Coyote Blog

The other day, I wrote about the left of late lamenting that the machinery of state control that they created, agencies like the FDA and public schools, are being taken over by their political enemies, the "Neanderthal southern religious conservatives".  I observed that they were not apologizing for creating a statist structure to control individual decision-making, but just were upset they lost control of it.

In using the FDA as one example:

Today, via Instapundit, comes this story about the GAO audit of the decision by the FDA to not allow the plan B morning after pill to be sold over the counter.
And, knock me over with a feather, it appears that the decision was
political, based on a conservative administration's opposition to
abortion.  And again the technocrats on the left are freaked.  Well,
what did you expect?  You applauded the Clinton FDA's politically
motivated ban on breast implants as a sop to NOW and the trial
lawyers.  In
establishing the FDA, it was you on the left that established the
principal, contradictory to the left's own stand on abortion, that the
government does indeed trump the individual on decision making for
their own body  (other thoughts here).
Again we hear the lament that the game was great until these
conservative yahoos took over.  No, it wasn't.  It was unjust to scheme
to control other people's lives, and just plain stupid to expect that
the machinery of control you created would never fall into your
political enemy's hands.

That has spurred a lot of email pointing me to other FDA-related articles.  I posted this one in the updates of that same post, pointing out how the FDA process (and the tort process, by the way) puts a much higher value on a life lost to drug side-effects than to a life saved from drug benefits.

Today I was pointed to this article by Derek Lowe who has been a drug development researcher for a number of years:

As a drug discovery researcher, I can tell you something that might sound
crazy: many of these older drugs would have a hard time getting approved today.
Some of them would never even have made it to the FDA at all.

The best example is aspirin itself. It's one of the foundation stones of the
drug industry, and it's hard to even guess how many billions of doses of it have
been taken over the last hundred years. But if you were somehow able to change
history so that aspirin had never been discovered until this year, I can
guarantee you that it would have died in the lab. No modern drug development
organization would touch it.

Thanks in part to advertisements for competing drugs, people know that there
are some stomach problems associated with aspirin. Actually, its use more or
less doubles the risk of a severe gastrointestinal event, which in most cases
means bleeding seriously enough to require hospitalization. Lower doses such as
those prescribed for cardiovascular patients and various formulation
improvements (coatings and the like) only seem to improve these numbers by a
small amount. Such incidents, along with others brought on by other oral
anti-inflammatory drugs, are the most common severe drug side effects seen in
medical practice....

That brings us up to penicillin, a drug with a clean reputation if ever there
was one. But at the same time, everyone has heard of the occasional bad allergic
reaction to it and related antibiotics. Even with the availability of skin tests
for sensitivity, these antibiotics cause about one fatality per 50 to 100,000
patient courses of treatment. Other severe reactions are twenty times as common.
Those are interesting figures to put into today's legal context: over 9 million
prescriptions were written for Vioxx, for example. Any modern drug that directly
caused that number of patient deaths and injuries would bury its company in a
hailstorm of lawsuits, because (unlike the Vioxx cases) there would be little
room to argue about

Over the past fifty years, a powerful driving force for statism in this country has come from technocrats, mainly on the left, who felt that the country would be better off if a few smart people (ie them) made the important decisions and imposed them on the public at large, who were too dumb to make quality decision for themselves.  People aren't smart enough,they felt, to make medication risk trade-off decision for themselves, so the FDA was created to tell them what procedures and compounds they could and could not have access to.  People couldn't be trusted to teach their kids the right things, so technocrats in the left defended government-run schools and fought school choice at every juncture.  People can't be trusted to save for their own retirement, so  the government takes control with Social Security and the left fights giving any control back to individuals.  The technocrats told us what safety equipment our car had to have, what gas mileage it should get, when we needed to where a helmet, what foods to eat, when we could smoke, what wages we could and could not accept, what was and was not acceptable speech on public college campuses, etc. etc.

Throughout these years, libertarians like myself argued that there were at least three problems with all of this technocratic statism:

• You don't have the right to make decisions for other people. Period.  No matter how high-minded and idealistic you want to portray
  it, at the end of the day you are proposing to use force to coerce another man into doing your will.  You may stop them from using force or fraud against others, but an adult may make decisions for themselves, even if they are bad.  I am reminded of a great line from the HBO show Deadwood, "Can you let me go to hell the way I want to?"

• You can't make better decisions for other people, even if you are smarter, because every person has different wants, needs, values, etc., and thus make trade-offs differently.  Tedy Bruschi of the Patriots is willing to take post-stroke risks by playing pro football again I would never take, but that doesn't mean its a incorrect decision for him.

• Technocratic idealists ALWAYS lose control of the game.  It may feel good at first when the trains start running on time, but the technocrats are soon swept away by the thugs, and the patina of idealism is swept away, and only fascism is left.  Interestingly, the technocrats always cry "our only mistake was letting those other guys take control".  No, the mistake was accepting the right to use force on another man.  Everything after that was inevitable.

I am reminded of all this because the technocrats that built our regulatory state are starting to see the danger of what they created.  A public school system was great as long as it was teaching the right things and its indoctrinational excesses were in a leftish direction.  Now, however, we can see the panic.  The left is freaked that some red state school districts may start teaching creationism or intelligent design.  And you can hear the lament - how did we let Bush and these conservative idiots take control of the beautiful machine we built?  My answer is that you shouldn't have built the machine in the first place - it always falls into the wrong hands.  Maybe its time for me to again invite the left to reconsider school choice.

Today, via Instapundit, comes this story about the GAO audit of the decision by the FDA to not allow the plan B morning after pill to be sold over the counter.  And, knock me over with a feather, it appears that the decision was political, based on a conservative administration's opposition to abortion.  And again the technocrats on the left are freaked.  Well, what did you expect?  You applauded the Clinton FDA's politically motivated ban on breast implants as a sop to NOW and the trial lawyers.  In establishing the FDA, it was you on the left that established the principal, contradictory to the left's own stand on abortion, that the government does indeed trump the individual on decision making for their own body  (other thoughts here).  Again we hear the lament that the game was great until these conservative yahoos took over.  No, it wasn't.  It was unjust to scheme to control other people's lives, and just plain stupid to expect that the machinery of control you created would never fall into your political enemy's hands.

OK, rant over.  No one wants to hear "you asked for it", but that is indeed my answer to many of the left's laments today about conservatives taking over their treasured instruments of state control.  I hate to be a geek here, but even Star Trek figured out this whole technocrat losing control of the fascist state thing 40 years ago.

Update:  Wow, I am not that skilled with reading academix-speak, but I am pretty sure that Ed Glaeser via Margina Revolution is saying the same thing:

Soft paternalism requires a government bureaucracy that is skilled in
manipulating beliefs.  A persuasive government bureaucracy is inherently
dangerous because that apparatus can be used in contexts far away from the
initial paternalistic domain.  Political leaders have a number of goals, only
some of which relate to improving individual well-being.  Investing in the tools
of persuasion enables the government to change perceptions of many things, not
only the behavior in question.  There is great potential for abuse.

Update:  Cafe Hayek discusses how the FDA is failing even technocratic objectives and this is an amazing data-rich in-depth analysis of the FDA vs. markets in managing drug risk/reward choices:

The debate over off-label prescribing is not about perfect safety; it is about
whether unavoidable trade-offs are best made for everyone by a centralized authority
such as the FDA or whether those decisions are best made by patients and doctors
acting independently. Whoever makes a decision to try (patient), prescribe (doctor),
or approve (FDA) a drug must face the trade-off between the costs of prescribing a
potentially unsafe medicine (a type II cost) and the costs of not prescribing a drug
that could have saved a life (a type I cost)....

The FDA tends to overemphasize the cost of using a potentially unsafe medicine,
because type II costs are highly visible and result in punishment of the FDA, whereas
type I costs are invisible and do not result in punishment.

If the FDA approved a drug that killed thousands of people, that story would make
the front page of every newspaper in the nation. Congressional hearings would certainly he held, the head of the FDA would probably lose his or her job, and the agency would be reorganized. But if the FDA rejected a drug that could save thousands of people, who would complain? When a drug kills a patient, that person is identifiable, and family and friends may learn the cause of the death. In contrast, the patient who would have lived, had new drugs been available, is identifiable only in a statistical sense. Family and friends will never know whether their loved one could have survived had the FDA not delayed the introduction of a new drug. In some cases the drug that could have saved the patient's life is never created, because the costs of the FDA's testing procedures make the necessary research and development appear unprofitable...

Patients and doctors do not face the same biased incentives as the FDA and thus
tend to pay more attention to the costs of not using a drug that could save a life.

There is an interesting discussion about liability going on at Overlawyered and Prawfsblawg.  The original subject was Eddy Curry, the basketball player who may or may not have a genetic heart condition.  The Chicago Bulls refused to play him until he had submitted to a series of tests that would let them determine for themselves if it was safe for him to play (Curry had already said that he wanted to play).

The Bulls have been derided in a number of venues for requiring privacy-invading tests which Curry reasonably refused to submit to.  However, in today's legal world, the Bulls are being entirely rational and in fact entirely consistent with the law, at least as it is practiced in courts today.  Many courts, including those in particular in legal hellhole Illinois, have pretty much thrown out most liability wavers.  Effectively, courts have said that Curry has no right to make risk-reward trade-offs for his own body and self, and if he gets hurt playing for the Bulls, it is the Bulls fault and they can be sued.  So, reasonably, the Bulls want the necessary information to make that safety decision, since the fact that Curry has already decided for himself holds no weight in courts today.

I have long lamented this statist tendency to treat us all like incompetent children, effectively revoking our ability to make decisions for ourselves and our own lives.  Where the discussion gets interesting, though, is when a lawyer suggests that Curry's liability waiver should hold more water than the average person's, since he is wealthy and has access to a full range of professionals to advise him.  Which suggests that there is some point, either in terms of wealth or education, where Americans may actually regain the right to make decisions for themselves and be held responsible for them.  I remember when I was working on an acquisition of a company, and was concerned whether a non-compete agreement I had the other party sign was enforceable.  After all, I had in the past had non-competes signed by my employees routinely thrown out by judges.  My attorney told me that it is assumed that the average ordinary employee does not know what they are doing when they sign an agreement, but that wealthy business people in a transaction are treated like big boys and it is assumed they actually understand and really mean what they sign their name to.

Overlawyered concludes:

A fascinating epitomization of the litigation culture: "ordinary"
people can't make intelligent and free decisions, but elites"”presumably
including lawyers and judges"”can properly advise them how to do so.

Paul's proposed rule of emancipation upon reaching a certain wealth
level has interesting ramifications. It would be fascinating to see
what democratic political consensus would develop for where to set the
Gowder Line above which people are permitted to make free decisions.
Many doctors and attorneys would be sufficiently wealthy to qualify,
but would public interest and government attorneys protest that,
through no fault of their own, they don't have the same rights as
BigLaw partners and their children? Would college professors lobby for
the same emancipation rights as wealthy millionaires because they're
already sufficiently sophisticated? And once that happens, would the
NEA dare to suggest that teachers aren't entitled to the same status?
Before you know it, every Sneech will have a star on his belly.

I made myself clear about this long ago:  We have got to move to a point where adults can be trusted to make decisions for themselves and take responsibility for those consequences.  However, the temptation is just too great, it seems, to act like you know more about someone's best interest than they do.

Update: By the way, we discuss this all in terms of capability and competence and knowledge.  One important factor not discussed above is that every person has a different set of values.  Mr. Curry may rank the value of playing basketball, or making lots of money, higher than the risk of losing his full four-score and ten year lifespan.  Or he might feel just the opposite.  I have heard athletes who have said they would have played pro sports even if they knew for sure they would only as a result live until 50, and I have heard athletes call those others insane.  We all have different values, and even beyond relative confidence and information in making decisions, it is IMPOSSIBLE for other people to make quality decisions about your life, because they are not going to share the details of what you value and how much.  But of course they do all the time.  And if we assign others liability when we make the wrong choice in our life, then we are just asking for other people to take over our decision-making. 

In a free society, I suppose you can delegate the decision-making for your life to others, if you lack confidence in your abilities, but don't give away mine!

Update #2:  Here is another decision adversely affected by lawsuits:

We've reported before (Mar. 18, 2004)
on how, after court decisions in Arizona eroded the state's
longstanding immunity from being sued over the actions of wild animals,
lawyers began obtaining large verdicts from public managers over
humans' harmful encounters with wildlife -- with the result that
managers began moving to a "when in doubt, take it [out]" policy of
slaughtering wild creatures that might pose even a remote threat to
people. The continuing results of the policy came in for some public
discussion last month after a bear wandered into a residential area
near Rumsey Park in Payson, Ariz. and was euthanized by Arizona Game
and Fish personnel:

[Ranger Cathe] Descheemaker said
that the two Game and Fish officials were no doubt following procedure,
and that bears are routinely destroyed ever since the agency was sued
when a bear mauled a 16-year-old girl in 1996 on Mt. Lemmon near
Tucson.

"Since Game and Fish lost that lawsuit, they do not relocate any
bears," she said. "The fact that bear was in town was its death
warrant."

I fear that this administration has effectively reenacted the much-hated Alien and Sedition Acts of the early 19th century.  Using the "war" on terror as its excuse, the Bush administration is rapidly expanding its ability to grab and hold people indefinitely without charge or trial.  This is not a huge surprise -- many presidents have tried to do similar things in time of war or in reaction to internal security threats.  Much of the Patriot Act was originally proposed by Bill Clinton, after all.

What is new is that the courts and the opposition party are letting him get away with it.

The Sept. 9 court ruling concerning Jose Padilla, an
American citizen locked up in a military prison in South Carolina for
three years, is a case in point. The ruling should send shockwaves
through the American public since the decision seriously undermines
constitutional rights.

A federal appellate court ruled that constitutional rules
that apply to the police do not apply to military personnel.... The federal
government has been given a green light to deprive Americans of their
rights to due process. No arrest warrants. No trial. No access to the
civilian court system. You may not be able to see it on television, but
this court decision is the equivalent of a legal hurricane-and it is no
exaggeration to say that this is a level 5 storm with respect to its
potential havoc for civil liberties.

Federal agents arrested Padilla at O'Hare International
Airport in Chicago just after he arrived on a flight from Pakistan. The
feds claim that Padilla fought against U.S. troops in Afghanistan,
escaped to Pakistan and returned to the United States to perpetrate
acts of terrorism for al-Queda. Instead of prosecuting Padilla for
treason and other crimes, President Bush declared Padilla an "enemy
combatant" and ordered that he be held incommunicado and interrogated
by military and intelligence personnel.
Padilla has not yet had an opportunity to tell his side of
the story. For two years the government would not even permit Padilla
to meet with his court-appointed attorney, Donna Newman. Newman has
nevertheless defended Padilla's rights, arguing that the president does
not have the power to imprison Americans without trials.

Bush has not made any dramatic televised address to the
country to explain his administration's attempt to suspend habeas
corpus and the Bill of Rights, but his lawyers have been quietly
pushing a sweeping theory of executive branch power in legal briefs
before our courts.

I actually am fairly radical on this - I don't think the fact that he is a citizen or not should even make a difference.  Citizenship does not confer rights, and governments don't hand them out -- rights are ours based on the fact of our existence.   While some of the rules of due process may change for non-citizens, just the fact that they are from a different country doesn't give us the right to lock them in a room indefinitely.  This is why I support free and open immigration - there is no reason why a person born in Mexico should have fewer rights to contract with me for a job or a home than an American citizen.  The right to associate, to contract, to agree on wages, to buy a particular home, all flow from being human, not from the US government.

So I wouldn't support Padilla's treatment if he was a Iranian citizen and I certainly don't support it for an American.  Yeah, I know, he may be a bad person.  But we let bad, dangerous people out of jail every day.  Our legal system is structured based on the premise that it is worse to lock an innocent person away than let a guilty person go free.  Its a trade-off that we have made for hundreds of years and I for one am pretty comfortable with.

I also get the argument that we are at war -- in Iraq.  If someone is captured in Iraq, that may be another story.  But Chicago is not in the war zone, by any historic definition of that term (unless you want to use WWII Japanese internment as a precedent, which I doubt).  Just calling it a "war on terror" does not make Chicago a war zone any more than declaring a "war on drugs" makes Miami a war zone where suspected drug users can be put in jail without trial.  Perhaps if Bush could get Congress to officially declare war, he might have firmer legal footing, but I don't think that's going to happen.  As I wrote here:

Yes, I know that there is a real risk, in fact a certainty, that
dangerous people will be let out on the street.  But that is the bias
of our entire legal system - the "beyond a reasonable doubt" standard
and other protections of the accused routinely put bad people back on
the street.  We live with that, because we would rather err in putting
bad people back on the street than in putting good people behind bars
for life.  Give them a trial, deport them, or let them go.  Heck,
airdrop them into Paris for all I care, but you have to let them get
due process or go free.

Sure, terrorists are using our free and open society against us, and its frustrating.  But what's the alternative?  I just don't think there is a viable alternative which says that we should destroy our open society in order to save it.  We've got to learn to be smart enough to work within the rules, and it may be that we have to expect that in the future our freedom comes at some statistical increase in the danger to ourselves (by the way, isn't that exactly the trade-off we have enforced on Iraq, without even asking them -- citizens are much freer that under Saddam but at  an increased risk of terrorism?).

By the way - where the hell is Congress?  Stop grandstanding in confirmation hearings and get to work reigning this stuff in.

My liberal in-laws always give me this strange condescending look whenever it comes up that I have voted for a Republican at some point in time, that same look you might give the otherwise beloved family dog that keeps pooping on the front lawn.  As a libertarian, I seldom fully agree with any political candidate of either party.  Every election is a tradeoff:  Do I vote for the unelectable and perhaps truly odd Libertarian candidate?  Or do I vote for a mainstream party with which I disagree with about half of everything they promote?

So here is how I normally make the decision:  On pure self-interest.  Since, as a small business owner, I am much more likely to need strong protection of property rights than I am going to need an abortion, a gay marriage, or legal marijuana, I end up voting Republican more often than I vote Democrat.  For this reason, the Republican party has generally garnered a good many libertarian votes, and the two most identifiable libertarians in Congress (Flake and Paul) have both called themselves Republican, though I am sure with some reservations.

This relationship, however, may be at an end as Republicans are disavowing their libertarian wing, and returning to their large government tendencies of the 1970's.  Bush and his buddy Tom Delay are turning out to be classic Nixon Republicans.  The most recent evidence comes from the fact that the following is not from our Republican President, or our Republican Speaker of the House, but from the for-god-sakes Washington Post:

But this spirit of
forbearance has not touched the Louisiana congressional delegation. The
state's representatives have come up with a request for $250 billion in
federal reconstruction funds for Louisiana alone -- more than $50,000
per person in the state. This money would come on top of payouts from
businesses, national charities and insurers. And it would come on top
of the $62.3 billion that Congress has already appropriated for
emergency relief.

Like looters who seize six
televisions when their homes have room for only two, the Louisiana
legislators are out to grab more federal cash than they could possibly
spend usefully. ...

The Louisiana delegation has apparently devoted little thought
to the root causes of the Hurricane Katrina disaster. New Orleans was
flooded not because the Army Corps of Engineers had insufficient money
to build flood protections, but because its money was allocated by a
system of political patronage. ...

The Louisiana bill is so preposterous
that its authors can't possibly expect it to pass; it's just the first
round in a process of negotiation. But the risk is that the
administration and congressional leaders will accept the $250 billion
as a starting point, then declare a victory for fiscal sanity when they
bring the number down to, say, $150 billion. Instead, Congress should
ignore the Louisiana bill and force itself to think seriously about the
sort of reconstruction that makes sense.

The Republicans are lost.  Combine this kind of spending with their Patriot Act and Sarbabes-Oxley driven Big-Borther-Is-Watching intrusiveness, luke-warm committment to free-trade, and bizarre , and I find nothing at all attractive about the party.  Only the economic insanity of the opposition party continues to keep Republicans in power. 

More on the Louisiana money grab here.

Does this make any sense:  It costs us a lot more, for small transactions, to process an ATM / debit card with the pin pad than a credit card.  Bank of America charges a flat 60 cents per ATM card / PIN pad transaction in our stores but charges 10 cents plus 2% on credit cards.  So, on a typical $5 convenience store purchase, BofA charges $0.60 or 12% to process a ATM / debit card but $0.20 or 4% for the credit card.

I understand the difference between value- and cost-based pricing, but in an economy of scale transaction processing business with a lot of competitors, I would think debit would be cheaper to process, even without the credit risk issues. 

Customers give me feedback that I am a neanderthal for not accepting ATM cards with a pin pad at the registers.  This is the reason.  Its cheaper for me to provide an ATM and then have them pay cash - that way they pay the fee, not me.  Also, their fee is lower.  Even if they only take out $20 and pay a $1.50 fee, they are still only paying 7.5% vs. the 12% typical I would be paying.  If anyone knows a company that offers a better deal, the comment section is wide open!

Update:  A couple of notes based on the comments.  First, I do indeed understand that prices are not cost-based.  The notion that pricing should be cost-based is one of the worst economic misconceptions held by the average person (behind the commerce is zero-sum myth).  When prices don't make sense to me, I don't run to the government asking for Senate hearings so corporations can "justify" their pricing, I just don't buy from them. 

Second, to another commenter's point, most card processing agreements and some state laws prevent merchants from passing card processing fees onto consumers in a discriminatory way - ie they can be built into the general pricing but you can't charge one person one price and another a different price for the same item based on what kind of payment they use.

Katrina comes at a very bad time for US gasoline markets.  Supplies are already tight, and now a substantial amount of US oil production and refining capacity are shut in, for an unknown period of time.  Long ago, I worked as an engineer in a refinery and it can take days to get everything restarted from a cold start.  The result will almost certainly be near-term gas shortages.

There are two ways this can play out:  1)  a short term spike in prices, as much as a dollar or more a gallon or 2) long and irritating gas lines.  Lets hope that prices are allowed to reach their level and gas lines can be avoided, but who knows what political stupidities (ala Hawaii) will be proposed. 

I really, really hate gas lines.  I hate the uncertainty of whether or not I can find a station open.  I hate refilling my tank every day to make sure I am not caught short.  And for those of you who say I am arrogant since I can afford higher prices but the poor cannot, I assure you that folks who are paid by the hour are hurt much worse waiting around for hours in gas lines than the mere irritation I encounter.  More on gas line expectations as a semi-self-fulfilling prophecy here.

PS-  Expect to see news of a refinery fire or explosion over the next week.  The risk of accidents is very high when these complex plants have to start up -- they weren't really meant to be turned on and off.

Update:  First signs of a gas shortage?
Update #2:  The Mises Blog has a roundup of economics posts supporting price spikes during spot shortages (popularly known as gouging).
Update #3:  Jane Galt has more in praise of price gouging

Katrina News at Technorati

I wrote about the Vioxx decision here as another defeat for personal choice. Marginal Revolution has a good post on gaps in the anti-Vioxx science.  Here is a taste:

...[E]ven if there actually is an elevated risk of the magnitude the studies
suggest but can't prove, the question is whether I might want to accept a 1 in 4,000 risk of dying
from a heart attack in order to get the only medication timt
makes my pain bearable and a mobile life livable.  And if I say no to the
Vioxx, I may end up taking something that is less effective for my pain but has
risks of its own.

.... How did we arrive at a system in which 12 random Texans are assigned
responsibility for evaluating the scientific merits of statistical evidence of
this type, weighing the costs and benefits, and potentially
sending a productive blue-chip American company into bankruptcy protection?

Lately I have been playing with Google Earth - I love flying from outer-space right down to my house.  However, this caught my eye yesterday.  As the risk of being the last person who has seen it, A9 (owned by Amazon) has a mapping program that shows pictures of the ground level view wherever you put the cursor.  Not all roads, by any means, are covered, so turn on the "mark streets containing images" box to see with blue lines where they have pictures.  I found the user interface for scrolling the maps around and zooming pretty counter-intuitive, so its kind of immature, but it is an interesting idea to be able to know what your destination looks like and maybe look at landmarks for key intersections.  A9's original product was a yellow pages that showed what your search results looked like and plotted them on a map.

My Vioxx post below got me thinking about choices, and in particular, how we "grade" other people's choices.

My first thought on this topic is that assessing the "right" choice for an individual, when a decision affects only that one individual, can only be made by that person.  That seems like a dumb and obvious statement, but actually its fairly relevant to public policy nowadays.  Want to ride your motorcycle without a helmet?  Sorry, we think that is a bad decision and we aren't going to let you make it.   Want to reduce excruciating pain even at the risk of future heart problems?  Sorry again, can't let you do that.  Want to let Florida State continue to use your tribe's name (Seminoles) for their mascot?  Sorry, but that is degrading to you, even if you don't know it.  Want to enjoy some french fries (maybe even some Snuffers cheese fries, for those who have ever lived in Dallas) at the risk of a future heart attack - well, you can still do that, but we're working on it.  I wrote much more on this topic here.

Beyond the moral problem I have with having the government limit our ability to make decisions for ourselves, the fact is that we are generally really bad at assessing other people's choices.  I will make the analogy using blackjack.  I remember sitting at a table in Vegas and watching some woman take a hit on 18.  For those who don't know blackjack, trust me - you are always statistically reducing your odds of winning when you hit an 18.  Anyone, the woman draws a three, for a perfect 21, the dealer reaches 20, and she wins the hand.  Several people around the table said to her "great decision to take another card".  No it wasn't!  It was stupid!  It was a bad decision that, in this particular case, she was bailed out of by good fortune, but over the long haul of hitting 18's, she's going home broke.

Lets take a second example.  I buy liability insurance for my company every year.  Because I am in a public contact business, which makes us a particular target of the litigation industry, we pay nearly $100,000 a year for the policy.  Last year, we had no claims.  Does this mean that I made a bad decision buying insurance last year, because it turned out that we had no claims?  No, of course not.  It would be irresponsible in today's litigious environment to engage in unprotected business.   The insurance is a smart decision, even in years without claims.

But juries always assess choices based on the outcomes, not on the inputs the individuals involved were facing when they made the choices.  In the hands of a good litigation attorney, a jury will always find that hitting on a 12 in blackjack and drawing a king was a bad decision, even when the dealer is showing an ace and the odds say you HAVE to draw. 

Which brings us back to Vioxx.  Lets imagine ten thousand people who have excruciating pain, pain that prevents them from actively participating in and enjoying life, that choose to take Vioxx, knowing that there is a tiny risk of heart problems.  9,999 live a better life.  One man dies.  A jury eventually decides that the one man made a bad decision (since he died).  I would argue that the man who died did not make a better or worse decision than the other 9,999.  He made what he thought was a good decision, the same decision all the others made; he just happened to be the one who came out unlucky, but they all knew going in that someone in their group would probably draw the short straw.

Postscript:  Of course, no one ever thinks its going to be them who draws the short straw.  There is a famous story from WWII about a soldier being told with his company that two out of every three of them would likely die in the coming D-Day invasion.  The soldier looked to his comrade on his left, and then the man on his right, and thought "poor bastards".

I won't go too much into the details of the recent Vioxx jury verdict.  Professor Bainbridge has a complete roundup which is worth reading, and Reason had an analysis of the merits of the case a while back.  Though its not really the point of this post, I can't resist a few snippets:

Jurors who voted against Merck said much of the science sailed right over their
heads. "Whenever Merck was up there, it was like wah, wah, wah," said juror John
Ostrom, imitating the sounds Charlie Brown's teacher makes in the television
cartoon. "We didn't know what the heck they were talking about."

One juror considered the fact that the CEO, whose company faces thousands of law suits, didn't show up as an admission of guilt:

... [juror] Ostrom, 49, who has a business remodeling homes, was also disturbed
that former Merck Chief Executive Raymond Gilmartin and another top Merck
official gave videotaped testimony but weren't in the courtroom. "The big guys
didn't show up," said Mr. Ostrom. "That didn't sit well with me. Most definitely
an admission of guilt."

And of course there is this now famous gem:

One juror, Ms. Blas, had written in her questionnaire that she
loves the Oprah Winfrey show and tapes it. "This jury believes they're going to
get on Oprah," Ms. Blue told Mr. Lanier. "They only get on Oprah if they vote
for the plaintiff."

Read the Bainbridge post, it has much more.

Anyway, the point of this post is that this verdict represents a very dangerous assault on individual choice.  Recognize that there are many, many activities in life where individuals are presented with the following choice:

If I choose to do X, my life will be improved in some way but I may statiscally increase my chance of an early death.

You may react at first to say that "I would never risk death to improve my life", but likely you make this choice every day.  For example, if you drive a car, you are certainly increasing your chance of early death via a auto accident, but you accept this risk because driving allows you to get so much more done in your life (vs. walking).  If you ride a bike, swim, snow ski, roller blade, etc. you are making this choice.  Heck, everyone on the California coast is playing Russian Roulette with an earthquake in exchange for a great climate, beautiful scenery, and plentiful jobs.

The vast majority of drugs and medical therapies carry this same value proposition:  A drug will likely improve or extend your life in some way but carries a statistical chance of inducing a side effect that is worse than the original problem, up to and including death.  The problem is that we have structured a liability system in this country such that the few people who evince the side effects can claim more money in damages than the drug was worth to all the people it helped.  For example, if a drug helps 999 people, but kills the thousandth, and that thousandth person's family is awarded $253 million in damages (as in this case), the drug is never going to be put on the market again.  Even if the next 1000 people sign a paper saying we are willing to take the one-in-a-thousand risk to relieve the pain that is ruining our lives, they still are not going to get the drug because the drug companies know that some Oprah-loving jury will buy the argument that they did not understand the risk they were taking and award the next death another quarter of a billion dollars.

This exact same effect nearly killed the vaccination industry.  In the end, Congress had to pass legislation  immunizing (ha ha) vaccine makers from lawsuits when known 1-in-10,000 side effects occur.  While I am not a big fan of the FDA, if it is going to exist and put drugs through 20 years of tests and a forest full of paperwork to get approved, I think that approval process should confer some sort of litigation immunity. 

By the way, have you noticed the odd irony here?  Robert Ernst (the gentleman who died in the Vioxx case) is assumed, both by the FDA and the litigation system, to be unable to make informed decisions about risk and his own health.  But a jury of 12 random people who never experienced his pain can make such decisions for him?  And us?

Richard Epstein said it better than me, in the WSJ but I will like to Reason which is free:

I would like to send my message to [plaintiff's lawyer Mark] Lanier and
those indignant jurors. It's not from an irate tort professor, but from
a scared citizen who is steamed that those "good people" have imperiled
his own health and that of his family and friends. None of you have
ever done a single blessed thing to help relieve anybody's pain and
suffering. Just do the math to grasp the harm that you've done.

Right now there are over 4,000 law suits against Merck for Vioxx.
If each clocks in at $25 million, then your verdict is that the social
harm from Vioxx exceeds $100 billion, before thousands more join in the
treasure hunt. Pfizer's Celebrex and Bextra could easily be next.
Understand that no future drug will be free of adverse side effects,
nor reach market, without the tough calls that Merck had to make with
Vioxx. Your implicit verdict is to shut down the entire quest for new
medical therapies. Your verdict says you think that the American public
is really better off with just hot-water bottles and leftover aspirin
tablets.

Ah, you will say, but we're only after Vioxx, and not those good
drugs. Sorry, the investment community won't take you at your word. It
realizes that any new drug which treats common chronic conditions can
generate the same ruinous financial losses as Vioxx, because the flimsy
evidence on causation and malice you cobbled together in the Ernst case
can be ginned up in any other. Clever lawyers like Mr. Lanier will be
able to ambush enough large corporations in small, dusty towns where
they will stand the same chance of survival that Custer had at Little
Big Horn. Investors can multiply: They won't bet hundreds of millions
of dollars in new therapies on the off-chance of being proved wrong.
They know they'll go broke if they win 90% of the time.

Your appalling carnage cries out for prompt action. Much as I
disapprove of how the FDA does business, we must enact this hard-edged
no-nonsense legal rule: no drug that makes it through the FDA gauntlet
can be attacked for bad warnings or deficient design.

Actually, there is no pilots union in the military, perhaps fortunately, because they likely would have opposed the creation of un-manned drone aircraft such as the Predator, which has been wildly successful in Middle East operations.  Current aircraft have both reconnaissance and air-to-ground attack capabilities.  These aircraft are piloted from the ground by ex-fighter pilots, but the next generation will be able to take off and land themselves, obviating the need for even a ground pilot.  Wired has a longer article on these cool drones.  Beyond the obvious reduction in risk to humans, the drones also have the advantage of being substantially less expensive than human piloted fighter craft -- as little as $15 million apiece, even for the next generation tricked up models.

A woman in Nigeria wants to buy 10 of my wife's handbags.   Right now, we have paypal's foreign credit card option turned off, and of course the Nigeria angle sends off warning bells.  Are there any good ways to accept money from Nigeria with minimal risk of fraud?

A few days ago, I spilled a lot of electrons discussing the sources of wealth and poverty. This week, Arnold Kling has a great article applying many of the same concepts to give advice to Live8 and others who want to eliminate poverty.  While I droned on for about 30 inches of computer monitor space, Robert Lucas's quote in Kling's article gets to the heart of the issue in just a few lines:

"of the vast increase in the well-being of hundreds
of millions of people that has occurred in the 200-year course of the industrial
revolution to date, virtually none of it can be attributed to the direct
redistribution of resources from rich to poor. The potential for improving the
lives of poor people by finding different ways of distributing current
production is nothing compared to the apparently limitless potential of
increasing production."

He concludes with some advice for protestors:

1. The world is a complex place. The farther you are
removed from a situation, the less likely that your intervention there will do
good and the greater risk that it will cause harm. No matter how thoughtfully it
is administered, long-distance aid will tend to be
ineffective.

2. The easiest poverty to prevent is poverty that is
close by. By developing useful skills and remaining employed, you can help keep
yourself and your family out of poverty. That makes you less of a burden on the
world than if you fly half way around the world to stage
confrontations.

3. Learn to distinguish motives from consequences. A
well-meaning policy can backfire. The seemingly cold-hearted impersonal market
is enormously beneficial.

4. Poverty is not a simple problem. See What Causes
Prosperity?

5. Remember that unlike the Folk Song Army of Tom
Lehrer's song, you have no monopoly on good intentions. A morality play in which
those who care crusade against those who are square makes for great theater.
However, it is not a realistic basis for economic policy.

As a parting shot, I noted previously the odd contradiction that is inherent in many G8 and similar protestors who purport to want to eliminate poverty:

In a nutshell, they want to fix poverty in the third world by
disavowing everything -- private property rights, individual
enterprise, free commerce, entrepreneurship, individual freedoms, etc.
-- that made the G8 not impoverished.  Rich nations, you have to help
the poor nations, but whatever you do, don't allow they to emulate what
you did to get rich. 

This is so nutty its unbelievable.  If they were camping outside of
the G8's door and saying that we want you to drop trade barriers on our
goods and help us foster entrepreneurship and we want your help
promoting private investment in our economy and infrastructure, I could
understand perfectly.  This is like activists camping outside of Jack
Welch's door looking for him to help the poor by funding programs to
teach children to drop out of school and avoid getting a jobs.

This is something our company has encountered a couple of times now:  There is apparently danger nowadays in posting warning signs.  Apparently, courts and juries are taking the position that by posting any warning at all, you are communicating to the public that you are taking on the task of warning them about any possible danger.  Then, when someone gets hurt by something you did not warn them about, they can argue that you are liable. Via Overlawyered:

Putting up signs warning visitors of the dangerous rip currents off New Jersey's
Long Beach might seem like an obvious step. "However, Long Beach Township
Attorney Richard Shackleton said there are liability issues to consider.
According to the law, the town does not have to warn people about natural
conditions, and if Long Beach put up a sign and a jury found its warnings to be
inadequate, the town could possibly be found liable for a drowning or injury.
Having no signs, he said, reduces the risk of being sued."

We have similarly had our attorneys and/or insurance inspectors recommend we take down a number of warning signs for this reason.  I have no idea how this outcome can be in the public interest.

Apparently, the mortality rates from obesity that the media has been breathlessly lecturing us with were overestimated by at least 1500%:

But in a study released this week by the CDC
and published in the Journal of the American Medical Association ("Excess Deaths
Associated with Underweight, Overweight, and Obesity"), the public health
community has finally owned up to their massive fib by acknowledging that the
number of deaths due to obesity in the US is closer to 26,000 not 400,000 as
previously reported.

The part of the earlier study that really got people's attention was the fact that even those slightly overweight but well short of obese had a significantly increased risk of death.  Now, the CDC channels Emily Littella in saying "never mind":

for the merely overweight with BMI's from 25-30 there is no excess mortality. In
fact, being overweight was "associated with a slight reduction in mortality
relative to the normal weight category." Being overweight not only does not lead
to premature death, something that dozens of other studies from around the world
have been saying for the last 30 years, but it also carries less risk from
premature death than being "normal" weight. In other words the overweight=early death "fact" proclaimed
by the public health community is simply not true.

In fact, the study argues, the risks from being underweight are greater than overweight, something that resonates with me having known two women who died due to complications from anorexia.

Other studies will have to replicate these findings, but this study does seem to have taken a more careful approach than previous approaches.  One thing you can be sure about, is that this will not stop lawsuits against fast food companies, since overwhelming medical evidence of the safety of breast implants has not stopped litigation in that arena.  Heck, the fact that most people who are suing asbestos companies admits they are not even sick has not stopped litigation in that arena.

When it comes to defending abortion, women's groups are great libertarians. They will point out that abortion is about the right to choose and about protecting the "fundamental civil and human right of women to make the most intimate decisions about their bodies and their lives".  Its about not letting the government interfere with individual decision-making or a "woman's right to privacy".  Its about assuming women are grown-up enough to make difficult choices about their fetus and their own health and safety.  Opponents of such choice are "ultra-conservatives trying to deny women control over their own bodies".  (all quotes from the NOW web site).

So, women's groups seem to be good libertarians concerned with the primacy of women's decision-making over their own body.  Except when they're not.  NOW has been feverishly campaigning to get the government to limit a women's right to choose breast augmentation, despite the fact that the science is overwhelmingly behind the safety of implants.  Sure, as in any medical procedure, there are some risks, but I defy anyone to tell me that the risks associated with breast implants are greater than the risks associated with abortion.  Abortion is a much weightier and more difficult decision, and, unlike breast implants, it is irreversible.  If women are mature enough to make abortion decisions, they certainly are mature enough to weigh the risks of breast implants.  Or take the birth control pill -- the impact to a woman's body of silicone sacks in their boobs is far less than that of trashing their entire hormone balance.  Sure, the pill makes sense for a lot of people and its great that the option exists, but don't tell me that the the changes the pill engenders in the body are OK but bags of silicone are not.

The real issue, as pointed out early and often by Virginia Postrel, is that feminists consider breast implants as at best frivolous, and at worst a demeaning surrender to male objectification of the female's body.  They don't think women who choose these implants are making the right choice, so they, in their elite holier-than-thou wisdom, want to take the decision away from women.  Hmmm.  Freedom for me but not for thee.  More along the line of distrusting individual decision-making here.

Update:  My main point of this post was on breast implants, and comparing feminist retoric on that issue vs. their retoric on abortion.  I feel the need, though, to mention that I don't accept that abortion is necesarily a pure individual choice situation.  Individual decision-making should be trusted when individuals make choices that affect only themselves, without coersion or fraud.  The problem in the case of abortion is whether the fetus is a piece of tissue that is a part of a woman's body, or an independent life.  In the former case, its removal is subject to individual decision making, but not in the latter.  As I have written before, I think the fetus is protoplasm at 1 week and a baby at 8 months.  At some point in between we draw an arbitrary line between part-of-the-mom and independent life.

Many abortion supporters, unwilling to risk that society might draw this line earlier in the pregnancy than they might want it, take the extra step of arguing that the very determination of whether the fetus is a life or not at 2 or 5 or 7 months should be up to individual taste, and that the government should have no say in that determination.  That strikes even me as the hardcore libertarian as going too far.  Certainly in its limited role of protecting individual rights, the government has a role in determining just who is an individual with rights subject to protection.  Determining if a fetus is an individual with independent rights and at what point in the pregnancy it is treated as such are reasonable roles for government legislation.

Its pretty clear that open academic discourse is on life support at Harvard in the wake of the recent Larry Summers vote of no confidence.  Now, there is a question about whether simple entrepreneurship can survive.   Via Cafe Hayek, several Harvard students created dormaid to provide maid services to dorm students that wanted to pay for it.  Seemed like a great idea to me, which I would have loved at school, but the Harvard student magazine has hammered the entrepreneurs:

By creating yet another differential between the haves and have-nots on
campus, Dormaid threatens our student unity.... We urge the student
body to boycott Dormaid

Socialism has been rejected by countries around the world.  It seems like it is still alive and well at Harvard.  Here is the angst coming through of a frustrated top-down Stalinist planner:

A service like Dormaid can bring many levels of awkwardness into this
picture. For example, do two people sharing a double split the cost?
What if one wants the service and the other does not? What if one
cannot afford it? Hiring someone to clean dorm rooms is a convenience,
but it is also an obvious display of wealth that would establish a
perceived, if unspoken, barrier between students of different economic
means.

Here is the Cafe Hayek response:

This episode is too typical. An enterprising soul perceives a need
and creatively offers a product or service -- at his own financial risk
-- to satisfy that need. Everything is voluntary. No one is forced to
buy the service; no one is forced to work for it. But well-read
ignoramuses, infatuated with their own imaginary higher capacity for
caring for others, viscerally react against commercial exchange. In
this case, those opposed to Dormaid worry that because some but not all
students will find it worthwhile to buy maid service, "inequality"
among the Harvard student body will increase.

Is the typical Harvard student so immature that he suffers envy when
some of his fellow students buy maid service that he chooses not to
buy? (Bonus question for economics students: Why did I say "that he
chooses not to buy?" rather than "that he can't afford?")  Is he so
sensitive, so very, very tender, that he loses emotional stability at
the sight of a friend's dorm room freshly cleaned by maids?  Is he so
intellectually and socially inept that he can't work out an amicable
arrangement with his roommate if one wants to use Dormaid and the other
prefers not to do so?

Read the rest - Cafe Hayek has links to the original Harvard Crimson article.  I will tell you that my roommates would have been fine if I had used this service in college.  In fact, I was such a mess that they might have paid for it for me!

A while back I wrote a series of posts here, here, and here on buying a small business.  One of the things I said in that post was:

Then, there are the banks. From my experience, it is very, very
difficult to get a bank to make an collateralized loan - i.e. a loan
that is secured only by the cash flow of a company rather than by
assets. In fact, I have never been successful at that. About the only
way that I have found that banks will make a loan is if it is an SBA
loan, where the SBA basically guarantees the loan for the bank. The SBA
goes through cycles of being very open to lending to being very tight.
I have not dealt with them for over two years, so I don't know what
their stance is today. Remember, though, that the SBA is not going to
approve any loan where the buyer has no experience in the industry or
where the buyer is not putting down his own money as well. The SBA has
a lot of information here.

This statement is still mostly true but I have learned a lot over the last couple of months.  The following is an update.

One of the things they tell you all the time in business school, but frankly I always found impossible to really internalize, was how much cash growth takes.  I guess I always thought of businesses with cash flow problems as being unsuccessful, slowly sliding down the drain and trying to make ends meet.  Wrong.  Growth is tremendously expensive.  And stressful.

My business is based on concession contracts.  Each winter, we are usually presented with the opportunity to bid on many contracts.  We narrow the field down to 4-6 we bid on, hoping to win about 2.  One of the things I did last year was greatly improve our standard bid materials, hoping that would help us win good projects.  Did it ever.  We bid on 6 last year and we won 6 (including Burney Falls, Pyramid Lake, and Lake Havasu).  Yea!  But then I began adding up all the investments in new inventory, new equipment, salary (you always have to hire people before the first revenues come in), licenses, building improvements, etc.  Eeek!

After a lot of work with bankers, I stand by most of my statement above.  Most bankers will not lend to businesses on cash flow, and always want some type of collateral (like my home equity).  Over time, though, I have found a few bankers who are willing to lend on cash flow and really understand business growth and why maybe I don't want to have my business's growth rate limited by how much equity I have in my personal home.  There are bankers who will put together packages of long-term loans backed by the SBA plus short term working capital loans that will now let me grow faster.  The folks at Copper Star Bank, for example, have been great. 

One of the reasons I felt the need to post this update is that I have been told that my difficulty finding a good business banker was due in part to my location here in Phoenix.  The Phoenix banking market is very real estate driven, so bankers usually come from that background rather than a business background.  I am told that those of you on the east coast or in the Midwest may have an easier time finding good business bankers.

Postscript: By the way, you might ask how I feel as a small government libertarian about accepting the government subsidy implicit in an SBA loan.  The answer is "conflicted".  Some libertarians are fine accepting government services, on the theory that they certainly have paid for them with all their taxes.  Some try to avoid government services, but that is almost impossible in today's world (such as using government roads).  I generally try to be pragmatic, operating somewhere in the middle.

As far as SBA loans go - I don't know what the commercial banking world would look like without SBA loans.  I think that the banking world would have found an alternative way to mitigate the risk (e.g. via securitization) without the government gaurantee, but we can't know.  The fact is that SBA gaurantees exist and banks would be crazy not to use the gaurantees in making business loans.  So, the reality is, if I want a cash flow based loan for a company my size, it will likely carry the SBA gaurantee.  My appologies to all those whose taxes support my loan gaurantee.

I have written several times that one of the perverse effects of lawsuits aimed at unsafe products is that they generally punish any company that has an open, honest internal debate on safety.  However, as I wrote here, that honest internal debate is critical to selling safe products and services.

Today, Marginal Revolution links a New Yorker article that points out the same deadly paradox:

Merck would seem to have one big thing in its favor: the company voluntarily withdrew Vioxx from the market. But while Merck executives may have hoped to persuade people that they were acting responsibly, plaintiffs' attorneys have taken the withdrawal as an admission of guilt...internal company documents show that Merck employees were debating the safety of the drug for years before the recall.

From a scientific perspective, this is hardly damning. The internal debates about the drug's safety were just that"”debates, with different scientists arguing for and against the drug....While that kind of weighing of risk and benefit may be medically rational, in the legal arena it's poison. Nothing infuriates juries like finding out that companies knew about dangers and then "balanced" them away. In fact, any kind of risk-benefit analysis, honest or not, is likely to get you in trouble with juries....Viscusi has shown that people are inclined to award heftier punitive damages against a company that had performed a risk analysis before selling a product than a company that didn't bother to. Even if the company puts a very high value on each life, the fact that it has weighed costs against benefits is, in itself, reprehensible. "We're just numbers, I feel, to them" is how a juror in the G.M. case put it. "Statistics. That's something that is wrong."...

Before a jury, then, a firm is better off being ignorant than informed.

Over the last two days, Phoenix put out an order to boil tap water before drinking and not to bathe or shower.  Many restaurants closed for the two day period, and many many people went out and loaded up on expensive bottled water.

What I found interesting was that through the whole "crisis", and now after the fact, Phoenix officials continued to say that they thought the water was safe, that they had not gotten any bad test results, but that people still shouldn't use the water "as a precaution".

Given the current state of liability and torts, I probably would have done the same in their shoes, but is this really the world we want?  There are costs to shutting off water in a city of 2 million plus people.  Shouldn't those costs be justified by some real risk? 

When I was an engineer, my job was often to rule on whether some condition was "safe".  Every day I had to make decisions like "should we shut this part of the plant down, or can we keep running it safely".  Certainly we wanted to err on the side of safety, but ruling every little concern as cause for shutdown would have caused the plant to be shut down almost all the time.  In that job, I had to take responsibility and make a decision, balancing risks and costs.  People want to say that shutting the plant (or the water system) at every hint of a problem is the "responsible" thing to do -- but in fact it is just the opposite.  It is an avoidance, both of decision-making and responsibility.

Unfortunately, no one wants to make such decisions anymore.  My wife's mammogram had something on it the doctor said he was 100% sure was just an artifact of the photography, but to cover his butt he said he had to get her to go have a biopsy (painful, expensive, and time-consuming) which was of course negative.  We are loading the economy down with risk-defense costs, an invisible tax that is already hammering the medical field.

But beyond just the costs, at what point does this hair-trigger defensive posture lead to a chicken-little syndrome where no one pays attention to warnings any more?  I know that the next time we get a warning about Phoenix water, I will be much less likely to be careful, because I remember that the last time nothing was really wrong with the water.  How many people pay attention to homeland security alerts any more?  Do you even bother to read warning labels any more, on the off chance it is a useful warning and not a "this toaster should not be used as a water ski" type warning?

As a follow-on to the issues I raised in this post about the FDA making our risk-reward choices for us, comes this tongue-in-cheek suggestions from Café Hayek:  Lets start the FCA, the Federal Car Administration, to approve cars for consumer use:

Choices would be few.  Because of the high costs of the approval process, only cars that appealed to large numbers of consumers would receive attention from the manufacturers.  On the plus side, the cars that did survive the process would be very safe and very good cars.  They'd have to be.  Manufacturers would want to reduce the odds of failure to avoid a ten year approval process that resulted in rejection.

It would be great, assuming the bureaucrats in Washington would make exactly the same choices that you would.  In other words, it would be great if we all wanted to drive identical Ford Taurus's.

If you think this suggestion is just ridiculous humor, ask yourself whether this is what Ralph Nader has been after all along.

I mentioned in this post on individual choice the example of the FDA risk-reward decisions for Americans as a whole, an impossible task when each individual's needs and decision making are different (also see here).  This is a couple of weeks old, but is a good article from USAToday about the millions of people who are suffering in the wake of Vioxx's removal from the market. 

Sales of the drug were halted worldwide on Sept. 30, after a study showed it doubled the risk of heart attack and stroke. But, for Rubinstein, relief trumps risk.

Vioxx "was the best pain drug I had been on in 27 years," says the 47-year-old Manhattan resident, who has fibromyalgia, a chronic condition that causes pain in muscles and joints. "I felt good enough to do some exercise. Getting to work was not such a difficult thing.

These people would gladly accept the increased risk of heart problems to reduce their debilitating pain, if only the government and/or the courts would allow them to make this choice.  (yes, I know that Vioxx was pulled by the maker, but this is only anticipation of a tort system that punishes the manufacturer for informed choices made by individual users).

Update:

This is a good post from Cafe Hayek on presecription drugs and individual choice

I have mentioned on a number of occasions that journalists seldom get science stories right.  Most journalists have no science background (if they were good at math and science, they would not have been journalism majors) and they and their employers have huge biases towards spinning every science story as an end-of-the-world disaster.  I remember when I lived in St. Louis we used to say that the local TV stations accurately forecasted 12 of the last 4 blizzards.

Here is a good story and analysis from Satblog analyzing one of the news stories popping us saying that we in the US are all at risk from 100 foot tsunamis or whatever.  The blog calls a recent Dallas Morning News front page story about a tsunami that could wipe out all of Florida

a great example of the crap that passes for science reporting these days, and demonstrates a fundamental misunderstanding of the scientific process.

This is wrong, wrong, wrong.  Yes, I know that there is a real risk, in fact a certainty, that dangerous people will be let out on the street.  But that is the bias of our entire legal system - the "beyond a reasonable doubt" standard and other protections of the accused routinely put bad people back on the street.  We live with that, because we would rather err in putting bad people back on the street than in putting good people behind bars for life.  Give them a trial, deport them, or let them go.  Heck, airdrop them into Paris for all I care, but you have to let them get due process or go free.