Jacob James Rich, a PhD candidate in epidemiology and analyst at Reason Foundation, targets the administrative state’s overreach, citing the 1798 case Calder v. Bull. He argues that the ex post facto clause should block retroactive civil laws, not just criminal ones, and help curb the “deep state.” His dissertation examines the opioid crisis, questioning whether state restrictions on prescriptions reduced deaths or shifted addiction elsewhere. On marijuana legalization, he finds reduced homicides and youth incarceration, but as an Orthodox Christian, he views heavy drug use as morally troubling. Quoting John Chrysostom, he favors persuasion over coercion: “We should not coerce people to change behavior.”
Bock raised Newton, Massachusetts’s cigarette ban for those born after a specific date, an anti-liberty overstep. Newton profits from marijuana dispensaries—3-6% of sales go to the city, while cigarette taxes flow to the state. Massachusetts’ menthol ban drove smokers to neighboring states, boosting regional cigarette sales. Yet, Rich sees smoking fading naturally. “Youth smoking rates are the lowest in history,” he said. “In 20-30 years, it won’t be an issue.” Regulators, he warned, target products with shrinking constituencies, pushing bans as use declines.
The Purdue Pharma saga, central to Bock’s Purdue Paradox, reveals state power’s weight. Purdue developed an abuse-deterrent OxyContin under government pressure, but users turned to illicit drugs, and deaths climbed. Purdue was scapegoated. “Innocence is irrelevant,” Rich said. “The government can destroy you.” Smaller firms like Purdue lack the legal clout of giants like Johnson & Johnson.
Public health’s drift alarms Rich. Epidemiology, his field, models disease spread but increasingly bends to politics. The American Journal of Public Health pushes advocacy, he noted, citing a call for papers on “government fascism” during the George Floyd riots. “They’ve drifted from pure science,” he said. National public health falters, lacking data to govern millions, while local efforts, like Cleveland’s lead pipe removal, succeed. Rich sees a field hijacked by ideological agendas, replacing evidence with activism.
Bock’s concern—the state’s severing of the doctor-patient bond—struck a chord. Rich lamented doctors acting as state agents, sidelining patient choice. “Doctors assume superior knowledge,” he said, “ignoring what the patient wants.” The Hippocratic Oath, once a sacred pledge to prioritize the individual, is morphing into a collectivist creed. “There are now multiple quasi-Hippocratic oaths,” Bock noted, pointing to a Marxist tint in academia.
This shift betrays the trust patients expect, akin to a lawyer serving only his client’s interests. “A doctor might know something unique about a patient the FDA can’t,” Rich said, defending off-label prescribing, as seen with hydroxychloroquine during COVID. Yet, state-driven mandates, like vaccine policies, crush dissent, eroding trust. “They saw ivermectin prescribing as indicating a Trump supporter,” Rich said, recalling politically charged license suspensions.
Rich’s minarchist view—government limited to defense and contracts—rejects state meddling in marriage or drugs. “Marriage is an agreement with God, not the state,” he said. He’d legalize all drugs, prioritizing freedom, though wary of moral decay. Rich and Bock see our state undermining health and autonomy, from Purdue’s fall to medicine’s drift from the patient. Their call: restore individual choice against a creeping, over-maternalistic (nanny state) system.
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