All laws reflect political compromise. There’s no “logical” way to regulate supplements because they inhabit a gray area between foods and medicines. Presumably the government’s interest in the area begins and ends with risk to the public. As an exercise to the reader, compare the number people die each year as a result of over the counter NSAIDS with those who have died from ephedra. Then contrast the media attention that has been given to both.

Ephedra is a useful medicine that’s been given a black eye from a foolish misuse of the product. The public thought it was a safe and easy way to lose weight. The public has learned better and abandoned it — prior to any FDA action. I am at least gratified the the FDA will allow TCM practitioners to continue to use it.

Your salary won’t be increasing with the ridiculous cost of drugs. The notion that extremely expensive ACE-I are either no better or potentially less effective than thiazide diuretics represents a huge waste of ((LIMITED)) health care dollars. Please choose one of the following:
1) Stick with your current salary and prescribe whichever antihypertensive you like.

2) Prescribe thiazides first line and advocate some of the money previously wasted on ACE-Is goes to help providing comprehensive outpatient care.

1 or 2 ?

The CDC had to guess on the strains to include in the influenza vaccine. They guessed wrong, but seemingly made the best guess possible given the data they had.

Which clearly illustrates the “study it to pieces before doing anything” approach of the federal medical authorities. Meanwhile, back in the real world, the situation literally evolves rapidly, and no battle plan survives contact with the enemy.

They did the same thing to the smallpox vaccine: killed the program because a couple of people had unusual reactions. Meanwhile, back in the real world, Soviet germ warfare people are still scattering to the four winds, and the price of gene synthesizers is still dropping on an exponential curve.

4. Dietary supplements – we have an illogical law pertaining to supplements. The ephedra fiasco represents the tip of the iceberg.

Which I see as another manifestation of the same problem. The FDA is so insistent on absolute control and massive studies, that the only way to allow supplements was to make them out-of-bounds for the FDA. If the tight-assed bureaucrats had done something sane with ephedra—like requiring pure, standardized doses, limiting the maximum dose per pill, and making the pills obnoxiously large—most of the damage would have been confined to reckless idiots. But that sort of practical risk analysis is anathema to the FDA. They decide what risk averseness is appropriate for you, and if you disagree you’re just SOL.

The flip side is that when the FDA doesn’t want to see something, no force in heaven or earth can make them. Trans fatty acids have arguably hurt Americans more than, well, nearly anything else, and the FDA has willfully ignored them. Even with all the nails driven into the coffin by massive studies, they still have done nothing yet. Ditto for nicotine, which could be made fairly harmless (as these things go) by simply restricting the use of smoke in the delivery formulation.