I love that this post is asking a important and big question at a pleasing level of abstraction, aiming for something productive.
(So as not to bury the lede: by the end, I will have gotten around to arguing that bureacracies are adaptation executors, where the adaptations are laws that can be good or bad.)
After reading this lovely post I hit ^fcapture and was mildly surprised that no one mentioned regulatory capture.
If you try ^fcorruption you easily find Dumbledore’s Army’s comment which is highly upvoted and somewhat pessimistic.
I’m going to try to sketch in more things along a similar like, with more standardized keywords, and more links, to weave together abstract ideas and concrete examples of those ideas.
As mentioned in other comments, a bureaucrat can play “do almost nothing but the procedural minimum” and collect checks.
They can try to conspire to rise using Moral Maze tactics against each other, playing a game whose broad strategic outlines have existed for a long time which can be called patrimonial bureacracy.
Alternatives to patrimonial bureaucracy are kind of hard to talk about, maybe like the old saw about how fish might not have a word for “wetness”, but my current working theory here is that a contrast object exists in the form of jurisprudential bureacracy (which almost no one talks about, and the google hit to that master’s thesis which finally uses the phrase on page 53 is typically narrow and obscure).
The gist is: there used to be noblemen who had inherited power to tax peasants. They semi-voluntarily joined more and more formal sorts of feudal factional alliances. They implicitly took for granted the right to brutalize and steal from THEIR OWN peasants in certain circumstances, but they had to justify such actions of with the peasants of their feudal allies.
The upshot was an environment where the noble-turned-bureacrats would argue in terms of the general principles which naturally apply to the general rights of feudal lords and their duties to each other and (minimally) to their peasants. Especially in central Europe (ancient germany?) “kings” were often de facto so weak as to be unable to rule except by the non-trivial consent of lesser nobles.
In this model: pirates and feudal lords might actually be MORE “morally proper seeming” than patrimonial bureaucrats because at least they had meaningful principles? Also they had some agency. (But the expectation was that their agency and principles would be used to prey upon peasants or defenseless boats or whatever.)
EXCEPT: what if the King at the top of the patrimonial system was Causing the pirate/bureaucrats to NOT necessarily follow norms, but actually just to to serve the King’s whims?
And what if the King was benevolent and had “good whims”?
HOWEVER, the very top dog of the bureaucracy, in nominally-modern nominally-democratic nominally-rights-respecting governments is supposed to be an elected official who could function kind of like a “Strong King” or a “actually somehow powerful head pirate” whose power over the other parts of the government descends from the consent of the median-voter.
So maybe a patrimonial bureaucracy with a Good president could be Good?
It kinda stands to reason that it would work this way? :-)
Note… the median voter would be patrimonially governed by a bureaucracy that is patrimonially governed by an elected official (who is electorally governed by the median-voter… (etc))) and this pattern makes it (hopefully) such that the elected leader could hypothetically impose principles or at least “know which side your bread is buttered on incentives” to the bureaucrats in the bureaucracy.
In the US, this is how it worked for a while.
HOWEVER: much of this logic was dismantled, with all such oversight deemed “political patronage”, in the 1883 Pendleton Reform.
(Arguably this actually was an objective and huge improvement in governance, but part of this might be that it rebooted an old system that could be goodhearted (by electoral crony systems that hacked voters to gain lots of government jobs) with a new system that could hypothetically be goodhearted but only by less mature and mesa-optimizers? ….and then maybe the post-Pendleton system WAS getting goodhearted and starting to rot by the 1920s and 1930s…
...but then FDR came in and did a sort of Good(?) Powerful King style reboot (incidentally inventing the NSF and assembling the CIA and a huge number of other now-normal and now-natural seeming institutions) which might have been terrible according to some abstract standards but had the practical virtue of: winning World War 2 for the US… And if you’re going to pick TWO virtues, then maybe ONE of them should probably be “being able to win giant wars”?
So this perhaps provides history and theory to power a deep claim here that “patrimonial bureaucracies don’t natively actually coherently maximize anything” but rather they might just start as the (metaphorical) adaptation executors of that someone, like perhaps a visionary goal-seeking founders, just wants to happen. Do X, do Y, do Z, and later someone with a brain can look at XYZ+results to see if the system works or needs to change or whatever. (Hat tip here to Gunnar who mentioned relevant things in a neighboring comment before me and other hat tip to Samo himself).
HOWEVER, I think that over time patrimonial bureaucracies probably devolve into “governance cancer”?
Maybe? Probably? Sometimes? Eventually always?
This is my own not-entirely-certain-or-well-supported hunch. If it could even be operationalized and researched I bet the diagnosis of this or that bureaucracy as “having already metastasized by date D” would be controversial… but if that was possible then I think it would be clearly “benevolently high value long term institution design research” to know what founding bureaucratic features cause the longest amount of time between (hopefully) BENEVOLENT bureaucratic founding and KLEPTOCRATIC bureaucratic metastasis.
There’s a deep analogy lurking here, I think, between bureaucracies, cancer, and mesa-optimization.
Part of why you kind of should predict actual human bureaucrats in actual institutions to eventually begin to be unaligned mesa-optimizers within a bureaucracy is a thing that Dumbedore’s Army might have missed...
...a key way for bureaucrats to gain value is by using their position in the bureaucracy to build allies and the PIVOTING at some point to working OUTSIDE of the bureaucracy for a lot of money.
This is called the revolving door problem when human government people do it. I haven’t yet found (but also haven’t looked super hard) for equivalent problems in biology. The closest biological analogy I have so far is prophages where “lysis” is kind of like “resign and work as a lobbyist”.
For example Scott Gottlieb was the head of the FDA and a mere 8 months before covid started in Wuhan he resigned from his role as the head of the FDA (whose legislative mandate is objectively dumb, and this dumbness made the covid response much much worse). Then about 5 months after covid (so this would be maybe 2 months after Moderna was testing the mRNA vaccine but still while the medical prototypes were illegal to sell no matter what opt-outs clever people might want to try) Scott Gottlieb joined the board of directors of Pfizer.
Presumably his job was to “give them insight” into “the process of regulatory compliance”?
If we had a coherent theory of public service, this might be illegal? (Certainly if it WAS illegal then joining the government would basically be a lifelong commitment, and the pensions and lack of fear of firing or layoffs would make a lot of sense.)
Caption: the penny just dropped for him, when he realized how much is NOT illegal, and already happening.
Grant that the US government won’t actually provide the public good of “adequate infectious disease fighting”, a way for private entities to make a profit by providing private goods to private purchasers RELIES on this large scale structural failure to provide an obvious public good is: to make and sell expensive individual medical coping mechanisms (like masks and imperfect vaccines and so on) to each patient, so each patient can mitigate the effect of “the public goods disaster” for themselves, by themselves, for their own benefit, in a personally “validly selfishly” way.
This is maybe not bad? If Pfizer was making money off of a situation that the government is tragically “merely incapable” of fixing that would be one thing. But hiring former government regulators is an extra layer of: WTF?
Also, the regulatory bureacrats and politicians in New Zealand and Taiwan and Singapore and China proved that “it can be done” pretty independently of being a democracy or an authoritarian dictatorship or whatever.
Solving covid was possible. Therefore the US’s failed half-attempt to solve covid is less excusable.
And so that “general failure” is perhaps part of how Scott Gottlieb’s new bureaucracy (the one that runs for-profit and has him as a board of director) remains happy in the status quo.
Also, they are almost certainly a beneficiary of regulatory capture by the FDA in a more direct way that has been true for decades, but harder to see because there wasn’t a novel plague: the big companies capture value instead of generating consumer surplus… as a side effect of not having to compete with the (currently non-existent because illegal-at-low-prices) cheaper competitors who are less able to jump all the sometimes-situationally-pointless FDA hurdles whose existence: (1) lets Pfizer have many fewer competitors and (2) therefore have substantial pricing power.
Like, with competition like we have for food, the margins on medical manufacturing could be almost zero… and maybe that would be a good thing.
If it happened, then I personally would be in favor of some kind of drug manufacturing subsidies (like the US has for food) to avoid gluts and shortages of medicine.
There’s a strong tendency, at this juncture, based on this kind of reasoning, to want to find alive and active PEOPLE responsible for the “bad personal behaviors and their macroscale consequences”.
I try to resist this impulse and look for knobs that can be turned that are formal and logical. It turns out: they exist!
Look at the naively obvious tippy top of one these systems… then look even higher than the “mere Scott Gottliebs of the world”, and see the actual presidents and legislators, and then look up even higher than that to see THE LAWS.
We have the rule of law, after all… right?
Then we could back chain from bad laws to elect people who will fix the bad laws. Then they might do that. Then the better laws should back-chain to bureaucracies that run according to those laws. Right?
Then we could hypothetically just reason directly about the obvious contents of laws, and the object level domain that the laws authorize the regulation of, and we can imagine what the laws would tend to cause if the laws were followed...
The existence of such actual literal laws is why I think it makes a lot of sense to think of these bureaucracies as essentiallyadaptation executors rather <anything>-maximizers.
Admittedly, from within the present system, the whole “rule of law + democracy” formula might be very hard to do, and to get the MEDIAN voters “riled up enough” it might be necessary to stoop to personal attacks on Official Scrapegoats as a sort of “rationally-calculated semi-tragic PR plan to educate the median voter in a way that the median voter will listen to”?
BUT FIRST: the actual laws! There is very little justification for smashing the bureaucrats who are following the laws unless you have a legislative proposal for what OTHER laws they could obey instead.
So: the FDA’s has the power, in the law, to make all drugs illegal-to-sell-by-default unless the drug makers have privately spent huge amounts on highly Formalized Bureaucratic Science, in advance of any sales, and the law that empowers them to do this is the Kefauver-Harris amendment.
If this law is repealed, they might stop actively hurting people by engaging in actively harmful behavior.
If all the FDA did was proactively buy drugs (OTC and prescription, both?) and test them for honest labeling of the ingredients and possible contaminants… I think that would be FANTASTIC.
That would generate a huge public good. That information would be helpful in many ways to many people, none of who could generate it themselves in a profitable way. It would be useful to funnel the things that were learned by active testing back into the supply chain and also useful to publish to help consumers demand better things and not demand more poisonous things with false dosing and ingredients and warning claims on the labels.
That kind of work might explain to me why the FDA could still sanely employ lots of people? Maybe? (But this is NOT WHAT THEY DO.)
Instead they… simply forbid medical competition unless certain kinds of very expensive cargo-culted scientific rituals have been performed, and also defend the monopoly pricing power of any company that performs the expensive rituals. The tens of thousands of employees oversee these cargo culted science rituals.
(I understand this characterization of FDA trials as cargo-culted “science” could be considered problematic, but actually, the place where the MOST empirical knowledge about clinical practice arises for really reals is IN THE CLINIC. The FDA trials aren’t super terrible. Some of them replicate and some of them generalize. However, they are not adequate, and yet they are treated as Officially Adequate. Every General Practice Doctor in the US is engaged in clinical practice, and any time they prescribe a drug they are following a diagnostic hunch and performing an N=1 experiment on a patient who feels bad enough to want to pay to be that kind of clinical medical scientific subject. This is how huge amounts of progress in medicine in the first half of the 1900s actually happened.
But that ongoing clinical practice doesn’t currently “count as science” so… that helps the monopolies remain monopolies? Also it prevents the original engine of innovation actually innovate.
And in the meantime, the ongoing clinical practice of prescribing approved drugs and watching what happens often turns up safety issues that lead to drug recalls. Every drug recall of an approved drug is maaaybe good “because safety”? (Or it could be just given some kind of warning on the label, and left in the toolset of doctors for more rare or cautious or “hail mary” uses.)
So every drug recall of an approved drug ALSO is a sign that the FDA’s mandated trials can’t actually “scientifically prove” what it claims that the medical trials proved: the safety (or efficacy) of the drug.
In this sense, the FDA’s processes are a cargo-cult of science. They ignore how the real knowledge was really acquired, and pretend more certainty up front, and pretend to be shocked by later “totally unpredictable” discoveries. Hence I say: cargo cult.
Also like: the existence of lots of cargo (from certain practices) is exactly what is LACKED by the Melanesia religions originally called “cargo cults”. They waved around magic sticks that looked like “antennas to talk to planes” and no planes landed and gave them food. We wave “science” around so: Where is the medical science cornucopia?
Where is the cure for death? Where is the cure for cancer? Where is the cure for covid? If we had robust “non-cargo cult” medical science practices, we would either have clear answers for why it was formally theoretically impossible to construct such “medical cargo”… or we would have the cargo.
In practice: we have neither. We don’t know that cures like this are impossible and we also don’t have the cures.
...
Pulling back more generally, I’m not saying CIA delenda est. I’m not saying NSF delenda est. (Remember above, FDR founded these other bureaucracies and we still have them.)
Those “executable (law-empowered) institutional adaptations” might have operations I don’t understand that well.
I think to say one way or the other that you would have to study the goals, constraints, and means and ends, and then look at the legislative and executive authorizations, and how those authorizations work in practice, and then decide one way or the other? Maybe?
Speaking to the larger point about bureaucracies in general: I do think that the “highest unelected/unappointed bureaucrat” is often de facto STRONGER in modern democracies than the elected and/or appointed officials who nominally regulate them.
The elected officials are beholden to the median voter, and if that voter changes his or her mind they are potentially VERY transitory.
Any time an elected official is clearly threatening to an (evil?) bureaucracy, the conspiracy of top bureaucrats has the incentives and sometimes the power to influence the median voter (such as by media leaks) to get rid of the elected official FASTER than the official can legislate them out of doing bad things.
The critical thing is the asymmetry: the bureaucrat is insulated from the median voter, while also having write access to the evidence and ideas in the head of the median voter through journalists. Thus, in a deep sense, the bureaucrat with the ear of journalists and the backing of their patrimonial clients within a bureaucracy is often STRONGER THAN a legislator or president that hypothetically might want to change the legislative mandate under which the bureaucrat operates.
Elected executive hire/fire power might be faster than media leaks… but that power IS ILLEGAL in most cases.
I think this is a deep structural problem, and the solution would be: the honor and goodness and sense of duty of the highest bureaucrats? Either that or a massive awakening among the voters to the operation of bureaucracies? And so in some sense maybe we’ve almost looped all the way around back to chivalrous knights using personally owned power to do good deeds (or just killing a bunch of peasants) according to their own conscience?
Except it doesn’t even work like that! And this again reveals how dangerous it is to focus on the mere people, rather than the formal laws that formally empower them in a system that runs according to the rule of law.
It isn’t like the FDA can just NOTICE that they are a net negative on the medical industry and simply CHOOSE to stop the process of limiting medical innovation without doing cargo-culted science first: they are literally legally required to do this.
If you absolutely insist on blaming a person… maybe Kefauver (who died in 1963)?
What these bureaucrats could do is not fight reform of their totally broken bureaucracy, in the press, when their legal mandate is noticed to be insane and subtracted from the law codes by thoughtful legislators elected by a minimally tolerant median voter.
However, in the case of the FDA specifically, they did the opposite of this, and just had enemies lists.
The Times’ report also details evidence of an “enemies” list within FDA-”unusual at domestic agencies that do not handle classified information,” it noted. The documents detailed efforts to fire employees within the agency that had gone public with complaints, attempts to track contacts with members of the media, get in front of potentially damaging stories by assessing which members of its staff were contacting media outlets and rank members of congress deemed to be unfriendly towards the agency.
Because of course that’s how it worked! Why would we imagine anything else in a system as broken as ours, that has incidentally killed as many people as ours has?
This is actively treacherously-turned mesa-optimization, implemented in human bureaucrats, with respect to their proper governors: the elected officials and the voters.
This is anti-democratic regulatory capture on top of bad legislation.
This is a bad institutional “adaptation” being staffed by bad people, where anyone good and smart would resign because the law commands objectively stupid behavior, and dumb people might just turn the crank anyway, and anyone really smart and bad could climb to the top, use the power for profits, chase elected officials away from spending political capital trying to reform them, and eventually leave for a cushy lobbyist job. This is organizational cancer. This is the FDA. Each part of it is rotten. Every new closet you look in… you find a new skeleton.
Maybe the other bureaucracies are good? On base rates surely some of them were set up well, and still serve a sane purpose faithfully? It would be kind of remarkable if ALL the bureaucracies were so dramatically “the opposite of good”. You’d have to look at each one individually I think. I haven’t looked at all of them?
Of the ones I’ve looked at, the FDA seems to me like it has the highest combined score of roughly: ((“really really bad”) x (“obviously so, to very many people, because of a Recent Event”) x (“deeply instructive such that getting the right answer about the FDA from first principles probably implies LOTS of other probably useful models for thinking about many similar issues”)).
I love that this post is asking a important and big question at a pleasing level of abstraction, aiming for something productive.
(So as not to bury the lede: by the end, I will have gotten around to arguing that bureacracies are adaptation executors, where the adaptations are laws that can be good or bad.)
After reading this lovely post I hit ^fcapture and was mildly surprised that no one mentioned regulatory capture.
If you try ^fcorruption you easily find Dumbledore’s Army’s comment which is highly upvoted and somewhat pessimistic.
I’m going to try to sketch in more things along a similar like, with more standardized keywords, and more links, to weave together abstract ideas and concrete examples of those ideas.
As mentioned in other comments, a bureaucrat can play “do almost nothing but the procedural minimum” and collect checks.
They can try to conspire to rise using Moral Maze tactics against each other, playing a game whose broad strategic outlines have existed for a long time which can be called patrimonial bureacracy.
Alternatives to patrimonial bureaucracy are kind of hard to talk about, maybe like the old saw about how fish might not have a word for “wetness”, but my current working theory here is that a contrast object exists in the form of jurisprudential bureacracy (which almost no one talks about, and the google hit to that master’s thesis which finally uses the phrase on page 53 is typically narrow and obscure).
The gist is: there used to be noblemen who had inherited power to tax peasants. They semi-voluntarily joined more and more formal sorts of feudal factional alliances. They implicitly took for granted the right to brutalize and steal from THEIR OWN peasants in certain circumstances, but they had to justify such actions of with the peasants of their feudal allies.
The upshot was an environment where the noble-turned-bureacrats would argue in terms of the general principles which naturally apply to the general rights of feudal lords and their duties to each other and (minimally) to their peasants. Especially in central Europe (ancient germany?) “kings” were often de facto so weak as to be unable to rule except by the non-trivial consent of lesser nobles.
So clear norms and clear reasoning within jurisprudential bureaucracy were possibly important in sort of the way (and probably for very similar reasons) that gave ocean-going sea pirates non-trivial loot sharing and governance norms?
In this model: pirates and feudal lords might actually be MORE “morally proper seeming” than patrimonial bureaucrats because at least they had meaningful principles? Also they had some agency. (But the expectation was that their agency and principles would be used to prey upon peasants or defenseless boats or whatever.)
EXCEPT: what if the King at the top of the patrimonial system was Causing the pirate/bureaucrats to NOT necessarily follow norms, but actually just to to serve the King’s whims?
And what if the King was benevolent and had “good whims”?
HOWEVER, the very top dog of the bureaucracy, in nominally-modern nominally-democratic nominally-rights-respecting governments is supposed to be an elected official who could function kind of like a “Strong King” or a “actually somehow powerful head pirate” whose power over the other parts of the government descends from the consent of the median-voter.
So maybe a patrimonial bureaucracy with a Good president could be Good?
It kinda stands to reason that it would work this way? :-)
Note… the median voter would be patrimonially governed by a bureaucracy that is patrimonially governed by an elected official (who is electorally governed by the median-voter… (etc))) and this pattern makes it (hopefully) such that the elected leader could hypothetically impose principles or at least “know which side your bread is buttered on incentives” to the bureaucrats in the bureaucracy.
In the US, this is how it worked for a while.
HOWEVER: much of this logic was dismantled, with all such oversight deemed “political patronage”, in the 1883 Pendleton Reform.
(Arguably this actually was an objective and huge improvement in governance, but part of this might be that it rebooted an old system that could be goodhearted (by electoral crony systems that hacked voters to gain lots of government jobs) with a new system that could hypothetically be goodhearted but only by less mature and mesa-optimizers? ….and then maybe the post-Pendleton system WAS getting goodhearted and starting to rot by the 1920s and 1930s…
...but then FDR came in and did a sort of Good(?) Powerful King style reboot (incidentally inventing the NSF and assembling the CIA and a huge number of other now-normal and now-natural seeming institutions) which might have been terrible according to some abstract standards but had the practical virtue of: winning World War 2 for the US… And if you’re going to pick TWO virtues, then maybe ONE of them should probably be “being able to win giant wars”?
So this perhaps provides history and theory to power a deep claim here that “patrimonial bureaucracies don’t natively actually coherently maximize anything” but rather they might just start as the (metaphorical) adaptation executors of that someone, like perhaps a visionary goal-seeking founders, just wants to happen. Do X, do Y, do Z, and later someone with a brain can look at XYZ+results to see if the system works or needs to change or whatever. (Hat tip here to Gunnar who mentioned relevant things in a neighboring comment before me and other hat tip to Samo himself).
HOWEVER, I think that over time patrimonial bureaucracies probably devolve into “governance cancer”?
Maybe? Probably? Sometimes? Eventually always?
This is my own not-entirely-certain-or-well-supported hunch. If it could even be operationalized and researched I bet the diagnosis of this or that bureaucracy as “having already metastasized by date D” would be controversial… but if that was possible then I think it would be clearly “benevolently high value long term institution design research” to know what founding bureaucratic features cause the longest amount of time between (hopefully) BENEVOLENT bureaucratic founding and KLEPTOCRATIC bureaucratic metastasis.
There’s a deep analogy lurking here, I think, between bureaucracies, cancer, and mesa-optimization.
Part of why you kind of should predict actual human bureaucrats in actual institutions to eventually begin to be unaligned mesa-optimizers within a bureaucracy is a thing that Dumbedore’s Army might have missed...
...a key way for bureaucrats to gain value is by using their position in the bureaucracy to build allies and the PIVOTING at some point to working OUTSIDE of the bureaucracy for a lot of money.
This is called the revolving door problem when human government people do it. I haven’t yet found (but also haven’t looked super hard) for equivalent problems in biology. The closest biological analogy I have so far is prophages where “lysis” is kind of like “resign and work as a lobbyist”.
For example Scott Gottlieb was the head of the FDA and a mere 8 months before covid started in Wuhan he resigned from his role as the head of the FDA (whose legislative mandate is objectively dumb, and this dumbness made the covid response much much worse). Then about 5 months after covid (so this would be maybe 2 months after Moderna was testing the mRNA vaccine but still while the medical prototypes were illegal to sell no matter what opt-outs clever people might want to try) Scott Gottlieb joined the board of directors of Pfizer.
Presumably his job was to “give them insight” into “the process of regulatory compliance”?
If we had a coherent theory of public service, this might be illegal? (Certainly if it WAS illegal then joining the government would basically be a lifelong commitment, and the pensions and lack of fear of firing or layoffs would make a lot of sense.)
Something I’ve noticed is that often people THINK lots of sort of obviously bad things like regulators working right afterwards for the people they regulate IS ILLEGAL because they assume the government runs in a morally sane way, and then are unhappily surprised when there is no law against such things.
Caption: the penny just dropped for him, when he realized how much is NOT illegal, and already happening.
Grant that the US government won’t actually provide the public good of “adequate infectious disease fighting”, a way for private entities to make a profit by providing private goods to private purchasers RELIES on this large scale structural failure to provide an obvious public good is: to make and sell expensive individual medical coping mechanisms (like masks and imperfect vaccines and so on) to each patient, so each patient can mitigate the effect of “the public goods disaster” for themselves, by themselves, for their own benefit, in a personally “validly selfishly” way.
This is maybe not bad? If Pfizer was making money off of a situation that the government is tragically “merely incapable” of fixing that would be one thing. But hiring former government regulators is an extra layer of: WTF?
Also, the regulatory bureacrats and politicians in New Zealand and Taiwan and Singapore and China proved that “it can be done” pretty independently of being a democracy or an authoritarian dictatorship or whatever.
Solving covid was possible. Therefore the US’s failed half-attempt to solve covid is less excusable.
And so that “general failure” is perhaps part of how Scott Gottlieb’s new bureaucracy (the one that runs for-profit and has him as a board of director) remains happy in the status quo.
Also, they are almost certainly a beneficiary of regulatory capture by the FDA in a more direct way that has been true for decades, but harder to see because there wasn’t a novel plague: the big companies capture value instead of generating consumer surplus… as a side effect of not having to compete with the (currently non-existent because illegal-at-low-prices) cheaper competitors who are less able to jump all the sometimes-situationally-pointless FDA hurdles whose existence: (1) lets Pfizer have many fewer competitors and (2) therefore have substantial pricing power.
Like, with competition like we have for food, the margins on medical manufacturing could be almost zero… and maybe that would be a good thing.
If it happened, then I personally would be in favor of some kind of drug manufacturing subsidies (like the US has for food) to avoid gluts and shortages of medicine.
There’s a strong tendency, at this juncture, based on this kind of reasoning, to want to find alive and active PEOPLE responsible for the “bad personal behaviors and their macroscale consequences”.
I try to resist this impulse and look for knobs that can be turned that are formal and logical. It turns out: they exist!
Look at the naively obvious tippy top of one these systems… then look even higher than the “mere Scott Gottliebs of the world”, and see the actual presidents and legislators, and then look up even higher than that to see THE LAWS.
We have the rule of law, after all… right?
Then we could back chain from bad laws to elect people who will fix the bad laws. Then they might do that. Then the better laws should back-chain to bureaucracies that run according to those laws. Right?
Then we could hypothetically just reason directly about the obvious contents of laws, and the object level domain that the laws authorize the regulation of, and we can imagine what the laws would tend to cause if the laws were followed...
The existence of such actual literal laws is why I think it makes a lot of sense to think of these bureaucracies as essentially adaptation executors rather <anything>-maximizers.
Admittedly, from within the present system, the whole “rule of law + democracy” formula might be very hard to do, and to get the MEDIAN voters “riled up enough” it might be necessary to stoop to personal attacks on Official Scrapegoats as a sort of “rationally-calculated semi-tragic PR plan to educate the median voter in a way that the median voter will listen to”?
BUT FIRST: the actual laws! There is very little justification for smashing the bureaucrats who are following the laws unless you have a legislative proposal for what OTHER laws they could obey instead.
So: the FDA’s has the power, in the law, to make all drugs illegal-to-sell-by-default unless the drug makers have privately spent huge amounts on highly Formalized Bureaucratic Science, in advance of any sales, and the law that empowers them to do this is the Kefauver-Harris amendment.
If this law is repealed, they might stop actively hurting people by engaging in actively harmful behavior.
If all the FDA did was proactively buy drugs (OTC and prescription, both?) and test them for honest labeling of the ingredients and possible contaminants… I think that would be FANTASTIC.
That would generate a huge public good. That information would be helpful in many ways to many people, none of who could generate it themselves in a profitable way. It would be useful to funnel the things that were learned by active testing back into the supply chain and also useful to publish to help consumers demand better things and not demand more poisonous things with false dosing and ingredients and warning claims on the labels.
That kind of work might explain to me why the FDA could still sanely employ lots of people? Maybe? (But this is NOT WHAT THEY DO.)
Instead they… simply forbid medical competition unless certain kinds of very expensive cargo-culted scientific rituals have been performed, and also defend the monopoly pricing power of any company that performs the expensive rituals. The tens of thousands of employees oversee these cargo culted science rituals.
(I understand this characterization of FDA trials as cargo-culted “science” could be considered problematic, but actually, the place where the MOST empirical knowledge about clinical practice arises for really reals is IN THE CLINIC. The FDA trials aren’t super terrible. Some of them replicate and some of them generalize. However, they are not adequate, and yet they are treated as Officially Adequate. Every General Practice Doctor in the US is engaged in clinical practice, and any time they prescribe a drug they are following a diagnostic hunch and performing an N=1 experiment on a patient who feels bad enough to want to pay to be that kind of clinical medical scientific subject. This is how huge amounts of progress in medicine in the first half of the 1900s actually happened.
But that ongoing clinical practice doesn’t currently “count as science” so… that helps the monopolies remain monopolies? Also it prevents the original engine of innovation actually innovate.
And in the meantime, the ongoing clinical practice of prescribing approved drugs and watching what happens often turns up safety issues that lead to drug recalls. Every drug recall of an approved drug is maaaybe good “because safety”? (Or it could be just given some kind of warning on the label, and left in the toolset of doctors for more rare or cautious or “hail mary” uses.)
So every drug recall of an approved drug ALSO is a sign that the FDA’s mandated trials can’t actually “scientifically prove” what it claims that the medical trials proved: the safety (or efficacy) of the drug.
In this sense, the FDA’s processes are a cargo-cult of science. They ignore how the real knowledge was really acquired, and pretend more certainty up front, and pretend to be shocked by later “totally unpredictable” discoveries. Hence I say: cargo cult.
Also like: the existence of lots of cargo (from certain practices) is exactly what is LACKED by the Melanesia religions originally called “cargo cults”. They waved around magic sticks that looked like “antennas to talk to planes” and no planes landed and gave them food. We wave “science” around so: Where is the medical science cornucopia?
Where is the cure for death? Where is the cure for cancer? Where is the cure for covid? If we had robust “non-cargo cult” medical science practices, we would either have clear answers for why it was formally theoretically impossible to construct such “medical cargo”… or we would have the cargo.
In practice: we have neither. We don’t know that cures like this are impossible and we also don’t have the cures.
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Pulling back more generally, I’m not saying CIA delenda est. I’m not saying NSF delenda est. (Remember above, FDR founded these other bureaucracies and we still have them.)
Those “executable (law-empowered) institutional adaptations” might have operations I don’t understand that well.
I think to say one way or the other that you would have to study the goals, constraints, and means and ends, and then look at the legislative and executive authorizations, and how those authorizations work in practice, and then decide one way or the other? Maybe?
But I have published in virology and tried to raise money for biotech startups, and read textbooks on the topic and I am saying: FDA delenda est.
Speaking to the larger point about bureaucracies in general: I do think that the “highest unelected/unappointed bureaucrat” is often de facto STRONGER in modern democracies than the elected and/or appointed officials who nominally regulate them.
The elected officials are beholden to the median voter, and if that voter changes his or her mind they are potentially VERY transitory.
Any time an elected official is clearly threatening to an (evil?) bureaucracy, the conspiracy of top bureaucrats has the incentives and sometimes the power to influence the median voter (such as by media leaks) to get rid of the elected official FASTER than the official can legislate them out of doing bad things.
The critical thing is the asymmetry: the bureaucrat is insulated from the median voter, while also having write access to the evidence and ideas in the head of the median voter through journalists. Thus, in a deep sense, the bureaucrat with the ear of journalists and the backing of their patrimonial clients within a bureaucracy is often STRONGER THAN a legislator or president that hypothetically might want to change the legislative mandate under which the bureaucrat operates.
Elected executive hire/fire power might be faster than media leaks… but that power IS ILLEGAL in most cases.
I think this is a deep structural problem, and the solution would be: the honor and goodness and sense of duty of the highest bureaucrats? Either that or a massive awakening among the voters to the operation of bureaucracies? And so in some sense maybe we’ve almost looped all the way around back to chivalrous knights using personally owned power to do good deeds (or just killing a bunch of peasants) according to their own conscience?
Except it doesn’t even work like that! And this again reveals how dangerous it is to focus on the mere people, rather than the formal laws that formally empower them in a system that runs according to the rule of law.
It isn’t like the FDA can just NOTICE that they are a net negative on the medical industry and simply CHOOSE to stop the process of limiting medical innovation without doing cargo-culted science first: they are literally legally required to do this.
If you absolutely insist on blaming a person… maybe Kefauver (who died in 1963)?
What these bureaucrats could do is not fight reform of their totally broken bureaucracy, in the press, when their legal mandate is noticed to be insane and subtracted from the law codes by thoughtful legislators elected by a minimally tolerant median voter.
However, in the case of the FDA specifically, they did the opposite of this, and just had enemies lists.
Because of course that’s how it worked! Why would we imagine anything else in a system as broken as ours, that has incidentally killed as many people as ours has?
This is actively treacherously-turned mesa-optimization, implemented in human bureaucrats, with respect to their proper governors: the elected officials and the voters.
This is anti-democratic regulatory capture on top of bad legislation.
This is a bad institutional “adaptation” being staffed by bad people, where anyone good and smart would resign because the law commands objectively stupid behavior, and dumb people might just turn the crank anyway, and anyone really smart and bad could climb to the top, use the power for profits, chase elected officials away from spending political capital trying to reform them, and eventually leave for a cushy lobbyist job. This is organizational cancer. This is the FDA. Each part of it is rotten. Every new closet you look in… you find a new skeleton.
Maybe the other bureaucracies are good? On base rates surely some of them were set up well, and still serve a sane purpose faithfully? It would be kind of remarkable if ALL the bureaucracies were so dramatically “the opposite of good”. You’d have to look at each one individually I think. I haven’t looked at all of them?
I’ve ready good things about the founder and founding of the naval nuclear power program, if someone wanted to do a deep dive on a potentially positive case.
Of the ones I’ve looked at, the FDA seems to me like it has the highest combined score of roughly: ((“really really bad”) x (“obviously so, to very many people, because of a Recent Event”) x (“deeply instructive such that getting the right answer about the FDA from first principles probably implies LOTS of other probably useful models for thinking about many similar issues”)).