Cry ‘havoc’ and let slip the dogs of war. ~ William Shakespeare
Politics. It helps to love history. It also helps if you are particularly fascinated by those shifts, some violent, like World War I and the Civil Rights Era, some gentle as when the brilliance of the Renaissance gave way to the Rococo.
If you love history, you have probably already concluded one of those shifts is upon us. If you are unsure, last week offers some convincing evidence.
Before the poorly named Select Subcommittee on the Weaponization of the Federal Government last week appeared former Rolling Stone reporter Matt Taibbi and author Michael Shellenberger.
Both men have published, along with Bari Weiss and several others, what has become known as the Twitter Files, a record of communication between United States Government agencies like the Centers for Disease Control and Prevention, NIH and the Food and Drug Administration and Twitter’s management.
Of particular interest to us are agency appeals to Twitter to suppress what the company called “true” content related to COVID-19 vaccine safety and efficacy. Twitter’s efforts included communication from the official account of Rep. Thomas Massie, including replies from his constituents.
These facts are not in dispute.
What appears to be the focus of controversy, especially for the minority party, are things that were last debated in the Johnson and Nixon administrations, like constitutionally protected speech.
A published account cannot do it justice so, please watch it. If you do and you can transcend the team spirit of partisan politics, you should see something that looks a lot like the 1969 Chicago Seven trial.
As was the case then, the struggle is not between political parties but by and between those in power and those that threaten it. It is a contest of ideas and ideals that will define, as they did in the 1960s, the moral and intellectual direction of the country.
I hope the music is as good.
Policy. One would think that, given the federal government has been accused of suppressing alternative interpretations of safety and efficacy data of medical products, it would move to defeat such arguments.
But no. FDA Commissioner, Dr. Robert Califf is making the press rounds to float the idea of eliminating voting questions for the adcomms, perhaps disbanding them altogether. He like, CDC Director Rochelle Walensky, has bemoaned mis/dis information that they believe has undermined trust in federal health care agencies.
Like the gentle Congresspeople questioning Mr. Taibbi and Mr. Shellenberger, Dr. Califf cannot understand why anyone gets their information on health care from Twitter. He longs for the day when “’The FDA says it’” was all that was needed.
The cure for that, apparently is less information not more. That, of course, translates to less trust, not more.
Power. As Mr. Taibbi and Mr. Shellenberger were doing their best Abbie Hoffman and Tom Hayden, the Silicon Valley Bank, which looks more like a club than a financial institution, was arriving at its inevitable destination.
Immediately, the cries of ‘havoc’ went up. From Garry Tan to David Sacks. Silicon Valley’s finest, its most accomplished, are sure there will be bank runs, threats to national security (yes, really), and an end to American innovation as we know it.
On that last point, American innovation, particularly in the creativity- deprived health care sector and especially for the last 10-15 years or so, puts the agrarian era to shame.
Multifactor productivity grew 0.7% between 1987 and 2020 with most credit going to the late 1980s and 90s, influenced by the decentralization and magnification of computing power. It has mostly been a wasteland since.
(Notable exclusions include EV-powered vehicles, robotics and engineered home construction products.)
With those few exceptions, the innovation of which these titans speak is marginal and, absent a lot of free money that pushed pension funds and other institutional investors toward risk, would probably have never been (over) funded.
We won’t know the extent of damage, if any, to the broader financial system for a few days but notwithstanding that outcome, we should conclude that the big dogs on Sand Hill Road recognize the end of an era.
As C. S. Lewis observed, grief feels a lot like fear.
Have a great rest of your long weekend.
Emily Evans
Managing Director – Health Policy
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