ADHD, Politicians, and Insanity
The definition of insanity is doing the same thing over and over again and expecting different results. This is what we are doing when we let politicians make public health policy. Granted, some government oversight is necessary to prevent unsafe health practices. However, my main point for bringing this up is the ADHD medication shortage. The head of the Food and Drug Administration Robert M. Califf, M.D. recently said the ADHD medication shortage is due to telehealth prescriptions and practices. This statement shows an ignorance about ADHD, its treatment, and basic economics.
It’s Not Just Me Complaining
Before I get into my rant, let me just point out that the American Academy of Child and Adolescent Psychiatry and the American Psychological Association sent a letter to Dr. Califf about this very issue, demanding a meeting with him to discuss the ADHD medication shortage. As far as I know, such a meeting has not occurred.
Is ADHD Overdiagnosed?
The short answer is no. Most experts in ADHD believe that most people who have ADHD do not know they have it. Sure, it may be over diagnosed by certain providers in certain areas, but it is probably under diagnosed overall. Many people who struggle with ADHD also struggle getting proper treatment. By decreasing or limiting access to proper treatment, the FDA is making matters worse. Do not doctors pledge to do no harm?
Supply and Demand
If the supply of ADHD medication is marked by a shortage, the price of these medications will rise. Anyone who has taken a basic economics course will tell you that, if there is an increase in supply, there will be a decrease in price. If we want to help ADHDers who are struggling to pay for ADHD treatment, we should be increasing the amount of supply, not limiting it.
An Ignorant Comment from Dr. Califf
In the WebMD interview that sparked this tirade, Dr. Califf made a stupid comment I wish to reflect on: “[W]e don't make the medicine and we can't tell someone they must make medicines.” The FDA does not tell companies to produce these medications. However, if the head of the FDA went to the DEA and told them to increase the quota of stimulant medications that can be manufactured, that would be a powerful statement. It would undoubtedly influence the decision makers at the DEA. The reason there is a shortage is the quotas are not be increased to meet the legitimate increase in demand. Therefore, Dr. Califf can do something to help mitigate the shortage, but so far, he has done nothing.
It’s All about Money and Power
The head of the FDA is appointed by the president. This is true no matter what party is in power. In short, if the head of the FDA wants to keep their job, they must keep the president happy. Therefore, they undoubtedly feel pressure to enact policies that align with the president’s political agenda (again, no matter what party is in power). What influences politicians’ decisions? My opinion is it is the desire to stay in power. We have this idealized view that politicians are acting for the greater good. However, it seems to me that politicians tend to do what will keep them in power. A lot of the causes politicians champion are just ways for them to virtue signal. They want to look good, so people vote for them. However, they cannot convince people to vote for them if they do not have campaign donations. In order to get those donations, they need to say and do things that will help them get wealthy people and organizations to donate to their campaigns. It’s not about doing the right thing; it’s about staying in power.
What Can Be Done?
We often forget that politicians work for us, the people. We can vote them out of power, and we can write letters to them demanding action. In short, we need to make noise. If enough people create noise around this issue, they will have to listen. We want them to feel scared. If they feel advocating for this issue will help their chances of getting re-elected, they will act.
Term limits would also help. If we limited how long someone can serve in the federal government, they will make the right decision, instead of the decision that will get them re-elected.