258 Comments

I'd add something about practice guidelines, particularly those involving revised definitions. You might be surprised how often definitions are "updated" based the results of clinical trials of treatments for that condition.

No investigator in a trial for a treatment for X should br involved in treatment guidelines, criteria, definitions, or anything else for X.

All changes in these areas should be clearly, completely, and accurately explained.

Ideally, there would be clear comparisons of guidelines in the US vs other countries with nationalized medicine (which are less susceptible to pharma bullying). Eg: what are "normal" limits for a specific condition? Do other countries have "pre-" categories--diabetes, hypertension, etc.

Expand full comment

This is very good and I want to get into it more...

Expand full comment

Alex, look at relentless periodic lowering of diagnostic cut-points for blood biomarkers in global clinical practice guidelines. Setting a lower cut-point for a given biomarker serves to greatly increase, and sometimes even doubles, the number of people who are "diagnosed" with a "risk factor" that makes them "eligible" for drug "treatment". These cut-point lowering and increased prescribing practices pertain to most, if not all, "CHRONIC-CONDITIONS", aka "LIFESTYLE DISEASES", including: blood sugar levels in type 2 diabetes; blood pressure levels in hypertension; blood cholesterol levels in hypercholesterolemia; blood thyroxine levels in hypo-thyroidism, etc. Of course, guideline committees are also notorious for having members with flagrant conflicts of interest via known, or thinly disguised, ties to the pharmaceutical industry.

Expand full comment

Funny. Lowering the threshold for Type 2 DM from HbA1c of 7 to 6.5...you think that is pharma driven and somehow nefarious. A normal A1c is well below 6. But wanting to treat people at 6.5 is somehow ...a conspiracy? High blood sugar results in retinal disease (blindness), heart disease, kidney disease, amputations...But hey! Let's wait til people have to have their legs cut off instead of treating their diabetes at an A1c of 6.5. So humane!

High quality research shows that a systolic BP above 120 increases mortality (that's death, for you mouth-breathers). But hey! That's just pharma! Never mind that there are NO branded drugs to treat BP at this point. No pharma company is getting rich off of generic BP meds.

Same with cholesterol, unless you are a patient with an MI and persistently high cholesterol. Every statin is generic. If you aren't a cardiovascular patient (Survived an MI or had a stent), you get a $5 medicine. But whoah! Evil pharma!

As for hypothyroidism...have you had your thyroid removed? I have, for cancer. Being hypothyroid SUCKS. Slow. Brain fog. Gain weight. And thyroid meds, being GENERIC are cheap.

You sound ignorant and hysterical.

Expand full comment

Anne, I'd love to respond to your comments here! So let's start with diabetes. Sure we can treat people with A1c of 6.5, but what's the treatment? Drugs? If they're obese as well, I'm sure drugs would be used right? If that's the case, lemme guess, GLP1s? Is this the route we want to go for 6.5 w/ factors? Why don't we intensify diet and exercise as I've written about here: https://unorthodoxy.substack.com/p/the-hidden-struggle-in-health-care

When it comes to both BP and Cholesterol, the same logic applies. With blood pressure, here's an article diving into the logic there: https://unbekoming.substack.com/p/high-blood-pressure

With statins and cholesterol, man, that's a big one. I've heard so many times that the reason we have GLP1s and COVID Vaccines is due to the propaganda and success behind statins. Sure they're $5 now, but they've made their money when they were branded drugs. Here's another article by A Midwestern Doctor addressing the statin controversy: https://www.midwesterndoctor.com/p/the-great-dangers-of-statins

Expand full comment

Oh, I agree with you 1000000000%! But people don't comply. MDs have been saying, "Diet and exercise" for decades. How much money--and how many lives--could we save if humans just got off their butts and cut back on their calorie intake? My older brother managed to lower his A1c from 7.4 to under 6 by losing 80 lbs, but many people will not do that.

And there are thin T2D, you know. My grandmother was one. So are many T2 Asians. (GLP-1 not ideal for them).

As for statins, I have come to believe that a person with out CV risk factors, with high cholesterol (but not familial hyperlipidemia) can probably take or leave a statin. But for those who have had an event, lowering cholesterol as much as possible seems to be a good thing.

When you figure out how to get people to take care of themselves, let me know.

Expand full comment

Are you a physician? Nurse? PA? Nurse practitioner?

Expand full comment

The station drugs are cheap. That is true. But the hospitals love the side effects of those drugs: muscular, arthritis, etc. It is a corporate business that the order comes from above. You don't news to be so smart to see the size and quality of hospitals, new healthcare facilities, etc to realize they need to make money long term

Expand full comment

I’ve worked for the pharmaceutical industry. What about you? Perhaps you’ve had the pleasure of reading some of the “high quality” research findings that I’ve helped to craft into more profitable terms. I trust those “generic thyroid meds” (you probably mean Levothyroxine) are working even better than your own endogenous thyroxine ever did, amirite? Always good to see people living better through chemistry.

Expand full comment

Since my thyroid was removed because it was cancerous, I guess I don't have a lot of choice. So you just sound like a dick.

Expand full comment

It's my former life.

Expand full comment

Dude, this is so insightful.

Thank you for your post.

All of it is so entrenched that nobody notices anymore. I guess that's the point.

"The most dangerous ideas are not those that challenge the status quo. The most dangerous ideas are those so embedded in the status quo, so wrapped in a cloud of inevitability that we forget they are ideas at all."

- Jacob M. Appel

Expand full comment

My favorite quote along that line: "In would rather have questions that cannot be answered than answers that cannot be questioned"

...Richard Feynman. One of the giants of 20th Century physics.

Expand full comment

Ooh. That is a good one in a similar vein

Expand full comment

Well...maybe. In many disease states, particularly rare disease, all of the best minds participate in Phase II and III trials. I am thinking of hematological malignancies where recruiting is difficult because so few patients exist--requiring broad participation by many academic centers. Additionally, these are the centers with the best outcomes because of the practice effect (treat more, get better outcomes). If these MDs are prevented from developing guidelines, who will do so? MDs who treat far fewer patients?

Many guidelines require that the treatments recommended have accompanying assessments of the quality of the clinical data backing up the recommendation (Class I, for example, is randomized, placebo-controlled, (or active against SOC), multi-center, etc.) Physicians can assess whether the evidence is high quality.

Further, physicians do not have to follow guidelines. (Cue Pirates of the Caribbean).

What would be far more effective than top-down control by people who don't even practice medicine is teaching medical students and fellows to read trials critically, know what biases to look for, and how to use statistics in medicine. Having clinicians demand trials that measure clinically meaningful outcomes would also help. Vinay Prasad (MD/hematologist/epidemiologist at UCSF) has great insight here. He is no friend of pharma, and I love reading what he writes because he makes me better.

Expand full comment

“ no friend of Pharma “ has such a beautiful ring to it! I’d support that all day long. 🏆💕

Expand full comment

Until you need pharma. When you have breast cancer and would like a med that doesn't make you vomit, lose your hair, and shit your pants. When you have kidney disease and would like to avoid dialysis. When you have a rare protein misfolding disease that results in death at age 60--but pharma has a med that lets you live a normal life span. When you have a leukemia that now gets called "chronic" because pharma has essentially cured it. Or hey, you need surgery. Oh! Anesthetics come from pharma! Antibiotics so you don't get septic? Pharma.

Easy to be no friend of pharma til pharma saves your life.

I spent 25 years in pharma and have plenty of criticism, but you reflexively anti-pharma people make me sick. No one makes you take medicine. I invite you to go through your next surgery without anesthetic, pain meds and antibiotics. I invite you to watch your mother or sister tackle breast cancer without drugs. Remember--even old chemo comes from pharma.

Headache? No Tylenol or ibuprofen for you! Pharma! Migraine? Suck it. Strep? Hah. Get rheumatoid when the strep isn't treated. Because pharma evil. Mumps? Who cares if your son becomes sterile! Evil pharma.

I am sick to death of people who act as though pharma has done nothing to make their lives better and longer.

No one crams a pill down your throat or sticks an IV in your arm. Die from your diabetes or lymphoma or suffer in silence with your compound fracture or migraine No one in pharma will lose a night's sleep.

Expand full comment

This is so disturbing. People suffering these disorders are not suffering from drug deficiencies. Pharma's parent is the chemical industry, which may have caused your breast cancer. Lousy agricultural practices may have depleted soils and foods of magnesium, and you now suffer migraines. Hormone disruptors and hormone-laced chickens may contribute.

Cancer may be seen as a cellular metabolic throwback to single cell behavior, which comes about when normal animal cellular metabolism has become impossible. It's not a act of God; about 3% of it may be genetic. I propose we lobby for research into the disease triggers instead of pining for a "cure".

Pharma has done amazing things, but it has too loud a voice, and distorts our thinking. If it is not killing us directly, it is bankrupting us. Spending 20% of GDP on a disastrous misperception of health/care is not sustainable. Over 75% of draft age Americans are "mentally or physically unfit for military service." We ae not asking the right questions.

For the record, there are doctors who treat cancer with nutrition and enzymes. They are at some risk of suffering mysterious deaths.

Expand full comment

Of course, we should also have a clear understanding of the financial incentives at play for other countries in denying access to meds. For instance, the UK denying access to disease-modifying drugs for multiple sclerosis. Because allowing a relatively small number of people to end up in wheelchairs saved money. Don't act like those countries prioritize patient outcomes. They do brutal cost/benefit analyses that would turn the stomachs of most Americans.

Expand full comment

Agree with all of these. And I’ll add a Number 11:

“Examine the childhood vaccination link to Autism”

There are too many stories of parents seeing their healthy children turn autistic after vaccinations.

We shouldn’t ignore them anymore:

https://unorthodoxy.substack.com/p/vaccines-cause-autism-no-one-wants

Expand full comment

Even if vaccines play zero role in autism, SOMETHING IS DRIVING IT. & it's not merely diagnoses (i.e. kids in the past who were merely deemed "quirky" are now diagnosed as autistic.) Severe, non-verbal autism is also way up. SOMETHING(S) are behind it.

Expand full comment

Exactly. I am 80 years old. There are a whole host of chronic conditions/illnesses that were known in my childhood, but rare, that are endemic today. Autism being Exhibit A.

Granted, "autism" is a "spectrum", I have no doubt that some of the increase is diagnosis. We did have some kids/adults that were "strange", no doubt some of them would be diagnosed as autistic today. Have a couple in my family. One nephew that couldn't read a word until the fourth grade. Introduced to phonics, was reading at high school level in a couple weeks. MIT PhD, biochemistry today.

OTOH, we had peanut butter and jelly sandwiches in the school cafeteria; never saw a single kid go into anaphylaxis.

My candidate for #1: Launch a Manhattan Project style effort to find out what in Hades is going on. SOMETHING (likely a lot of "somethings") has changed. We are a sick nation. I can think of no higher priority than finding out what is going on.

I voted for Trump because of the RFK, Jr. connection. I don't agree with Kennedy on a whole host of things--but he gets it and if allowed will do something, at least.

Expand full comment

How can it NOT be vaccine related when Amish communities don’t have autistic kids? It could be food related also but vaccines need to studies first. And Covid shots pulled asap.

Expand full comment

I have heard the same about children in Africa — no autism to speak of until vaccines arrived. White saviour indeed.

Expand full comment

Thank you, Almost. EMFs should also be investigated.

Expand full comment

How about just starting with testing against a proper placebo and actually providing the results.

Expand full comment

It's wacky how many people refuse to believe they haven't been placebo-tested, like it's some dark conspiracy theory, because of COURSE they have...um. Nope. Sorry

Expand full comment

updating to say - INERT-placebo-tested

Expand full comment

Get a load of New England Journal of Medicine July 11 '24 letter to the editor discussing - spilling the beans - that no adequate safety studies have been done on (at least some) childhood vaccinations. Has major media told you about this? This type of info has to become available to the public. Maybe at an NIH website??

Expand full comment

Side note: I'm still trying to get over the fact that even 5 years ago I thought that people who talked about the mainstream media being captured where Maybe kind of insane. And now I'm one of those people 100%

Expand full comment

See my comment above. While I don't watch TV much, right now football is on--a watch a couple games a week. Seems like every third ad is for some drug treating some strange ailment. Huge revenue, MSM is dying anyway. They can't irritate the guy that is writing the checks.

As an aside. When did "ED" become a thing? Looking back at the men of my youth--guys that had grown up in the Depression, landed at D-day, Iwo Jima, etc.--compared to the "men" of today, I guess limp dickism is likely endemic.

Expand full comment

Join the club!

Expand full comment

I’m responding to Bridget, not anything about “ dick-ism”. Just want to clarify.

Expand full comment

There's no way major media would ever tell anybody about this. And if they did, they would smear the author and ensure that everyone believed it was some kind of Crank who wrote it

Expand full comment

Can you copy- paste that? I tried to find it.

Expand full comment

I found it! I’m a finder. Took awhile.

Expand full comment

Funding Postauthorization Vaccine-Safety Science

It won’t let me copy & paste, so you have to look it up. It’s such a great subject. Yes! We need to follow up on vaccine effects. Duh?!

Why isn’t this an automatic federal mandate?

This alone shows that the gov. agencies care zero for citizens. Zero!

Expand full comment

Check out Sweden's autism rates - very high, with lower vaccine rates.

Expand full comment

Again, I ask: "why".

I have near zero expertise in anything biological. But, back when, I did some fairly serious statistical analysis. Correlation isn't causation and time series analysis is particularly squirrelly. But correlation does give you a place to start looking. There are people out there better than I ever was. Turn them loose.

It may not be vaccination in general, but a particular vaccine. Or, it may be fermented herring.

Expand full comment

Sweden’s vaccination rates for childhood vaccines are all over 90%. I would say that’s a pretty high rate. Show me where you saw the rates were low? From 1980- 2022, the rate was 95%.

Expand full comment

Right?! Imagine that. The results will probably be too much to handle. And who will approve for their kids to be in this trial? Let’s just figure out what vaccines are, and what they CAN’T do. After that, the truth will show that vaccines are NOT safe OR effective.

Expand full comment

12. Release all the meeting notes from the late winter/spring/summer of 2020 that involved Fauci et al.

13. Bring more market pricing back into the system. Pre-90% tax rates when firms added health insurance as a "benefit" to get more pay to people without having it be taxed at 90%, there was competition which encouraged low prices. Perhaps this was an intended side effect, perhaps not.

14. After or in conjunction with #13, allow people to get "major medical" and nothing else, e.g. a super-charged HSA plan with a $50k deductible with much lower premiums.

15. Outside of HHS, but allow people to take half of their social security taxes and invest them in a Roth type plan that can't be touched until they take social security.

Expand full comment

16. Commision studies for the "woke mind virus" and its resulting effects on mental health

liberals can't even get up in the morning without Prozac. it might be time to declare a national emergency & save them!

Expand full comment

#14. 100 percent. Let people self insure. A $50K deductible combined with a HSA sort of account into which is deposited the balance of the current health "insurance" premium.

I scare quote "insurance" because our current system really is "prepaid health care"--not "insurance".

Expand full comment

I like your # 14: "Medical" insurance used to cover major events, and was not pre-paid disease processing as we see today. It might impress on the public that their health is up to them.

Expand full comment

Kennedy has often mentioned suspected side effects of certain vaccines, including autism, and I'm pretty sure he's going to address this issue.

Expand full comment

Steve Kirsch has evidence the CDC has known about the link between vaccines and autism since forever.

https://kirschsubstack.com/p/over-300-pages-of-evidence-from-the?r=r9a2h&utm_campaign=post&utm_medium=email&triedRedirect=true

Expand full comment

I'd make that broader - look for all possible causation pushing the autism epidemic. Can't scare everyone in the public off from allowing this to happen (and Alex would NEVER, EVER agree with you if phrased this way, because he refuses to accept that this is a legitimate thing, even though it so, so clearly happens, OFTEN - he'll accept anecdotal proof about other stuff, but not this).

Expand full comment

Yes because I believe it’s multi factorial. The human body is very complex and generally if A then B is not the case. My educated guess is that it’s the combination of many factors that push the individual’s ability to maintain homeostasis and properly functioning systems over the edge. Toxins such as vaccines and environmental exposures play a huge role, I think. Maternal health issues/paternal health issues also play a role, in my opinion. I think it’s the perfect storm of things which is not the same storm for each child.

Expand full comment

I agree it's probably many factors & not the same for each - but with the huge rises in autisms of all severity, I would imagine there are some common underlying causes. Just like with smoking - not all smokers get lung cancer, and not all who get cancer smoked, but the causation is there.

As for maternal health - I've read some suspect giving pitocin in labor. Childbirth is way over medicalized in the US, so I see it as plausible.

Expand full comment

That does go along with my theory of toxins- drugs admin during labor that cross into the placenta. Theses small bodies can only take so much. Good points.

Expand full comment

How about making sure young parents are aware that by the time they put their kids in school they are de facto required to have 70 vaccines!

I guarantee 95% of parents are clueless to this. I know I was.

That's criminal imo. Especially because many provide no meaningful benefit to children.

Expand full comment

@Ryan- my older grandchild, son's daughter, is 24 and has an infant of her own. I was floored by the amount of vaccines those babies/children are required to have had. FFW to now. I have a 3 yr old grandson, daughter's son (yes, my grandkids are 21 years apart) who is required to have even more than the granddaughter!!! But he will never receive the Covid shot until it's been thoroughly studied and approved. But the list of vaccines....Mind blowing.

Expand full comment

Its really sad.

You can only put so many chemicals in your system before something goes wrong.

You talk about the dose being the poison.

Expand full comment

Completely agree-

Expand full comment

Yes parents also have to be aware of their rights to say no to some or all - education will hopefully be a part of his agenda.

Expand full comment

Exactly. Consent.

Expand full comment

I'm in a state with a "religious exemption" - BUT, the private schools don't recognize ANY exemptions! & with the public schools closing for over a year - yes, over a year- with Covid, many of us fled for private. The kids went feral, behavior out of controls, so we're staying out of public school.

Expand full comment

@mb- their parents went feral, too. Daughter is a director of a federal Pre-K program and sees it every single day.

Expand full comment

My knee jerk response is… well elite private schools. Maybe a little Lutheran-run private school would have been more flexible.

Expand full comment

probably time to move!

Expand full comment

Drug advertising is Constitutionally protected? What about cigarette advertising? Was that a consent decree.

I think it is simple. Require each ad to clearly and slowly state the highest price that the drug is sold at. To any individual or organization in the US. BEFORE insurance coverage.

There are those of us that think that Big Pharma runs those ads not so much to sell the drug, but to capture the media financially. Feed the dog and it is less likely to bite you.

Expand full comment

Recall that before 1996 prescription drug advertisements were restricted to only professional journals. They could not be advertised to the public at large. That method worked well. It could be restored.

Expand full comment

Not just cigarettes, alcohol advertising is restricted as well! So it's absurd to say we can't ban Rx ads.

Expand full comment

And disclose do Dr's get paid for offering your drug to their clients?

Expand full comment

This is a no. That anyone thinks otherwise is insane. A rep can't even leave a pen anymore. The government tracks every dime pharma spends on a prescriber--from lunch to copies of clinical trials.

I had two MDs in the course of 25 years demand a quid pro quo for prescribing (both wanted gift cards). I and my teammates reported them to our company, and we were told to cease calling on them. It felt degrading, besides being illegal and unethical.

I think skeptics should spend a day with a drug rep. Be told "No, you can't see the doctor" 90% of the time. Get 45 seconds most of the rest of the time. Have the doctor say what he thinks you want to hear, while you both know he won't prescribe your product. Have a physician complain about side effects, lack of efficacy, cost, the prior auth process, the weather...

Physicians are smart people, not easily led. Anyone who thinks they uncritically listen to pharma reps is silly.

Expand full comment

I think there's another facet to this: Reportedly, Pediatrician offices receive hefty "kickbacks"? from mfgrs depending on what percentage of patients are fully vaccinated. The one Dr who doesn't get his/her numbers up will decrease everybody's take...!

Expand full comment

I never had vaccines and never called on peds. However, no individual MD actually buys the vaccines given in the office. Therefore, I doubt they get kickbacks from the manufacturers. Hell, most companies are too cheap to buy the individual prescribing data on MDs, while expecting their reps to know exactly what their docs are doing anyway.

Most likely, the system (think Kaiser or Mayo or any large delivery network) that buys in bulk gets incentivized by the companies. and those systems know what their individual docs do. That happens with pathways for common disease states (x% of patients with Y disease should be receiving the drugs/procedures in the pathway), so I suspect it happens with vaccines.

Pharma doesn't sell direct. Pharma sells to big buying aggregates called GPOs (group purchasing organizations)which frequently have their own pathways, or to wholesalers like Cardinal and McKesson. Pharmacy Benefits Managers also have preferred drugs and pathways and impact pricing more than the pharma company. These intermediates can monitor prescribing--pharma companies can only purchase individual MD prescribing data from them. It is expensive, and a lot of companies don't buy a lot of data. Certain large organizations don't sell their data, either. Wal-Mart didn't use to, which killed a rep when a Wal-Mart opened, because all of a sudden, the # of prescriptions filled in the territory would plummet, so the rep wouldn't make quota.

TL;DR pharma has much less control than most of the commenters here seem to realize. A lot of money gets spent in the interstitial layers between manufacturer and patient.

Expand full comment

To that end, political advertisements on TV are just as toxic as cigarette commercials war, and they were banned with nobody crying foul about the first amendment! Political ads on television given their content, and cost are the root of corruption in our political system!

Expand full comment

How about: if you advertise this drug to anyone other than physicians, then it is automatically not covered by Medicare/Medicaid?

Expand full comment

See Virginia State Bd. of Pharmacy v. Virginia Citizens Consumer Council, 425 U.S. 748 (1976). This with respect to pricing and there are more cases.

Expand full comment

Those are GREAT! I would add too the banning of royalties paid by drug companies to government public health employees. And we should also have a full accounting of these royalties that have already been paid.

Also limit the power of those like FauXi to shape narratives with grants.

Expand full comment

Surprised this didn’t make it on the short list.

Expand full comment

Me too!

Expand full comment

Reinstate all physicians who were fired, fined or otherwise penalized for daring to speak out against the COVID vaccine

Expand full comment

Along with nurses, police, firefighters, and military personnel who were fired for refusing vaccine.

Expand full comment

Here’s looking at you The Methodist Hospital Houston.

Expand full comment

How about no more personal royalties for government employees!

Expand full comment

Can he institute rules so that government assistance cannot be used on junk food, like chips, cookies, etc?

And overhaul nutrition guidelines to focus more on protein, especially relatively cheap eggs, and fruits and vegetables? And emphasize the drawbacks of sugar.

Expand full comment

Ha, there have been efforts to stop food stamps/ SNAP benefits going to soda, in particular-- efforts the NAACP has fought (among others.) It's so unethical, they should all be ashamed.

Expand full comment

The American Diabetes Association takes lots of money from Pepsi(or is it Coke?). No health association should be taking money from a soda or highly processed food company. If these associations receive any government money they should be barred from this or have it widely publicized.

Expand full comment

Great list. I would add: make ivermectin OTC

Expand full comment

Alex still does not believe in effective early Covid treatments.

Expand full comment

When Ivermectin first came out, it’s anti-viral properties were recognized in some circles. However, effective dosing to achieve anti-viral effects approaches or exceeds LD50. It and avermectins are very effective as anti-parasitics. However, it’s viral inhibiting properties do not seem to be robust enough at safe dosages.

Expand full comment

Spoken like someone who succumbed to disinformation rather than look at the actual science. Also, "its properties" has no apostophe.

Expand full comment

When ivermection and the avermectins in general were first hitting the market, we experimented with them in vitro at U of IA Medical School labs for other properties including anti-viral properties. We concluded that any efficacy in anti-viral properties would likely be toxic based on available LD50 (rat) information. My opinion hasn't changed but if someone wants to use it in safe dosages, they are certainly free to try but I am convinced that any user will only be parasite free and nothing more. (As to the "it's", I use a Spanish keyboard with LatAm Spanish language settings and sometimes French - Ile de France settings which can result in incorrect autocorrect/completions in English).

Expand full comment

So your in vitro experiments showed that it "would likely be toxic based on available LD50 (rat) information"? Well, based on IN VIVO HUMAN oucomes (including for myself and my 90+ in-laws and many other relatives and friends), it is not only not toxic, but is very effective against Covid. So effective, in fact, that it truly makes the vaccine unnecessary -- if only all malaises went as easy as Covid does with Ivermectin... Which is WHY it was suppressed as part of the vaccine drive.

Expand full comment

Well, Alex has to miss the mark every now and then.

Expand full comment

Not in Kennedy's wheelhouse, but term limits for all members of the house and senate would cure a variety of ills.

Expand full comment

The amount of money and corruption that's tied into all of these items, as well as it's intertwining into government agencies has me scared for his safety.

Expand full comment

Love this list! Also add research all food additives currently banned in Europe and other western countries that are allowed in the US (like dies, etc) and ban them in the US. Make our food healthier!

Expand full comment

Look at John Abramson‘s books for very specific non Covid additional recommendations including the “data protection“ rule that allows manufacturers to hide the data and real test results underlying their studies – – therefore avoiding any scrutiny in the rollout, including by the journals who read only the summaries/propaganda. Abramson himself was only able to see the data in litigation discovery.

Expand full comment

🎯

Expand full comment

1. Make Pharma do safety studies on all vaccines that were added to kids schedule after 1986, after they remove liability protection.

2. As for the advertising - make Pharma start every ad with clearly spelled out side effects and options to the drug.

Expand full comment

Two thoughts.

1. Let any Pharma company advertise as they wish but charge a tax for doing so.

On point 9 biosimilars, there is a simple fix offer Pharma and biotech patent length liked to price. If a Pharma company wants to cap a drug at a reasonable price offer them extra patent protection. You could offer a sliding scale. This would get to the heart of why they claim they have to charge so much. Thoughts?

Expand full comment

A provocative and creative idea.

Expand full comment

We could probably list 100 nickel and dime regulations that would initially appear to nudge things in a better direction, like your suggestion of limiting CEO compensation at non-profits.

I would suggest, for example, it should be illegal to give doctors incentive bonuses for giving more vaccines.

But, there's hubris in thinking anyone, let alone the theater kids who go into government, can tinker with complex systems top-down in a way that will produce good outcomes. Who knows what knock on effects these nudges might have (e.g., hospitals might get the weakest executives because, by definition, you would make it illegal for them to hire anyone actually worth more than $1M).

So, I say the *best* thing to do would be to get the federal government as much out of the business of paying for and regulating health care as possible. Stop tinkering.

If you want federal funds to help defer/smooth costs, start with block grants to the states and let them be laboratories of innovation.

One of the primary lessons from COVID should be the absolute horror of centralized decision making. So, stop doing it.

Expand full comment