The Altucher Confidential
By James Altucher
(she's $300,000 in debt).
Time to end the FDA, traditional medical education and the insurance companies. Just get rid of them.
Let’s start with the worst and most corrupt semi-government institution known to mankind: the Food and Drug Administration. The administration that lets you smoke as many cigarettes as you need to get lung cancer, drink a ton of alcohol to get liver cancer, but then won’t let you take any of the drugs or treatments for lung cancer or liver cancer.
I have to tell you something: almost every cancer has been cured already. But let’s say I’m a scientist with a bad personality (I’ve been accused of being a bad scientist with a congenial personality but never the former). Let’s also assume I’ve developed a drug that will cure your liver cancer without chemo. Now what do I do?
Here’s the four steps I would CURRENTLY have to do:
A) It costs a billion dollars to get a drug through the Food And Drug Administration. This is why I mention the bad personality part. There’s zero chance I’m going to raise this money. Instead, because my personality is so bad I have no friends at the various research magazines so I’ll never get my findings published and consequently I’m going to get fired before I get tenure and I’m going to end up as a cashier at Walmart. What sort of tests do I need to do? I have to round up potentially thousands of people to take my drug, take placebos, check for safety, effectiveness, blah blah blah. It takes ten years to do this so potentially valuable drugs stay out of the hands of patients who will most assuredly die in this time.
B) At any one of these four steps, judges at the FDA can decide if I passed or failed my trial. These judges are often people who have worked at my competitors or who want to work at my competitors, making it extra hard to get through the implicit corruption that surrounds the FDA.

C) Now I have to convince the insurance companies to pay for my medicine so patients don’t have to pay the full cost. Because I just spent a billion dollars on approving my medicine (over a TEN YEAR period on average) the medicine is VERY expensive so I can make back the cost. Insurance companies don’t want to pay for my medicine. They don’t want to pay for any medicine really. So this is a hard process. And I have to raise another $50 million to survive long enough to hire people who will convince all the insurance companies to accept my drug.
D) Finally, I have to educate doctors that my drug will cure liver cancer. Doctors could care less about me. They are going on cruises funded by the big pharma companies (who just finished spending billions on their drug trials) and the big insurance companies where they are told what billion dollar drugs to recommend to their patients. They aren’t going to listen to me.
So basically, if I have the cure for liver cancer, nobody is going to ever find out. It’s like a five year old with the talent of Mozart who never touches the piano. Nobody will ever know. I’ll give up in the laboratory before I even tell anyone. The best doctors do, in fact, educate themselves and illegally prescribe “orphan drugs”: Drugs that might have been approved for kidney cancer but NOT approved for liver cancer and will recommend those drugs for liver cancer. But most doctors will not do that because it’s technically illegal..And certainly no doctor will recommend a drug that has NOT been approved by both the FDA and the insurance companies.
Wow, you might think. This is a disaster. Will Obamacare help? Will anything help?
And the answer is “Yes”. Here’s the very simple solution:
A) Get rid of the FDA. Simple. Let the Internet be a virtual FDA. A drug will have a web page, a scientist with verified credentials will document his research, and comments from users will describe their experiene with a drug. Many people die and get sick from FDA-APPROVED(!) drugs. The same thing will happen here. But will save the billion dollars and will allow drugs to be quickly tested by the audience that needs it most – people dying of terminal diseases. These people will quickly report back if there is success and we’ll know what works and what doesn’t. If there are bad stories then it’s a guarantee we will hear about them. And it won’t require a billion dollars and ten years to hear about them.
Well, what about the rest of the FDA? Oh, you mean the part that puts labels on cigarettes and allows hot dogs (also related to intestinal cancers) to be colored red? You can get rid of them also. They cause more cancers than they cure anyway.
(this is APPROVED by the FDA)
But don’t they fight drugs? Uhhh….Good luck with that.
What’s the net outcome of having zero FDA?
The cost of drugs will go down from $600 for a month’s use to $10. And drugs that actually cure things (instead of drugs that had the personalities behind them to raise a billion) will actually make it to market. The net result: more people will live longer. And drug research will be infinitely more productive.
B) Get rid of 90% of insurance companies. Once drug treatment costs go down to zero and there’s more competition among drugs (because more drugs are available) then why do you need to insure for them? I still might want to insure for things like long-term disability or life insurance but almost all medical insurance will be eliminated. Why is this a good thing? Because medical insurance, which claims to help you, is actually on the other side of the table from you – they will try to deny that you have an illness, or they will try to limit the amount of treatment you get- simply because they don’t want to pay for it. So they are not your friend. As I mentioned in my post “How to Deal With Crappy People” – stop hanging out with the people who are not your friends.
C) Get rid of Medical Education. Doctors graduate with $300,000 in debt often. So they have to make it up by recommending every treatment possible to you and charging as much as possible so they can pay back their loans. This is not in your favor. Almost everything I can learn in an expensive medical school I can learn with a combination of Passion + Internet + Apprenticeship.
So if someone truly wants to help people and be a “MEDICAL DOCTOR” here’s what I recommend: the following three (or four) step medical education:
(I can totally do this)
1) At the age of18, spend a year changing bedpans at a hospital and let’s see if you truly have the passion AND compassion to be a medical doctor (most don’t have either but by the time they finish their $300,000 in debt education they are forced to continue in order to pay back their loans and to justify the 12 year time invested).
2) Spend a year where you pay a GP (or whatever field you want to go in) to be their intern. This should cost you about $20,000.
3) Spend a year as an apprentice for the same GP but charge a lower rate to patients.
4) If you want to be a surgeon, go to a 1-2 year “surgeon school”
5) A yelp-like system should be created to review both drugs and doctors. Yelp has proven to be extremely efficient for ranking the most important aspect of our society – our culinary tastes. Why not use it for other important things. Like where and how we get treated for illness.
Now you’re an MD. At theage of 20 or 22. Not 32.
Net result of all of this:
A) Cheaper and more drugs
B) More diseases cured
C) Bigger community discussing the diseases and various treatments. This is what social media is for. It should be transformative of the medical industry.
D) More doctors.
E) Less expenses all around for the patient
F) More medical facilities around the country
G) Less corrupt influence of the big insurance and pharma companies
H) Less government expense by eliminating the FDA.
You can argue, “But more people will die from bad drugs.” Many many more people will be saved also. And once a drug is truly discovered (and this will happen much faster in my system) to cure liver cancer then that drug will quickly rise to the top in the yelp-system and everyone will begin using it and all the people with liver cancer will be saved. Let’s not forget, the FDA recalls as many drugs as it approves. How come? Because the real world is different from a laboratory. And once a drug is approved it often is shown to have harmful effects when it’s prescribed. So then it’s recalled, showing once again the FDA does nothing useful but cost people money.
On top of all of this, my system will create many more doctors with much more compassion. And if they want to suddenly change jobs, then let them. They haven’t invested 12 years and$300,000 to be a doctor. But that’s ok, because there’s many people lining up to replace them.
What about all the jobs lost at the insurance companies and the FDA? Well, maybe they should become doctors and help people instead of hurt them!
So, for anyone needing a pap smear, or a check of their tonsils, or having problems with depression or post-traumatic stock market stress, give me a holler. Office hours are open.
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And you can buy my book: I WAS BLIND BUT NOW I SEE