Indeed Joe,
“Imagine there is no [FDA]
You can do it if you try. . . ”

The drug companies have to make drugs that work (phase I and II trials) and do not cause harm (phase III),
then they advertise to the public.

Then instead of, as the Health Affairs article suggests: “help restore public, scientific, and professional confidence in the FDA …”

Individuals then must rely on their own confidence in the integrity and scientific expertise of the drug company. They test the drug on themselves and continue to buy it if it works and does not cause them harm. If it works, they tell their friends and relatives (without fear of HIPAA confidentiality rules) and the drug will do well in the marketplace. Those individuals who do not have confidence in the drug companies (and think they are an evil cousin to the oil/military complex, unless the FDA says okay) will not take the pill right away, but will probably try it after they find it gaining popularity among their friends.

By the way, Do lawyers run in and sue meth-amphetamine makers when someone ruins their life due to regular use?