“Friedman Friday” FREE TO CHOOSE “Who protects the consumer?” Video and Transcript Part 3 of 7 “Not only have our pockets been picked of billions of dollars, but also we are left less well protected than we were before”

In 1980 I read the book FREE TO CHOOSE by Milton Friedman and it really enlightened me a tremendous amount.  I suggest checking out these episodes and transcripts of Milton Friedman’s film series FREE TO CHOOSE: “The Failure of Socialism” and “What is wrong with our schools?”  and “Created Equal”  and  From Cradle to Grave, and – Power of the Market.

From the original Free To Choose series Milton asks: “Who Protects the Consumer?”. Many government agencies have been created for this purpose, yet they do so by restricting freedom and stifling beneficial innovation, and eventually become agents for the groups they have been created to regulate.

Milton Friedman noted, “The men and women who have fostered this movement… believe that we as consumers are not able to protect ourselves… But as so often happens the results have been very different from the intentions. Not only have our pockets been picked of billions of dollars, but also we are left less well protected than we were before.”
Part 3
Friedman: The implications for the patients are that therapeutic decisions that used to be the preserve of the doctor and the patient are increasingly becoming made at a national level by committees of experts. And these committees and the agencies for whom they are acting, FDA, are highly skewed to avoid risks. So there is a tendency for us to have drugs that are safer but not to have those that are effective. Now, I’ve heard some remarkable statement from these advisory committees in considering drugs. One has seen the statement, there are not enough patients with the disease of this severity to warrant marketing this drug for general use. Now that’s fine if what you are trying to do is to minimize drug toxicity for the whole population. But if you happen to be one of these “not enough patients” and you have a disease that’s of high severity or a disease that’s very rare than that’s just tough luck on you.
For ten years Mrs. Esther Usdane suffered from severe asthma. The medication she received had serious side effects. Her condition was getting worse. But the drug her doctor preferred is prohibited by the FDA. So, twice a year Mrs. Usdane had to set out on a journey.
Mrs. Usdane: I had been very sick. I had been in and out of the hospital several times and they couldn’t seem to find a way to control the asthma and I had to change my lifestyle once I was out even for a short time, mainly because the cortisone derivatives were softening the bones and causing a puffiness of the face and other changes in my body. The doctors were pretty anxious to get me off the cortisone derivative.
Friedman: The drug her doctor wanted her to have had been available for use for five years in Canada. Once across the boarder of Niagara Falls, Mrs. Usdane could make use of the prescription that she obtained from a Canadian doctor. All she had to do was go to any pharmacy. There she could buy the drug that was totally prohibited in her own country. The drug worked immediately.
Mrs. Usdane: This one made such a difference in my life both because of the shortness of breath being resolved and also because now we don’t have to worry so much about the softening of the bones. Fortunately, once I got that medicine, very quickly, everything sort of reverted back to a much more the normal lifestyle and I’m very grateful that I was able to find relief.
Friedman: It was easy for Mrs. Usdane to get around the FDA regulations because she happens to live near the Canadian boarder. Not everyone is so lucky. It’s no accident that despite the best of intentions, the Food and Drug Administration operates so as to discourage the development and prevent the marketing of new and potentially useful drugs. Put yourself in the position of a bureaucrat who works over there. Suppose you approve a drug that turns out to be dangerous, a thalidomide. Your name is going to be on the front page of every newspaper. You will be in deep disgrace. On the other hand, what if you make the mistake of failing to approve a drug that could have saved thousands of lives. Who will know? The people whose lives might have been saved will not be around. Their relatives are unlikely to know that there was something that could have saved their lives. A few doctors, a few research workers, they will be disgruntled, they will know. You or I, if we were in the position of that bureaucrat, we’d behave exactly the same way. Our own interests would demand that we take any chance, whatsoever, almost, of refusing to approve a good drug in order to be sure that we never approve a bad one.
Drug companies can no longer afford to develop new drugs in the United States for patients with rare diseases. Increasing, they must rely on drugs with high volume sales. Four drug firms have already gone out of business and the number of new drugs introduced is going down.
Where will it all lead? We simply haven’t learned from experience. Remember Prohibition? In a burst of moral righteousness at the end of the first world war, when many young men were oversees, the non-drinkers imposed on all of us prohibition of alcohol. They did it for our own good. And there is no doubt that alcohol is a dangerous substance. Unquestionably, more lives are lost each year through alcohol and also the smoking of cigarettes than through all the dangerous substances the FDA controls. But where did it lead?
This place is today a legitimate business. It’s the oldest bar in Chicago. But during Prohibition days it was a speakeasy. Al Capone, Buggs Moran, and many of the other gangsters of the day sat around this very bar planning the exploits that made them so notorious; murder, extortion, highjacking, bootlegging. Who were the customers who came here? They were people who regarded themselves as respectable individuals, who would never had approved of the activities that Al Capone and Moran were engaged in. They wanted a drink but in order to have a drink they had to break the law. Prohibition didn’t stop drinking, but it did convert a lot of otherwise law obedient citizens into law breakers. Fortunately, we’re a very long way from that today with the Prohibition on cyclamate and DDT. But make no mistake about it, there is already something of a gray market in drugs that are prohibited by the FDA. Many a conscientious physicians fees himself in a dilemma caught between what he regards as the welfare of his patient and strict obedience to the law. If we continue down this path, there is no doubt where it will end. After all, if it is appropriate for the government to protect us from using dangerous guns and bicycles for logic calls for prohibiting still more dangerous activities such as hand gliding, motorcycling, skiing. If the government is to protect us from ingesting dangerous substances, the logic calls for prohibiting alcohol and tobacco. Even the people who administered the regulatory agencies are appalled at this prospect and withdrawal from it. As for the rest of us, we want no part of it. Let the government give us information but let us decide for ourselves what chances we want to take with our own lives.
As you can see all sorts of silly things happen when government starts to regulate our lives. Setting up agencies to tell us what we can buy, what we can’t buy, what we can do.
Remember, we started out this program with a Corvair and on the bill that was castigated by Ralph Nader as unsafe at any speed. The reaction to his crusade led to the establishment of a whole series of agencies designed to protect us from ourselves. Well, some ten years later, one of the agencies that was set up in response to that, now finally got around to testing the Corvair that started the whole thing off. What do you suppose they found? They spent a year and a half comparing the performance of the Corvair with the performance of other comparable vehicles and they concluded and I quote “The 1960_63 Corvair compared favorably with the other contemporary vehicles used in the test.”

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