Episode Transcript
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Speaker 1 (00:00):
Let's do something completely different, don't.
Speaker 2 (00:03):
I don't know how many of you know this, and
and I don't know why you would know this, because
I probably never talked about it and it's not very important.
Speaker 1 (00:11):
But both my parents are medical doctors.
Speaker 2 (00:14):
My dad is a general surgeon, my mom is a pediatrician.
Speaker 1 (00:19):
They both served in the United States Navy.
Speaker 2 (00:21):
My mom's a retired admiral, dad's a retired Captain six,
the equivalent of an Army or Marine Corps Air Force colonel.
Both were tired now and I was, and I was
pre med, you know, as a as a kid of
two doctors and as a grand kid of two Depression
era a Jews who said, you basically have to be
(00:42):
a doctor because you know, it's it doesn't matter what
the economy is, people get sick or they told me,
at least be a lawyer like eh.
Speaker 1 (00:50):
So I was.
Speaker 2 (00:50):
I was pre med for a long time until I
found something I wanted to do better. And part of
my mindset was in order to be a doctor, you
have to have a certain desire to help people that
I I do not have. But my next guest does,
and that's Jeff Singer. He's been on the show once
or twice before, although I think this is the first
time by zoom where I can see him. Jeff is
(01:10):
a practicing surgeon in Phoenix.
Speaker 1 (01:13):
He's a senior.
Speaker 2 (01:14):
Fellow in Health Policy Studies at the Cato Institute. I
have lots of Cato guests on the show. I love
the Cato Institute and have for decades. And Jeff has
a new book out called Your Body, Your Healthcare, published
by the Cato Institute. Release what today or sometime right
around now April eight, okay, April April eight, released a
(01:35):
couple of weeks ago. So Jeff, it's good to talk
to you again. Thanks for being here.
Speaker 3 (01:38):
Oh, thanks for having me all right.
Speaker 2 (01:40):
I don't want to spend too much time just on
the philosophical concept of autonomy, because I think it's pretty
well understood, but just as a foundation, give us a
few seconds on autonomy and then we'll go into some
more detailed stuff.
Speaker 4 (01:53):
Well, basically, the economy means that we as adults own
ourselves and we have the right to make our own
decisions about our own life as long as we don't
interfere with the equal rights of others. So what we
put into our body, what medication we choose to take
what kind of people we seek to get healthcare advice from.
(02:15):
All of these kind of decisions are really up to us.
Nobody has the right to interfere with it. And I
was listening to some of your discussion in my book.
I started off by pointing out that it took a
long time, but for about the last fifty years, when
you're starting medical school, it's drilled into from the get
go that you need to respect patient autonomy. You can't
(02:37):
do any tests or procedure or treatment without they're fully
informed consent. And if they refuse, even if you think
they're making the biggest mistake in the world, you just
have to respect that because it's their body and you
have to respect that. But unfortunately that's not the way
the government approaches our health care decisions.
Speaker 1 (02:55):
Yeah, all right, So two quick things.
Speaker 2 (02:56):
One, I had an incident entoma, and I'm sure you
know what that term means, and so I had me
I had fairly major abdominal surgery to remove a mass
that turned out to be nothing that was found when
I was getting a cat scan for a kidney stone.
Speaker 1 (03:15):
And while the doctor was in there, he.
Speaker 2 (03:19):
Took out my appendix, which had not been discussed in
a sense I didn't mind. It might have saved me
a surgery in the future, who knows. But my dad,
a surgeon, said he shouldn't have done that without talking
to you first.
Speaker 1 (03:33):
So that's just one story.
Speaker 2 (03:34):
You want to just say anything about that real quick.
Speaker 4 (03:37):
Yeah, well that's an example. When you I mean, even
though we are drilled into it, we have the ethics
drilled into us. We're humans too, so we transgress and
that doctors should have discussed with you.
Speaker 3 (03:50):
Look, while I'm in there, if.
Speaker 4 (03:52):
I have your permission, for example, if I decide that
I take out the appendix, that I can go ahead
and do that while I'm there, and then you would
probably say, well, why would you want to do that
if there's nothing wrong with it, and you'd have to make.
Speaker 3 (04:04):
You feel either agree or not.
Speaker 4 (04:06):
So he should you should have had You should have
had that discussion, all right.
Speaker 2 (04:10):
So one other and I may have told you this
the last time you were on with me, But I
have some chronic sacro iliac joint issues, possibly associated with
ankylosing spondylitis, and VOX used to be my medicine of choice.
Viox got what's the band, right, because of issues that
(04:33):
we won't get into. Murk made a replacement called Torracci,
which is the generic name of it. Arcoxia is the
brand name of it, and the FDA has not approved it.
It's approved almost everywhere else in the world. So when
I don't need this medicine very much anymore, which is good,
but I used to have to buy my medicine from
India or maybe when I went on vacation in Mexico,
and I always felt like there's some bureaucrat somewhere who,
(04:55):
if they saw me doing this, would think I was
a criminal. So that's not a question, but I want
you to that's true.
Speaker 1 (05:01):
Yeah.
Speaker 3 (05:02):
Yeah.
Speaker 4 (05:02):
In fact, I'm sure most people have seen Dallas Buyer's
Club by this point, which is a great movie, And
there were people who were trying to get bring into
this country drugs to treat AIDS at a time when
there was no real treatment for it, and they were
getting arrested for bringing in drugs that were not FDA approved.
A little side note about viox. Viox actually was approved
(05:23):
by the FDA. By the way, in my book, I
point out that you know that's a government monopoly deciding
what we can and cannot have access to what medications
we can take, and so I really prefer to say
instead of the FDA approved VIAX, the FDA got out
of the way of me.
Speaker 3 (05:41):
Having access to viox.
Speaker 4 (05:43):
But interestingly, it was it was discovered after it was
already out there that it can cause serious cardiovascar problems.
Speaker 3 (05:51):
It wasn't discovered by the FDA.
Speaker 4 (05:53):
It was discovered actually by a pekaiser Permanente, which the
prepaid health system, which had an incentive to monitor these
things because they don't want to be because they have
to pay for any of the complications of medications that
their customers are taking. So they're the ones who discovered right,
And the manufacturer pulled it off the market before the
(06:14):
FDA asked them to because they watched the liability.
Speaker 1 (06:18):
My recollection, and this could be wrong.
Speaker 2 (06:21):
My recollection was that it was at least alleged that
mrk knew this and hit it, and that was I
thought part of the And I didn't say that Viox
hadn't been approved. I said the replacement for viox wasn't
approved by the FDA, and so could I could.
Speaker 1 (06:37):
Buy viox here?
Speaker 2 (06:39):
But then it was pulled and then they didn't approve
its replacement. But so let's let's keep going because we
only got about eight minutes. We only got about eight
minutes left, So I want to stick with something related
to this though. I of course, if I if I
were going to take a medication, I would probably ask
a doctor, And if I didn't ask a doctor, I
(06:59):
would sure a hell of a lot of homework about
it myself. Why should I have to get somebody's permission
to take a medication that, based on my own research,
let's say I think would be beneficial for me.
Speaker 4 (07:13):
Well, that's a very good question. That's because ever since
nineteen fifty one, Congress gave the FDA the power to
decide what medications you can take by purchasing it over
the counter, and what medications it wants you to get
a permission slip from from another adult called a licensed
(07:33):
healthcare practitioner, in other words, a basically a gatekeeper for
the state.
Speaker 1 (07:40):
Now, to be.
Speaker 4 (07:41):
Fair, even before that, however, and this is okay, a
lot of drug makers made a decision.
Speaker 3 (07:48):
Look, this drug is really complicated.
Speaker 4 (07:50):
If somebody doesn't use it as we direct them to
on the package, they could have a bad outcome.
Speaker 3 (07:55):
And then we're going to get sued and a reputation
is going to be destroyed.
Speaker 4 (07:58):
So we're going to say to the pharmacy, you cannot
sell our product anybody unless they have a prescription from
a healthcare practitioner, because that'll take some of the.
Speaker 3 (08:09):
Responsibility off of us.
Speaker 4 (08:10):
And that's totally okay because that's a voluntary contract. But
that power was taken away from them in nineteen fifty one,
and then it became basically the government has a monopoly
on that decision, and of course it's subject to all
sorts of special interest pleading and politics, which is why,
for example, despite the fact that for more than twenty years,
(08:32):
the American College of Obstetrics and guide Incology has been
saying women shouldn't have to get a prescription from us
and come to see us in order to be able
to get birth control pills, and it's available over the
counter in one hundred countries, but the FDA in this
country says, no, you've got to get a prescription from
a doctor. I means you have to take off time
from work and go sit in the waiting room and
(08:53):
pay money for the consultation. So there's an example of
when you have a monopoly and it's a government.
Speaker 3 (08:59):
This is what happened.
Speaker 2 (09:00):
So in that case, do you think and I thought
that was changing, right, I think you can get.
Speaker 4 (09:04):
Birth control over the counter now, only only one I
talk about it in my book. Finally, they allowed one,
one brand of one type to mini pill, which is very,
very uninconvenient because the mini pill is a single it's
just progested only, and you have to take it within
(09:24):
three hours of this time.
Speaker 3 (09:26):
You took it on the first day. Every single day.
Speaker 4 (09:29):
If you're outside of that three hour window, then you
just got to give it up, go on other form
of contraception until the next cycles start again. So it's
very inconvenient. All right, So we got about five only
one brand is allowed. Okay, we got about five minutes here,
Just one quick follow up on this. Do you think
that the FDA is requiring prescriptions for most birth control
pills because they like having the power and they want
(09:50):
to use it, or because they think they're actually helping people,
or might it be that a lot of these people
are doctors and they like the idea of helping their
fellow doctors by allowing by forcing people to have to
go there and pay a doctor's bill Well, Actually, like
I said, you would that would be what you would think.
But the American Cause of Obgyns, the American Medical Association,
(10:11):
and the American Academy of Family Physicians are saying for
twenty years, look, you shouldn't have to come to see me,
so and they get paid for it.
Speaker 3 (10:19):
So if they're telling you.
Speaker 4 (10:20):
That, that really means something because they're actually getting paid
for you coming to see them. So in this case,
I think that there are two factors at play. One
is insurance doesn't usually pay for over the counter medicine,
so there are some people who don't want the FDA
to make it over the counter because they don't want
to have to pay out of their own pocket for it,
(10:41):
and they'd rather be paid by a third party.
Speaker 3 (10:43):
Which tends to make the price go up.
Speaker 4 (10:46):
The other factor is there are people who are socially
conservative who are concerned that it'll cause more sexual promiscuity,
and we don't want to make it that easy to get.
And then they're finally, there's some people who are not
educating about this. Because I interact with people on social
media about this and lay people say to me, you
(11:08):
should get a doctor to examine you before you go
on that medication.
Speaker 3 (11:12):
And my answer to them is.
Speaker 4 (11:13):
Well, look, nobody's preventing you from going to a doctor
to examine you before you go on that medication.
Speaker 3 (11:19):
But the doctors themselves don't think it's necessary.
Speaker 4 (11:21):
And so if another woman doesn't want to go to
a doctor, you shouldn't prevent her from not going to
a doctor and just getting it.
Speaker 1 (11:28):
We're talking with Jeff Singer.
Speaker 2 (11:30):
He's a practicing surgeon in Phoenix, Arizona.
Speaker 1 (11:32):
He's a senior.
Speaker 2 (11:33):
Fellow in Health Policy Studies at the Cato Institute. Cato
dot org is their website, and Jeff's new book is
Your Body, Your Healthcare. We've got just about two and
a half minutes left. Jeff, what is the iron law
of prohibition?
Speaker 4 (11:47):
Okay, the island prohibition shorthand the harder the enforcement, the
harder the drug. So pro drug prohibition incentivizes the cartels
to come up with more potent forms of whatever it
is they're trying to smuggle to sell to people, because
it's easier when it's more potent to smuggle it in
in smaller sizes and sneak it in.
Speaker 3 (12:08):
And also for the risk you're taking.
Speaker 4 (12:11):
You could if it's more potent, you could sell more
units of it real life. First of all, during alcohol prohibition,
they weren't smuggling in beer and wine.
Speaker 3 (12:19):
They were smuggling in whiskey.
Speaker 4 (12:21):
And a real life example of the eyelore prohibition is
football games. When people are tailgating outside, they're drinking beer
and wine, which you're not allowed to bring alcohol into
the stadium. They're smuggling in the hard stuff and flasks,
and that's smuggling in six packs of beer or bottles
of wine.
Speaker 3 (12:36):
It's the same.
Speaker 4 (12:37):
So it's just basically it's a basically economic principle. And
so the reason why we're seeing drugs get more and
more deadly and more and more potent is.
Speaker 3 (12:46):
Because of prohibition.
Speaker 2 (12:47):
Fascinating, all right, let's see if we can squeeze one
more in in one minute. I hear the term frequently,
especially from the Democrats in our state government. I hear
the term harm reduction. So what should it mean and
what does it mean in practice? You got about a minute?
Speaker 3 (13:05):
Well, okay.
Speaker 4 (13:06):
Harm reduction is a non judgmental approach of saying, look,
I'm not necessarily endorsing what you do, but let me
take steps that I am able to take to make
whatever personal decisions you're making less risky for you.
Speaker 3 (13:21):
We doctors do this every day.
Speaker 4 (13:23):
I mean, there's so many situations where we have a
patient who is overweighted and has borderline diabetes and high
blood pressure and high cholesterol, and if we could just
get them on a proper diet and exercise regimen, they
wouldn't need any medication. They'd be much healthier. But for
whatever reason, either they don't want to, or they can't,
or they enjoy with their lifestyle choice, so they don't.
(13:43):
So we say, okay, let me put you on a
statin drug to lower your cholesterol, let me put you
on a blood pressure pill to get your blood pressure
in a safe range, and maybe if you've got borderline diabetes,
gets you on something that form. And we're practicing harm reduction.
We're not encouraging you to make this lifestyle choice. We're
just saying, as people who care and whose mission it is.
Speaker 3 (14:03):
To you know and suffering, to say, okay, well.
Speaker 4 (14:06):
If you're going to do this, let me at least
make it less dangerous for you, and that's harm reduction. Unfortunately,
a lot of people moralize, so they're okay with harm reduction,
for that. They're okay with me giving brock and hailers
to the lungs for people who develop COPD from smoking,
But they're not okay with me giving, for example, a
(14:26):
fentanyl test strip that people who are buying drugs on
the illicit market so they can make sure it doesn't
have fentanyl in it when they thought they were buying
maybe something like oxycodone, or I can't give them a
clean syringe if I know they're going to inject and
at least I'm reducing their chances of getting HIV appatitis.
Speaker 3 (14:44):
I can't do that.
Speaker 4 (14:45):
But I can give breathing in the halo breathers to
people who are smokers.
Speaker 3 (14:49):
So it's all moralization. It's this.
Speaker 4 (14:52):
In my book, the chapter on drug prohibition is called
the War on some drugs because we're not declaring war
on other drugs like alcoholic tobacco or well, if you
are to a certain degrees, but we're okay with you
doing that, and we're okay with reducing coming up with
measures to reduce the risk of that.
Speaker 3 (15:09):
But with a different set of drugs, we're not okay.
Speaker 2 (15:12):
Jeff Singer's new book is called Your Body, Your Healthcare,
You can also learn more at the Cato Institute website
Cato dot org. But again, all the links for all
of this stuff, including Jeff's book on Amazon. You can
just go to Amazon and type your body, your healthcare,
you'll find it. It's all up on my blog as
well at Rosskiminski dot com.
Speaker 1 (15:30):
Jeff, great to see you, great to talk to you.
A fascinating book, Thanks so.
Speaker 3 (15:33):
Much, Thank you for having me.
Speaker 1 (15:35):
Glad to do it.
Let's do something completely different, don't.
Speaker 2 (00:03):
I don't know how many of you know this, and
and I don't know why you would know this, because
I probably never talked about it and it's not very important.
Speaker 1 (00:11):
But both my parents are medical doctors.
Speaker 2 (00:14):
My dad is a general surgeon, my mom is a pediatrician.
Speaker 1 (00:19):
They both served in the United States Navy.
Speaker 2 (00:21):
My mom's a retired admiral, dad's a retired Captain six,
the equivalent of an Army or Marine Corps Air Force colonel.
Both were tired now and I was, and I was
pre med, you know, as a as a kid of
two doctors and as a grand kid of two Depression
era a Jews who said, you basically have to be
(00:42):
a doctor because you know, it's it doesn't matter what
the economy is, people get sick or they told me,
at least be a lawyer like eh.
Speaker 1 (00:50):
So I was.
Speaker 2 (00:50):
I was pre med for a long time until I
found something I wanted to do better. And part of
my mindset was in order to be a doctor, you
have to have a certain desire to help people that
I I do not have. But my next guest does,
and that's Jeff Singer. He's been on the show once
or twice before, although I think this is the first
time by zoom where I can see him. Jeff is
(01:10):
a practicing surgeon in Phoenix.
Speaker 1 (01:13):
He's a senior.
Speaker 2 (01:14):
Fellow in Health Policy Studies at the Cato Institute. I
have lots of Cato guests on the show. I love
the Cato Institute and have for decades. And Jeff has
a new book out called Your Body, Your Healthcare, published
by the Cato Institute. Release what today or sometime right
around now April eight, okay, April April eight, released a
(01:35):
couple of weeks ago. So Jeff, it's good to talk
to you again. Thanks for being here.
Speaker 3 (01:38):
Oh, thanks for having me all right.
Speaker 2 (01:40):
I don't want to spend too much time just on
the philosophical concept of autonomy, because I think it's pretty
well understood, but just as a foundation, give us a
few seconds on autonomy and then we'll go into some
more detailed stuff.
Speaker 4 (01:53):
Well, basically, the economy means that we as adults own
ourselves and we have the right to make our own
decisions about our own life as long as we don't
interfere with the equal rights of others. So what we
put into our body, what medication we choose to take
what kind of people we seek to get healthcare advice from.
(02:15):
All of these kind of decisions are really up to us.
Nobody has the right to interfere with it. And I
was listening to some of your discussion in my book.
I started off by pointing out that it took a
long time, but for about the last fifty years, when
you're starting medical school, it's drilled into from the get
go that you need to respect patient autonomy. You can't
(02:37):
do any tests or procedure or treatment without they're fully
informed consent. And if they refuse, even if you think
they're making the biggest mistake in the world, you just
have to respect that because it's their body and you
have to respect that. But unfortunately that's not the way
the government approaches our health care decisions.
Speaker 1 (02:55):
Yeah, all right, So two quick things.
Speaker 2 (02:56):
One, I had an incident entoma, and I'm sure you
know what that term means, and so I had me
I had fairly major abdominal surgery to remove a mass
that turned out to be nothing that was found when
I was getting a cat scan for a kidney stone.
Speaker 1 (03:15):
And while the doctor was in there, he.
Speaker 2 (03:19):
Took out my appendix, which had not been discussed in
a sense I didn't mind. It might have saved me
a surgery in the future, who knows. But my dad,
a surgeon, said he shouldn't have done that without talking
to you first.
Speaker 1 (03:33):
So that's just one story.
Speaker 2 (03:34):
You want to just say anything about that real quick.
Speaker 4 (03:37):
Yeah, well that's an example. When you I mean, even
though we are drilled into it, we have the ethics
drilled into us. We're humans too, so we transgress and
that doctors should have discussed with you.
Speaker 3 (03:50):
Look, while I'm in there, if.
Speaker 4 (03:52):
I have your permission, for example, if I decide that
I take out the appendix, that I can go ahead
and do that while I'm there, and then you would
probably say, well, why would you want to do that
if there's nothing wrong with it, and you'd have to make.
Speaker 3 (04:04):
You feel either agree or not.
Speaker 4 (04:06):
So he should you should have had You should have
had that discussion, all right.
Speaker 2 (04:10):
So one other and I may have told you this
the last time you were on with me, But I
have some chronic sacro iliac joint issues, possibly associated with
ankylosing spondylitis, and VOX used to be my medicine of choice.
Viox got what's the band, right, because of issues that
(04:33):
we won't get into. Murk made a replacement called Torracci,
which is the generic name of it. Arcoxia is the
brand name of it, and the FDA has not approved it.
It's approved almost everywhere else in the world. So when
I don't need this medicine very much anymore, which is good,
but I used to have to buy my medicine from
India or maybe when I went on vacation in Mexico,
and I always felt like there's some bureaucrat somewhere who,
(04:55):
if they saw me doing this, would think I was
a criminal. So that's not a question, but I want
you to that's true.
Speaker 1 (05:01):
Yeah.
Speaker 3 (05:02):
Yeah.
Speaker 4 (05:02):
In fact, I'm sure most people have seen Dallas Buyer's
Club by this point, which is a great movie, And
there were people who were trying to get bring into
this country drugs to treat AIDS at a time when
there was no real treatment for it, and they were
getting arrested for bringing in drugs that were not FDA approved.
A little side note about viox. Viox actually was approved
(05:23):
by the FDA. By the way, in my book, I
point out that you know that's a government monopoly deciding
what we can and cannot have access to what medications
we can take, and so I really prefer to say
instead of the FDA approved VIAX, the FDA got out
of the way of me.
Speaker 3 (05:41):
Having access to viox.
Speaker 4 (05:43):
But interestingly, it was it was discovered after it was
already out there that it can cause serious cardiovascar problems.
Speaker 3 (05:51):
It wasn't discovered by the FDA.
Speaker 4 (05:53):
It was discovered actually by a pekaiser Permanente, which the
prepaid health system, which had an incentive to monitor these
things because they don't want to be because they have
to pay for any of the complications of medications that
their customers are taking. So they're the ones who discovered right,
And the manufacturer pulled it off the market before the
(06:14):
FDA asked them to because they watched the liability.
Speaker 1 (06:18):
My recollection, and this could be wrong.
Speaker 2 (06:21):
My recollection was that it was at least alleged that
mrk knew this and hit it, and that was I
thought part of the And I didn't say that Viox
hadn't been approved. I said the replacement for viox wasn't
approved by the FDA, and so could I could.
Speaker 1 (06:37):
Buy viox here?
Speaker 2 (06:39):
But then it was pulled and then they didn't approve
its replacement. But so let's let's keep going because we
only got about eight minutes. We only got about eight
minutes left, So I want to stick with something related
to this though. I of course, if I if I
were going to take a medication, I would probably ask
a doctor, And if I didn't ask a doctor, I
(06:59):
would sure a hell of a lot of homework about
it myself. Why should I have to get somebody's permission
to take a medication that, based on my own research,
let's say I think would be beneficial for me.
Speaker 4 (07:13):
Well, that's a very good question. That's because ever since
nineteen fifty one, Congress gave the FDA the power to
decide what medications you can take by purchasing it over
the counter, and what medications it wants you to get
a permission slip from from another adult called a licensed
(07:33):
healthcare practitioner, in other words, a basically a gatekeeper for
the state.
Speaker 1 (07:40):
Now, to be.
Speaker 4 (07:41):
Fair, even before that, however, and this is okay, a
lot of drug makers made a decision.
Speaker 3 (07:48):
Look, this drug is really complicated.
Speaker 4 (07:50):
If somebody doesn't use it as we direct them to
on the package, they could have a bad outcome.
Speaker 3 (07:55):
And then we're going to get sued and a reputation
is going to be destroyed.
Speaker 4 (07:58):
So we're going to say to the pharmacy, you cannot
sell our product anybody unless they have a prescription from
a healthcare practitioner, because that'll take some of the.
Speaker 3 (08:09):
Responsibility off of us.
Speaker 4 (08:10):
And that's totally okay because that's a voluntary contract. But
that power was taken away from them in nineteen fifty one,
and then it became basically the government has a monopoly
on that decision, and of course it's subject to all
sorts of special interest pleading and politics, which is why,
for example, despite the fact that for more than twenty years,
(08:32):
the American College of Obstetrics and guide Incology has been
saying women shouldn't have to get a prescription from us
and come to see us in order to be able
to get birth control pills, and it's available over the
counter in one hundred countries, but the FDA in this
country says, no, you've got to get a prescription from
a doctor. I means you have to take off time
from work and go sit in the waiting room and
(08:53):
pay money for the consultation. So there's an example of
when you have a monopoly and it's a government.
Speaker 3 (08:59):
This is what happened.
Speaker 2 (09:00):
So in that case, do you think and I thought
that was changing, right, I think you can get.
Speaker 4 (09:04):
Birth control over the counter now, only only one I
talk about it in my book. Finally, they allowed one,
one brand of one type to mini pill, which is very,
very uninconvenient because the mini pill is a single it's
just progested only, and you have to take it within
(09:24):
three hours of this time.
Speaker 3 (09:26):
You took it on the first day. Every single day.
Speaker 4 (09:29):
If you're outside of that three hour window, then you
just got to give it up, go on other form
of contraception until the next cycles start again. So it's
very inconvenient. All right, So we got about five only
one brand is allowed. Okay, we got about five minutes here,
Just one quick follow up on this. Do you think
that the FDA is requiring prescriptions for most birth control
pills because they like having the power and they want
(09:50):
to use it, or because they think they're actually helping people,
or might it be that a lot of these people
are doctors and they like the idea of helping their
fellow doctors by allowing by forcing people to have to
go there and pay a doctor's bill Well, Actually, like
I said, you would that would be what you would think.
But the American Cause of Obgyns, the American Medical Association,
(10:11):
and the American Academy of Family Physicians are saying for
twenty years, look, you shouldn't have to come to see me,
so and they get paid for it.
Speaker 3 (10:19):
So if they're telling you.
Speaker 4 (10:20):
That, that really means something because they're actually getting paid
for you coming to see them. So in this case,
I think that there are two factors at play. One
is insurance doesn't usually pay for over the counter medicine,
so there are some people who don't want the FDA
to make it over the counter because they don't want
to have to pay out of their own pocket for it,
(10:41):
and they'd rather be paid by a third party.
Speaker 3 (10:43):
Which tends to make the price go up.
Speaker 4 (10:46):
The other factor is there are people who are socially
conservative who are concerned that it'll cause more sexual promiscuity,
and we don't want to make it that easy to get.
And then they're finally, there's some people who are not
educating about this. Because I interact with people on social
media about this and lay people say to me, you
(11:08):
should get a doctor to examine you before you go
on that medication.
Speaker 3 (11:12):
And my answer to them is.
Speaker 4 (11:13):
Well, look, nobody's preventing you from going to a doctor
to examine you before you go on that medication.
Speaker 3 (11:19):
But the doctors themselves don't think it's necessary.
Speaker 4 (11:21):
And so if another woman doesn't want to go to
a doctor, you shouldn't prevent her from not going to
a doctor and just getting it.
Speaker 1 (11:28):
We're talking with Jeff Singer.
Speaker 2 (11:30):
He's a practicing surgeon in Phoenix, Arizona.
Speaker 1 (11:32):
He's a senior.
Speaker 2 (11:33):
Fellow in Health Policy Studies at the Cato Institute. Cato
dot org is their website, and Jeff's new book is
Your Body, Your Healthcare. We've got just about two and
a half minutes left. Jeff, what is the iron law
of prohibition?
Speaker 4 (11:47):
Okay, the island prohibition shorthand the harder the enforcement, the
harder the drug. So pro drug prohibition incentivizes the cartels
to come up with more potent forms of whatever it
is they're trying to smuggle to sell to people, because
it's easier when it's more potent to smuggle it in
in smaller sizes and sneak it in.
Speaker 3 (12:08):
And also for the risk you're taking.
Speaker 4 (12:11):
You could if it's more potent, you could sell more
units of it real life. First of all, during alcohol prohibition,
they weren't smuggling in beer and wine.
Speaker 3 (12:19):
They were smuggling in whiskey.
Speaker 4 (12:21):
And a real life example of the eyelore prohibition is
football games. When people are tailgating outside, they're drinking beer
and wine, which you're not allowed to bring alcohol into
the stadium. They're smuggling in the hard stuff and flasks,
and that's smuggling in six packs of beer or bottles
of wine.
Speaker 3 (12:36):
It's the same.
Speaker 4 (12:37):
So it's just basically it's a basically economic principle. And
so the reason why we're seeing drugs get more and
more deadly and more and more potent is.
Speaker 3 (12:46):
Because of prohibition.
Speaker 2 (12:47):
Fascinating, all right, let's see if we can squeeze one
more in in one minute. I hear the term frequently,
especially from the Democrats in our state government. I hear
the term harm reduction. So what should it mean and
what does it mean in practice? You got about a minute?
Speaker 3 (13:05):
Well, okay.
Speaker 4 (13:06):
Harm reduction is a non judgmental approach of saying, look,
I'm not necessarily endorsing what you do, but let me
take steps that I am able to take to make
whatever personal decisions you're making less risky for you.
Speaker 3 (13:21):
We doctors do this every day.
Speaker 4 (13:23):
I mean, there's so many situations where we have a
patient who is overweighted and has borderline diabetes and high
blood pressure and high cholesterol, and if we could just
get them on a proper diet and exercise regimen, they
wouldn't need any medication. They'd be much healthier. But for
whatever reason, either they don't want to, or they can't,
or they enjoy with their lifestyle choice, so they don't.
(13:43):
So we say, okay, let me put you on a
statin drug to lower your cholesterol, let me put you
on a blood pressure pill to get your blood pressure
in a safe range, and maybe if you've got borderline diabetes,
gets you on something that form. And we're practicing harm reduction.
We're not encouraging you to make this lifestyle choice. We're
just saying, as people who care and whose mission it is.
Speaker 3 (14:03):
To you know and suffering, to say, okay, well.
Speaker 4 (14:06):
If you're going to do this, let me at least
make it less dangerous for you, and that's harm reduction. Unfortunately,
a lot of people moralize, so they're okay with harm reduction,
for that. They're okay with me giving brock and hailers
to the lungs for people who develop COPD from smoking,
But they're not okay with me giving, for example, a
(14:26):
fentanyl test strip that people who are buying drugs on
the illicit market so they can make sure it doesn't
have fentanyl in it when they thought they were buying
maybe something like oxycodone, or I can't give them a
clean syringe if I know they're going to inject and
at least I'm reducing their chances of getting HIV appatitis.
Speaker 3 (14:44):
I can't do that.
Speaker 4 (14:45):
But I can give breathing in the halo breathers to
people who are smokers.
Speaker 3 (14:49):
So it's all moralization. It's this.
Speaker 4 (14:52):
In my book, the chapter on drug prohibition is called
the War on some drugs because we're not declaring war
on other drugs like alcoholic tobacco or well, if you
are to a certain degrees, but we're okay with you
doing that, and we're okay with reducing coming up with
measures to reduce the risk of that.
Speaker 3 (15:09):
But with a different set of drugs, we're not okay.
Speaker 2 (15:12):
Jeff Singer's new book is called Your Body, Your Healthcare,
You can also learn more at the Cato Institute website
Cato dot org. But again, all the links for all
of this stuff, including Jeff's book on Amazon. You can
just go to Amazon and type your body, your healthcare,
you'll find it. It's all up on my blog as
well at Rosskiminski dot com.
Speaker 1 (15:30):
Jeff, great to see you, great to talk to you.
A fascinating book, Thanks so.
Speaker 3 (15:33):
Much, Thank you for having me.
Speaker 1 (15:35):
Glad to do it.
The Ross Kaminsky Show News
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