Topic: Regulatory Studies

The American Meddling Association

By
Radley Balko

The American Medical Association has long ceased to be a serious advocate for doctors. It instead has become a propaganda arm for the wackier factions of the public health movement. The Chicago Sun Times reports that at its annual meeting this week, the AMA is considering throwing its support behind a move to tax soda sales, with proceeds going to various anti-obesity measures. This, despite little evidence that soda consumption is linked to weight gain (non-diet soda consumption has remained virtually unchanged since 1988). Not to mention the fact that if we’ve learned anything about sin taxes, it’s that they’re inevitably used for projects far removed from those educational programs promised when they’re enacted.

The soda tax endorsement comes on the heels of the AMA’s embarassing attempt to pass off a web-based survey (which the organization later admitted was an “advocacy” tool) about alcohol consumption as scientific research, complete with a fake margin of error. Last year, the same organization and its president expressed shock that – gasp! – most minors get their first taste of alcohol from… their parents. Seems to me that the supervising eye of a parent would be the ideal circumstance under which a minor would get his first sip of beer or wine, wouldn’t it?

Consider these other action items from the agenda for the AMA’s annual meeting this week:

  • Support a 50 percent reduction in salt in processed foods, fast foods and restaurant meals over the next decade.
  • Oppose beer ads on college sports broadcasts.
  • Prepare a report summarizing video game research, including emotional and behavioral effects and addictive potential.
  • Push to ban smoking in all public places and workplaces.
  • Support mandatory school instruction on the dangers of Internet pornography.

Meanwhile, as it continues to tell parents how to raise their children, and push for government regulation of private behavior, the AMA has been conspicuously silent, passive, or just plain wrong on issues you’d think would be high-priority for a group that claims to represent doctors: The relentless DEA campaign against doctors who specialize in pain management, for example. Pain activists say the AMA has been AWOL. And not only didn’t the AMA oppose many of the more onerous HIPAA regulations, it lobbied for their enforcement. The organization has also taken a relatively passive stance of the federal prohibition on medical marijuana, which puts political drug eradication goals ahead of patient care.

The AMA’s percentage of revenue from membership dues has fallen over the last few years. It now counts just 26% of U.S. physicians among its dues-paying members.

Given the organization’s priorities, I can see why. Journalists should keep that figure in mind when reporting on official AMA positions. The group certainly doesn’t represent the opinion of all doctors. Of, for that matter, even a majority of them.

Topics: 
General, Health Care, Law and Civil Liberties, Regulatory Studies

A.I. Yai Yai!

By
Andrew J. Coulson

Economist Robin Hanson suspects that the world economy may soon be doubling every week or two. He arrived at that suspicion based on historical extrapolations, but he also has a theory as to how it might happen: the development, in the near future, of intelligent machines.

According to Hanson, efforts to computationally model the human brain, neuron by neuron, could reach fruition within the next 25 to 50 years. He plays pretty fast and loose with the details, though, so let’s take a closer look at the bleeding edge of the field.

The mother of all brain simulation projects is Blue Brain, a joint project of IBM and Ecole Polytecnique Fédérale de Lausanne (a Swiss town also known for its lower tech, but tastier, fondue). Announced with much fanfare in 2005, Blue Brain has as its anything-but-modest mission to create a complete and exhaustively accurate simulation of the human brain within a decade or so. They figure they can knock out the neo-cortex in the next few years.

Somebody buy these guys a calculator.

The current Blue Brain hardware has 8,000 processors and they have apparently set it up so that one chip models one or two neurons. That has allowed them, as of this month, to model a 10,000 neuron grouping called a “column.” That’s hugely impressive. But, umm, 10,000 down, 99,999,990,000 to go.

The human brain is estimated to have about 100 billion neurons, so they’re going to need another 10 million or so Blue Brain computers to finish the job given the current specs. They’re having a tough time convincing the Swiss government to spring for another one or two of them.

Mind you, computer processing power per dollar has been increasing exponentially over time since the earliest electromechanical computers. So maybe, in a generation, we’ll be revisiting this question. But that’s an awfully big maybe.

It seems doubtful that we’ll be able to create Marvin the paranoid android any time this century. And it’ll be some time after that before the technology is commercialized and we all have “plastic pals” who are “fun to be with!”

So keep contributing to that 401K. It’s gonna be a while before it starts doubling every week or two.

Topics: 
General, Regulatory Studies, Telecom, Internet & Information Policy

The FDA and Your Dinner Plate

By
Radley Balko

Two years ago, Time asked me to write one half of a short point-counterpoint on the obesity debate for a special issue of the magazine entirely devoted to how government should intervene to prevent the fattening of America.

My job was to defend the notion of personal responsibility (my meager 350 words were the only such defense the entire issue). I remember squabbling with one of the magazine’s editors over one contention I made in the article – that it was only a matter of time before public health activists and the federal government would attempt to regulate the portion sizes of food served in restaurants. Seemed like a logical prediction of where things were headed. The editor accused me of hyperbole, and nixed the prediction from the piece.

Last week, this story hit the wires:

Those heaping portions at restaurants – and doggie bags for the leftovers – may be a thing of the past, if health officials get their way.

The government is trying to enlist the nation’s eateries in the fight against obesity.

The report, funded by the Food and Drug Administration, lays out ways to help people manage their intake of calories from the growing number of meals prepared away from home, including at the nation’s nearly 900,000 restaurants and other establishments that serve food. One of the first things on the list: cutting portion sizes.

“We must take a serious look at the impact these foods are having on our waistlines,” said Penelope Royall, director of the health promotion office at the Department of Health and Human Services.

The recommendations are voluntary.

For now.

Topics: 
General, Health Care, Law and Civil Liberties, Regulatory Studies

An Otherwise Helpless Consumer Public?

By
Michael F. Cannon

In 1971, a federal court expressed the rationale behind the federal Food, Drug, and Cosmetic Act when it wrote that the law was “enacted for the protection of an otherwise helpless consumer public” [United States v. Lit. Drug Co., 333 F.Supp. 990, 998 (D.N.J. 1971)]. But would consumers be helpless without the Food and Drug Administration certifying the safety and effectiveness of drugs, biologics, and medical devices? A recent National Public Radio report suggests the answer is no.

The one area where Congress has reined in the FDA’s regulatory authority has been dietary supplements. The FDA has no authority to regulate the content or safety of dietary supplements before those products are sold. Since the FDA doesn’t require testing, there is no testing. Right?

Wrong. A for-profit firm called ConsumerLab.com tests dietary supplements with an eye toward catching unsafe or mislabeled products in the lab before they harm anyone. ConsumerLab.com provides reports on its findings to consumers who pay an annual fee, but it provides information on product recalls at no charge. 

According to the firm’s web site:

ConsumerLab.com, LLC (“CL”) is the leading provider of independent test results and information to help consumers and healthcare professionals evaluate health, wellness, and nutrition products. It publishes results of its tests at www.consumerlab.com — which receives nearly 2 million visits per year, in its acclaimed book ConsumerLab.com’s Guide to Buying Vitamins & Supplements, and in special technical reports. Its research is cited frequently in the media, books, and at medical meetings. As a certification company, CL enables companies of all sizes to have their products voluntarily tested for potential inclusion in its list of Approved Quality products and bear the CL Seal. In the past five years, CL has tested more than 1,200 products, representing over 250 different brands and nearly every type of popular supplement.

ConsumerLab.com was launched by William Obermeyer, a former FDA official whose job it was to test these products after problems emerged. When Obermeyer realized he could do more good by testing these products ex ante, he quit his day job and helped create ConsumerLab.com. 

Some have argued that allowing dietary supplement manufacturers to pay for the review that determines whether the CL Seal will go on a product creates a conflict of interest. Yet the value of the “CL Seal” depends on ConsumerLab.com’s reputation for independence. NPR reports, “There are no indications that this has created any bias.” (Besides, many see indications of bias at the FDA itself, even when the agency’s funding does not come from private parties.)

So it is not the case that the FDA is an indispensable agency. It performs an indispensable function. But if it disappeared tomorrow, private organizations would meet (1) consumers’ demand for independent product reviews and (2) producers’ demand for credible quality signals. And those private organizations would have to compete with each other on the basis of thoroughness and integrity. As NPR reports:

ConsumerLab.com isn’t alone in testing supplements. Another logo beginning to appear on labels is a blue NSF mark, which signals that a product has been certified by the National Sanitation Foundation.

And it doesn’t stop there. Other private organizations that set quality standards or evaluate the quality of various goods and services include:

Read more about a world without the FDA.

Topics: 
General, Health Care, Regulatory Studies

With Enzi Bill, GOP Abandons Federalism, Free Trade

By
Michael F. Cannon

The U.S. Senate steps through the looking glass this week, with a debate on a health care bill that would shift power from the states to the federal government. Republicans, who typically argue against such things, support the bill. Democrats, who never miss a chance to expand federal power, oppose it.

The bill, sponsored by Sen. Mike Enzi (R-WY), deals with health insurance regulation. That has traditionally been the province of the states, with one large exception: In 1974, the feds allowed large employers to avoid state regulation by opting for federal regulation.  That gave multi-state employers the benefit of only having to contend with one set of health insurance regulations (rather than 50). Federal regulation has also traditionally been less burdensome than state regulation.

In fact, the states have been regulating health insurance like mad. Many states require consumers to purchase unwanted or even offensive coverage. (Thirty states require Catholics to purchase coverage for contraception; 14 states require them to purchase in-vitro fertilization coverage.) States have passed some 1,800 of these “mandated benefit” laws. The states also regulate insurance prices, which actually increases the number of uninsured.

States get away with over-regulation because they prohibit consumers and employers from buying health insurance from out-of-state. If you lived in some regulatory hell-hole – let’s say, New Jersey – you could obtain much cheaper coverage by dealing with a carrier regulated by another state.

If Bruce Springsteen can purchase voice insurance from Lloyd’s of London, surely his neighbors should be able to buy health insurance from Pennsylvania.

Enter Sen. Enzi, who has an odd solution to this mess: Let trade associations offer health insurance to their members, and let the feds decide what state regulations they follow.  The bill seems to be deregulatory; it would allow “association health plans” to avoid some unnecessary regulatory costs. But it would be the feds – rather than employers or consumers – who choose the set of rules that govern one’s health coverage. Thus the bill would shift power from the states to the feds.

Democrats oppose the bill, though it’s hard to fathom why. The bill would make broad-based federal health insurance regulation – a long-time Democratic goal – much easier to achieve. In short order, that would erase any short-term savings the Enzi bill might deliver.

Sometimes, I suspect the Democrats’ opposition is a ruse: They keep opposing the idea because if they supported it, Republicans might come to their senses.

The real tragedy is that Republicans have at their fingertips legislation that would give individuals consumers and employers the right to purchase coverage from out-of-state.  Sen. Jim DeMint (R-SC) and Rep. John Shadegg (R-AZ) have a bill that would tear down those barriers to trade between states, as Congress was meant to do under the Commerce Clause. 

But the Shadegg-DeMint bill doesn’t have a powerful coalition of trade associations lobbying for its passage. Trade associations like the Enzi bill because it would allow them to offer health insurance as a benefit to their members. The Shadegg-DeMint bill would do the same thing. But somewhere along the way it was determined that federal regulation would be more politically feasible than free trade between the states.

I guess it’s easier to convince Republicans to increase their own power than to return power to individuals.

Topics: 
General, Health Care, International Economics and Development, Law and Civil Liberties, Regulatory Studies

Beyond Parody

By
Radley Balko

The Nanny State grows too bizarre for satire.

Here’s The Onion in 1998:

According to a controversial Federal Trade Commission report released Tuesday, food manufacturer Hostess may have intentionally marketed “Twinkies”—a dangerous snack cake linked to obesity and hyperactivity—to minors.

There is substantial evidence supporting the claim that, for decades, Hostess has carried out an aggressive marketing campaign with the goal of promoting Twinkie use among underage consumers,” the FTC report read. “Our nation’s children have been targeted for the consumption of these fattening, unwholesome cakes at a vulnerable age, before they are old enough to make responsible decisions about health and nutrition. “The report also stated that “as a result of Hostess’ targeting of minors, millions of young bodies have been exposed to potentially harmful substances such as fat, sugar, cholesterol, polysorbate 60, calcium sulfate, partially hydrogenated vegetable oil and caramel color.”

Among the questionable Hostess marketing tactics the FTC report cites: positioning Twinkies billboards in the direct view of schoolyards, airing Twinkies ads on Saturday-morning TV and, most notably, developing and aggressively promoting “Twinkie The Kid,” a smiling, lariat-wielding cowboy cartoon mascot shaped like a Hostess Twinkie.

Believe it or not, here’s an actual press release from the FTC, issued yesterday:

The Federal Trade Commission and the Department of Health and Human Services today released a report recommending concrete steps that industry can take to change their marketing and other practices to make progress against childhood obesity.

[…]

“Responsible, industry-generated action and effective self-regulation are critical to addressing the national problem of childhood obesity,” said FTC Chairman Deborah Platt Majoras. “The FTC plans to monitor industry efforts closely, and we expect to see real improvements.”

This isn’t the first time the Nanny State has caught up to an Onion parody. See here, for example. Or here. Or here.

For an explanation why SpongeBob Squarepants isn’t to blame for childhood obesity, check here.

Topics: 
General, Law and Civil Liberties, Regulatory Studies

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