It's a Gordian Knot

My response to Steve Kirsch's "Ideas for how to fix a broken medical system"

Twitter-banned Steve Kirsch recently published a list of 20 "ways to restore trust in the medical system." He says he has a more detailed list of more than 100 ideas for change, and I believe him.

From the blatant and ubiquitous influence of pharmaceutical companies over everything from medical schools to licensing boards to medical research and legislation, to obscene prices detached from any recognizable elements of reality, to the removal of liability from harm caused by medical products, and medical licensing being used as a tool for political control… Kirsch's complete list could end up filling volumes.

And yet at the same time, so many of these problems have their roots in a single source. Yes, healthcare has become a massive tangled mess. But rather than attempt the overwhelming task of figuring out how to address every piece of that mess, I believe it makes more sense to step back and view that mess as a coherent whole, and to address the source of that whole.

Looking through Kirsch's list, it is striking that nearly every item has to do with either power (censorship, silencing doctors via medical boards or their employers), or accountability (insulation from liability, inability to challenge the alphabet agencies, lack of transparency in approval processes, etc.)

Power:

The assertion that no-one should have the power to silence speech, or to force others to undergo a medical procedure against their will, ought to be uncontroversial. Yet here we are.

In fact, brute, political power is everywhere in medicine. This is not new. The state dictates who may or may not practice medicine, who may establish a hospital and under what conditions; it dictates what kind of medicine may be practiced, what medicines and other products may be sold on the market and what can be said publicly about them; and it dictates that grown, competent adults must get written permission from other adults before using many of these products.

…and accountability:

Steve proposes "A means for public accountability for FDA, CDC, public health, and outside committee members who can currently duck all legitimate attempts by credible scientists to challenge them."

…and there's the rub. Because despite everything we've been taught from Kindergarten through college about how "we" control "our" government, how it represents "our" interests, the reality is that government is a monopoly on force. And where there is monopoly, there can be no accountability.

This is true enough in the realm of elected representatives, where the vast majority are bought and paid for by monied interests - and it is vastly more true in the realm of the alphabet agencies that do not even profess any accountability to an electorate.

The good news is that all of America is getting an invaluable lesson in the real nature of the state under which we live (and yes, "under" is the correct word) right now. The question then is: What do we do about it?

With regard to the realm of medicine, here is what I believe must be done. (My list is shorter than Steve's.)

My list of ways to restore trust - and accountability - in the medical system:

1. Abolish all government agencies involved in regulating medicine and healthcare. Yes, even the FDA. Especially the FDA. For some analysis on why that particular agency does more harm than good, see here and here.

2. …and related to this one, end all restrictions on who may practice medicine, what may be practiced, and what medicines and other products may be bought and sold and discussed in public.

3. Abolish medical patents. I know, this is a controversial one. But if you recognize that allopathic medicine (I had to stop myself from putting that last word in scare quotes) has taken over the medical industry, and has done so by essentially buying up the political establishment and using political force against its competitors - then you must also recognize that the only reason it was able to do so is that its products are patentable.

Of course if you think patents are legitimate, then maybe I'll never convince you on this one. But just in case, here are a few pieces arguing for the illegitimacy of intellectual property that might induce you to think differently on the topic.

4. End government spending on healthcare and medical research. Government spending = government control.

5. Abolish medical licensing. This is a big one. It is no longer a secret that licensing boards use their power to silence dissent, to punish doctors who challenge the agenda of the pharmaceutical industry by doing things like writing exemptions for childhood vaccines or speaking favorably about out-of-patent treatments - and ultimately clear the industry of any practitioners who challenge that agenda.

If you are under any illusion that medical licensing provides some kind of benefit or protection from bad actors, please take steps to address this fantasy. Here are a few places to start:

Medical Licensing: An Obstacle to Affordable, Quality Care, by Shirley Svorny

The Medical Monopoly: Protecting Consumers or Limiting Competition? by Sue A. Blevins

The mess that is healthcare is a Gordian knot. Rather than try to fix each individual tangled piece, we need to slice right through the whole thing. The way to do that is simple: Get the state out.

How to accomplish this is a separate, and not-so-simple question (I have a private Substack devoted to that question). But the goal should be clear: Get the state completely out of medicine and the healthcare industry before it kills us all.