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What Kennedy Must Do To Defeat Regulatory Capture – OpEd

6 0
23.11.2024

President-Elect Donald Trump’s nomination of Robert F. Kennedy, Jr. to head the Department of Health and Human Services is cause for celebration for anyone who cares about the pharmaceutical industry’s influence over regulatory agencies, and the deleterious effect it has had on the health of Americans.

It is nearly impossible to express just how remarkable and potentially world-changing this is. Only a few years ago, it would have been beyond the imagination of any serious political commentator. Those of us who believe in the freedom of medical choice – and especially those who have been personally harmed by the industry – have every reason to be ecstatic.

But even if Kennedy is confirmed, and even if he manages to implement his ideas, will they be enough to bring about real, lasting, change?

One of Kennedy’s primary targets will be the regulatory capture that practically defines the pharmaceutical industry and the agencies tasked with overseeing it. He has spent decades tirelessly battling this particular beast, and has recently articulated a number of specific policy ideas aimed at rooting out the “corruption” that characterizes the regulatory agencies as well as the world of medical research. But is that even possible?

In order to answer this question, we need to examine the nature of the regulatory state itself.

There is nothing new about private commercial interests seeking to use government force to subvert the free market to their advantage – and to the disadvantage of everyone else. The medical and pharmaceutical industries are hardly unique in this regard. Generally, interest groups, or individual corporations, do this by convincing politicians to erect barriers – in the form of laws and regulations – to those who would compete with them.

Much has been written about the extent to which the regulation of business sprang, not from a desire to protect consumers, but rather from the desire on the part of a few businesses to secure for themselves an environment in which they are insulated from competition. In their 1993 paper, “The Protectionist Roots of Antitrust,” for example, Don Boudreaux and Tom DiLorenzo look at some specific examples of business interests lobbying government to enact antitrust legislation that would stifle their competition.

They write:

“(F)or over a century the antitrust laws have routinely been used to thwart competition by providing a vehicle for uncompetitive businesses to sue their competitors for cutting prices, innovating new products and processes, and expanding output. This paper has argued that, moreover, antitrust was a protectionist institution from the very beginning; there never was a ‘golden age of antitrust’ besieged by rampant cartelization, as the standard account of the origins of antitrust attests.

The world of health care as we know it today in America is the result of similar efforts by some practitioners and professional associations to defeat their competitors, not by outperforming them in the marketplace, but by enacting laws to limit their ability to practice.

Most notorious among these efforts was the 1910 Flexner Report. Commissioned by the Carnegie Foundation, the Report recommended closing down the vast majority of medical schools; streamlining medical education to exclude non-allopathic modalities (and mostly eliminating medical schools for women and African Americans); giving state governments the power to approve medical schools; and dramatically tightening medical licensing restrictions.

In fact, the Flexner Report was, for the most part, an unpublished 1906 reportwritten by the American Medical Association (AMA). At the time, the AMA made no secret about its motives in seeking the reforms to which Abraham Flexner lent his name. It sought to reduce the supply of physicians in order to further enrich its own members. In 1847, the Association’s committee on educational standards reported that:

“The very large number of physicians in the United States…has frequently been the subject of remark. To relieve the diseases of something more than twenty millions of people, we have an army of Doctors amounting by a recent computation to forty thousand, which allows one to about every five hundred inhabitants…No wonder, then, that the profession of medicine has measurably ceased to occupy the elevated position........

© Eurasia Review


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