One of the few things I am actually an alarmist about is biological pandemics. Given the past 50 years of US history I have no reason to be this way, but as this Megan McArdle post illustrates, there has been a really disturbing trend happening in medicine over the last 30 years:
The first shows the rise of antibiotic resistance in various common infections.
The second shows the decline in the approval of new antibiotics.
Read the whole thing. So, our most common bacterial infections have drastically increased their resistance to our known antibiotic treatments, and the flow of new antibiotics to the market has slowed to a trickle, with few prospects going forward.
The medical profession is “guarded” by the American Medical Association and various government regulatory agencies. If any sector is the mark of the modern “mixed” economy, this is it. Furthermore, the drug sector is heavily, and I mean heavily, regulated by the FDA. Two points come to mind as I ponder this.
No answers forthcoming from me. But this episode, as well as any other, perfectly illustrates the totally distorted view of the trust that people seem to have in regulation and their public officials, and also illustrates the fact that what people think of as “market” failures are better thought of as “cooperation thwarters” — these external problems are not endemic to market and commercial transactions, but rather anytime two people get together. I argue that the market process is superior (not perfect) at producing mutually satisfactory results without imposing costs on others, whereas other ways of engaging in transactions, such as under the watchful eye of regulators, is at least as prone to imposing costs on others. That view is not popular, and will keep you from being invited to most dinner parties.
But I love dinner parties!
I think you’re misdirecting anger. The majority (70%) of the antibiotic use in the United States is to promote growth in livestock. Certainly there’s some doctor-patient misuse in terms of handing out antibiotics for the flu and such, but I doubt you’d find very much, especially today. Even if 20% is not warranted, that’s still only .2*.3 = 6% of what’s dispensed.
Your second point is also confusing to me. Suppose there was only one doctor allowed antibiotics. He’d want to maximize their effectiveness and extract monopoly rents as along as possible. Presumably his earning ability falls once people realize his antibiotic is useful. I don’t see how strict AMA gatekeeping promotes misuse.
For a long time now, we’ve been breeding resistant bacteria through such things as the incomplete use of antibiotics: the admonition to take your prescription until there are no further pills left is supposed to ensure that you get all the bacteria and that a small colony of surviving bacteria does not get killed.
Malpractice and product liability lawsuits tend to discourage drug companies from producing new antibiotics, especially the ones for the new resistant strains. Call 1-800-Bad Drug.