659. Can Marty Makary Fix the F.D.A.?
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What is the main topic discussed in this episode?
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When it comes to public health, the first year of the second Trump administration has been an unusually busy one and unusually controversial. Most of this has run through Robert F. Kennedy Jr., the Secretary of Health and Human Services. In just the past few weeks, Kennedy overhauled the government's recommendations for childhood vaccines and revised the so-called food pyramid, promoting animal proteins especially, while downgrading ultra-processed foods, refined carbohydrates, and added sugars. Kennedy's policies affect several agencies under his purview, including the Food and Drug Administration. The FDA has had a busy year of its own, approving new treatments for several rare diseases, including cancers, as well as for rheumatoid arthritis and HIV.
The agency also approved a non-opioid pain medicine, the first of its kind in many years. The next few years may be even busier.
The FDA today is not going to be an FDA in a receive-only mode. We're not going to be stingy librarians. We're going to go into the pipeline, find out what sounds promising, and bring that to the forefront.
That is Marty McCary, commissioner of the FDA. He has been on Freakonomics Radio a few times in the past, and he made a brief appearance in last week's episode about brain supplements. McCary was a longtime surgical oncologist and professor of surgery at Johns Hopkins University. He's also done a lot of health policy research. He's published hundreds of papers and three books that critiqued the American health care system. Running the FDA is McCary's first job in government, and he knows it's a big one.
The FDA regulates 20% of the U.S. economy. And there are so many aspects to the FDA. And there are so many things broken at the FDA.
I spoke with McCary in October, but our release of this episode was delayed by the government shutdown. What's interesting is just how timely the conversation feels right now. It's always good to get an insider's view from an institution like the FDA. So today, as we continue our Freakonomics Radio guide to getting better, Marty McCary on food recommendations, drug approvals, public health, and what people in the White House like to call Trump derangement syndrome.
If literally we had discovered and announced the cure for cancer, you would have some people say, well, the Trump administration interfered. They did this too quick. They did it too slow.
What exactly does Marty McCary's FDA want to accomplish? That's coming up, starting now.
This is Freakonomics Radio, the podcast that explores the hidden side of everything with your host, Stephen Dubner.
Hey, Stephen. Marty, how are you? Hey, great. It's been a while.
What is the role of the FDA and its recent changes under Marty Makary?
Can I still call you Marty, even though you're... Yes. What have been the biggest adjustments for you so far in moving from a life of a physician scientist, an author, surgical oncologist, now to a government regulator?
I was in the operating room the day before my Senate confirmation hearing and then immediately plunged into a whole world of working within government to try to make things better. I came in with my team and we started doing an assessment. And it was a very different life, although some of the basic principles applied. And that is challenge deeply held assumptions, make a diagnosis before recommending any treatment option or change, and look at the patterns of dogma to find out where we are doing things just for the sake of doing things, not because it's the right way.
What does McCary mean by the patterns of dogma? There are a lot of illustrations of this in his most recent book, which is called Blind Spots, When Medicine Gets It Wrong and What It Means for Our Health.
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Chapters
5 chapters
1
What is the main topic discussed in this episode?
0:00–3:56
2
What is the role of the FDA and its recent changes under Marty Makary?
3:56–9:45
3
How does Marty Makary plan to modernize drug approval processes?
9:45–17:08
4
What are the implications of changing food recommendations at the FDA?
17:08–38:49
5
How does the FDA address past mistakes, like the approval of OxyContin?
38:49–58:36
Speakers
2 identifiedMore from Freakonomics Radio
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