Monopoly gatekeepers

The system that requires paying a financial tribute to someone with "MD" after their name in order to be allowed access to certain medications is one that seems so normal that it is rather startling to think about how completely inconsistent it is with basic notions of self-ownership that underpin a free society.

This report, from something called the Center on Addition and Substance Abuse (CASA) at Columbia, describes the market's attempts to work around this restriction. As you might guess from the inclusion of the word "pushers" in the title, CASA is one of many institutions that produce advocacy cloaked as research. This impression is reinforced once you learn that Joseph Califano, an old political hack who was Secretary of Health, Education and Welfare (this was back in the dark ages before education was important enough to have its own separate department) during the Carter administration, heads CASA. It is not clear why a serious place like Columbia University would have this sort of center under its wing.

What the report does provides is a descriptive analysis of prescription drug availability on the internet combined with a lot of alarmism. I suppose in some sense it is cheering to know that the internet is helping sick people to find the treatments they want without the intervention of the government's licensed monopolists. This is particularly important given the harrassment and persecution of physicians who prescibe what the amateur physicians at the Drug Enforcement Agency feel is "too much" pain medication. On the other hand, it would be nice to be having a serious debate about how to restore the right of individuals to control their own bodies, while at the same time still preserving what to me seems the valuable information provision function provided by disinterested and systematic testing of safety and efficacy along the lines of what the FDA currently does.