Protecting Our People

by hilzoy

Exhibit A, from Ezra Klein:

Ezra adds: "Our spending is 43 percent of the total. Not the total on that chart. The total of the world." (Figures for 2005; source here.)

Exhibit B, from the NYT:

"The Food and Drug Administration is so understaffed that, at its current pace, the agency would need at least 27 years to inspect every foreign medical device plant that exports to the United States, 13 years to check every foreign drug plant and 1,900 years to examine every foreign food plant, according to government investigators.

Computer systems at the drug agency are so inadequate that it can only guess the number of the plants, and it cannot produce a list of those that have not been inspected. The situation is particularly dire in China, which has more drug and device plants than any other foreign nation but where F.D.A. inspections are few.

These findings come from a series of reports by the Government Accountability Office — obtained by The New York Times — scheduled to be released Tuesday at a hearing of the House Energy and Commerce Committee.

The reports and a recent assessment by the agency’s Science Board conclude that the F.D.A. is so overwhelmed by a flood of imports that it is incapable of protecting the public from unsafe drugs, medical devices and food.

“This is a fundamentally broken agency, and it needs to be repaired,” said Peter Barton Hutt, a former top lawyer with the agency who will testify Tuesday before the committee.

Warnings about some of these problems have been sounded for years. And there have been fitful efforts at an overhaul. Last year, Congress passed and President Bush signed a law that changed the way the F.D.A. regulated the drug industry.

But recent disasters involving several of the agency’s crucial responsibilities — a withdrawn painkiller, an unsafe implantable heart defibrillator, deadly pet food and contaminated spinach — led to multiple Congressional investigations that came up with the same finding: After decades of political neglect, the agency is near the breaking point. As a result, there are growing calls on Capitol Hill to provide the agency with substantially more money."

Exhibit C: the laboratory responsible for safety testing of all toys imported into the US:

Surely, somewhere in the more than half a trillion dollars we now spend annually on the military, there must be some small amount that would be better spent on improving the FDA, the CPSC, or another of the agencies that are charged with protecting the public, as the Department of Defense is. Suppose, for instance, that we had not invaded Iraq, and had spent just one percent of the nearly half a trillion dollars we have now spent reducing Iraq to chaos on those two agencies. Over the five years since the war began, that would come to about a billion a year. The FDA has requested $2.1 billion for 2008; the CPSC (pdf) wants a mere $63,250,000. An extra billion a year would have bought a whole lot more testing for lead-tainted toys, toxic drugs, and defective stents. We could have used the remaining $495billion to pay down the deficit, or repair our crumbling infrastructure, or do some other worthy thing. Nearly four thousand of our soldiers, and God alone knows how many Iraqis, would still be alive.

And, unlike the war in Iraq, this would actually have made us safer.

Comments

[Hartmut]

The given number for US military spending is actually not the whole thing because lots of things are not on the offical DoD budget (e.g. nukkular wep-ons are under the Energy department). I have read comparisons that take all military-related expenses together and went far above the 50% of our planet's spending on that.
I also read that Bush is asking for another off-the-Pentagon-budget tuppence of $70 billion.

[LT Nixon]

Hmm, maybe if our NATO allies chipped in a little more on military spending, and a little less on quasi-socialist programs, we could get some more much needed help in Afghanistan.

As for the Iraq war, I can't argue with you there, Hilzoy, this place is a total money pit.

My argument for spending the most on the military, with regards to tax dollars, is that it is fundamentally the job of the federal government: to protect its citizens' life, liberty, and property. I still lean towards the free market in a lot of other sectors as opposed to the state fouling it up.

[Brett Bellmore]

And do you suppose there's anybody running for President besides Paul who would actually attempt to change that pie chart?

Anyway, I wonder how China is totaled up; One of the weird things about their system is that the military is largely self funded, by running and profiting off it's own businesses. Which businesses are largely exempt from regulatory oversight, and otherwise specially privileged, precisely because the Chinese government doesn't want to put the full cost of the military on budget, and so can't permit those businesses to go under or fail to show a profit.

[Barnabas]

You realize that by saying this you are emboldening shoddy toymakers the world over... I just got a vision of a cave full of fundamentalists fashioning deadly carebears.

Even if the number for China was actually three times bigger it is still a big difference... For that kind of money you would expect at least an Empire.

[Barrett Wolf]

Barnabas... for that kind of money I'd expect a successful and prosperous empire, damn it!

[KipEsquire]

Of course, there's no reason why safety and quality inspections and certification couldn't be done privately.

We do it all the time: Underwriters Laboratories, Good Housekeeping seal, Consumer Reports, Moody's. Not to mention Zagat, TripAdvisor -- the list is endless.

And those who performed such certifications for profit would, contrary to liberal malcontents, do it far better than the FDA, CPSC, etc., who have no incentive to "do it right," or politicians who have incentive to "fund it right."

The question is not one of, "Why spend more on defense than on safety inspections?" The question is which is the legitimate public good and which is not.

[KipEsquire]

politicians who have NO incentive to "fund it right." Gack.

[Gary Farber]

Hurting the Army.

"One of the weird things about their system is that the military is largely self funded, by running and profiting off it's own businesses."

That's not uncommon in some countries. Pakistan, for instance.

[John Thullen]

Along with the 15% flat tax imposed in Iraq, you would think that the Chinese government's ground-breaking concept of a privatized and unregulated military would cause a massive migration of dyspeptic libertarians, Blackwater mercenaries, and a sizable contingent of House Republican lawmakers to pull up stakes and move out of the U.S. to live in their theoretical paradises made real.

No such luck.

As to the photo of the F.D.A. lab that tests imported toys for safely, Hilzoy's per usual tendentiously biased cropping leaves out the rest of the story.

If you pan to the right, you will find the F.D.A. volunteer toddler testing staff, in the shank of their teething stage, busily gnawing on Barbie's jewelry, tiny cars, and those toy anti-personnel devices kids are so fond of.

Even that doesn't tell the whole story, because most of the toddlers work from home, which saves the taxpayer transportation and socialist daycare dollars; plus it keeps those fascist Swarthmore coeds who weasel their way into jobs perverting our Nation's youth from snatching away the toddlers' daily prescribed source of lead and heavy metals.

You know, it wasn't so long ago that liberal busybodies decided for us that toddlers in Newark, who were perfectly happy to volunteer their services, free of charge, to eat flakes of lead paint off baseboards, thereby recycling the lead into the precious environment, should be replaced by taxpayer-funded do-gooders who accomplish the same task at higher cost, though we've still managed to not pay their medical insurance bennies.

But you just wait, because that bastion of freedom is about to fall too, expanding government and killing the spirit of volunteerism that the for-profit sector has fled our shores to preserve.

Should Ron Paul become President, a little-known plank in his shabby little shed held together by rusty ideological nails is to put those volunteer toddlers back to work solving the problem of what to do with all of that nuclear waste we are sure to produce if we are to solve our energy problems now that world oil producers have given up volunteering to supply energy below cost to America.

He has a vision of plutonium-laced baby food, baby cribs constructed of treated uranium tailings which could be weaponized at a moment's notice, and teething rings that glow unregulated in the dark.

Or else he threatens to move to China.

P.S. I favor nuclear power, should various technical issues be resolved, but I never let coincidence get in the way of some cheerful eye-poking, which some cranky regulator is soon bound to curtail, the poops.

[John Thullen]

Kip Esquire:

Moody's you say.

The same folks, with help from their other private sector colleagues, who were incentivized to rate what, a trillion or so dollars of funky illiquid paper AAA so that it could be packaged into "financial instruments" like razor blades in a Halloween Mars bar, and passed off into every bank, money market, and bond fund portfolio the world over.

Actually, I think "politicians who have incentive to fund it right" was the correct wording. Well, last week when everyone was complaining that politicians spend too much of our money.

I long for the good old days when folks complained that regulators were too effectual, too overbearing, overfunded, and doing too good of a job.

Actually, the politicians who were elected and thus incentivized to fund regulation improperly came on the scene, as I recall, in 1980, with a second wave in 1994.

Now we're told by the same folks that the regulators are misappropriated and falling down on the job.

Which is it?

Not that the other side wasn't incentized or disincentivized at times by their private industry clients in our Pavlovian world of involuntary salivation.

I have no problem with private entities, profit or non-profit, doing the work. But they kind of missed the boat on the imported quality problems.

Mattel didn't step up and volunteer to have their products lead tested. They moved abroad to escape government regs and they didn't call up the Good Housekeeping Seal of Approval people to come down to the docks and lick their products to clue the public in.

And I want to see the writers and editors of Consumer Reports (which last I heard were a bunch of liberal crybabies) start skulking around factories in China and then see what sort of visa problems they have on their next trip.

It took notice by the awful Federal Government and State governments for anyone in the private sector, Mattel (to pick on them) or the certifying companies to think to themselves that there might be a marketable idea in screening products from abroad, rather than counting on the unaccountability and secrecy of selling the American consumer tainted stuff.

I generalize unjustly, sure. Who doesn't?

[Bernard Yomtov]

We do it all the time: Underwriters Laboratories, Good Housekeeping seal, Consumer Reports, Moody's. Not to mention Zagat, TripAdvisor -- the list is endless.

I wouldn't be touting Moody's work right now. And testing toy safety is not quite the same as reporting on what's a good restaurant or nice hotel.

As for Good Housekeeping:

Since 1909, the Good Housekeeping Seal has been a highly recognized statement of the magazine's renowned Consumer's Policy. The Good Housekeeping Consumer's Policy, published in every issue of the magazine, states that if a product bearing the Seal proves to be defective within two years of purchase, Good Housekeeping will replace the product or refund the purchase price.

The Seal may be carried only by those products whose ads have been reviewed and accepted for publication in Good Housekeeping.

Not quite what we're after.

UL may be OK, but its model of laboratory inspection paid for by manufacturers is not universally applicable.

And those who performed such certifications for profit would, contrary to liberal malcontents, do it far better than the FDA, CPSC, etc., who have no incentive to "do it right," or politicians who have incentive to "fund it right."

UL and Consumer Reports are non-profit.

"Why spend more on defense than on safety inspections?" The question is which is the legitimate public good and which is not.

It is very clear that information about safety is a public good just as much as national defense. Consumption is non-rival, and it is also difficult or impossible to exclude non-payers. As such it will be undersupplied - that is, supplied at less than the most efficient amounts - by private producers.

[hilzoy]

LT Nixon: "My argument for spending the most on the military, with regards to tax dollars, is that it is fundamentally the job of the federal government: to protect its citizens' life, liberty, and property. I still lean towards the free market in a lot of other sectors as opposed to the state fouling it up."

I'm fine with spending most, by a considerable margin, on the military, especially now, when we are going to have to spend a lot of money replacing things and trying to do right by the people who have served in Iraq and Afghanistan. On the other hand, I do suspect that somewhere in the vast amount of money we spend on defense, there must be something we don't actually need.

I mean: thinking that we spend too much on defense is like thinking that taxes were too high in Sweden in the 1970s:people with very, very different opinions can agree on that. Given how much we spend, the people who think we spend too much can range from Quakers to people like me, who really want to do right by the military but think: even so, is it obvious that we need all those weapons systems? To defend ourselves against those other countries on the graph, who are spending a lot less than us, and most of whom moreover are separated from us by oceans, which makes invasion pretty unlikely, and accurate missiles a lot harder to land than they would be in, say, southern Israel?

Personally, I've always suspected that part of the problem (along with Congresspeople treating stuff in their district as though they were jobs programs) is that it takes a lot of guts for a civilian leader to say to the military: yes, I know you say this program would be good, but it's too expensive/unreliable/whatever. Since if you said that, to the people who supposedly know what they're doing, and you turned out to be wrong, the downside would be so enormously high.

As for the private sector and testing: I normally think: the private sector works best given certain rules -- the laws establishing property, the rules that make e.g. the stock market as transparent as it is, etc. -- but it does not necessarily do a good job in establishing those rules in the first place. I think we should not go around establishing rules willy-nilly, but when we think that some rule really should structure the competition we want companies to engage in, or that it puts penalties on stuff that should be penalized, OK.

I think that the case that companies that manufacture toys should not be able to compete on price by making those toys poisonous to kids, and that companies that produce food should not be able to compete on price by letting that food be poisoned, is about as strong as it gets. Especially when you add in the fact that we have an obvious interest in nailing people who make poisonous toys, dysfinctional pacemakers, etc., before someone dies, rather than afterwards.

I can't recall who mentioned Zagat's, but: I have worked as a writer of travel guides, and I really don't think you want to hold us up as a model for the FDA. There are a whole lot of perverse incentives at work for writers of travel guides. For one thing, back in the day (this was a while ago, it might have changed) it was not uncommon for either the company as a whole or the individual writer to be bought off. The outfit I was with (Let's Go) didn't do this, nor did I personally, but I was absolutely approached, in one case by an entire tourism ministry.

The reputation of the guidebook suffers if, on the whole, it recommends crappy places. It does not suffer so much if it recommends basically OK places that are not at all the best: the whole point of buying a travel guide is that you don't know what the best places are, so how would you know? It is also less likely to suffer if only individuals, not the whole guidebook, is bought off, and it is not easy for the people who run the company to check your work and notice that your recommendations are off.

[John Thullen]

Well, I've always been puzzled by the following:

The government is incompetent and inefficient and gets no results.

The private sector is by comparison very competent and efficient.

The most important task, the protection of our life, liberty, and property, should be undertaken by the incompetent, inefficient government.

All of the other less important tasks, including everything but not excepting anything except the most important job, should be done by the efficient, competent private sector.

Not saying I don't agree with this within very wide parameters, but it cracks me up.

It cracked up the founding fathers too, who were heard between gales of laughter to comment:

"Well, it makes no sense, but that's all we could agree on. Which direction is the pub?

[hairshirthedonist]

To defend ourselves against those other countries on the graph, who are spending a lot less than us...

This is where your thinking is a bit limited, Hilzoy. You see, there are known knowns, known unknowns and (here's the kicker) unknown unknowns. We know about the other countries with whom we share this planet, which is but a speck in the vastness of our known universe. But who else might we have to defend ourselves against? Who else do we not know that we don't know about? You never really know, do you? Health care and product safety won't help much when they show up.

[russell]

The most important task, the protection of our life, liberty, and property, should be undertaken by the incompetent, inefficient government.

Yes, I see your point. But we're fixing that, too.

Thanks -

[hilzoy]

hairshirthedonist: Cylons. It's all about the Cylons.

[Barnabas]

Speaking as someone who has worked all his life in private companies I have less faith in their abilities. Surely the fun and games with "funky paper" also falls entirely within the private sector?

When thinking of privatized defense and security a name pops up, Darkfluid or something of the sort...

[hilzoy]

OT: RedState: now with fecal filled facts.

Ewww.

(To be fair: it's a diary, not a front page post.)

[Jeff]

The outfit I was with (Let's Go)

Now I really want to read a "hilzoy's guide to..." anywhere. Are any still extant and/or relevant?

If not, could you, in your copious spare time, write a short travel guide to one of your favorite places?

[hilzoy]

I think I worked on Europe, Greece, and Israel/Egypt for -- well, I think it came out in '85, and USA and Mexico for '86. I was occasionally very funny. But an evil editor inserted, into my prose (Jerusalem chapter), the appalling sentence: "When it comes to Jerusalem, there's no place like hummus". (This from memory. It still rankles, on those very, very rare occasions when I think of it at all.)

[liberal japonicus]

Why is self-funding a bug in China and a feature in the US?

If the Chinese army depends on the output of toy factories and nike sweat shops, won't they think long and hard before they try and reduce the standard of living in the West?

I don't think these are trick questions.

[Phil]

Hmm, maybe if our NATO allies chipped in a little more on military spending, and a little less on quasi-socialist programs, we could get some more much needed help in Afghanistan.

It would take a lot of convincing to budge me even an inch towards the idea that NATO countries would actually be doing more for their citizens by spending their tax money on shooting Afghanis than on health care and infrastructure, but by all means, go ahead.

My argument for spending the most on the military, with regards to tax dollars, is that it is fundamentally the job of the federal government: to protect its citizens' life, liberty, and property.

In what meaningful ways are product safety and medical device testing not contributors to the protection of our life, liberty and property?

[Phil]

It took notice by the awful Federal Government and State governments for anyone in the private sector, Mattel (to pick on them) or the certifying companies to think to themselves that there might be a marketable idea in screening products from abroad, rather than counting on the unaccountability and secrecy of selling the American consumer tainted stuff.

Not only that, but one of the major toymakers -- I can't remember which, and can't find a link right now -- has filed suit in Federal court over one of the states' (Illinois?) extremely stringent product safety laws, saying that they should be subject only to the Federal product safety law, not to the state laws. The Federal laws are, of course, less stringent than the state law in question.

[ral]

hairshirthedonist: ...known knowns, known unknowns and (here's the kicker) unknown unknowns.

Ah, the memories this brings back!

I give you two out of Three Rumsfeld Songs. Introduction is at 51:40, music starts at 54:25.

Thank you WNYC.

[Gary Farber]

"Hmm, maybe if our NATO allies chipped in a little more on military spending, and a little less on quasi-socialist programs, we could get some more much needed help in Afghanistan."

NATO in Afghanistan. A different POV.

Alternatively.

It seems to my distant, and highly limited, view, that both NATO and the U.S. could do a lot more in Afghanistan, or, at least, could have done a lot more if not for Iraq.

I also strongly question the emphasis on fighting the drug war simultaneously, rather than simply buying up the opium crop legally for use in making legal morphine.

Lastly, of course, much of the problem in Afghanistan lies in Pakistan.

[Gary Farber]

Protecting our people.

Back on Afghanistan, this and this aren't good.

But there's always Belgium.

[ajay]

"Hmm, maybe if our NATO allies chipped in a little more on military spending, and a little less on quasi-socialist programs, we could get some more much needed help in Afghanistan."

As GF said: maybe the US wouldn't have to beg Belgium and Denmark to help it defend itself if it hadn't put the bulk of its army into a pointless Middle Eastern occupation.