[bduerst]

My point is not that safety needs to be increased to the maximum. It's assumed the current level of safety takes into consideration existing market signals and the economic trade-off of diminishing returns.

My point is that trading safety simply to solve the barrier to entry problem has a dangerous cost/benefit trade-off, especially when it is not the only way to solve the problem.

[snagglegaggle]

>It's assumed the current level of safety takes into consideration existing market signals and the economic trade-off of diminishing returns.

Considering the current pharma market and everyone's assumption it's distorted I think this needs a pretty airtight defense. Everyone is aware of the tradeoff, but countries like India, where drugs are easier to bring to market and more drugs are available OTC, has great healthcare outcomes for its poorest citizens.

[bduerst]

Market availability isn't the same as OTC distribution though.

The expensive clinical regulations that creates barriers to entry for the market and leads to monopolistic incumbents is not the same to being able to buy the good with or without an prescription.

The latter is tied more to remuneration from insurance companies - i.e. private insurance companies that are incentivized to not pay for prescriptions are more willing to only pay when care providers specifically order it.

[snagglegaggle]

Yes, yes, I know. But so many drugs requiring a prescription in the US is a market distortion similar to the high cost of bringing drugs to market. It reduces the availability of life saving medicines to people while attempting to minimize other dangers that are likely overstated. Frankly it seems like something doctors lobbied for to ensure a steady stream of office visits.

[bduerst]

Doubtful. Doctors are incentivized to not have to write prescriptions, because it legally shifts the liability (and malpractice claims) to them.

[snagglegaggle]

Whether they prescribe it or not is irrelevant, you still need to pay to ask them. Doctors are risk averse for that reason, among others, and most people I know loathe going to them because they never actually try to treat the problem.

[sokoloff]

> India has great healthcare outcomes for its poorest citizens.

Does it? Why does the life expectancy at birth (68-69) trail the US (76-81) by so much then? That's an average across the country; presumably the poor in India have even lower than that average.

[snagglegaggle]

The country is massive and much of it is in poverty, this is looking at improvements relative to other similarly disadvantaged areas.