Do we need the FDA?

John Stossel got a lot of angry mail over his recent contention that the Food and Drug Administration amounted to an unnecessary and burdensome exercise of federal authority.  Stossel argues that the FDA (and also the DEA) should interfere less with our liberties and let consumers protect themselves.   Tonight, he’ll address the question on his Fox show, but in the meantime he responds to his critics on his blog, including this post from Frances Martel at Mediaite, prompted by Stossel’s appearance on Bill O’Reilly’s show:

Stossel argued that private consumer reports would be enough to keep the companies on their toes, but a private system would be based on trial and error and on trusting the drug companies, with no authority to coerce them into honesty. Stossel’s “private” version of the FDA would look something like the current news media, with consumers picking and choosing who they trust based on personal biases. This works great in a field where the product of consumption is the bias itself, but when the product of consumption can potentially kill the consumer, the stakes change and an impartial authority should take control. This segment was likely a victory for O’Reilly.

Stossel says he’s not asking for blind trust:

They miss the point. A “private system” is not simply based on “trusting drug companies.” Competition leads both drug companies and private regulators to be trustworthy. If they are not trustworthy, they die. Fear of losing business and fear of lawsuits (some lawsuits are useful) “coerce them into honesty.” American food makers rarely poison us today not because of government regulation, which is largely ineffectual, but because they know that if they poison their customers, they’ll go out of business.

My bigger point is that allowing the FDA to hold a total monopoly on drug testing and allowing the DEA to limit pain medication deprives free people of the right to medicate themselves. If I am dying, how dare the FDA tell me I may not take an experimental medication! If I am in terrible pain, how dare the DEA limit the pain reliever that I take. It’s my body. Leave me alone.

There is a private-sector middle ground between government control and blind trust. In many industries, that is provided by insurers to make sure that products and services are genuine, safe, and tested. The most well known of these, Underwriters Laboratories, performs the FDA function in the private sector on a wide range of products and services. Hardly any consumer electronics gets sold today without the UL label on it. The certification process costs manufacturers and other providers a pretty penny — and I can tell you this from personal experience.

In my former industry, burglary/fire alarm services, businesses and residences can get insurance-premium breaks when they install alarm systems and have them monitored by UL-certified providers. UL requires providers to meet a lengthy series of requirements on manufacturing, installation, and service, and the providers pay thousands of dollars every year to retain their certification. Factory Mutual provides a parallel certification, mainly in fire systems, which competes with UL. Each monitoring facility gets an annual inspection to ensure compliance, and UL follows up on complaints from consumers to determine whether certification should be suspended. It’s a powerful compliance incentive, and it comes completely separate from any government intervention.

Could that same process be used for pharmaceuticals? It’s difficult to see why it couldn’t — and I’d bet UL itself would jump into that space quickly, especially since insurers already pay for much of the prescription medication on the market. They would have more incentive to expedite research and hold pharmaceuticals accountable for their actions, since the underwriters themselves would be on the hook for failures. Other associations would form to compete, and consumers (and insurers) would be able to make the decision on which organization to trust most. Meanwhile, the government could get out of a process in which it clearly has no authority to intrude, and for which it presents a nearly-unaccountable stumbling block for quick turnaround on new treatments.

We can argue whether that would be the best approach, but let’s not kid ourselves that government control is the only approach for consumer safety.

Update: I’m told that Stossel has also used UL on occasion to exemplify the potential for private-sector compliance, so I’ve edited out the reference that Stossel missed that point in his blog post.

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