09:54 am
Two Out of Three Ain’t Bad
It’s almost spring, the new administration’s honeymoon appears to be ending, and it is starting to feel like the economic crisis is bottoming out - at least from where I am sitting. Accordingly, there are a lot of new ideas flying around for how to do things differently, how to do things better, and that is as true in the science & technology space as anywhere else. It’s easy to have an idea, it’s harder to have a good idea, and it is the hardest to make a good idea work. Thus I was pretty encouraged by a couple of stories I’ve come across in the last couple of weeks.
Good idea #1: a bipartisan proposal introduced in the Senate would encourage the Food and Drug Administration to approve generic (as opposed to branded) biotechnology drugs. This is long overdue, as many biotech drugs cost tens of thousands of dollars per year, with some close to $100,000 annually, and per my earlier post, there is often little evidence that they are substantially more effective than other, cheaper treatments. A little competition never hurt anyone, and will greatly help healthcare consumers and payers. Here’s the money quote from the original article:
In 1984, Congress passed legislation allowing the [FDA] to accept simple laboratory tests as proof that generic versions were equivalent to branded medicines. That led to the birth of the modern generics industry, which makes two-thirds of all medicines used in the United States.
I believe that modern medicine’s success up to now can be mainly attributed to sanitation, vaccinations, antibiotics, and modern pharmaceuticals, and this change, if enacted, will further broaden the reach of that last option beyond the changes of 1984.
Good idea #2: innovative thinking by the town of Lecco, Italy. The original article by Elisabeth Rosenthal says it best:
In 2003, to confront the triple threats of childhood obesity, local traffic jams and — most important — a rise in global greenhouse gases abetted by car emissions, an environmental group here proposed a retro-radical concept: children should walk to school.
They set up a piedibus (literally foot-bus in Italian) — a bus route with a driver but no vehicle. Each morning a mix of paid staff members and parental volunteers in fluorescent yellow vests lead lines of walking students along Lecco’s twisting streets to the schools’ gates, Pied Piper-style, stopping here and there as their flock expands.
In my opinion, the modern world makes it very difficult for people to lead healthy lives. We are encouraged to work long hours, leading to high stress and the associated stress hormone-driven accumulation of fat in our bodies. Long hours also leads to no time or energy for exercise, nor time or energy to prepare healthier meal alternatives than those we can quickly purchase and prepare with the little time we have remaining in our days. There is no easy solution to this lifestyle problem, especially when everyone is under greater economic pressure, but Lecco provides a possible starting point for the younger among us who may have a little more time.
Not-so-good idea #3 that could still be saved - A couple weeks ago I read an interesting op-ed in which the author, a farmer, describes how a proposed animal ID system to help control disease among farm animals could hurt small farms. The author makes the case that the incremental cost of adopting such a system will be much greater for a small farm than for a large farm - which is basic economics and surely true - and is thus bad because it will hurt small farms disproportionately. She argues instead that:
To heighten our food security, we should limit industrial agriculture and stimulate the growth of small farms and backyard food production around the country.
Assuming for the sake of argument that her basic claim is true - that food produced without the use of antibiotics, pesticides, or other industrial-scale strategies results in better human health (which on its face seems obvious, but so did the supposed health benefits of antioxidants on cardiovascular health until multiple large clinical trials showed no measurable benefit) - I still have a different take on efforts to improve food safety for consumers, and how they will impact different producers in the system.
First, we should remember our very recent history. In 2007, the FDA reported that millions of Americans had eaten chicken and pork fattened on melamine-contaminated feed, and that thousands of pet cats and dogs in the US died from melamine-laden pet food. In 2008, the FDA was halting the import from China of many foods containing milk products to test for melamine contamination, and melamine traces were being found in infant formula produced in the US. In 2009, we’ve had food scares involving both peanut butter and pistachios (and pistachio products) contaminated with salmonella. We Americans consume from a globalized food chain of domestic and foreign origin, and it would appear to not be safe enough.
I agree with the author that making food safer will have to be paid for somehow, and with her assumption that this increased cost will fall on some more than others. But consider the argument in a different context: pharmaceuticals. No one would ever argue that small biotech companies should be allowed to sell drugs that they haven’t demonstrated to be safe because it costs relatively more for them to do so than it does a large pharmaceutical company. But that is implicitly what the author is arguing.
Rather than endorse blatant intervention by the government to pick winning and losing producers in a market, with no formal concern for what is best for the consumer, I would rather the government restrict itself to two activities.
First, adequately provide sufficient resources (meaning not just money but also staff and legal authority) to a single regulatory body with responsibility for maintaining a minimum safety level for food consumed in the United States. Currently this work is spread across USDA, FDA, and numerous state agencies, and is probably understaffed and under-resourced by all interested parties.
Second, it may be that the data don’t exist to allow consumers to compare the safety of food entering the chain from small versus large producers, or that such data exist but are not widely available. If so, the government should intervene, sponsoring or mandating studies to generate these data, and requiring them to be made available to the average grocery-store shopper in some reasonably digestible form. It always costs money to reduce risk in your life, and this will cost money as well.
I do not feel unsafe in my food choices, but I would be willing to pay a little to ensure that useful information is available for other citizens. My impression is that most Americans understand that organic and locally grown foods cost more, and many are willing to pay more for the perceived benefits. Despitethe author’s concern, they may be willing to pay even more if they conclude that it will offer a demonstrable health benefit.
If the real issue instead is lifestyle support for small farmers, and a connection between the consumer and that world, a much better way to achieve that would be sites like Findthefarmer.com. I leave it to you to explore.