Donald Trump is certainly causing a lot of angst among the political class with his cabinet appointments. Analysts who are invested in the business-as-usual approach to Washington are horrified at his selection of a school choice advocate for secretary of education, and a climate change skeptic for head of the EPA. The latest handwringing comes over speculation that Trump will Tap Jim O’Neill, a Silicon Valley entrepreneur, as head of the Food and Drug Administration.
If there’s one agency that needs a shakeup more than any other, it’s the FDA. By controlling the supply of medicine and subjecting new drugs to an overly burdensome, lengthy, and costly regulatory regime, the agency literally has the power over life and death. Because a death caused by an unsafe drug is a highly visible tragedy, the agency is inherently biased towards caution, a position that seems understandable until you realize that delaying drug approvals costs lives too — just not as visibly.
O’Neill appears to recognize this, saying that he wants his priority to be speeding up the approval of drugs by focusing on safety more than on efficacy. As long as a drug is not too dangerous, let people try it and see if it works for them, rather than delaying its release for months and years to find out just how well it works.
This position has provoked ire among doctors, who claim that O’Neill’s lack of a medical degree disqualifies him from the position, and that he doesn’t understand how drugs work. With all due respect to the medical profession, we’ve had professional experts running the FDA for a long time. The result has been an absurd level of bureaucracy and the preventable deaths of thousands of Americans. Shaking things up with some new blood seems entirely appropriate.
Given that the mainstream has been such an abysmal failure, however, I welcome the arrival of new ways of thinking.
On average it takes 12 years and $350 million to bring a drug to market, due to the costly FDA approval process. The delays are deadly, so much so that many states have tried to circumvent these regulations with ”Right to Try” laws. Such laws allow terminal patients to try experimental medications not yet fully approved by the FDA. Since these patients will die without treatment, they should be given access to new medicine that could save their lives. Sadly, most states have not been able to successfully pass these laws, and even the ones that have retain large amounts of bureaucratic red tape that make it hard for patients to get the drugs they need. An FDA director focused on speeding up the approval process would be just what the doctor ordered for the sufferers of terminal disease.
O’Neill also holds the controversial position of allowing kidney donors to seek compensation for their organs. While this horrifies many people, it’s actually a simple solution to the problem of organ shortage. Prohibiting a market for kidneys means that there are never enough to go around. Raise the price above zero, and more people will be willing to sell, just as with any other good. The alternative is the status quo, in which not only is it difficult to find a kidney should you need one, but the legal prohibition of kidney sales creates a black market rife with unsafe surgical procedures and other criminal behavior. If someone is willing to give up one of their functioning kidneys in exchange for some cash, why should they be prevented from making that sale?
There’s no question that O’Neill’s views are largely out of the mainstream. Given that the mainstream has been such an abysmal failure, however, I welcome the arrival of new ways of thinking. There is no guarantee that Trump will end up selecting O’Neill or that he will be confirmed, but I’m impressed by the way Trump is willing to shake up the status quo and bring fresh thinking to the regulatory bureaucracy.
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Logan Albright is a researcher for Conservative Review and Director of Research for Free the People. You can follow him on Twitter @loganalbright73.