MEDICINE IS A LOT WORSE THAN WE BELIEVE.  IT IS LIKE GOVERNMENT, NOT HOW MUCH HAS BEEN DONE, BUT HOW MUCH OUGHT TO BE DONE.  THE HARM SO MEASURED IS ASTRONOMICAL.  BILLIONS ARE SPENT ON NEW DRUG TREATMENTS, MANY OF WHICH ARE NOT BETTER THAN EXISTING DRUG TREATMENTS, OR MERELY MARGINALLY BETTER.  SUCH A MARGINAL NEW TREATMENT ARE WORSE BECAUSE THEY ARE OFTEN MUCH MORE EXPENSIVE.  AND ALL TOO OFTEN THE NEW TREATMENT HAS MORE SIDE EFFECTS THAN THE EXISTING TREATMENT.   THE METHOD OF REVIEW, THE FDA, HAS THROUGHOUT ITS HISTORY BEEN AT ITS HIGHEST POSITION DOMINATED BY THOSE WHO HAVE WORKED AT THE HIGHEST LEVELS FOR DRUG COMPANIES. THEIR PRO BUSINESS BIAS COLORS THEIR ACTIONS.   AND SINCE THE PASSAGE OF PRESCRIPTION DRUG USER FEE ACT OF 1992, THE FDA RECEIVES $500,000 FOR EACH DRUG THEY APPROVE.  CONGRESS HAS PLACED BUSINESS BEFORE ETHICS.  WHAT WE GET IS A REFLECTION OF BOTH THE PROFIT MOTIVE AND THE QUALITY OF CONGRESSIONAL SUPERVISION. 

THE QUESTION ARISE AS TO WHY DO DOCTORS PRESCRIBE THESE NEW TREATMENTS?  SINCE THEY ARE PREVENTED BY LAW FROM OWNING PHARMACIES, THEY DO NOT PROFIT FROM THEIR PRESCRIPTIONS.  THEN WHY?  THE ARTICLE BELOW CONTAINS ONE OF THE TWO PRINCIPLE CAUSES.  SIMPLY PUT, THE DRUG COMPANIES MANIPULATE THE RESULTS OF THEIR RESEARCH--WHICH THEY OWN--TO CREATE ON PAPER RESULTS THAT SHOW THEIR NEW PRODUCT BETTER THAN THEIR COMPETITIOR'S EXISTING PRODUCT.  SINCE THERE IS NO OTHER SOURCE OF EVIDENCE, THE DOCTOR HAS TO RELY UPON THE DRUG MANUFACTURES PUBLISHED RESULTS, THOUGH HE KNOWS THE RESULTS HAVE BEEN EXAGERATED.  INDEPTENDENT RESEACH IS RARE AND EXISTS ONLY FOR A FEW OLDER PRODUCTS.  HE KNOWS THAT FDA REVIEW IS PREFUNCTORY.    MOREOVER, HE KNOWS THAT THE PATIENT EXPECTS THE LATEST DRUGS, AND HIS FAILURE TO DO SO WILL TYPICALLY TARNISH HIS REPUTATION AND POSSIBLE RESULT IN THE PATIENT FINDING ANOTHER PHYSICIAN.  THIS IS THE PRINCIPLE REASON PHYSICIANS PRESCRIBE NEW MEDICATIONS.  HE KNOWS THAT THE AVERAGE PATIENT IS NOT AWARE OF HOW UNCERTAIN THE NEW HYPED MEDICATIONS ARE.      THE PHYSICAN MUST DEAL WITH WHAT IS.

THERE IS MUCH ROOM FOR IMPROVEMENT.  SINCE PERFORMANCE IS MEASURED BY PROFITS, EXTERNAL SUPERVISION IS NEEDED.  THIS COULD COME FROM THE GOVERNMENT OR BETTER YET FROM THE GOVERNEMT EMPOWERING A COMMITTEE OF PEER- SELECTED UNIVERSITY PROFESSORS TO OVERSEE THE PRODUCTION OF INFORMATION. 

THE PRESENT FDA SUPERVISION OF THE DRUG COMPANIES--Arianna--IS A MOCKERY.

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