Whither An Old Problem: Sweden, New York, and Problems with Elderly Care

Andrew Donaldson

Born and raised in West Virginia, Andrew has since lived and traveled around the world several times over. Though frequently writing about politics out of a sense of duty and love of country, most of the time he would prefer discussions on history, culture, occasionally nerding on aviation, and his amateur foodie tendencies. He can usually be found misspelling/misusing words on Twitter @four4thefire and his writing website Yonder and Home. Andrew is the host of Heard Tell podcast.

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133 Responses

  1. Jaybird says:

    Anything that can’t go on forever, won’t. The comparison to the AIDS virus in the early 80’s keeps popping up over and over again… and that makes me wonder at the comparisons between quarantine and abstinence. There are things that are exceptionally reasonable to ask for such as a 3 week lockdown. A 3 month lock down is a lot tougher to ask for.

    There’s a point at which society will change in response to the new normal and many of these ways that society will change will be less than aesthetic to those who have aesthetic tastes developed in the old normal.

    I don’t know how far we are from that point, though. I just suspect that there’s a lot of overlap with the whole “very slowly and then all at once” model.

    And, yeah, anything that can’t go on forever, won’t.Report

  2. Chip Daniels says:

    The reaction of our citizenry is the most telling thing here.

    In previous generations, expose’s about the mistreatment of the mentally ill, or of migrant farmworkers resulted in public outrage and hearings and legislative actions.

    Today we have the dominant political party going on tv and telling us we should let old people die as the price for economic recovery, and it is shrugged off as just part of the normal discourse in American politics.

    As I’ve asked before here, how would you know if you are living in a failed state?

    I suggest this is one way.Report

    • Philip H in reply to Chip Daniels says:

      I agree about the failed state analysis, in as much as failed central and south american states were topics of discussion around our dinner table growing up.

      I disagree however that the suggestion was just shrugged off. Lots of digital ink equivalent was spilled across the internet on many platforms decrying that notion, including by some ordinary folks. Its not a part of the protest movement such as that is,but said protest movement has been bankrolled by the very same political party making the suggestion.Report

      • Chip Daniels in reply to Philip H says:

        In history books, one of the data points historians use is when previously taboo actions (such as crossing the Rubicon, or suspending Parliament) are violated without punishment.

        In the past two decades there have been repeated taboo violations- normalization of torture, warrantless surveillance, lawless imprisonment; The acceptance of Presidential grifting, merging his own personal interests with the power of the office, weaponizing the Justice Department for partisan gain.

        There is outrage, but it is effectively neutered by the fact that a plurality of Americans heartily approve of each and every one.

        Think of how quaint Watergate would seem today, or the Teapot Dome scandal, things which destroyed previous administrations yet are acceptable by today’s standards.Report

    • Jaybird in reply to Chip Daniels says:

      “resulted in public outrage and hearings and legislative actions”

      There’s plenty of public outrage and hearings and legislative actions going on, Chip. Tons of it.Report

    • Kazzy in reply to Chip Daniels says:

      Is the “dominant political party’s” stance — as described here — better or worse than Cuomo’s rationale for letting old people die?Report

      • Chip Daniels in reply to Kazzy says:

        Sending infectious patients into nursing homes isn’t a party position.Report

        • Kazzy in reply to Chip Daniels says:

          Sure. But it was an action. One I’d argue is more risable.Report

          • Chip Daniels in reply to Kazzy says:

            Imagine though, if we had pundits and commenters writing essays on how this was a good thing, a harsh but necessary sacrifice. And imagine if we had other governors and officials following suit and issuing similar orders, and fighting with court battles against anyone who obstructed these actions.

            Its one thing to have a foolish or mendacious official, its another to enshrine mendacious foolishness as dogma.Report

            • Kazzy in reply to Chip Daniels says:

              Cuomo is actively defending his handling of the situation, including nursing homes. He is arguing that what he did was good and right. O…kay? It almost certainly wasn’t. And IF it was… to what end? Why did he require nursing homes to admit infected individuals? To be non-discriminatory?

              Both groups — the GOP and Cuomo — advocates or enacted policies that upped the risk for the elderly. One is doing so in the name of the economy. Why did Cuomo do it?

              I’m not defending Trump or the GOP. Not by any shot. But Jesus, if we are going to pick sides here, we loose all claims to our humanity.Report

              • Chip Daniels in reply to Kazzy says:

                Nor am I defending Cuomo.

                I am defending liberalism narrowly, and the more broadly the idea that we not toss the weak and infirm to the wolves.

                At one time, this was not a debatable idea. Today it is a partisan issue.Report

              • Kazzy in reply to Chip Daniels says:

                How is it partisan when it’s happening on both sides?

                When Abbot advocates it, it’s evidence of GOP evil.
                When Cuomo does it, it’s a whoopsie.Report

              • Chip Daniels in reply to Kazzy says:

                It isn’t just Abbot. Or Kemp. Or De Santis. Or the Fox News commenters. Or Gateway Pundit, or The Federalist, or Erick Erickson.

                No, it isn’t both sides.
                Only one of our American political parties is urging that we accept mass death.

                Only one.Report

              • Aaron David in reply to Chip Daniels says:

                Wait, Abbot had Covid infected people transfered to nursing homes? And then ordered staff and patients not to be tested?Report

              • Kazzy in reply to Chip Daniels says:

                Please point to someone in the GOP saying we must accept “mass death”.

                I really hate that others on the left make me feel compelled to defend some on the right.Report

              • Chip Daniels in reply to Kazzy says:

                In addition to the ones listed above?

                Start here:

                It seems harsh to ask whether the nation might be better off letting a few hundred thousand people die.”

                What do you think it means when people hear public health experts warn that deaths could number into the hundreds of thousands, yet urge us to reopen anyway?

                Yes, they are saying that reopening the economy is worth letting hundreds of thousands die. It would be a lie to characterize it any other way.Report

              • Aaron David in reply to Chip Daniels says:

                That doesn’t say what you are implying it says. Try another quote.

                Also, a pundit is not a governor.Report

              • Chip Daniels in reply to Aaron David says:

                What exactly are they saying then?

                The game that is being played is that the Republicans dismiss the expert warning of mass death, then when they can no longer do that, tell us that some unspecified number of older people dying is an acceptable price to pay, then when we cry out, they shift back to pretending that ass death won’t really happen because it is a hoax, then start the game all over again.

                And when, as in Florida and Georgia, the bodies become too hard to ignore, they play games with the numbers like Soviet apparatchiks at Chernobyl.

                At no point in this catastrophe have any of the Republican party officials or pundits or opinion shapers taken this seriously or made any effort to do anything but hide and obfuscate and deflect blame.

                We are now at like over 100 thousand dead Americans, and they are still sneering and smirking like oppositional adolescents.

                So yeah, its completely fair to say that Republicans find hundreds of thousands of dead Americans preferable to mild inconvenience or embarrassment.Report

              • Aaron David in reply to Chip Daniels says:

                His quote is agreeing with you. That asking for a trade off is harsh.

                And yes, all those staked bodies in FL and GA. Littering the streets, I mean, just look at the pictures of them!

                You do have pictures, no? Reports from the slaughter? Anything?Report

              • Chip Daniels in reply to Aaron David says:

                Got me there.

                We do have the weird documents from the Georgia Ministry of Truth telling us that the day after Thursday is Sunday.Report

              • Chip Daniels in reply to Chip Daniels says:

                I need a ruling here- Is this nutpicking?

                The organization describes itself on its website as a “pro-Trump, pro-business, pro-individual rights, and anti-government overreach group.”

                New York City is one of the global epicenters of the pandemic with more than 20,000 deaths due to the virus, and almost 200,000 people infected, according to the city’s health department data on May 18 — but, when asked whether it was worth risking hundreds of further deaths by allowing businesses to reopen, the protest organizer said it was and questioned the staggering death tolls.

                “Absolutely, absolutely. But there’s a difference, it’s what they didn’t tell you is what is the mortality rate that’s already been in place,” said Liberate America’s founder Frank Scurlock, who is from New Orleans.

                Hmm, nope not nutpicking at all.
                Oh wait…

                Scurlock, a former candidate for mayor in New Orleans and heir to an inflatable bounce house fortune, was arrested in 2017 for allegedly masturbating in the backseat of an Uber in California, for which he pled no contest in 2018, according to a report in the Times-Picayune.

                Ehh, mebbe. But its debatable.


              • Dark Matter in reply to Chip Daniels says:

                Yes, it’s nutpicking (unless he holds an elected office).Report

          • Philip H in reply to Kazzy says:

            More risable then the lieutenant Governor of Texas telling old people to die to restart the economy?Report

    • Dark Matter in reply to Chip Daniels says:

      …telling us we should let old people die as the price for economic recovery,

      We can reverse that. To keep a few very old and very sick people alive, all you young people need to lose your jobs and we’ll max out your credit cards for you.Report

  3. Damon says:

    “Yet for many weeks, New York policy allowed nursing homes to accept positive Covid-19 patients back into nursing homes, some of which were not routinely testing staff and residents.”



    “Gov. ­Andrew Cuomo of New York and Gov. Phil Murphy of New Jersey issued almost identical orders in late March requiring nursing homes to accept COVID-19 patients being discharged from hospitals. The orders barred the homes from even asking if the patients had the virus, lest they be discriminated against.”

    This wasn’t allowed it was a directive. Nice attempt at revision history. As far as I’m concerned, the governors are liable for those deaths.Report

    • George Turner in reply to Damon says:

      The safest place for New York’s elderly is Florida, where they’re safe from Cuomo. Florida has massive retirement communities and nursing homes, yet New York has 15 times Florida’s per-capita Covid death rate. Florida’s governor focused on protecting the at-risk elderly population from the virus. New York decided to sacrifice the elderly to protect hospital beds.Report

  4. Doctor Jay says:

    One of the foundational premises of government is that it protects its citizens. I was taught that feudalism came to be as a response to Viking raids.

    So, when a government says, “Oh never mind, just be a warrior” it’s giving up. It’s walking away from its most important job. Protecting the weak is a core concept of chivalry, which isn’t exactly a left-wing nutty idea.

    I think people are going to notice this. I think people ARE noticing this.Report

    • Jaybird in reply to Doctor Jay says:


      • Chip Daniels in reply to Jaybird says:

        If other governments around the world perform competently, wouldn’t that suggest that government itself is not the problem?Report

        • DensityDuck in reply to Chip Daniels says:

          We’re getting back to that thing where Jaybird says “what’s the difference between those competent world governments and the USA government”, and you say “I don’t KNOW, dear JAYBIRD, what IS the difference between those competent world governments and the USA government,” and you waggle your eyebrows like we’re all supposed to know what the hell you’re talking about.Report

          • Philip H in reply to DensityDuck says:

            Here’s an example – Other governments more quickly got to levels of testing that are below the US i.e. they are testing more people per million (or 100,000) then the US, even though we have the largest economy in the world.Report

          • Chip Daniels in reply to DensityDuck says:

            The set of “government itself” includes South Korea and Hong Kong. So if “government itself” were the problem, then logically we would expect to see these other governments fail.

            Maybe “governments in English speaking nations headed by conservative white males are the problem” would be a better argument.Report

          • veronica d in reply to DensityDuck says:

            “If South Korea could do it, why can’t we?”

            It’s a fair question. Why can’t we?

            One possibility is it’s a matter of scale. It is easier to organize 5 people rather than 10, and in turn easier to organize {population of S. Korea} people compared to {population of US} people.

            I’m sure that’s part of it.

            Another theory is that Asian cultures are just better at self-organization than we are.

            Is that true?

            I don’t know. We “self organized” pretty well during the second world war. Those were, however, our greatest generation. Evidently we’re not. Perhaps modern South Korea is in the midst of their greatest generation.

            Maybe. I don’t know. In any case, good for them. I’m happy for them.

            Another theory is that Trump is an incompetent jackass who couldn’t manage a kid’s birthday party, never mind a nation.

            Look, that theory is plainly true. Trump is an incompetent buffoon who (mostly) hires incompetent bootlickers. He’s a delusional jackass who lords over a cadre of opportunistic nitwits who have zero integrity and decency. This is plain to see.

            On the other hand, Trump is a symptom, not a cause. Trump isn’t accidentally incompetent. We (as a nation) knew exactly what he was when we elected him. We (as a nation) chose this.

            (Which is to say, I didn’t choose him. But a lot of people did.)

            All that said, to a fair degree, the States and local communities can make up for a lack of federal leadership. It’s harder. It’s slower. It will take longer. Certain things will be impossible, those that require a large amount of money. But congress can get around Trump’s stupidity. They could. It’s possible. Do we want them to? Are we demanding it?

            It’s possible that, as a nation, we could never have achieved what South Korea did. However, it would be deeply foolish to think we’ve achieved the best we could. We fell short, and obviously so. We didn’t get testing in place as fast as we could have, had we good leadership.

            We fucked up. Trump fucked up, but Trump was always an obvious fuckup.

            I told you so.

            You know — it’s actually doesn’t feel good to say that. It sucks.Report

            • DensityDuck in reply to veronica d says:

              “the States and local communities can make up for a lack of federal leadership.”

              They certainly can.

              Do we want to normalize, as you used to put it, the idea that in the absence of competent Federal leadership, states and local communities should decide things for themselves?

              Because I kinda think you had different thoughts regarding, e.g., Arizona and New Mexico deciding, a few years back, that the Federal government was incapable of providing effective border security, and deciding that they needed to handle that sort of thing themselves.

              “Trump is an incompetent buffoon who (mostly) hires incompetent bootlickers.”

              The people in the CDC declaring that there was no risk of airborne infection weren’t Trump appointees. The people at the FDA threatening to jail the employees of companies who produced tests without authorization weren’t Trump appointees. Cuomo isn’t a Trump appointee.Report

            • LeeEsq in reply to veronica d says:

              Ignoring the tricky issue of culture, the countries that managed to get Covid-19 under control had some things in common. They tended to be population and geographically small to mid-sized with one international entry point. America is not geographically small and doesn’t have a small population either. We have lots of geographic entry points.

              We also face political issues. The other countries don’t have a political party that doesn’t believe in government action per se and is dedicated to owing the libs. America does. They control the Presidency, the Senate, judiciary, and many state governments. Since half the political establishment is resistant to doing anything about Covid-19, dealing with Covid-19 in the South Korea manner is hard.Report

              • George Turner in reply to LeeEsq says:

                The problem is that America also has New York City, Boston, Chicago, Detroit, and Baltimore. States that aren’t anti-Trump are doing relatively great, despite getting infected from the aforementioned liberal cities and their respective states.

                Worldwide, the deaths per million population goes like this:

                4 Singapore
                5 South Korea
                98 Germany
                157 Canada
                283 USA
                371 Sweden
                429 France
                521 UK
                532 Italy
                594 Spain
                786 Belgium

                But US states have vast differences, and there’s a possibility that it depended who was in charge.
                The worst hit 12 are:

                1472 New York
                1192 New Jersey
                974 Connecticut
                862 Massachusetts
                567 Wash DC
                555 Louisiana
                502 Michigan
                502 Rhode Island
                371 Pennsylvania
                346 Illinois
                344 Maryland
                312 Delaware

                In contrast to the least hit 12
                12 Hawaii
                14 Alaska
                15 Montana
                17 Wyoming
                25 Utah
                33 Oregon
                34 Arkansas
                38 West Virginia
                43 Idaho
                45 Tennessee
                48 Texas
                52 South Dakota

                The difference between 1472 deaths per million in New York and only 48 deaths per million in Texas is pretty stark. Florida has a huge retirement population but only 96 deaths per million.

                Now if this was all Trump’s fault, Texas should have more deaths than New York, whose wise leaders like Cuomo and DeBlasio would’ve have protected their populations from Trump’s folly. But instead the data seems to show the exact opposite.

                As an aside, Governor Whitmer, like Governor Cuomo, ordered nursing homes to take Covid patients. That only makes sense if the government’s plan for Covid was to help it kill everyone that it can possibly kill.Report

              • Dark Matter in reply to George Turner says:

                As fun as it is to blame Trump, my expectation is he had little to do with those numbers good or bad. The overall situation did the heavy lifting one way or the other.

                Trump is very unpopular in dense urban areas which are great breeding grounds for the virus. Trump is very popular in places which aren’t.

                I don’t think those numbers would be very different if HRC had won. Take Michigan, if you look at it county by county, Detroit is a problem and everywhere else isn’t. Similarly Detroit voted HRC and everyone else voted Trump. We have one governor.Report

              • George Turner in reply to Dark Matter says:

                I think it would look much, much worse if Hillary, Obama, or Biden had been in charge due to their party’s love affair with virtue signaling. They wouldn’t have cut flights from China until many weeks later.

                Sure, it is possible that they would have stopped the flights not long after Trump did, and Biden’s cries of “xenophobia!” was mostly due to Trump Derangement Syndrome, but I really doubt it because they are completely wedded to the open-borders narrative.Report

              • Chip Daniels in reply to Dark Matter says:

                Here’s a map.

                Your expectations may be tempered.Report

              • Dark Matter in reply to Chip Daniels says:

                Not sure what I’m supposed to see here. To a first approximation this lines up with what I’m saying. Dense urban areas have more exposure to this.Report

              • Chip Daniels in reply to Dark Matter says:

                Look at the map of cases per capita.

                See all those hotspots in Iowa, Kansas, Nebraska and Oklahoma?

                Los Angeles County, cases per 100K: 384
                Louisa County, Iowa, cases per 100K: 2,707

                There isn’t any magic to rural or suburban living that makes them immune to the virus.

                Anyplace where people gather like oh say, a church or office or factory or restaurant can become a breeding ground for contagion.

                CDC: Arkansas coronavirus outbreak linked to church services

              • See all those hotspots in Iowa, Kansas, Nebraska and Oklahoma?

                I won’t speak to the others, but the hot spots in NE are each centered on a massive meat packing operation. The workers at those plants are largely legal immigrants (big refugee communities) from Mexico and Central America, Sudan, and Somalia. There’s a huge language barrier. Housing, health care, and other social services were stretched past the breaking point before the virus hit. It’s an ideal situation for the virus to spread.Report

              • Dark Matter in reply to Chip Daniels says:

                Louisa County, Iowa, cases per 100K: 2,707

                Population of Louisa County, Iowa: 11,387

                Ergo that 2,707 translates into 308 actual cases. So it’s one outbreak.

                There isn’t any magic to rural or suburban living that makes them immune to the virus. Anyplace where people gather like oh say, a church or office or factory or restaurant can become a breeding ground for contagion.

                Yes. Absolutely true. Similarly there are counties in Michigan with scary high cases/million which aren’t Detroit. However those counties also have VERY low populations so I assume one nursing home or whatever gets infected in a county where they are a significant amount of the population.

                However “anyone can get it” thinking isn’t very useful when we’re trying to evaluate risk and decide what to do.

                Go back to the 70’s and look at AIDS. Yes, anyone could get it, the virus doesn’t care about you personally. However your personal risk if you’re having sex with 50+ different partners every year was extremely different than if you were having sex with 0 new partners.

                There were people who beat those odds; Some drug-free virgin got it in her dentist’s office, so math matters until it doesn’t.

                However in terms of gov policy, the way to bet is to follow the math. For Covid, if your community is a bunch of single houses and it’s trivial for you to socially isolate, then the rate of transmission in your area can be expected to be very low. Low enough that the virus will die out rather than spread in your area.

                This partly explains the political differences, it certainly should be used in terms of gov policy.Report

              • Dark Matter in reply to LeeEsq says:

                Ignoring the tricky issue of culture,

                I don’t think we can. A lot of this is rate of transmission, which is going to vary wildly from situation (and partly sub-culture) to situation.

                If your group has lots of personal contacts and dense family housing, then that’s a problem.

                So Detroit takes it on the chin, the sub-urbs are mostly fine, and the interior States want to reopen.

                And yes, I’m sure there are big cities which didn’t go as bad as Detroit so luck plays a roll, but that’s just a roll.Report

              • Jaybird in reply to Dark Matter says:

                And we are now easing into A/C weather. Recirculated.

                This is going to hit asymmetrically.Report

              • Dark Matter in reply to Jaybird says:

                RE: A/C
                IDK if that’s a thing… I’ve never heard of it for this thing’s relatives. Now if it is a thing, then yeah.

                RE: Asymmetrically.
                Yes… and it already is. There are groups and zip codes (the ones with fenced in yards) which find it easy to socially isolate (and work).

                That “cases per million” should be driving that home.Report

              • Chip Daniels in reply to Dark Matter says:

                COVID-19 Outbreak Associated with Air Conditioning in Restaurant, Guangzhou, China, 2020

                There’s even a handy diagram showing how the air conditioning spread the virus.Report

              • Dark Matter in reply to Chip Daniels says:

                Great link and example.

                It’s worth noting this example has the scales be very small. Those tables are 1 meter apart and the exposure was long.

                So the good news is the AC isn’t spreading it throughout the building. The bad news is the AC’s focused wind does improve Covid’s reach, like from 1m to 3m.Report

        • Jaybird in reply to Chip Daniels says:

          If colleges in other countries develop tests, do their governments tell them to stop?Report

          • Michael Cain in reply to Jaybird says:

            It’s interesting to look at South Korea, who put a plan in place after SARS and MERS. The plan said, basically, private companies who already develop and manufacture tests at scale will do the development. While tests can vary as far as the biological markers and such they use, every test must use the same laboratory procedures. Skilled staff at universities were to use their labs to read tests, so that can be done at scale. The KCDC would coordinate, approving tests on short turnaround (but not developing or producing) and generally making sure everyone is doing their job.

            So yes, South Korea told their universities to stop. The told them years ago. They told them that developing tests was not their job in the event of an epidemic/pandemic. Their job was learning the single process and performing the back end of the national testing program. I recently read a piece about a high-ranking professor of virology at a Korean university, who is still spending his days from 5:00 am to 11:00 pm doing the back end work for tests he had no part of designing.Report

            • PD Shaw in reply to Michael Cain says:

              That’s interesting. Good government includes planning, otherwise your response time lags for decisionmaking. At some point, the plan has to be jettisoned.

              On a related note, its my understanding that the UK government was informed by public health officials that it didn’t need to worry about the old age homes, presumably because they were already in lock-down and they already have infection mitigation and quarantine plans in place. Again, at some point that assumption defied observable facts.Report

            • Jaybird in reply to Michael Cain says:

              Huh. That’s a pretty good way to do it.

              The google says that the first antibody test was approved by the FDA on April 3rd.

              Huh. They got an Emergency Use Authorization to do that.

              Better than just accepting whatever slipshod tests other countries figured out, I guess.Report

      • Doctor Jay in reply to Jaybird says:

        I’m pretty sure that there are some, but not very many, people who don’t think the police should come and take care of it when there’s an active shooter.

        I find it hard to take the position that we don’t need any government at all seriously. This is a political observation, not a philosophical one.Report

        • Jaybird in reply to Doctor Jay says:

          The last high profile shooting we had involved law enforcement hiding while children were being shot.

          At some point, we are going to need to discuss supporting the theoretical things that everyone supports versus continuing to support the institutions that actually exist.

          I support the colleges coming up with tests. I don’t support the FDA having the authority to tell them to stop.Report

          • InMD in reply to Jaybird says:

            At the risk of whatever street cred I have there was a McMegan article awhile back responding to Scott Alexander’s cost disease piece that I think is pertinent. It’s paywalled here: https://www.bloomberg.com/opinion/articles/2017-02-14/why-some-consumer-costs-just-grow-and-grow

            Alexander quotes almost all of it here: https://slatestarcodex.com/2017/02/17/highlights-from-the-comments-on-cost-disease/

            And at the risk of giving up a little bit of my libertarian cred, I’ll say that government intervention in these markets did not have to be as expensive-making as it has turned out to be in America. Other countries have these sorts of problems too, but they’re nowhere near as large as ours.

            Part of that is just that we’re richer than most of those other countries. We were going to spend the portion of our budgets no longer needed for food somewhere, and health care, education and housing are pretty good candidates. But that’s only part of the story. A big part of the story is that America just isn’t very good at regulation. When you talk to people who live elsewhere about what their government does, one thing that really strikes you about those conversations is how much more competent other rich industrial governments seem to be at regulating things and delivering services. Their bureaucracies are not perfect, but they are better than ours.

            That’s not to say that America could have an awesome big government. Our regulatory state has been incompetent compared to others for decades, since long before the Reagan Revolution that Democrats like to blame. There are many, many factors in this, from our immigration history (vital to understanding how modern urban bureaucracies work in this country), to the fact that we have many competing centers of power instead of a single unified government providing over a single bureaucratic hierarchy. There is no way to fix this on a national level, and even at the level of local bureaucratic reform, it’s darned near impossible.

            In other words, this is probably what we’re stuck with. It may not be Baumol’s cost disease — but it’s potentially even more serious, and it’s going to be a lingering condition.Report

      • greginak in reply to Jaybird says:

        “Size” of government is usually a useless term meant for throwing out red meat to get people raging. Crude and devoid of information.Report

        • Philip H in reply to greginak says:

          I goes along with the notion that “waste, fraud, and abuse” in government is a political term for “something I don’t think we should spend money on.”Report

          • greginak in reply to Philip H says:

            Yeah. People also often seem to think those things are an actual line item that can be zero’d out. Or that getting rid of those things is easy, has no cost and doesn’t come with often onerous restrictions.Report

          • Jaybird in reply to Philip H says:

            In this particular case, it refers to the FDA stopping tests from being developed.Report

            • greginak in reply to Jaybird says:

              Again, where is the political leadership. What has Jared been doing? What has Azar been doing besides appointing a dog breeder head of the HHS response. The FDA has made mistakes. Some were apparently technical and some were…??? I don’t know. But pointing out the FDA problems isn’t proving what you think it is.Report

              • Jaybird in reply to greginak says:

                We have been pointing out problem with the FDA for years now. Remember the EpiPen discussions?

                Good times.

                Remember the time we pointed out that insulin has been around for a hundred years and all of the insulin sold in the United States is name brand?

                Is there any point at which you will follow up a plea for a more European health care system without appending “but we should keep the FDA”?Report

              • Dark Matter in reply to greginak says:

                Again, where is the political leadership.

                The current FDA is what you have AFTER political leadership. I hear all the time how much faster they’re working and how things are being approved at light speed.

                As for early in the process (back when the WHO was claiming it may not be humanly transmittable), I think it’s unrealistic to expect the POTUS to personally intervene at this level.

                More generally, it’s a problem if we need POTUS to personally intervene to make something work.Report

              • greginak in reply to Dark Matter says:

                Huh. This makes no sense. The heads of all the fed departments are political appointees. That is how the gov is designed. If trump can fire all sorts of IG’s investigating him or his cronies how come he or his peeps cut through FDA red tape? Prez sets the priorities and gets his underlings going. Azar, HHS head, appointed a dog breeder to head the HHS response.

                The gov had repeated warnings in Jan and Feb about how bad it could get. Navarro directly warned about it in the beginning of Feb. We also have all sorts of intell agencies whose job it is to find out stuff. Blaming the WHO is the weakest shite ever. I think we have a few assets focused on what is going on in China. Just a couple, well at least one guy somewhere, keeps track of china.Report

              • Dark Matter in reply to greginak says:

                You’re armchair quarterbacking.

                You’re also confusing “FDA in high gear with red tape cut” with “No FDA”.

                This is what the FDA looks like moving in high gear. That’s why we’re seeing progress in real time rather than it taking months or years.Report

              • What purpose does the FDA serve when the president can tell us which drugs are safe and effective?Report

            • Chip Daniels in reply to Jaybird says:

              In this case, the bailey of “government itself” is the motte of “the Trump Administration FDA”.Report

              • Jaybird in reply to Chip Daniels says:

                Chip, if I can find you examples of people defending the FDA not allowing EpiPens that the European version of the FDA allowed, would you be willing to believe that there just might be more going on here than the FDA worked fine until Trump broke it?Report

              • Chip Daniels in reply to Jaybird says:

                We should adopt the European health care system and its regulatory apparatus.Report

              • Jaybird in reply to Chip Daniels says:

                And we shouldn’t allow a second EpiPen to be used by the American People a moment before?

                I realize that I’m in a weird place where I think it’d be more beneficial to make the FDA step off than pass Bidencare but also that it’s more likely that we pass Bidencare without changing the FDA which means that we’ll have the same regulatory environment tacked onto Obamacare II: Electric Boogaloo.

                Which wouldn’t get us anything past making the enemies lament loudly and confuse us that people aren’t better off even though we passed a law.Report

              • CJColucci in reply to Chip Daniels says:

                Chip, a serious, comprehensive comparison of US and European drug and medical device regulation by someone who actually knows what he (or she) is talking about would be a useful thing. I, for one, would like to see it. Maybe someday, someone somewhere, though probably not here, will provide it and people seriously interested in the topic can engage it. I plan to wait. Some folks’ mileage may vary.Report

              • Jaybird in reply to CJColucci says:

                If you want to read where we discussed EpiPens, we did so here.

                If you’re waiting for someone who knows what they’re talking about, the original post links to Slate Star Codex where Scott Alexander discusses the EpiPen thing. Speaking of SSC, he talks about insulin here (skip down to part II!) and you can read that there.

                Anyway, after reading what he has to say, I came to the conclusion that the FDA is too restrictive.

                Plus there’s the whole “Should Marijuana Be On Schedule I” thing that the FDA has reviewed multiple times and, each time, said that “yes, it should be”.

                Which, right there, tells me that shenanigans are going on at the FDA.

                But some people weaponize their own skepticism about such things to the point where they prefer the status quo to even discussing whether things should change.Report

              • CJColucci in reply to Jaybird says:

                Um, no, I don’t want to read what “we” discussed, because on these issues I’m not interested in what “we” think. Hell, I’m not interested in what “I” think until I know a lot more than I know now. A hard concept to grasp, perhaps.Report

              • Jaybird in reply to CJColucci says:

                Well, then you should read Scott Alexander. He works in the field of medicine and he discusses such things on the FDA being too restrictive.

                I linked to him in my comment too.

                Or, I suppose, you could wait until you found someone who validated your priors and then rest well knowing that you’ve finally found someone with sufficient knowledge to overcome your weaponized skepticism.Report

              • Jaybird in reply to CJColucci says:

                Oh, there is one interesting thought experiment that I’d like to hear your take on, though.

                In the comments to the post that you don’t want to read, Vikram Bath mentions that an acquaintance of his has access to a medical device that was approved for home use in Europe but hasn’t been approved for such use by the FDA.

                My question for you is this:
                When you hear that someone has access to a medical device that has been approved in Europe but not by the FDA, what is your response?

                Is it something like “Oh, good. I’m glad they got their hands on that”?

                Is it something like “Those fools are taking a huge risk by using something not approved by the FDA! Not just the legal ones, but also they’re taking huge risks for their own person because we don’t know whether the European FDA is any good”?

                Something in between?

                Something else entirely?Report

              • CJColucci in reply to Jaybird says:

                I tend not to have reactions to things I don’t know much about — or at least know I don’t know much about. Maybe that’s “weaponized skepticism,” or maybe it’just humility. But, of course, it wouldn’t be for me to say whether I’m humble — sort of self-refuting. Perhaps just good mental hygiene.Report

              • DensityDuck in reply to CJColucci says:

                “I have strong opinions about this, until I start to feel like maybe having a strong opinion is a trap, at which point I have no opinion and fuck you very much for expecting me to have one!”Report

              • CJColucci in reply to DensityDuck says:

                That’s certainly a point of view. It isn’t mine, but you’re entitled to yours.
                If, instead of merely stating your own view of the matter, you think I’m being disingenuous, you are welcome to dig up anything where I have expressed “strong opinions” about the FDA. I have suggested that squabbling with Jaybird over his frequently-expressed views of the FDA is not likely to be a productive endeavor, but that is about Jaybird, not the FDA.
                In the course of your digging, you might dig up an old post of mine about my long-time fantasy of having a TV talk show where I headline some current controversy and, instead of bloviating about it, explain that I have no basis for an opinion, and likely neither do you, and, therefore, don’t have one, and, likely, neither should you.
                Maybe that type of thinking is foreign to you, DD, but it has long been my standard operating procedure. Which explains why I haven’t weighed in on the amateur epidemiology squabbles that have been so prominent a part of recent discussions here.Report

              • Jaybird in reply to CJColucci says:

                Personally, I think it’s more than appropriate to not have opinions on things that have no relevancy to one’s life.

                The question then becomes, in a pandemic, is the FDA and its habits relevant to my life?

                If they block Apple Watches from dual use as Oxygen Readers, is that relevant to my life?

                If loved ones of mine need EpiPens and the only EpiPen allowed in the USA costs $400 while EpiPens in the EU only cost $40 because they allow 8 different kinds to be sold, is that relevant to my life?

                If the FDA has had multiple opportunities to reschedule marijuana, and, each time it has declined to move the Devil’s Lettuce from Schedule 1, is that relevant to my life?

                Is there a point at which I am no longer not only required to not have an opinion, but to tell other people that they shouldn’t have an opinion either?

                I’m not asking for a line, necessarily. Just a blob at which we can say “okay, I was unsure before… but now I am certain that I won’t be offended by the fact that you have an opinion on the FDA telling you that this product shouldn’t be available to you”?Report

              • CJColucci in reply to Jaybird says:

                You asked for my response to your “thought experiment.” I gave it. Now you’re telling me your view on the FDA and when you feel you ought to have views about it. I am not “offended” by it; I’m just not interested in it.Report

              • Jaybird in reply to CJColucci says:

                So just limiting it to the thought experiment.

                A friend of mine cannot get a product in the US that helps him with his problem. The FDA has not approved it.

                He has access to a friend in the EU that can send him this product which has been approved in the EU.

                My response is to say “good!”

                And my response is “good!” knowing that my other potential responses include “but, wait! The FDA hasn’t approved it!”

                From my perspective, saying that “well, I don’t have an opinion on whether the FDA has approved this product or not” is an opinion that is passively in favor of the status quo (which is that my friend not have access to it). And saying “Well, my friend knows what’s best for him” is one that implicitly says that he should be able to use this product despite the FDA not approving it.

                Nothing wrong with being in favor of the status quo, of course.

                A lot of people are passively in favor of it.

                But my thought experiment was intended to get you (or anybody) to put themselves in a situation where they ask “do I think that the FDA might be too restrictive and should loosen up a little?”

                And while I understand saying something like “I’m not interested in that question”, I don’t understand saying something like “I’m not interested in that question and other people shouldn’t be either!”

                Because, at that point, that seems to switch to actively in favor of the status quo… while hiding behind a façade of indifference.Report

              • Chip Daniels in reply to Jaybird says:

                Speaking on behalf of the Leftintern, we would welcome adoption of a European form of healthcare regulation.Report

              • Jaybird in reply to Chip Daniels says:

                You might enjoy the link to the original threads too!

                You may be surprised by some of the people (that you probably identify as leftish) who argued against changing the status quo.Report

              • CJColucci in reply to Jaybird says:

                OK. now you have my answer to your thought experiment and your answer to your thought experiment. They differ. No surprise. I think we’re done here.Report

              • DensityDuck in reply to CJColucci says:

                I mean, it’s really interesting to see you retreat to abstract totally-indifferent skepticism as a position, given the degree to which you and others get angry at Jaybird for presenting a position of abstract totally-indifferent skepticism.

                Sure, I guess if you want to say “I know nothing about that so I can’t possibly render an opinion of any sort”, that’s fine, but this really kinda seems like something it would not be too hard to have an opinion about.Report

              • CJColucci in reply to DensityDuck says:

                The difference is when I don’t know enough about something to have an opinion, I don’t express an opinion. You have to have a position to “retreat” from it. If the night-time clash of ignorant armies gets sufficiently annoying, I might point out that I don’t know enough to have an opinion, or that various other folks who seem to have opinions don’t seem to know enough to have an opinion, but that’s a different matter.
                As for how hard it is to have an opinion, I remember a case I had where a doctor I represented was asked if, based on some remarks he had heard from others, he thought the Department Chair was an anti-semite. He said he didn’t have a view on whether the Chair was an anti-semite. The lawyer asked him whether he believed or disbelieved what he had been told to that effect. He said he simply filed the remarks away for future reference and would await further evidence before forming an opinion. The lawyer was getting very flustered and demanded to know how it was possible not to have an opinion. The doctor said, “opinions, if they’re responsible, are hard work. I try not to form them on anything that matters unless I need to.”Report

              • Jaybird in reply to CJColucci says:

                Is there any amount of information that I could give you that would get you to change your opinion?

                Like, if I linked to essays written by medical professionals that talked about the FDA being too restrictive and those essays had not only illustrative examples but links to primary sources, would you read those?Report

              • CJColucci in reply to Jaybird says:

                Why are you so interested in getting me to “change” an opinion I don’t even have? I’ve never said a word about the FDA, because I don’t think I’m sufficiently well-informed to have a useful view on the subject. Someone out there may do, or may have done, the necessary work on the broad structural issues of how medical devices and pharmaceuticals are best regulated. That will be useful. I’m not interested in random decisions that someone disagrees with; any system will have those. But to answer your specific question, there is nothing you can give me. I don’t take random homework assignments. You’re obviously spoiling for some kind of fight, about who knows what. It isn’t going to be with me.Report

              • Jaybird in reply to CJColucci says:

                Well, that’s why I call your skepticism “weaponized”.

                It’s not that I want you to change your opinion.
                It’s that I wonder if your opinion can be changed.

                If not your opinion of the FDA, your opinion of whether you should have an opinion on the FDA.

                I don’t need you to agree with me.
                I am merely curious as to whether your opinions (or your opinions on whether you should have opinions) are, theoretically, changeable by new information coming in.

                Like you saidReport

              • CJColucci in reply to Jaybird says:

                I am merely curious as to whether your opinions (or your opinions on whether you should have opinions) are, theoretically, changeable by new information coming in.

                No, you aren’t. Because there is only one possible answer to this pseudo-question and you already know what it is, as does any sentient person who can read and comprehend English. But then, we’ve seen this move before.Report

              • Jaybird in reply to CJColucci says:

                Which is odd because there is no shortage of information about the FDA out there and you seem a sentient person who can read and comprehend English.

                You’ve seen the stories about the FDA squashing testing during coronavirus.
                You’ve seen the stories about the FDA not allowing the Apple Watch to be used as a blood oxygen measuring device.
                You’ve seen the stories about the FDA refusing to reschedule marijuana.
                You’ve seen the stories about the FDA refusing to certify re-imported drugs from other countries due to safety issues.
                You’ve seen the stories about the FDA and EpiPens.
                You’ve seen the stories about the FDA and insulin.

                And you still don’t have enough information to come to a conclusion? You still don’t have enough information to come to a conclusion about whether you ought to come to a conclusion?

                I know what the answer to those questions are… as does any sentient person who can read and comprehend English.Report

              • CJColucci in reply to Jaybird says:

                Unlike you, Jaybird, I don’t have a bug up my ass about the FDA. I know these stories exist, but I rarely read them. I have other fish to fry, if you’ll pardon the mixed metaphors. Which is why I haven’t bloviated about the FDA. There’s lots of information out there about things I don’t know much about. What matters to me in forming or not forming opinions is not the information OUT THERE, but the information I HAVE. The information I have is based on the direction of my interests, and the work I am willing to put into it, not on homework assignments from some random guy on the internet.
                You find the FDA story more interesting than I do. Fine. Knock yourself out. We all have our obsessions. I’m not going to tell you you’re wrong. You might not be. And one of these days, maybe someone whose views actually matter will pique my interest and I’ll dig into it. Until then, your fight is with someone else, not with me.Report

              • Jaybird in reply to CJColucci says:

                Well, I guess there are a lot of stories that I don’t see as issues of Justice but merely Personal Interest myself.Report

              • CJColucci in reply to Jaybird says:

                If you let the witness go on long enough ——-the capital letters give the game away.Report

              • Chip Daniels in reply to Jaybird says:

                I know that what you are angling for is to convince us of the proposition that the FDA is overly strict and needs to be less so.

                And its trivially easy to agree with that, but only because it is a platitude on par with “The Pentagon needs less red tape!”

                Have you considered the idea that large organizations can be both sclerotic with red tape, and yet in need of oversight and boundaries?

                Overly cautious, and simultaneously reckless and slipshod?

                Unable to make innovation, yet free to make arbitrary and whimsical decisions?

                That inefficiency isn’t a matter of the number of regulations or their reach, but whether they are well crafted and precise, or poorly drafted and unclear?

                For example, I have personal experience where poorly written and ambiguous regulation resulted in a low level official being given overly broad discretionary power, resulting in arbitrary and conflicting direction.

                The solution wasn’t to strike the regulation but just to clarify it, and eliminate the discretionary power.

                Other times, just the reverse was true, where a too tightly written rule hampered a reasonable level of discretion.

                Sitting here, as laypeople commenting at OT, how could any of us say which is producing the inefficiency at the FDA?

                All we can really agree on is that the FDA should be reformed to make drug delivery more efficient while maintaining the core mission of safeguarding the public health.

                Beyond that, we pretty much just have to delegate the mechanics of that to experts.Report

              • Jaybird in reply to Chip Daniels says:

                You might be surprised at who would be unwilling to say whether the FDA needs to change at all.

                “Have you considered the idea that (examples)?”

                Yes. And that’s why I want the status quo to change and do not argue that it shouldn’t.

                And why I’ve argued that it needs to change for years now.

                Against people who, at various points, have argued that it shouldn’t.

                Beyond that, we pretty much just have to delegate the mechanics of that to experts.

                I’d be fine with an agreement that “the end result we’re hoping for is something like ‘it is agreed that it is not an unacceptable risk to reimport drugs that were approved the first time’ or something like that”.

                It’s true that I don’t know which bureaucrat we need to put in which seat to sign which form to allow this to happen…

                So I’m stuck arguing that the FDA shouldn’t have the power to do that sort of thing in the first place.Report

              • Chip Daniels in reply to Jaybird says:

                If you don’t know enough about the mechanics of the bureaucracy to determine the course of action, why would you then resort to stripping them of power?

                That just sounds like trying to fix a watch by hitting it with a hammer. It makes you feel good, but doesn’t get you closer to telling the time.Report

              • Jaybird in reply to Chip Daniels says:

                Well, I have a fundamental assumption that is significantly different from a lot folks.

                I begin by asking “Do I have the right to prevent you from doing X?”

                And, if I wouldn’t, I assume that the burden of proof is on the person telling me that they have the right to prevent me from doing X or that some other third party has the right to prevent me from doing X.

                Do I have the right to prevent you from smoking marijuana?

                I think that we agree that I do not have the right to prevent you from smoking marijuana.

                And now I say that the burden of proof is on you to explain to me why you have the right to prevent me from smoking it or why the police have the right to prevent Person P from smoking it.

                You’ve heard the position of “Pro-Choice” for abortion that says that women should have the right to get an abortion *AND* that that guy over there doesn’t have the right to prevent her from getting one?

                It’s like that.

                Just for smoking marijuana.

                And other stuff too, for that matter. But smoking marijuana is probably a pretty accessible example.

                But I can extend it to “reimporting drugs that we exported to Canada”, if you want.Report

              • Chip Daniels in reply to Jaybird says:

                Sure, that’s fine, but now you’ve moved from the motte of “FDA bungling” to the bailey of political ideology.

                The motte is easily defended by proposing reasonable things like “re-import drugs previously approved’ while still retaining the authority and mission of the FDA.

                The bailey of your political position is the broad premise that the FDA’s mission and scope is illegitimate to begin with. And you need to work a lot harder to defend that one.Report

              • Jaybird in reply to Chip Daniels says:

                You asked “If you don’t know enough about the mechanics of the bureaucracy to determine the course of action, why would you then resort to stripping them of power?”

                The same reason that the FDA shouldn’t prevent me from getting an abortion. If the FDA started saying “oh, we’ve determined that Plan B causes psychic distress and thus are taking it off the market”, would you understand someone who said “but they shouldn’t be able to do that!”, even as you tried to explain to them that, well, that’s what the FDA is *FOR*?

                If you can understand why someone would say “the FDA shouldn’t be able to ban Plan B for psychic distress!”, then you understand my position as to why I think the FDA should be stripped of its power to do that for other drugs such as, say, Marijuana.

                If you’d like, I’ll agree that the FDA’s mission is legitimate, its scope is not, and it has not proven itself a responsible user of its own power NO MATTER WHICH PARTY IS IN OFFICE.

                Which means that this isn’t a problem we can elect our way out of.Report

              • Chip Daniels in reply to Jaybird says:

                If you want to make a persuasive case for a different scope of FDA authority you need to lay it out in some coherent way.

                After all these comments, it isn’t clear what sort of scope you want- You’ve mentioned Epipens and marijuana and spoken about the FDA’s testing regulations and a lot of other things, but it isn’t clear at all what sort of scope you actually want.

                No authority over drugs at all? Only over some drugs, if so which?

                If you want to find a middle ground between the status quo and total abolition, you need to craft a theory or conceptual framework of what that might be.Report

              • Jaybird in reply to Chip Daniels says:

                Well, all of the examples I’ve given are examples of the FDA exceeding its power and mission.

                The main thing I’m hoping for is some acknowledgment that, yes, while we appreciate that there is a need for the FDA, there isn’t a need for an FDA that is either incompetent, malicious, or captured (or some combination of all three).

                Arguing that a good FDA with this amount of power would be good is an interesting point, I suppose, but we don’t have one of those.

                So I’m stuck trying to get people to say something like “okay, yeah… I agree that the FDA is screwing up. And they should stop.”

                If you’d like me to explain what not screwing up would look like, I’d just point to the mistakes that we agree exist and say “not making those mistakes”.

                And if you want to know which processes within the FDA need to have which line-items modified from “must” to “may”, I don’t have an answer to that.

                I can only say “maybe take away some of its power to ban things?”

                Knowing, of course, that there is no way to remove power from the FDA. Like, not even in theory. It can’t be done.

                But… if, maybe, someday it could be done? I’d like to think that one of the necessary first steps is to get people to acknowledge that “yeah… that’s not a legit use of its power.”Report

              • Chip Daniels in reply to Jaybird says:

                You need to choose an argument.

                Is it incompetence at carrying out a legitimate scope?
                Or exceeding its legitimate scope?
                Or is its scope illegitimate in the first place?

                These are all very different arguments!Report

              • Jaybird in reply to Chip Daniels says:

                See each of those as a counter-argument for any given argument.

                Is the argument “The FDA’s scope is legitimate!”

                Then the counter-argument is that the FDA is incompetent… and here are some examples that demonstrate that.

                Is the argument that the FDA is within its legitimate scope?

                The counter-argument is to point out that, no, it’s not within its legitimate scope and here are some examples demonstrating that.

                Is the argument that the scope is legitimate in the first place?

                Then the counter-argument is that the scope is illegitimate.

                Which is the original position for why the FDA doesn’t need to change? I have a counter-argument for why it does.

                “You need to pick a counter-argument and stick with it!”

                No. I will use different counter-arguments depending on the original argument.

                But if you want to know the first principle that I am operating from, it’s that if I know that I wouldn’t have the right to tell you “you can’t get an abortion!”, I don’t see where the government gets that right.

                And if you understand how I could hold that position on abortion, then you have an insight into how I might hold that position on whether I, or the government, should have the right to prevent you from eating a marijuana edible to ease some of the symptoms of glaucoma.Report

              • Dark Matter in reply to Jaybird says:

                Abortion I’m clearer on because I don’t think the gov should be involved. Even the corner cases like late term abortions are so rare and so ugly-in-reality that I still don’t see the need for the gov to be there.

                Saying the gov shouldn’t have a role, at all, in drug safety is harder.

                I think if you cut back it’s authority you’d get a lot of benefit but if you totally eliminate it we’ll have a bunch of ugly situations that end up in the news.Report

              • Jaybird in reply to Dark Matter says:

                This is one of those things where I am arguing that the machine is set to ‘7’ and I think we should turn it down.

                People are arguing against me as if I’m suggesting setting it to ‘0’.

                No, let’s set it to ‘6’.

                But if we set it to ‘0’, everything goes to hell!, they tell me.

                So let’s not set it to ‘0’. Let’s set it to ‘6’.

                I see through you! First you’ll want to set it to ‘6’, then you’ll want to set it to ‘5’! Then ‘4’! Then ‘3’! Then ‘2’! Then ‘1’! THEN ‘0’ AND WE ALREADY SAID THAT ‘0’ IS A NON-STARTER!

                ‘7’ is bad. Let’s turn it down.

                …I can’t believe you want to set the machine to ‘0’. People will die.

                People are dying now! Let’s turn the machine down!

                WE ARE NOT SETTING THE MACHINE TO ‘0’!


              • Chip Daniels in reply to Jaybird says:

                Do you understand why your statements sound unpersuasive and unformed?

                Because you aren’t setting out a coherent logic structure between your specific concern (authority over marijuana) and a strawman absurdity (authority over anything ever).

                In Jaybird World, what is the logic that separates those two?

                Regular World people have a series of logic structures that define the scope of FDA authority which result in it being able to regulate aspirin but not Vitamin C for example.

                You just keep resorting to what is almost a parody of the libertarian argument, which is that somehow some way the world should be reshaped so you can smoke weed.Report

              • Jaybird in reply to Chip Daniels says:

                Chip, we live in a world that has been reshaped so I can smoke weed. Colorado has legalized recreational marijuana. Here’s a link to Maggie’s Farm, seven locations in Southern Colorado. (You must be 21 to visit the website so, please, don’t click on it unless you are 21 or older.)

                I could drive over there, grab a bag, put in my Quantum Leap DVD, and enjoy myself and I would not be arrested.

                So this ain’t about me.

                “Because you aren’t setting out a coherent logic structure between your specific concern (authority over marijuana) and a strawman absurdity (authority over anything ever).”

                I’m trying to get you to understand how someone might think “wait, the FDA has done something that it should not do”.

                If marijuana does not provide a good example of the FDA doing something that it ought not have done, I could switch to the whole EpiPen discussion and we could do a compare/contrast with Europe and discuss whether Europeans are likely putting themselves at risk by using seven different brands of EpiPens that have merely been approved by their FDA and not approved by ours.

                It’s about finding a single example that might get you to say “okay… I admit… the FDA might have room to be criticized here to the point where I could see how someone else, not me but someone else, might say that it should be different.”Report

              • Chip Daniels in reply to Jaybird says:

                Eh…I’ve said several times how I agree the FDA can be improved.
                Even to the point of a wholesale switch to the French version.

                Would that satisfy you, if we did that?
                Or does the French regulatory regime violate your first principles?Report

              • Jaybird in reply to Chip Daniels says:

                I think that the European Medicines Agency would be preferable to the FDA and would prefer a wholesale switch, in toto, to how the EMA does things.

                Which would not get me to where I think we ought to be, but I do think that we would be turning the machine down from a ‘7’ to a ‘6.2’ or so.Report

              • Dark Matter in reply to Chip Daniels says:

                What is the French version of the FDA?Report

              • Jaybird in reply to Dark Matter says:

                It’s called “European Medicines Agency” (or “EMA”).

                Read the thread about EpiPens. We discuss how the EMA had approved 8 different kinds and the US had only approved 1.

                And whether that meant that the US was too restrictive or that the people in the EU were taking their own lives into their own hands.Report

              • Dark Matter in reply to Jaybird says:

                I know from first hand experience that the EMA has the rep of being way less nit-picky and painful to deal with than the FDA…

                …but I don’t know what the difference is in their underlying mission/approach or what Chip (or anyone) thinks is the difference.

                It wasn’t the difference in their title that led to them approving 8 e-pens.Report

              • Chip Daniels in reply to Dark Matter says:

                I don’t know the difference either, but since Europe is a modern peer nation and seems to have pretty good health care outcomes, I am confident an American version couldn’t be too bad.

                Mostly I am just trying to separate the mottes from the baileys

                The EMA is a motte and can reasonably be defended, as is re-importation. Both are reasonable if debatable positions people can agree on easily.

                The bailey of Jaybird’s idealized position is not yet articulated much less defended.

                And maybe it doesn’t need to be. I mean, we all have these sorts of things (like my notion of massively scaling down our global military posture).Report

              • Jaybird in reply to Chip Daniels says:

                My idealized position is something that I know probably isn’t appealing to most people.

                I’m willing to not let the perfect be the enemy of the good.

                Which, I suppose, can be read as hypocrisy by some.Report

              • Dark Matter in reply to Chip Daniels says:

                I am confident an American version couldn’t be too bad.

                It’s not clear to me that we don’t already have that.

                Something that (should) comes up a lot when we compare countries is culture matters a lot. Afaict Europe’s better health comes from them eating less, exercising more, and being less murderous… and not from their healthcare.

                So… does their FDA work better because of cultural differences that we can’t duplicate?

                If that’s the difference, then JB is right and our FDA should have some of it’s toys taken away from it.Report

              • DensityDuck in reply to Chip Daniels says:

                “The bailey of your political position is the broad premise that the FDA’s mission and scope is illegitimate to begin with.”

                Looks to me like his bailey is that the FDA is doing its job badly, not that there shouldn’t be an FDA.

                Says a lot that people see “we should improve things somewhat” and immediately run all the way to “and therefore society is all wrong, bad is good baby, down with the government!”Report

              • Dark Matter in reply to Jaybird says:

                “re-import drugs previously approved’

                That is very unlikely to result in the savings you want. The Canadian market is one tenth the size of the US. Vast importation by the US of Canadian drugs will result in vast shortages in Canada. Canada will outlaw exports, they’ve already toyed with the idea.

                Neither Canada nor the drug manufacturers are stupid. Either of them could stop it and they’re both motivated to do so.Report

              • Jaybird in reply to Dark Matter says:

                Dark, this is an interesting point but I hope you see the difference between the FDA banning reimportation because of safety reasons and the FDA banning reimportation because that it is unlikely to result in significant savings for the American People.Report

              • DensityDuck in reply to CJColucci says:

                “Unlike you, Jaybird, I don’t have a bug up my ass about the FDA.”

                This is like a white man saying that he doesn’t have a bug up his ass about police racism, and yeah sure maybe you do but it’s not something he knows anything about and he’s not interested in spending hours and hours reading about it just so that he can have an informed opinion, so stop acting like he’s some kind of moral failure for not having an opinion…Report

              • CJColucci in reply to DensityDuck says:

                Deal — as long as your hypothetical white man holds up his end of the bargain and doesn’t express an opinion. Let’s see how long that lasts.Report

              • DensityDuck in reply to CJColucci says:

                apparently you forgot all those discussions about how it was expression of racist privilege to not have an opinion about that sort of thingReport

              • CJColucci in reply to DensityDuck says:

                They weren’t mine. Take it up with them.Report

  5. Chip Daniels says:

    Anne Appelbaum writing in the Atlantic:

    Americans, as a rule, rarely compare themselves with other countries, so convinced are we that our system is superior, that our politicians are better, that our democracy is the fairest and most robust in the world. But watch this video and ask yourself: Is this the kind of leadership you expect from a superpower? Does this make you feel confident in our future? Or is this man a warning signal, a blinking red light, a screaming siren telling all of us, and all of the world, that something about our political system has gone profoundly awry?

    Nancy Le Tourneau at Washington Monthly connects the last three years of failure to the past 40 years of conservativism, where the very idea of a competent effective government response is mocked and derided.Report

    • Jaybird in reply to Chip Daniels says:

      Yeah, you should see how people respond when we say “our FDA should be more like the European one”.Report

    • George Turner in reply to Chip Daniels says:

      Perhaps the idea of competent effective government response was mocked and derided for the past 40 years because people finally noticed that they hadn’t seen many examples of competent, effective government response since maybe the Battle of Midway, if not Valley Forge. Just sayin’.Report

  6. Damon says:

    French doctors believe they may have treated coronavirus patients last fall:


    Curious and more curiousReport