Gottlieb: Friend or Foe?

On Monday, the outgoing FDA capo Scott Gottlieb published an opinion piece in The Wall Street Journal to address the climate surrounding vaping in America. In the maelstrom surrounding San Francisco’s impending e-cigarette ban, Gottlieb’s piece comes off as a friendly, rational counterpoint to the hysteria driving lawmakers in Northern California – or does it?


While the piece, entitled “The FDA’s Challenge on E-Cigs”, contains some decent and well-articulated points, the entire concept is worthy of skepticism, owing largely to the character of Scott Gottlieb himself.

Gottlieb made his political bones at the American Enterprise Institute. For the uninitiated, the AEI is a neocon thinktank headed by Arthur C. Brooks and counting among its alum such ghouls as Jonah Goldberg and Newt Gingrich. Over the years, they’ve pounded the war drums for American imperialism, advocated regressive climate policies, and, of course, wholeheartedly supported the decimation of American healthcare via unfettered capitalism. Naturally, under the current White House regime, a protégé of this institution became the clear choice to head the FDA.


If you dare to venture into the AEI archives, you’ll stumble upon dozens of pieces written by Scott Gottlieb on various healthcare-related topics. In literally each of these pieces, Scott champions a laughable mélange of capitalist fetishism and cynical, empty turns of phrase invoking the supposedly altruistic motives of medical professionals. Take, for instance, his article entitled “We need to make sure new drug cures don’t widen income gap for the poor” in which he explains how drugmakers really wish they could lower drug prices for lifesaving medical treatments, but they just can’t because innovation is so gosh-darn expensive! This sympathy with exploitative pharmaceutical companies and jackbooted dedication to Randian capitalism are the hallmarks of Scott Gottlieb’s career.


Fast-forward to Gottlieb’s latest piece for the WSJ where he once again comes dangerously close to getting the point but can’t quite bring himself to draw the correct conclusion. For instance, he clearly identifies the beneficial impact of e-cigarettes before swinging into full “teen epidemic of vaping” hysteria. In one sentence, he recognizes the potentially life-saving impact of e-cigarette devices while patting himself on the back in the next for implementing “new restrictions on the flavored, cartridge-based products”. Taken as a whole, the op-ed reeks of Gottlieb’s signature “aw-shucks-wouldn’t-it-be-great-if” attitude. In the world of Scott Gottlieb, e-cigarettes may save lives of countless smokers, but it just doesn’t matter in light of the minute risk they pose to children. Rather than accurately and soberly assessing the pros and cons in play, Gottlieb opts to embrace the pathos of anti-vaping fanatics.


Of course, credit where credit is due, even for neocon shills like Gottlieb. His article correctly identifies the ways in which e-cigarettes can form a useful component of a smoking cessation plan. He even lays out some ideas for streamlining manufacturing processes and FDA approval.

Then there’s his bizarre closing paragraph. After winning a few points by acknowledging the health benefits of e-cigarettes, he essentially flushes any good will he’s earned down the drain. After raising the specter of e-cigarettes harming children and waxing on about the “potential but unproven” benefits of e-cigarettes, Scott has a solution: make e-cigarettes an over-the-counter drug.


This point is to be dismissed on two counts. First, if this was Gottlieb’s solution, he should have done so during his time running the FDA. His justification for not doing so is that e-cigs have not proven a “’net public health benefit,’ which is the legal standard”. This, of course, is flatly untrue. Several studies have proven exactly this point and have even laid the groundwork for institutions like Britain’s NHS to advocate for the use of e-cigs in smoking cessation programs. Secondly, this “solution” would inexplicably require e-cigarettes to submit to higher testing, standards, and regulation than traditional cigarettes, which are explicitly murdering millions of Americans on a regular basis. The implication seems to be that youth vaping is somehow far more of a pressing issue than adult smoking, which is a theory not borne out by a single reputable study since vaping’s inception.


The piece ends with Gottlieb’s credentials as a resident fellow at the American Enterprise Institute, a post to which he is likely to return following his departure from the FDA. Once there, we can look forward to hearing more about how the best way to tackle predatory pharmaceutical pricing is to raise the bar for what we consider a disease. Or maybe Scott can explain to us again how competition on the free market is actually more effective at treating diabetes than insulin.


To Scott: we appreciate your half-hearted gesture towards legitimizing the vaping industry for what it’s worth, but otherwise we say good riddance to you. If only we could have faith that your vacant post would be filled by someone any less parasitic in the near future.