YouSaid · the spoken record

Balaji Srinivasan

lines on the record: 605
first: 2022-10-20
most recent: 2022-10-20
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“Once that is the case, the regulatory agency basically comes back to Congress each year. And if you look at its budget approvals, it's saying we find this many guys, we found this many violations, right? They have an incentive to exaggerate the threat in the same way that a prosecutor or a policeman has a quota. One way I describe it also is like, you know, like a step down transformers. You have high voltage electricity that's generated at the power plant and it comes over the wires and then there's step down transformers that turn it into a lower voltage that you can just deal with out of your appliances, right? Similarly, you have something where the high voltage of like the US military or the police and that is transmuted down into a little letter that comes in your mailbox saying pay your $50 parking ticket.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Happened in tech. So Facebook is the outlier because Zuck still controls the company. But just like, I mean, why had tech had a good reputation for a while? Because there wasn't a regulatory agency whose justification was regulating these corporate criminals.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“To hover on that, that's a really big deal because if their primary customer is this government agency, then it has nationalized it just indirectly. This is partially what's just happened with Microsoft, Apple, Google, Amazon, the other MAGA. They have been That's funny”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes. But why is that? Because reputation and power, FDA beat down the reputation of pharma companies just like EPA helped beat down the reputation of oil companies. And as it says over here, right, in practice, dealing with the fact of FDA power meant a fundamental change in corporate structure and culture. At Abbott Net Genentech robb's most central transformation was in creating a culture of acquiescence towards a government agency, as was done at other drug companies in the late 20th century, Rob essentially fired officials at Abbott who were insufficiently compliant with the FDA. What that means is de facto nationalization of the industry via regulation.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“If you are regulated by FDA, they are your primary customer. If they cut the cord on you, you have no other customers. And in fact, until very recently with the advent of social media, no one would even tell your story. It was assumed that you were some sort of corporate criminal that they were protecting the public from, that you were going to put poison and milk, you know, like the melamine scandal in China. I'm not saying those things don't exist, by the way. They do exist. That's why people are like, they can immediately summon to mind all the examples of corporate criminals, right? That's why I mentioned those fictional stories. Those templates, even if Star Wars doesn't exist, how many times have you heard a Star Wars metaphor or whatever for something, right? Breaking bad, you know, go ahead.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Gotta come in. And he took his machine gun, took the safety off, and pointed at me and said, You can't come in. And I said, Oh, now I got it. I can't go in there. And that's the way I always describe the FDA. The FDA is standing there with a machine gun against a pharmaceutical industry, so you better be their friend rather than their enemy. They are the boss. If you're a pharmaceutical firm, they own you body and soul. Okay, that's the CEO of a successful company, Genentech. He says told the story hundreds of times, and regulatory approval is a fundamental challenge facing his company because”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“So Genentex executive G. Kirk Grob, right? Rob would describe regulatory approval for his products as a fundamental challenge facing his company. And he would depict the administration a particularly vivid metaphor. I've told a story hundreds of times to help people understand the FDA. When I was in Brazil, I worked on the Amazon River for many months selling teramycin for Pfizer. I hadn't seen my family for eight or nine months. They're flying into S ⁇ o Paulo, and I was flying down from some little village on the Amazon to Manus and then to S ⁇ o Paulo. I was a young guy in his 20s. I couldn't wait to see the kids. One of them was a year-old baby. The other was three. I missed my wife. There's a quanset hut in front of just a little dirt strip with a single engine plane of flying to menus. I roll up and there's a Brazilian soldier there. The military revolution happened literally the week before. So this soldier is standing there with his machine gun and he said to me, you can't come in. I speak in pretty good Portuguese by that time. I said, my God, my plane, my family, I got to come in. He said again, you can't come in. I said,”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Conflicted, right? It's a little bit like CFTC and SEC have a door jam over who will regulate cryptocurrency, right? Sometimes regulators fight each other But they fight each other. They fight companies. They're active players. This reputation and power book, the reason I mention it is I want to see if I can find this quote. So let me see if I can find this quote.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Are just two portrayals, but in general, what you find is when you talk One thing I'll often hear from folks is, why would they do that? They have no mental model of this. They kind of think of it as Why would this thing, which they think of as sort of the DMV? They don't think of the DMV as like this active thing. Why would the FDA do that? Well, it is because it's filled with some ambitious people that want to keep increasing the power of the agency, just like the CO wants to increase the profit of the company, right? I use that word ambitious ambit? Because these folks are, we know the term greedy, right? These folks are power hungry. They want to have the maximum scope. And sometimes regulatory agencies collide with each other, right? Even though FDA is under HHS, sometimes it collides with HHS and they've got regulations that conflict. For example, HHS says everybody's supposed to be able to have access to their own medical record. FDA didn't want people to have access to their own personal genomes, that conflicts, okay? And both of those are kind of anti-corporate statutes that were put out with HHS thing being targeted at the hospitals and FDA being targeted at the personal genomics companies.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“So, the EPA is actually the villain in that, where they flip a switch that lets out all the ghosts in the city. And essentially, the guy is coming in with a head of steam as this evil regulator that just totally arrogant, doesn't actually understand the private sector or the consequences of their actions. And they force, and crucially, they bring a cop with them with a gun. So it shows that a regulator is not simply some piece of paper, but it is the police. And that cop with a gun forces the Ghostbusters to like release the containment and the whole thing spreads. A second example is Dallas Biers Club, which is more recent. And that actually shows the FDA blocking a guy who with a life-threatening illness, you know, with AIDS from getting the drugs to treat his condition and from getting it to other people, right?”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“So if the establishment is wrong, if the bureaucracy is wrong, they're all wrong at the same time. Who could have known? Whereas if you deviate, then you are a deviation who can be hammered down. Now, the school fish strategy is unfortunately very successful because truth is whatever. If you just always ride with the school of fish and turn with the intern and so on, unless there's a bigger school of fish that comes in, you basically can never be proven wrong, right? And this is actually, you know, of course, someone who believes in truth and believes in, you know, innovation and so on just physiologically can't ride with a school of fish. You just have to say what is true or do what is true, right? Still, you've described correctly, you know, how it's faceless, right? So I will give two examples of fictional portrayals of evil regulators. One is actually the original Ghostbusters.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Right. That's what I call the school of fish strategy, by the way. It's something where you are an individual and you can be signaled out, but there's more accountability for one person's bad tweets than all the wars in the Middle East, right? Because it's a school of fish.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“And they may actually be doing good, but the thing is with CEOs, we have a zillion images in television and media movies of the evil corporation and the greedy CEO. We have some concept of what CEO failure modes are like. Now, when have you ever seen an evil regulator? Can you name a fictional portrayal of an evil regular? Can you name an evil?”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Sure, but the fiduciary duty will push people to get the ambitious, the profit maximizing expansionist CEO is selected for. Basically, they believe crucially they're not just this important, they're not just, I mean, some of them are Grand Theft Auto make as much money as possible, but they believe in the mission. They've come to believe in the mission, and that is a person who's selected. Chomsky actually had this good thing, which is like, I believe that you believe what you believe, but if you didn't believe what you believe, you wouldn't be sitting here.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Wait a second He is describing this as an active player. It's not like a DMV kind of thing which is passed through. It's talking about cultivating a reputation, its power, resisting efforts to curb its own authority, right? The thing is now you're kind of through the looking glass. You're like, wait a second, this is kind of language I don't usually hear for regulatory agencies. The thing is, the kind of person who becomes the CEO of a giant company, what do they want to do? They want to expand that company. They want to make more profit. Similarly, the kind of person who comes to run a regulatory agency or one of the subunits, that person wants to expand its ambit.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“It's a good book. Yeah. Or it's now a little bit outdated because it's like almost 10 years old. Still, as a history of the FDA, it is well worth reading. And by the way, the reason I say it, like the FDA is so insanely important. It's so much more important than many other things that people talk about, but they don't talk about it, right? I just want to read his little blurb for it, right? This is 2010. The U.S. Food and Drug Administration is the most powerful regulatory agency in the world. How did the FDA become so influential? And how does it wield its extraordinary power reputation power traces the history of FDA regulation pharmaceuticals, revealing how the agency's organizational reputation has been the primary source of its power its ultimate constraints? throughout the last century and how this organizational image has enabled agency to regulate while resisting efforts to curb its own authority. First of all, just that description alone, you're like,”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Up prices in the US medical system. So now you have something where these CEOs, they're going through this aperture. They can't tell anybody about it because if you read reputation and power, okay, I'm going to just quote this because amazing book, right? It's written by a guy, Daniel Carpenter, a smart guy, but he's an FDA sympathizer. He fundamentally thinks it's like a good thing or what have you. Nevertheless, I respect Carpenter's intellectual honesty because he quotes the CEOs in the book, you know, verbatim, and he gives some paragraphs. And essentially, from their descriptions, it's like, think about like a Vietnam War thing where you've got a POW and they're blinking through their eyes of being tortured. Okay. That is the style when you read Carpenter's book, you read the quotes from these CEOs. Let me see if I can find it.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Impede the approval of something and choke you out financially because you don't have enough runway to get funded. So impose more wait time. Guess what? We want another six months. Data is going to take you another six months. Your company doesn't have the time. You die, right? If you live, you have to raise around at some dilutive valuation. And now the price gets jacked up on the other side. That's the one thing that can give, by the way, in this whole process. When you push out timelines from days to get a vaccine approved or vaccine evaluated rather via challenge trials to months or years, the cost during that time, when you, it just increases nonlinearly, right? Because you can't iterate on the product. All the normal observations, if it takes you 10 years to launch a product versus 10 days, what's the difference in terms of your speed of duration, your cost, et cetera, right? So this is part of what, it's not the only thing. There's other things. There's AMA and CPT. There's other things. But this is one of the things that Jackson.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“That to FDA, just like a lot of what TSA does is security theater, arguably all of it. A lot of what FDA does is safety theater. The difference is there's far fewer people who go through the aperture. There are the biotech and pharma CEOs. So you don't have an understanding of what it is to deal with them, number one. Number two is the penalty is not a few hundred dollars of missing your flight. It is a few million dollars or tens or hundreds of millions of dollars for getting your company subject to the equivalent of a retaliatory wait time. Just like that bouncer threw you out, just like the TSA officer, if you make a joke or, you know, they can just sit you down and make you lose your flight, right? So two, can the FDA just”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Right, now it's guns and drugs. Basically, it's like essentially what they've done is they've repealed the Fourth Amendment. Search and seizure, they can do it without probable cause. Everybody is being searched. Everybody's a potential terrorist. So they've got probable cause for everybody in theory. And so what they do, they'll post on their website the guns and drugs or whatever that they seized in these scanners. Well, of course, if you search everybody, you're going to find some criminals or whatever. But the cost of doing that is dramatic. Moreover, the fact that people have been trained to have, you know, compliance, it's like the Soviet Union, right? Where, you know, just grudgingly RI go along with this extremely stupid thing. What's my point? The point is this is a really stupid regulation that has existed in plain sight of everybody for 20 years. We're still taking off our shoes because some shoe bomb or whatever number of years ago, okay? All of this stuff is there as opposed to other things you could potentially do different paradigms for quote airport security. But now...”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Point being that despite the cost, despite how many people are exposed to it, despite how obviously patently ludicrous it is, you don't make any trouble, nor do people organize protests or whatever about this because it's something where people, the security theater of the whole thing is part of it. Oh, well, if we took them away, there would be more terrorism or something like that. People think, right?”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“I think it's quite likely, by the way, that if there was even a slightly increased cancer risk, that the net morbidian mortality from those would have outweighed the deaths from terrorism or whatever that were prevented. You can work out the numbers, but you can just get the math under reasonable assumptions. It's probably true if it had any increased morbility and mortality. I've not seen the recent things, but I've seen that a concern expressed 12 years ago.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“And the thing about this is everybody in line, actually some fairly high, let's say called it influence or net worth or whatever, people fly, right? Millions and millions and millions of people are subject to these absolutely moronic regulations. It's all what, you know, I think security theater is Schreier's term, right? A lot of people know this term. So millions of people are subject to it. It costs untold billions of dollars in terms of delays and whatnot. If you just walk up to, right? It irradiates people in this other FDA thing, by the way. This is an FDA TSA teamup. In 2010, the TSA body scanners, there were concerns expressed. But when it's a government-to-government thing, see a dot-com is treated with extreme scrutiny by FDA. When it's another.gov, well, they're not trying to make a profit. So they kind of just wave them on through, okay? So these body scanners were basically applied to millions and millions of people. And this huge kind of opt-in experiments.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“That's exactly right. So, just like with the TSA, just to extend the analogy, when you're in line at the TSA, you don't want to miss your flight. That could cost you hundreds of dollars. And so you comply with absolutely ludicrous regulations like, oh, three ounce bottles. Well, you know what? You can take an unlimited number of three ounce bottles and you can combine them into six ounce bottle through the terrorist technology called mixing. Okay, advanced, right”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Absolutely. The best analogy is you think about the TSA. Have you flown recently? Okay. Do you make any jokes about the TSA when you're in the TSA line?”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“So it depends, right? Basically, this is why you have to pick off individual elements. There's essentially a combination of first recognizing that DFT is actually bad. Even be able to say that, let me put it like this it does a lot of bad things. It is something which you need to be able to criticize. You might be like, well, that's obvious, right? Well, in 2010, for example, there's a book that came out, if anybody wants to understand FDA, it's called Reputation and Power.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Here's how that would work, right? You go to the pharmacy or wherever, and you hold up your phone and you scan the barcode of the drug. What does it say? Instantly you see global reports, by the way, because your biology or physiology, that's global, right? Information from Brazil or from Germany or Japan on their physiological reaction to the same drug you're taking is useful to you. It's not like a national boundaries thing. You want is to see every patient report and every doctor around the world on this drug. That might be really important to your rare or semi-rare condition. Just that alone would be a valuable site.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“So 3500B consumer voluntary reporting. When do I use this form? You were hurt or had a bad side effect. Use a drug which lives unsafe use, etc. The point is FDA already has a terrible Yelp for drugs. It has a terrible version of it. What would the good version look like? The fact that you've never, I mean, this fact you have to fill out a PDF to go and submit a report. How do you submit a report at Yelp or Uber or Airbnb or Amazon UTAP and their star ratings, right? So just modernizing FDA 3500B. And modernizing phase four, okay, is a huge thing.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, so it's like it's called Medwatch, right? And so you can do voluntary reporting and you can get like a PDF and just like upload it, right?”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Sure. I mean, they did a lot of other good things, but this is one thing that they did well, right? So PillPAC just shows what you can get with improving on user interface. reviews for everything, right? One thing that, you know, like people have sort of, in my view, somewhat quoted out of context are like, oh, biology thinks you should replace the FDA with the ELP for drugs. Actually, there's something called phase four of the FDA, which is so-called post-market surveillance. Do you know that that's actually something where in theory you can go and fill out a form on the FDA website, which basically says I've had a bad experience with a drug?”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Just on user interface, you can innovate. And why is it important? Well, there's a company called Pillpack, which innovated on, quote, the user interface for drugs by giving people a thing which had like a daily blister pack. So it's like, here's your prescription and you're supposed to take all these pills on the first and second. And basically whether you had taken them on a given day. Was manifest by whether you had opened it for that specific day. This is way better than other kinds of so-called compliance methodologies like the guys who tried to do like an IoT pill where when you swallow it, it gives you measurements. This was just a simple innovation on user interface that boosted compliance in the sense of compliance with the drug regimen dramatically, right? And I think they got acquired or would have you for a lot of money”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“That's what it is, right? That's what a terrible user interface. We don't usually think of it that way. Why is user interface so terrible? That's a web of regulation that makes it so terrible. And, you know, there's actually guys who try to innovate just on user interface call like, help, I need help. That was like the name of the company a while back. And it was trying to explain the stuff in plain language.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Safety is actually relatively easy to test for. There's very few drugs that are like, there's TGN 1412. That's a famous example of something that was actually really dangerous to people with an early test. So those do exist. Just acknowledge they do exist. But in general, testing for safety is actually not that hard to do. And if something is safe, then you should be able to try it usually. Now, what does that decentralized FDA look like? Basically, you take individual pieces of it and you can often turn them into vehicles. And this is like 50 different startups. Let me describe some of them. First, have you gotten any drugs or something like that recently? I mean, like prescribed drugs, prescription drugs.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Compounding pharmacies, these were under attack. I'm not sure actually where the current statute is on this, but this is the idea that a pharmacist has some discretion in how they prepare mixtures of drugs. Off-little prescription by MDs. So MDs have enough weight in the system that they can kind of push back on FDA. And off-little prescription is the concept that a drug that's approved for purpose A can be prescribed for purpose in B or C or D without going through another whole new drug approval process. And then countries that aren't harmonized, right? So those are like five different kinds of exits from the FDA on different directions. So first, those exits exist. So for those people who are like, oh my God, we're all going to die or is going to poison us with non-FDA approved things or whatever, right? Those exits exist. You've probably actually used tests or treatments from those. You don't even realize that you have, right? So it hasn't killed you, number one. Number two is actually testing for safety. There's safety, efficacy, and like comparative.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Crypto economy. So that part, I think, is going. Okay. We can talk about that. What does that look like for biomedicine? Well, first, what does exit the FDA look like? So there actually are a bunch of exits from the FDA already, which is things like right to try laws, CLIA labs and laboratory developed tests, compounding pharmacies, off-label prescription by doctors, and countries that aren't fully harmonized with FDA. For example, Kobe Bryant before he passed away went and did stem cell treatments in Germany. Stem cells had been pushed out, you know, I think in part by the Bush administration, by other things. So those are different kinds of exits, right to try basically means, you know, at the state level, you can just try the drug. CLIA Labs and LDTs, that means that's a path where you don't have to go through FDA to get a new device approved. You can just run it in a lab.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“And this is where I'm talking about V3 as critical as I am of FDA or the Fed for that matter. I also actually recognize that the Ron Paul type thing of end the Fed is actually not practical. End the Fed will just be laughed at. What Bitcoin did was a much, much, much more difficult task of building something better than the Fed. That's really difficult to do because the Fed and the FDA, they're like the hub of the current system. People rely on them for lots of different things. And you're going to need a better version of them. And how would you actually build something like that? So with the Fed and with SEC and the entire, the bank. and whatnot, crypto has a pretty good set of answers for these things. And over time, all the countries that are not, all the groups that are not the US establishment or the CCP will find more and more to their liking.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Various attacks on raw milk, where they were basically saying, here's a quote from FDA filing in 2010. There's no generalized right to bodily and physical health. There's no right to consume or feed children any particular food. There's no fundamental right to freedom of contract. They basically feel like they own you. You're not allowed to make your own decisions about your food. There's no generalized right to bodily and physical health. Direct quote from there, like written kind of thing. The general frame is usually that FDA says it's protecting you from the big bad company, but really what it's doing is preventing you from opting out.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“For the entire North American continent. So that was a time when Pharma moved at the speed of software When it was a willing buyer, willing seller because the past is demonized as something that our glorious regulatory agency is protecting us from. But there's so many ways in which what it's really protecting you from is being healthy. As, you know, I mean, there's a zillion examples of this. I won't be able to recapitulate all of them just in this podcast, but if you look at a post that I've got, it's called Regulation, Disruption, and the Future, Technologies of 2013, Coursera PDF, okay. This lecture, which I'll kind of link it here so you can maybe put in the show notes if you want, this goes through like a dozen different examples of crazy things the FDA did from the kind of stuff that was dramatized in Dallas Byrus Club where they were preventing people from getting AIDS drugs to their”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“V1 was quote patent medicines. That's what some people say. But V1 was also banting in best. Banting in best. They won the Nobel Prize in the early 1920s. Why? They came up with the idea for insulin supplementation to treat diabetes. And they came with a concept. They experimented on dogs. They did self-experimentation. They had healthy volunteers. They experimented with the formulation as well, right? Because just like you'd have like a web app and a mobile app, maybe a command line app, you could have a drug that's administered orally or via injection or cream or there's different formulations. Dosage, all that stuff, they could just like iterate on with willing doctor, willing patient. These folks who are affected just sprang out of bed. The insulin supplementation was working for them. And within a couple of years, they had won the Nobel Prize and Eli Lilly had scaled.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Right. So FTA has got there. So coming back up basically. Just talk about FDA and then come back to your question on the de-platform.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Okay, okay, okay. Sorry. So basically, like English start going one, two, three, four, five. And I believe it's like the Germans start with like the thumb. Something that you'd never know, right I may misremembering that, but I think that's right. Okay. So that's like.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“They have a sort of in group lingo where when you are kind of talking about them the way that they talk about themselves, it is something that kind of piques interest. It's kind of like in LA, people say the 101 or the... Whereas in Northern California, they'll say 101, or people from Nevada will say Nevada.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, right. So, what was before FDA, right? So there was both good and bad before FDA because people don't necessarily have the right model of the past. So if you ask people what was there before the FDA, they'll say, and by the way, FDA itself omits the, right? Their pronouns are just FDA FDA, okay? But basically, why was it?”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Ah, so let's talk about that, right? Something like FDA. So, this is very important. In general, the way I try to think about things is. V1, V2, V3, as we've talked about a few times”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“To do it right, and you know, look, it's hard to call every single thing right, and I'm sure someone will find some errors, but in general, I think that was actually pretty good for like early February of 2020, right? So it's my point, though. The point is rather than copying Chinese lockdown, what we should have had were different regimes around the world. To some extent, Sweden defected from this, right? They had no lockdowns or what have you. But really, the access that people were talking about was lockdown versus no lockdown. The real axis should have been challenge trials versus no challenge trials. We could have had that in days. And those are two examples on both vaccines and testing. There's so many more that I can point to.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Contagious in that basically no NPI, no non pharmaceutical intervention really turned out to work that much, right? And actually at the very beginning of the pandemic, I said something like, look, this is actually February 3rd, about a month before people, you know, I was just watching what was going on in China. I saw that they were doing digital quarantine, like using WeChat codes to block people off and so on. I didn't know what was going to happen, but I said, look, if the coronavirus goes pandemic and it seems it may, the extreme edge case becomes the new normal, it's every debate we've had on surveillance, deplatforming, and centralization accelerated. Pandemic means emergency powers for the state even more than terrorism or crime. And sometimes a solution creates the next problem. My rough forecast of the future, the coronavirus results in quarantines, nationalism, centralization. And this may actually work to stop the spread, but once under control, states will not see their powers, so we decentralize. And I didn't know whether it was going to stop the spread, but I knew that they were going to try to...”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, that's right. Like, if military service is something which is its ritualized thing, people are paid for it, but they're not paid that much. They're really paid in honor, you know, and in duty and patriotism. That is actually the kind of thing where I do believe some fraction of those folks would have raised their hand for this important task. I don't know how many of them, but I do think that volunteers would have been there. There's probably some empirical test of that, which is there's a challenge trials website. There's a Harvard prof who put out this proposal early in the pandemic. And he could tell you how many volunteers he got. But something like that could have just shortened the time from pandemic to functional vaccine, right? To days even, if you had actually really acted on it. The fact that that didn't happen and that the Chinese solution of lockdown, that actually, you know, at the beginning, people thought the state could potentially stop the virus, stop people in place. It turned out to be more.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, so let me put it like this had we done that, we could have had vaccines early enough to save the lives of like a million Americans, especially seniors and so on. Soldiers and more generally first responders”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“And then that would have given you all the data because ultimately the synthesis of the thing, I mean, yes, you do need to scale up synthesis in manufacturing and what have you. But the information of whether it worked or not and was safe and effective, that could have been gathered expeditiously with volunteers for challenge.”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, it may be, by the way, that those who are the most susceptible to the virus died faster earlier. It's as if you can imagine a model where those who were exposed and had the lowest susceptibility also had the highest severity and died in greater numbers early on. If you look at the graph, like deaths from COVID were exponential going into about April 2020 and then leveled off to about 7,500, 10,000 a day and then kind of fell, right? But it could have gone to 75,000 at the beginning. So we didn't know how serious it was. So this would have been a real risk that these people would have been taking. But here's what they would have gotten for that. Basically, in a challenge trial, somebody would have been given the vaccine and then exposed to the virus. And then put under observat”
2022-10-20 · Lex Fridman Podcast · #331 – Balaji Srinivasan: How to Fix Government, Twitter, Science, and the FDA · IDENTIFIED FROM THE TRANSCRIPT · source