In defense of the FDA, which I promise is not an instituion I have much affection for, they are asked to strike an impossible balance. More or less the same regulatory impulse that allowed Richard Sackler to build an empire on the killing of millions of americans is the same one that allows very sick people to access very, at times dubious, drugs and trials that sometimes save their lives.
Most of medicine is very centrally built around the "first do no harm" approach, even at the cost of lives by non-intervention sometimes. With the FDA most people want a "do so harm some of the time for the greater good" approach which is a really difficult thing for a federal agency to put into practice. I think they do an especially awful job with it but I appreaciate that it is a really hard balance to strike.
The Sacklers aren’t the problem here, corruption is.
Why not both?
People aren’t dying very young with tobacco addiction for the most part. There is cancer in youth sure , but tobacco is not the leading cause of that .
People who die of tobacco related illnesses are functioning adults and contributing members of society for the vast majority of their lives .
The disruption to the lives of drug addicts and their friends and family far exceeds those faced by tobacco addicts.
Not everything is a conspiracy or corruption people only react to what they see, the impact of drugs is far more visceral and immediate than tobacco or say obesity which kills even more, so pressure for legislation is higher
If tobacco killed because the of one wrongly cut cigarette you smoked , it would require prescription too
The regulation is a function of that, not how many people are killed by one item or other, it is merely just how easy is it die of OD with a poorly sourced drug, is why we have FDA and regulations etc is my point.
The FDA doesn't have jurisdiction over "many things".
I personally think the FDA shouldn't exist, or should not have power to regulate (and should be a toothless advisory/certification authority). That said, if they are to exist, they should do their job. They're not. We're paying the bill but not getting the service.
Same goes with OSHA. Every casino in Las Vegas demands their employees work in rooms filled with tobacco smoke. Why? Money. It's pure corruption.
We have the rules, they're just not enforced, because if you have enough cash flow, you get a special carve-out so that the rules that apply to everyone else don't apply to you.
Big Tobacco gets it from the FDA. Big Telecom gets it from the FCC. Boeing gets it from the FAA. It's everywhere, and once you see it, you can't unsee it. We're paying billions and billions for these huge bureaucracies and they're only pretending to provide us with the service they exist to provide.
The FDA has jurisdiction over tobacco[2] and various food products contributing to obesity and those are the only two examples highlighted by OP or me in the thread.
> We're paying the bill but not getting the service.
Don't think we are, there is very little money for Food part of FDA, in the last 5-6 years the money for food has gone from 1,037M(2018) to 1,145(2022)[1] which in real terms considering inflation means it has gone down and last 30 years it has been similar story.
Last Week Tonight had a recent in depth segment on how little resource we have for food enforcement[3] sometimes as little as singe digit inspectors for an entire industry.
We don't really enforce food regulations, because we don't fund the regulatory body for food safety.
[1] https://crsreports.congress.gov/product/pdf/R/R44576, compare that Drugs moved from 1,330 to 2,116M in the same time period.
It would also be nice to reform the FDA and the clinical trial system: https://bessstillman.substack.com/p/please-be-dying-but-not-...
"Antitrust litigation" covers this, but to spell it out, the increasing monopolization of many local healthcare systems is a huge problem.