any way you slice it people are going to die and make grave errors. but open transactions between researchers and free human beings would have drugs evolving much faster than unaccountable and corruptible overlords. reputation systems could replace much of their most important functionality.

> reputation systems could replace much of their most important functionality.

I'll start believing this once you show that a "reputation system" (don't these already exist?) actually does anything to stop quacks from peddling diluted water as a cure-all.

If you relied on reputation alone to regulate the medical market, feel-good snake oil treatments would prosper at the expense of legitimate medical advancement.

>reputation systems could replace much of their most important functionality.

The same "reputation systems" that saved us from the million miracle-cures sold on late night tv, from "green coffee diet" to "Oxygenated water"?

> and free human beings

Do you honestly believe that people with a fatal illness, dealing with people offering a "cure" for that fatal illness, are free to make a rational choice?

You have cancer. You are going to die. Having a terminal illness changes the risk/reward beyond the bounds that most people can imagine. Even so, it seems that most people can make a reasonable decision, as long as the worst of the snake-oil peddlers are kept out. Here are your choices.

Do nothing. Make your time. You are going to die pretty soon. Try to make yourself and your family comfortable.

Take what treatment your insurer allows. You die more slowly, with a small chance of remission, but also with a small chance that the treatment will kill you sooner. Maybe your won't consume your family's assets.

Take what treatment you can afford. Die even more slowly (probably), with a small (but probably better) chance of remission, but also with a small chance that the treatment will kill you sooner. You may consume all your assets, and or incur huge debt/bankrupt your family.

Get yourself into an experimental trial. There is some chance that you will be in the control group (if one is used) in which case, you will die. There is some chance to suffer some adverse reaction in which case, you may be removed from the trial, back to step 1. There is some chance to suffer some catastrophic adverse reaction, in which case you will die, and if you are unlucky the death will be worse than death by cancer/chemo. There is some remote chance the treatment will work as good or marginally better than existing treatments, you win, congratulations. There is some very extremely remote chance the treatment will work amazingly (as in fairy-tale amazing) well, epic win. It may cost little or nothing, but who cares what it cost, you're alive and you just helped save the lives of many others.

Thanks, but I'd rather have medical research systems designed by scientists than libertarians. Free markets are not a panacea, and it's dangerous to think of them as such. In fact, the medical community used to be such a place, and it was dominated by quacks and snake oil salesmen.