pick the arena.

        You just mentioned the FDA and the EPA. In another post, you mentioned the financial industry. Pick one. You pick the topic and I’ll state my case. The offer doesn’t get much sweeter than that, does it?

      • Somite says:

        Isn’t that my original question regarding the FDA or EPA?

      • derwood says:

        The magical market and its cure all properties. If the market really coul ddo what its proponants insist it does and is capable of doing, one has to wonder why regulations were produced in the first place.

        If ‘the market’ were in charge, do you think that lead would have been removed from gas and paint? Would there still be safety standards at places of work? Seal belts?

  4. David says:

    In the case of faith healers, it is also all too easy to blame the victim. You weren’t healed because you didn’t have enough faith, not because my “gifts” as a healer aren’t real or because god didn’t hear my prayer for you. Not to mention all the psychological processes at play generally – confirmation bias, etc., which might account for some victims’ lack of awareness or unwillingness to be exposed.

  5. Marnie says:

    Considering the recent stories about evangelical churches telling HIV patients to forego medicine and pray instead, or churches who preach faith healing instead of real medicine, even for children, I think anyone promoting a treatment (prayer) with a promise of a particular outcome (cure) who cannot show their treatment is medically and scientifically credible, should be tried for the same reasons Christine Daniel was. And if members of their congregation have died as a result of their false claims, the church should be accountable for those deaths.

    Not nearly enough quacks and manufacturers of phony treatments are tried for their criminal behavior but it’s unconstitutional that we give a free ride to churches that are using their role as figureheads to encourage people to make dangerous decisions with their health.

  6. Miles says:

    Donald, I applaud your desire for there to be less fraud in the world, as well as your desire for individuals to make more rational and educated decisions in their lives. However, I’m curious as to why you believe that replacing individuals (making decisions for themselves) with a government agency (making decisions for everyone else) will reduce fraud or increase rational decision making? My understanding of history suggests that centralizing decision making in such a way tends not to improve the outcome of those decisions, but degrades those outcomes.

    Now, I grant you that this can be difficult or sometimes impossible to measure. For example, there are no statistics to show how many people have died waiting for life saving drugs to be approved by the FDA, how many relatively safe drugs have never come to market or never will because of how expensive it is for FDA approval, or how much innovation is lost because making and selling pharmaceuticals is only possible for companies with the deepest pockets and political savvy. Because the cost of regulation and compliance is so high in this country, there will never be an equivalent of Apple or Microsoft for the pharmaceutical industry. Further, the pharmaceutical companies who are able to spend the average of 10 years and billions of dollars to get their drugs to market, are able to use those very regulations to keep outsiders from competing. Big corporations tend to like regulation, because it can be used to keep the smaller guys out of the market.

    But I wonder, would a responsible scientist or a rational skeptic assume that because such statistics are difficult to measure, that they don’t exist? Yes, regulations can increase safety and save lives. But are we doing good science if we only pay attention to the good things that regulation brings us, and ignore the bad things, simply because some of those bad things are difficult to measure? Is it rational to simply assume that increasing regulation will have the intended consequences of increasing safety, lowering fraud, or producing more informed consumers? I eagerly await your reply.

    • Derek says:

      “My understanding of history suggests that centralizing decision making in such a way tends not to improve the outcome of those decisions, but degrades those outcomes.”

      I’d be interested to what history you are referring. My reading of history is that regulation has measurably reduced harmful health effects. I’m not sure a quick google search can answer these questions, since the statistics are abused for political reasons.

      But, I submit as evidence FDA regulations of milk and meat and the government regulations of automobiles. The history indicates that these regulations reduced the illness/deaths traceable to fraudulent or poorly produced milk and meat. Also, mandatory automobile regulations have reduced automobile related deaths.

      More likely than not, regulation has increased safety, reduced fraud, and produced more informed consumers; at least relative to a laissez-faire methods. Is there any evidence you have to contradict this?

      • Miles says:

        “I’d be interested to what history you are referring. My reading of history is that regulation has measurably reduced harmful health effects. I’m not sure a quick google search can answer these questions, since the statistics are abused for political reasons.”

        As far as the “centralizing decision making” point goes, I’ll submit communist Russia and socialist Cuba as examples. The basic idea of these governments was to have everything planned out by the “experts” for maximum efficiency and safety. I think we all know how those experiments turned out.

        Your evidence for regulations being superior to free markets is interesting, since we do not have numbers for the free market alternatives, because they haven’t happened. Basically, you are comparing a world of regulations, for which you do have numbers, and simply assuming they are higher than the free-enterprise alternative.

        To do a proper comparison of which is superior, we would have to study two relatively technologically equal societies side by side, and control for other factors. The only time in history I’m aware of, which this kind of natural experiment took place, was between east and west Germany. I’m pretty sure the “freer”, less restricted side was better off.

        One of the common statistics I see is a correlation to safety increasing as regulations increase. People show a line graph for automobile deaths for example, and show that deaths have gone down over time, and regulations have gone down over time. What they tend not to show, is that deaths were already declining and safety was already going up, before the increase in regulation. In free markets, where businesses compete with each other to make a better product, things like quality and safety tend to increase over time on their own, without the help of regulation being necessary.

        But of course, statistics can be thrown back and forth all day long to no avail. For every statistic you can find to support regulation, I can find another to support markets. We can do this back and forth forever, and never reach a conclusion because we cannot perform a scientifically closed experiment to prove this either way. It’s impossible to replay history and control for all the other variables. It’s also impossible to model a modern economy. It can’t be done.

        Your hope that this can somehow be settled in a scientifically satisfactory way, they way you can in pure physics or math, is a fantasy. Economies and human beings are too complex to reduce to statistics and equations. Subjective things like human incentives, how much we value different things, preferences for safety vs. cost, the value of spending resources one way vs. another. These cannot be reduced to mathematical formulas.

        Thinking of economics as a science is a dangerous and foolish endeavor.

      • Derek says:

        Not to be trite, but compare deaths from autos before regulations (50s) and after (60s). Pretty easy comparison. Just like any experiment. After regulations, auto deaths decreased. Same with food regulation. Where’s the confusion?

        Also, blindly asserting Russia and Cuba is a false equivalence argument. Regulations = Russian or Cuban Communism. Which of course is illogical. What’s your evidence that reasonable laissez-fair model improves safety, reduces fraud, etc? I suspect you will be hard pressed to find that evidence.

      • Miles says:

        Straw-man, and straw-man. It’s like a broken record.

        “Not to be trite, but compare deaths from autos before regulations (50s) and after (60s). Pretty easy comparison. Just like any experiment. After regulations, auto deaths decreased. Same with food regulation. Where’s the confusion?”

        I’m not sure how I could explain this any easier. Okay, let me try again. What you point out is what we call a correlation. A correlation, means that two events happen at the same time.

        But you are interpreting this correlation to as a causation. A causation is an event that causes the other. Correlation and causation are different.

        You point out that around the 60s, we starting implementing more auto regulations. And in the 60s, deaths went down. These are two events that happened at the same time. This is what we call a correlation. It does not necessarily mean that one thing caused the other.

        In the particular case of car autos, there is another piece of data which suggests that regulation is not what is responsible for increasing auto safety. The evidence is that car safety was already rising, on its own, in the free market, before heavier regulations were imposed. People were already demanding safer cars, and auto manufacturers were already competing with each other to provide what consumers wanted.

        If your story is true, that regulation is the major factor responsible for safety increasing, then safety should have only been getting better once regulation went into effect. But that’s not what happened. How do you explain this?

        “Also, blindly asserting Russia and Cuba is a false equivalence argument. Regulations = Russian or Cuban Communism. Which of course is illogical. What’s your evidence that reasonable laissez-fair model improves safety, reduces fraud, etc? I suspect you will be hard pressed to find that evidence.”

        You guys are SO good at falsely portraying my arguments. “Regulations = Russian or Cuban Communism. Which of course is illogical. ”

        Yes, that is illogical. And of course, as usual, I never said that. I was talking about “central planning”. I used Russia and Cuba as examples of “central planning”. Do you disagree that they are examples of central planning? Yes, they are the *extreme* examples of central planning, but that is the point: to illustrate the result when you believe that central planning is superior to markets as a fundamental truth.

        When you guys come back to this thread to look at my replies, I wonder if you ever feel even the slightest be apologetic for continuing to misrepresent me over and over again. If I were having a discussion with someone else, and I kept doing that to them, I would be a bit embarrassed.

        “What’s your evidence that reasonable laissez-fair model improves safety, reduces fraud, etc?”

        Finally a fair question! First I’ll answer your question, and then I want to make another point about the nature of this question.

        Historically, there really has never been a truly “laissez-fair” experiment that has taken place. Additionally, I want to caution you: don’t assume that just because I am skeptical of the FDA, and in general skeptical of the power of regulation, that I believe in no government, anarchy, or pure laissez-fair capitalism, because I don’t.

        The *closest* we have ever come to running a laissez-fair experiment, was Europe and America during the Industrial Revolution. The Industrial Revolution was the single greatest period of human innovation that we have had so far, and it was the period with the least amount of government interference into the markets. The human standard of living rose higher and faster than any other time in human history during the Industrial Revolution. And, for the most part, did this without governments regulating businesses for safety. Safety increased on its own. I have a feeling I know how you are going to reply to this example, because there are some very popular misconceptions about the Industrial Revolution, but I’m not going to make that assumption about you. I’ll just listen to your response first.

        Finally, I wanted to point out one more thing about your question:

        “What’s your evidence that reasonable laissez-fair model improves safety, reduces fraud, etc?”

        Markets are good and producing the things that people desire. That’s basic economics 101. If there is a demand for more comfortable houses, someone invents air conditioning. You get the idea.

        Safety and security, are things that people desire just like comfort and convenience. People want their children’s toys to be safe. Consumers have a desire for things like anti-lock brakes.

        I find it interesting, that when it comes other desires like convenience, comfort, fun, etc., most people have no problem conceding that it’s basic economics when people desire those things, producer make their money by providing what people want.

        But somehow, when it comes to safety, your view of markets dictates that producers refuse to provide those things for some reason. I’d like to know why? What is this mechanism that causes a producer of a good or service, to refuse consumers when they demand safety, but pander to their every other desire? Why do producers hate safety so much?

        Do you think that producers who make unsafe products have a good track record of competing in the market? Do you think that the Firestone tire scandal didn’t affect their ability to compete with Goodyear or other competitors? Do think they sat back said, “You know, if we make unsafe tires, it will save us money, and people will keep buying our tires anyway. Let’s do it!” If I am going to run a successful business, and I have half a brain, I need to ensure that I’m not killing or injuring my customers. I think most producers know this. Why is it that you seem to think the opposite?

        I find this thought process fascinating, and I’d really like to hear from you guys why you think that producers don’t already have natural incentives to provide safe products to their customers.

    • Somite says:

      Miles. How many incidents of death, blindness or sterility due to a prescription drug would you accept before considering that screening drugs for toxicity is necessary.

      It costs so much for a drug to be developed in the US because most toxicity testing is done here and then subsequently accepted by other countries. If toxicity testing was not done in the US other countries would begin their own programs. What makes the US central in this so far is our expertise. Costs of drug development would be reduced is management compensation would not be so high. There is no Apple in the pharma industry because pharma like many other industries was taken over by MBAs without expertise whose only concern is to stuff their pockets.

      • Miles says:

        “Miles. How many incidents of death, blindness or sterility due to a prescription drug would you accept before considering that screening drugs for toxicity is necessary.”

        Decided to throw another straw-man argument into the mix? If I didn’t know any better, I might get the idea that group-think and ideology are causing a group of skeptics to outright dismiss alternative arguments because they don’t like the conclusion.

        When, have I ever claimed, hinted at, or suggested in any way, that I don’t believe that screening drugs for toxicity is necessary? Can you point me to where I said that or even suggested it?

        I’ve already stated that I believe the private sector can do that testing, and do a better job of that testing than the FDA. The private sector can do it better and cheaper, in my opinion. But you are so blinded by bias toward government always being the solution, that you make really weird assumptions that I don’t think safety screening is necessary. You even suggest that I want people to suffer or die.

        Do you recognize how far off the deep end you’ve gone with this? I’m trying to make an argument that the private sector can provide for safety better, and you interpret that to mean that I don’t think safety is important at all. Sometimes I don’t even know why I bother. I don’t expect you to agree with me. But can you please just concede that maybe, it just might be possible that I’m not an evil-heartless lunatic who wants people to suffer and die or that safety is important? I give you the same courtesy. I don’t assume the worst about any of you who disagree with me. Why do you assume the worst about me?

      • Somite says:

        Let me explain to you how this works. The private sector does all regulatory testing. It is an industry like any other and is composed of contract research organizations (CROs) contracted by pharmaceutical companies. The FDA publishes guidelines and ensures that pharmaceutical companies have shown that drugs are safe and effective for prescription by physicians and other medical personnel.

        That is all. It is all people coming together to agree that a drug should be given to treat a condition and that it is safe. If the FDA disappears overnight you would hope pharmaceuticals would still do exactly the same testing they currently do. But this is like hoping that there would be no crime and therefore no police is needed.

        You wrote: “You cannot “maximize” safety. Safety is a preference. Did you get your brakes inspected for safety before you drove to work today? Will you get them inspected tomorrow? Safety is a cost-benefit decision that each individual person evaluates according to their own tastes, needs, and preferences.”

        Most people are not MDs or toxicologists and do not have the training to make these decisions and to ensure drugs are safe. Side effects like death and blindness would be common without applying toxicology principles to drug development and having a regulatory agency to make sure toxicities have been characterized.

      • Miles says:

        “It is all people coming together to agree that a drug should be given to treat a condition and that it is safe. If the FDA disappears overnight you would hope pharmaceuticals would still do exactly the same testing they currently do. But this is like hoping that there would be no crime and therefore no police is needed.”

        There is no *correct* amount of safety. I’m never going to get you to admit this, am I? No matter how hard I try, you will continue to make arguments based on the idea that some “expert” knows what the correct amount of safety is for everyone else. I hereby give up on this attempt. There is no use trying to convince you otherwise.

        “Most people are not MDs or toxicologists and do not have the training to make these decisions and to ensure drugs are safe. Side effects like death and blindness would be common without applying toxicology principles to drug development and having a regulatory agency to make sure toxicities have been characterized.”

        Most people aren’t toxicologists? Huh, I guess you got me there. Here I have been, thinking this whole time that most people are! I’m so silly.

        You know what, on second thought, most people don’t have any expertise in a good many of things. I wonder how people who don’t know anything about cars manage to buy good ones? There must be a government agency somewhere who makes that decision for the rest of us. I know that when I went car shopping, my only choices were:

        A) Have a government expert choose my car for me.

        B) Make a random choice of my own, wallowing in my ignorance, and hope that by sheer dumb luck I pick a good one.

        You know what, on second thought, I don’t even know why my doctor bothers asking me if I want further testing done when I go in for a check-up. I mean, I’m not an MD. How could I possibly make an informed decision? He’s the expert. He shouldn’t even ask, he should just say “I have decided that the risk of you having this illness is high enough, that we need to do more expensive testing. Don’t bother objecting, I’m an *expert* and therefore know better than you. I know how much safety is the *correct* amount of safety for you to incur. After all, I went to school for this sort of thing and you did not.” I mean, there is nothing that I could possibly do to make an informed decision according to my own person needs and preferences. I’m too ignorant and/or stupid!

        Thank you Somite, for relieving me of the nasty burden that is self-responsibility. I feel so much better!

      • Somite says:

        “There is no *correct* amount of safety.” Yes there is and there are whole fields of expertise dedicated to determine that a drug is appropriately safe. Just like there are a lot of regulations in place to ensure that the car you buy is functional, safe and pollutes as little as possible.

        I don’t understand this mentality libertarians have that any form of organized discussion to achieve a goal is inappropriate because there is a cost associated with it. It has been the base of society so far. I don’t want to be part of a cheap anarchy where everyone believes they are right because it suits their purposes over everyone else’s.

      • Miles says:

        @Somite

        “There is no *correct* amount of safety.” Yes there is and there are whole fields of expertise dedicated to determine that a drug is appropriately safe. Just like there are a lot of regulations in place to ensure that the car you buy is functional, safe and pollutes as little as possible.”

        Again, I’ll let this go because I feel it is a lost cause.

        “I don’t understand this mentality libertarians have that any form of organized discussion to achieve a goal is inappropriate because there is a cost associated with it. It has been the base of society so far. I don’t want to be part of a cheap anarchy where everyone believes they are right because it suits their purposes over everyone else’s.”

        Straw-men are falling like rain! When have I ever suggested that “any form of organized discussion to achieve a goal is inappropriate because there is a cost associated with it”?

        Please, point it out. You accuse me of making really dumb arguments that I don’t make in just about every post of yours. Please, point it out. When have I ever said this or suggested this? When have I ever suggested than an “organized discussion” is inappropriate in any way, shape, or form?

        I’m not going to discuss anything further with you until you retract all of these absurd, straw-man arguments you keep making on my behalf.

      • Somite says:

        It will be easier to discuss with you if you commit to a position. In typical libertarian fashion you leave your points vague enough so that you can squirm out after being confronted by reality. Do you want to commit to a solid position and play out for us how it would work in real life?

      • Miles says:

        @Somite

        “It will be easier to discuss with you if you commit to a position. In typical libertarian fashion you leave your points vague enough so that you can squirm out after being confronted by reality. Do you want to commit to a solid position and play out for us how it would work in real life?”

        Hmmmmm. No, that’s not good enough for me. If you want to continue discussing this with me, here is what I want to hear:

        “I’m sorry Miles. You in fact, did NOT state or suggest several of the things that I have accused you of saying. I understand how irritating that can be, especially when you make an effort not to jump to conclusions yourself, or think the worst of people who disagree with you. In the future, I shall endeavor to disagree with the things you actually say, instead of making things up to try and make it seem like you are not being rational.”

        Otherwise, I will assume that you don’t have much interest in listening to the merit of what I have to say, but are much rather interested in arguing for the sake of argument.

      • Miles says:

        Oh, and I’d like to add one thing.

        Unlike you:

        “In typical libertarian fashion you leave your points vague…”

        I will NOT make sweeping generalization about your or the political group with which you identify. You *might* be a liberal, but I will not make that assumption. Nor will I make sweeping generalization about what you must believe because you are a liberal, nor will I generalize that “liberals all think this…” or “liberals all say that..”

        Instead, and in spite of all the generalizations, group selection, and ideological dismissals that have been fired my way, I will continue to take each individual policy, statement, or idea that I disagree with, and evaluate it based on evidence and merit.

      • tmac57 says:

        Miles,is what you are advocating that there should be no legal requirement for a company to test their drugs for safety and efficacy,and that if their product causes harm,it is up to individuals to prove it,and take action against them?

      • Miles says:

        @tmac57

        Miles,is what you are advocating that there should be no legal requirement for a company to test their drugs for safety and efficacy,and that if their product causes harm,it is up to individuals to prove it,and take action against them?

        Good question! You came right out and simply asked me what I’m advocating, instead of suggesting that I’m a crazy anarchist who doesn’t value safety and wants people to die. I appreciate that more than you know, because it is so rare, even among a so-called “skeptic” group that champions rational thinking.

        First off, I don’t think we need the FDA. I don’t think we need an agency of government dedicated to regulating the way drugs are tested, and I think what we have right now is WAY too much. I also think that adults should have the unalienable right to decide for themselves what to put into their body.

        As far as no legal requirement at all to test their drugs for safety at all (and there is a pretty big gap between the HUGE amount of money and testing currently required, and none at all), no, I do not think it would be necessary. I don’t think it’s necessary, but I concede that I could be wrong, and I would be fairly happy if we at the very least get rid of the FDA and have some very simple, easy minimum legal requirements which would drastically reduce cost and the time required to get drugs to market, thereby increasing innovation and opening up the market to more people who want to try and compete.

        Of course it is still very important for the government to prosecute and punish people who are found to be guilty of fraud. But no, I don’t think the government should be in the business of telling adults how much risk they are allowed to take when ingesting a drug. I think each individual adult should have the freedom to make that choice for themselves, and I think that way of doing it leads to better overall outcomes for everyone.

        Different people want different amounts of safety, and in a free market, different companies can provide different amounts. For people who want lots and lots of safety testing done before they take a drug, they can get their drugs from company A. For people who are a bit more desperate, might be dying of a terminal illness, and are willing to take a drug that hasn’t been tested as extensively for safety, they can go to company B. We still get the innovation of the fre e market, we still open ourselves to the possibility of a Bill Gates in the drug industry, but we have different options for different people with different preferences.

        And not only do I think that we won’t have a long-term, significant rise in toxic drug-related injuries/deaths, but like every other product or service that the government leaves alone, we will end up with better drugs more often, and save more lives than we do now.

      • tmac57 says:

        1.Miles,if drug company ‘A’ claims to throughly test their products,how would we know that they really do?
        2.If they use an independent testing facility,how do we know that they are not just producing the results that their employers (the drug companies who pay for their services) want them to produce?
        I don’t know how we can avoid inherent conflicts of interests in such a scenario.

        3.Tracking adverse side effects of drugs,can also be tricky and confounding(not for amateurs).That’s why it costs so much to test them ahead of time.If we eliminate testing requirements,would we be at risk of turning our general populace into a vast group of test subjects for the drug companies?

      • Miles says:

        @tmac57

        1.Miles,if drug company ‘A’ claims to throughly test their products,how would we know that they really do?

        2.If they use an independent testing facility,how do we know that they are not just producing the results that their employers (the drug companies who pay for their services) want them to produce?
        I don’t know how we can avoid inherent conflicts of interests in such a scenario.

        I’ll try to answer both of these at once, since I think they are essentially the same question. What you are essentially concerned about is (and let me know if you disagree): how do we evaluate the evaluators? How do we know that the people testing for safety are doing a good job?

        That is a really good question. In my opinion, there is no perfect solution to this, only different alternatives, some of those alternatives providing better results than others. But I want to be clear, that this question is important no matter who is doing the testing, or who is deciding what tests should be done.

        It’s true, safety tests done by private companies are likely to have flaws, sometimes big flaws. But what is the alternative? Does that mean that tests done by government employees are not likely to have flaws? Sometimes big flaws?

        You are identifying a problem with human beings in general. Sometimes they make mistakes, and sometimes they do things out of malice. This fact isn’t altered by whether or not the human being is a government employee or a private sector employee. This fact does not change if the human being is writing laws on a piece of paper that everyone else must follow, or if it is a human being writing a procedure on a piece of paper for his company to follow. They are both frought with the same potential problems.

        So, let’s compare what kinds of natural mechanisms each approach has in place to compensate for those problems.

        What is the government mechanism in place to compensate for government failures? It’s more government. The only mechanism they have to correct bad policies, bad laws, and bad regulations, is with new policies, new laws, and new regulations. Essentially, more of the same. What kinds of natural incentives are in place for the government to produce laws and regulations that benefit the citizens? The answer is supposed to be a democratic process. Basically, the majority wins. In essence, that means that if 51% of the population want things done one way, and 49% want things done another, well, the 49% lose. (It doesn’t quite work out that simple, I know that I am grossly simplifying things, but I’d need to write a book to describe this process with much justice). With government, the most powerful special interest groups tend to get what they want, at the expense of everyone else. So for example with the FDA, pharmaceutical companies with good political contacts, lobbyists, and deep pockets, get to participate and sell their products at the expense of everyone else. Nobody else gets to participate.

        The result of this, is that you don’t get very innovative solutions to problems. You simply get more regulation. You don’t get very many people working on the problem, because only politically connected and wealthy people are able to take part. You essentially end up with a small, privileged group that gets their way at the expense of everyone else, not because they are necessarily making better products (serving the customers better), but because they can navigate government beauracracy better, and because they have more money to burn on behalf of the FDA.

        Now let’s compare this to how an open market deals with these problems: competition. When we institute a market, we freely admit that sometimes people make mistakes, and that some times people take advantage of others. Instead of trying to deny that, and just assume that if we pick the right people to put in charge, that these human problems will go away, markets compensate for that by rewarding producers only if they make consumers happy.

        In this way, competition ensures that company A does a good job testing, because if it doesn’t, their unsafe drugs will not be purchased by consumers, who instead choose to purchase from company B. Even the threat of competition acts as a natural restraint on producers from making bad products. Even if Apple were run by people who did intentionally want to make a terrible product and pass it on to consumers, they wouldn’t dare. Because consumers would just stop buying iPhones, and everyone would just go buy Android phones.

        The other beauty about this, is that markets provide something the government doesn’t: choice. Some people, would rather have a cheaper car that isn’t going to last as long, and buy Kia instead of Honda. Some people would rather have looks and speed rather than reliablitiy, so they buy Corvettes. In the government scenario, 49% of the people simply lose, and don’t get what they want, because the other 51% voted for their way. But in a market, one guy gets a Kia, the other guy gets a Honda, the other guy gets a Corvette. The same thing would happen for drugs. One guy would spend twice as much money to get a drug that has been tested for safety a lot more than others. Someone else, who is willing to take the risk, would have the option of taking a different drug.

        But the beauty of the market, is that even if you disagree, and hate the idea of buying a car that isn’t reliable, you don’t have to. As much as you might look at the guy who wants to take a newer drug that hasn’t been tested as much as others, and think that he is stupid and taking a dumb risk, you don’t have to follow him. You still get your choice, he still gets his choice.

        And over time, every producer gets better at what they produce, not because the leader is a good person (what we rely on with government), but because if they didn’t get better, they will go out of business.

        3.Tracking adverse side effects of drugs,can also be tricky and confounding(not for amateurs).That’s why it costs so much to test them ahead of time.If we eliminate testing requirements,would we be at risk of turning our general populace into a vast group of test subjects for the drug companies?

        In a way, yes, we would be at “risk of turning our general populace into a vast group of test subjects”. You are right. Over time, people who made bad choices would suffer the consequences of those choices, and the rest of us would learn from those choices to make better decisions of our own.

        Now, this might seem brutal and unfair to you, but it is no different under the current system with the FDA. Consider the truth of this statement:

        No matter how strict the safety requirements imposed by the FDA, there will ALWAYS be risk. There will NEVER be 100% safety. Even drugs that pass the strictest FDA requirements, have the potential to hurt people.

        The only way to be 100% safe with drugs, is to not take them. What happens when the FDA approves a drug, is that they proclaim the drug to meet a set of standards. But in the same way that consumers become test subjects when they take a drug that has gone through a weaker set of standards, they are still “test subjects” if the drug has gone through stricter standards.

        It’s important to keep in mind that higher standards doesn’t necessarily mean more safety. Spending $30 billion on testing a drug instead of $10 billion, isn’t necessarily going to make the drug safer by a factor of three. Eventually, these kinds of things tend to reach diminishing returns. To say that one drug must be safer than another because it was tested for longer, is a fallacy.

        It is logical to assume that drugs which have gone through harder safety testing standards will tend to be safer on average than drugs that have not gone through those higher standards. But there are always exceptions, and there is never 100% safety or certainty.

        In a free market, drug companies will compete with each other to try and figure out cheaper and more efficient ways of testing their drugs, because this gives them an advantage over the other companies. This does not happen with government, because the same set of standards is applied to everyone. Free-enterprise tends to do a better job, because companies are competing with each other to try and figure out new and innovative ways to test drugs for safety, which produce good results at lower costs.

        Basically, my argument comes down to the following claim:

        Competition is a more effective mechanism of producing better results than rules and laws.

        By the way, I’ve mentioned in a previous post that there is a part of the medical industry that has been mostly left alone by government regulation. It’s a medical procedure which can be very dangerous and end up doing permanent physical harm to consumers if not performed safely. It’s the kind of industry that you would think would require government oversight, else you would end up with too many safety problems and people would get hurt. But that hasn’t been the result. In fact, within this industry, safety has increased dramatically over the last decade, the cost has gone down dramatically, and consumers are consistently quite happy with the experience. I challenged someone else to identify what industry this is and didn’t get a response. The answer: laser eye surgery.

        Laser eye surgery has escaped most of the government interference that other medical industries have not. For someone who believes that the market simply can’t provide for safety without government oversight, the overwhelming success of laser eye surgery is an awkward fact to have to face.

      • tmac57 says:

        Actually,refractive surgery lasers themselves,have to conform to FDA laws,regulations and performance standards.And I would bet that eye surgeons are glad that they do.That way they can have more confidence in their equipment,and not worry about harming their patients by accident.

        And to your other points,I will have to say that I believe that things such as food,water,and drugs,are in a different class of ‘consumables’ that require special attention and care,that I don’t think most people are willing to cede oversight completely to free market forces in hopes that they will do the right thing,rather than do what is expedient and profitable. You obviously see it differently,and that is fine,and I see no prospect of swaying your opinion,so I will leave it at that.
        I think that you will have a difficult time gaining widespread support for your vision of a better system,but who knows?You do display a lot of energy and fervor in your advocacy at least.

      • Miles says:

        @tmac57

        And to your other points,I will have to say that I believe that things such as food,water,and drugs,are in a different class of ‘consumables’ that require special attention and care,that I don’t think most people are willing to cede oversight completely to free market forces in hopes that they will do the right thing,rather than do what is expedient and profitable. You obviously see it differently,and that is fine,and I see no prospect of swaying your opinion,so I will leave it at that.
        I think that you will have a difficult time gaining widespread support for your vision of a better system,but who knows?You do display a lot of energy and fervor in your advocacy at least.

        Very well. I’ll leave you with one final suggestion. This is not to sway your opinion, but to perhaps broaden your perspective in a way that I think will be comfortable for you.

        Most of you on these forums are perfectly comfortable with the idea of evolution. The idea of complexity, emerging on its own, without a designer. Yet, you seem very uncomfortable with the same idea as applied to markets. You are comfortable with the idea that natural selection can produce solutions to problems, adapt to changing conditions, and ensure not only the survivability of life, but an overwhelming bloom of variation. You are comfortable with the idea that nobody designed a human being, but that a human being “emerged” from this process of natural selection.

        This, is exactly what a market is. It’s the notion that instead of having someone design things from the top down, you have millions of individual people interacting with each other in different ways, which, over time, produces results that naturally emerge from the market. It’s the idea that this natural emergence is much more effective at increasing the human lot in life than top down control.

        I find it strange that so many of you accept this principle on the one hand, but are so suspicious of it on the other. Charles Darwin and F.A. Hayek are much more alike in their theories than I think most of you would be willing to admit.

        Finally, I would like to point out that some of the very people you all admire, advocate for the power of free markets. I assume that you are all fans of Michael Shermer here? Have you ever read “The Mind of the Market” by Michael Shermer? It’s an excellent book that not only advocates for the power of free markets, but shows how parallel the ideas of Capitalism and Evolution really are. They really are the same theory applied in two different ways. Perhaps if you automatically mistrust me, and think that this is all nonsense because I’m biased and ideological, you might be interested in reading a book by one of your own role-models which will fit your comfort zone better. It’s a short book, and I think you might enjoy it very much.

        I’m not advocating that you should agree because he is Michael Shermer and you are all more likely to agree with what he says. I’m simply betting that because you are hearing it from him, it is more palatable to your mind.

      • tmac57 says:

        Miles,I will consider what you said.I will also offer the idea that our present form of government also evolved under societal pressures into a more complex (if flawed) system that it is now (appendix,bad back,and all!). The laws and regulations that choke our system, each had some sort of genesis,and removing them without thinking through the consequences,could prove to be disruptive in ways that most people would not be happy with.I won’t argue that changes aren’t warranted,but I will vigorously oppose wholesale abandonment of the hard won protections that our society has seen fit to put into place for our food,environment,and healthcare.

      • Somite says:

        Evolutionists like Richard Dawkins and PZ Myers would be the first to say you can not apply the principles of evolution to society goals. Evolution is also based on the extreme suffering of many many individuals for an inch of ‘progress’.

        Societies should be built around the principle of maximizing well being for everyone. Similar to what Sam Harris proposes.

  7. Max says:

    RateMDs deleted reviews of Dr. Monita Poudyal that criticized her for hawking glucosamine supplements in infomercials. I guess the reasoning is that the site is for patients to rate their personal experience with the doctor, not for random people to share their opinions.
    The rating instructions indicate a fear of being sued for libel:
    “Please make your comments detailed, helpful and polite and tell us WHY you rated as you did. Libelous or very short comments may be deleted. Further, this is not the right place for reporting illegal activity, unless you include a link to a site with supporting evidence. You are legally responsible for what you write here.” (emphasis in original).

    I saw another doctor get 1.5 stars and bad reviews on Yelp, and wondered how he stays in business, but googling him returned all kinds of media appearances by him and websites where he had 4-5 star ratings but no actual reviews.

  8. Max says:

    NBC investigated car repair ripoffs recently. They recommend getting a second opinion about big repairs, and going to mechanics recommended by others.
    But I wonder, what if you go to separate mechanics for diagnosis and repair? Would this eliminate the incentive to overdiagnose, and would this work with doctors as well?

    • tmac57 says:

      Well,one problem that I see with this idea,is that most doctors would want to make their own diagnosis.When I was a communications technician,whenever I was called in to troubleshoot a difficult problem,I always 1st listened to what the previous tech found,and took that in to consideration,and then did my own diagnosis before trying anything to fix the problem.Often,I would discover something missed by the previous tech,and if I had blindly followed their path,I would have gone down the wrong alley,so to speak.

      • Max says:

        So let the second repairman or doctor corroborate the diagnosis. That’s basically a second opinion. If he finds different problems, go to a third person to repair them.
        Bear in mind that some experts might be good at diagnosing, while others are good at repairing.

      • Max says:

        Actually, the second repairman will have an incentive to agree with the first diagnosis.

      • tmac57 says:

        Hey man,we’re having enough trouble with doctors finding time to see the patients they have now.And you want to go and triple the case load! ;)

      • Max says:

        This should reduce the number of unnecessary repairs or procedures by reducing overdiagnosis. Measure twice, cut once.

      • tmac57 says:

        “Measure twice, cut once.” Especially if you’re a mohel!

  9. Chris Howard says:

    Is there a site that lists woo-peddlers? Something up to date, with links to the actual research, and commentary on said research.
    It could list the practitioner, what woo they practice, and provide a link to any data (for or against) with professional consensus, and expert commentary on the findings.
    That way there is no allegation of slander, or liable.
    Perhaps something in the style of Trick or Treatment?

    • tmac57 says:

      Just go to Whale.to or naturalnews.com…then do the opposite of what they say.
      Actually Quackwatch.org is a really good reference.

  10. So can anyone out there identify the original source of the quote in the title, which I changed slightly in a bit of wordplay?

  11. Chris Howard says:

    Tmac, (at the risk of sounding like a 15 year old girl) OMG! A friend sent me a link to naturalnews.com, because he was excited about the myriad cures for cancer available on their site. That place is Ducks#%t crazy, central!
    I tried showing him Quackwatch, and sent him a copy of Trick or Treatment, but to no avail.

    I think part of the problem is the fact that the FDA isn’t the paragon of virtue, it once, if ever; was. So people are skeptical, as they should be, of that particular organizations findings.
    The problem is that they, tend to, paint with an overly broad brush. They may not realize that the FDA, while wrong, or “corrupted” when it comes to certain things can be correct with regard to others.
    I think that this generally comes from a segment of the population that regards itself as “activist consumers” Fighting “The Man” with boycotts, and purchasing choices. All that’s fine as long as one’s done their homework, and it isn’t an “ideology over evidence” based decision.

    What I’d like to see from Quackwatch, or something like it, is an evidence based assessment, with commentary from the medical field (research & practicioner). Perhaps a “Scientific Seal of Approval/Gold Stars” rating system (yelp is opinion based) that rates doctors based upon their adherence to evidence based medicine.
    Something that a consumer could look at when assessing who to go to in their area, as well as verify, or ausage, any doubts they may have about the efficacy of any treatment(s).

    • tmac57 says:

      Chris,
      I think that is something that many of us would like to see,a kind of ‘Consumer Reports’ for doctors (by the way,Consumer Reports does have a newsletter called onHealth,which is pretty good most,if not all,the time). Until that day we are pretty much on our own I guess.

  12. @Max: BINGO! Yes, this message was related by an American officer back to base when Wade McCluskey’s Douglas SBD Dauntless dive bombers sank 3 of Japan’s four top carriers in 5 minutes at the Battle of Midway, changing the tide of war in the Pacific.

    • OOPS! I was wrong. When I looked it up on line, it turns out Lt. Commander Robert Dixon said it during the Battle of Coral Sea, when they sank the Japanese carrier Shoho. They used the line in the movie “Midway” and that Hollywood distortion fooled me, too….

  13. MadScientist says:

    There are a number of things:

    1. in our adversarial system, someone has to bring up charges

    2. the DA will not typically bring charges because (1) not enough victims complained to be able to put a case together and (2) everyone has a limited budget and investigating these cons would take up resources which are already oversubscribed

    3. cases not tried by the public prosecutor can cost the plaintiff huge amounts of money which they simply don’t have. Although the principle has always been that matters of general public concern should be tried by the state to ensure that a lack of resources does not leave the public at a disadvantage in proceedings, you do need to put some pressure on the DA’s office to get them to committ to investigating and prosecuting a case.

    And of course there are a million other reasons.

    • The Midwesterner says:

      In No. 3, you’re mixing up criminal and civil cases. Governments bring criminal charges, handled by public attorneys, for violations of statutes or ordinances. The burden of proof is beyond a reasonable doubt and the penalty is a fine and/or incarderation. Civil cases are brought by individuals who have “standing.” In other words, they must be an injured party (or the legal guardian of an injured party). The petitioner must hire their own attorney and bear all costs of litigation through verdict or settlement. The burden of proof is preponderance of evidence as to both liability – did the defendant do something purposefully that harmed petitioner -and damages – what is the dollar value of petitioner’s injuries. Civil cases are always about money or, in a few cases, specific performance, never incarceration.

    • oldebabe says:

      Indeed, there are a lot of other reasons (maybe not a million, tho). One that you do not mention, however, ISTM, and from my observation and personal experience, is that medical docs/orgs, are reluctant to take a stand against `one of their own’, and maybe not even from any ethical reasons, but that they do not want to be on the receiving end themselves of investigation into their decisons and practice.

  14. Chris Howard says:

    I’ve been watching “God in America.” on PBS (it’s awesome) and saying to myself “Why is David Prothero talking about puritanism, and the Protestant reformation in the U.S.?”
    That’s when I realized that I’m suffering from early onset dementia, confusing Stephen Prothero with David.
    Can faith healing cure my failing brain?!

  15. Chris Howard says:

    And by David, I mean Donald! I really need “pyramid power” memory enhancement treatments. Sorry Donald, I’m old. :-)

    • @Chris: apology accepted. And since you brought it up, no, I don’t think I’m related to Stephen Prothero you’ve seen on TV, at least not closely. My ancestors came over from Wales in the 1830s, and we have most of them on the family tree identified. It turns out that “Prothero,” “Prothro”, “Prithers”, and cognates are common names in South Wales (all are derived from “ap Prythergh”, “Son of Roderick” in Welsh), so there have been many ancestors coming over from that large family stock over the past two centuries. There’s even a “Miss Prothero” in Dylan Thomas’ “A Child’s Christmas in Wales”.

  16. Max says:

    “On September 27, 2011, a federal jury convicted her of peddling expensive phony treatments to desperate patients, and sentenced her to 150 years in prison and a $5.5 million fine.”

    She was convicted but not sentenced yet. I doubt she’ll get the maximum 150 years. Conrad Murray faces a maximum of 4 years if convicted of involuntary manslaughter of Michael Jackson.
    Most of Christine Daniel’s victims who died were terminal cancer patients who would’ve died anyway, though maybe not as fast or as painfully with palliative care.

  17. BillG says:

    Donald, reasons include not only a back-load of cases for DA’s or even the priority of violent criminals, but perhaps which side of tracks the offense takes place on.

    Inner city gang violence yields to suburban crimes as priorities – internet and medical scams, though common are likely further down that list. Hence, only the occasional Dr.Daniel(s).

  18. Daun Eierdam says:

    Just for the record, the character of Elmer Gantry was not a faith healer. I don’t believe the other major figure in the movie, the lady evangelist, was either.

  19. Somite says:

    I wonder how the Amazon reviews of drugs would look in libertarian world.

    “Stay away. Killed my daughter and left my mother blind.”

    “Pleasant flavor. Causes sterility”

    “Worked great for me. Not so much for my neighbor”

    • Miles says:

      I’m glad that human tragedy is a joke to you Somite.

      You do realize that by generalizing and bashing the libertarians the way you are, you are also bashing this guy:

      http://www.youtube.com/watch?v=kKf0NW7cxq4&feature=channel_video_title

      • Somite says:

        Of course. I am a constant critic of how ideologies of some famous skeptics cause harm to the movement. Libertarianism is right there with climate change denial.

      • Miles says:

        “I am a constant critic of how ideologies of some famous skeptics cause harm to the movement.”

        I assume you mean specific ideologies. In other words, ideologies opposed to your own.

      • Somite says:

        Any ideology. Ideologies have no place in science or skepticism. I strongly disagree that regulations that decrease suffering can be achieved by the invisible hand. Actually, I think it has been proven over and over the hand can be bought and used by a small number of people.

      • Miles says:

        Any ideology. Ideologies have no place in science or skepticism.

        I see. Am I to understand that you believe yourself devoid of ideology when it comes to evaluating government control vs. markets? I’d like to hear in your own words, whether or not you have any ideology, or if you believe that you are looking at the issue purely from a disinterested, unbiased view?

      • Somite says:

        I try to look at any issue using the most amount of factual information and the least ideologic bias.

      • Miles says:

        Smote:
        “I try to look at any issue using the most amount of factual information and the least ideologic bias.

        It is quite good of you to do so. But of course, that’s not what I was asking you. I’m not interested in whether or not you try to avoid idealogical bias. As a skeptic, I’m less interested in your intentions, and more interested in results.

        I’m interested in whether or not you believe that you are successful in avoiding ideological bias. So what do you say?

        I’m also interested in how your supporters answer this question. Max? tmac57? If you are still out there, what do you think? Do you believe yourselves to be evaluating this issue from a purely disinterested, unbiased perspective?

        Donald, what about you? You haven’t weighed in on my questions to you about the FDA, so I don’t know what your views actually are. But whatever that view happens to be, do you believe that you evaluate the issue and make your decision from a purely unbiased perspective?

      • tmac57 says:

        Miles,for my part I would have to confess that I have obvious biases.
        I like the Shermer video (I wish all YouTube videos had that good of video quality),but I do think that he engaged in a bit of ‘handwaving’ about 5min. in when he said something like “well of course we have to have laws/rules”.
        Well,yeah,but isn’t that the path that you start down that ends up in the tangle of laws and regulations that we now have? I can easily imagine wiping the slate clean,and starting from a purely free market basis with minimal rules,and gradually tweaking and adjusting the system to account for flaws,until you finally end up back where we started,or worse.
        It doesn’t necessarily have to end that way,but I think that our previous experience with human nature does not bode well for a pristine free market society.That’s my bias.

      • Somite says:

        What I think it is telling is that no one can cite specific examples of blatant wrongdoing by regulatory agencies. On the contrary, whenever regulations are removed the negative effects can be seen quite readly as seen in our recent financial collapse. This is the best evidence that promoters of de-regulation are acting out of ideology rather than using facts or historical precedent.

        Again. Miles – can you supply examples of negative effects of FDA or EPA regulations or in other other regulatory field like finance?

      • Miles says:

        Somite:
        Again. Miles – can you supply examples of negative effects of FDA or EPA regulations or in other other regulatory field like finance?

        I tell you what, I will answer this question in the other thread you asked it (which got side-tracked), IF you answer my question about bias in this thread. So I’ll ask you again:

        Do you believe that you are successful at evaluating this issue without having any ideological bias?

        Thanks for your answer tmac57. I agree with most of the things you said. I don’t want to derail from the bias/ideology question in this thread though, because I still would like to hear from Somite and maybe even Donald if he is interested in participating. This is all leading up to an actual point I’m trying to make, which is, I suspect, why Somite seems reluctant to answer my question.

      • Somite says:

        Ok. I’ll humor you. There is no ideology behind anything I type or think.

        Of course this is woefully inadequate because it is the ideologies of fairness, well-being and rationality that are actually behind everything I type or think.

      • Miles says:

        Ok. I’ll humor you. There is no ideology behind anything I type or think.
        Of course this is woefully inadequate because it is the ideologies of fairness, well-being and rationality that are actually behind everything I type or think.

        What does THAT mean? Yes or no? Are you biased or not?

      • Somite says:

        I have absolutely 0 bias.

      • Miles says:

        “I have absolutely 0 bias.”

        That is quite a claim. You should expand your horizons with this book:

        http://www.amazon.com/Believing-Brain-Conspiracies—How-Construct-ebook/dp/B004GHN26W/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1319589670&sr=1-1

  20. Donald Prothero says:

    SO did anyone click on that link to Benny Hinn as Emperor Palpatine/Darth Sidious? I thought it was hilarious….

    • tmac57 says:

      Yes ! That was a hoot,and very clever,but honestly…just watching Benny Hinn the way he really is is pretty damn amusing.

  21. Loren Petrich says:

    Miles’s capitalist Panglossianism is absurd. Anarchy has been tried, and it tends to be replaced by de facto governments, if not de jure ones. Somalia’s de jure goverment is VERY limited, so that nation may seem like a libertarian utopia, but it has de facto governments in the form of militias like Al Shabaab.

    He also ought to look at the history of quack medicines before the FDA and other regulatory agencies. Oodles of quack medicines, often worthless and sometimes dangerous. There used to be quack medicines that contained sizable amounts of radium, of all things. Did the makers of them commit suicide in shame when their health hazards became apparent?

    He also ought to look at the “frog wars” between rival railroads building their lines outwards. Some of them would even have their employees fight other ones’ employees.

    Or better yet, let’s look at organized crime. Much of it involves capitalism, but that does not exactly turn criminal gangsters into pacifist saints.

  22. BEHIND-THE-SCENES INSIDER SKEPTIC says:

    People…people…people, please!
    Skepticblog.org???
    What can an individual do when even
    skepticblog.org drops the ball?!

    [On September 27, 2011, a federal jury convicted her of peddling expensive phony treatments to desperate patients, and sentenced her to 150 years in prison and a $5.5 million fine.]

    WTF!?

    Listen, skeptics of the world…especially you, Mr. Prothero:

    She was not sentenced 150 years in prison and fined $5.5 million on September 27, 2011!!! She was found guilty, not sentenced on this date! Her sentencing was supposed to be last December 5th, 2011.

    Oakie Doakie, folks…what was her sentence, then?

    She currently works at her clinic in the San Fernando Valley, and yes, she’s open for business! She was not sentenced! The judge reversed himself, and there’s going to be a new trial. How can that be, skeptics? For all of you being skeptics and all, shouldn’t you have asked, “Could there be more to this?” A slam dunk of a case if there is ever one? Innocent people on death row, skeptics?

    Stay tune…and please, if you are indeed a true skeptic…then by all means, stay one, why don’t you!

    SMART AND TRUE SKEPTIC!