Essential Complexities

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In my current column for the Pittsburgh Tribune-Review (which will be my final one for that splendid publication) I challenge the popular notion – one unsurprisingly pushed by Trump’s trade advisors – that the U.S. government should restrict Americans’ trade to ensure that we Americans produce all of our “essential medicines ^[2].” A slice:

Consider a drug with no substitutes and a 90% chance of working. Is this drug sufficiently essential to justify government preventing Americans from importing lower-cost versions of it? Many people will answer “yes.” But what if this drug’s chances of working are only 50%? Or a paltry 5%?

If you encounter difficulty answering such questions, the reason is not just that there’s no objective point at which a drug’s success rate transforms it from inessential to essential. Any such question is difficult to answer because a “correct” answer depends also upon just what illness a particular drug treats.

Which of the following four drugs, if any, would you classify as essential: one with a 0.1% chance of curing covid-19; one with a 10% chance of curing covid-19; one with a 40% chance of curing leukemia; one with a 100% chance of curing toenail fungus?

You’re more astute than me if you have a sure answer to this question.

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