Wall Street Week: The 'broken things' Makary found at the FDA

Welcome to the Wall Street Week newsletter, bringing you stories of capitalism about things you need to know, but even more things you need to think about. I'm David Westin, and this week we talked with FDA Commissioner Marty Makary about the fundamental changes he's making, and with corn farmers in Iowa about the export markets they need to make their business work. If you're not yet a subscriber, sign up here for this newsletter.

Science Plus Common Sense at the FDA

Marty Makary has been the commissioner of the FDA for more than 100 days, much of which he has spent doing what he calls a "listening tour" in six cities and asking FDA staff what they've always wanted to do at the agency.

What has he learned? And how could it change the agency he heads?

On approval of new drugs, he said "we can be more transparent," including by "making decision letters public so that drug developers can see why drugs are not accepted by the FDA."

On vaccines, Makary leaves no doubt that they "save lives," but said "we have seen a loss in public trust in doctors and hospitals because officials demanded that people do something when you're not honest with them that you're not sure."

Makary said reforms at the FDA can lead to more and better investment in the health care sector because "we're cutting red tape — we're going to speed up the approval process without cutting any corners on safety."

One of the biggest issues for the FDA in recent years was its role in approval of opioid drugs like Oxycontin, and Makary said "the FDA did fail." Combining gold-standard science with common sense will help protect against similar failures in the future, he said.

US Agriculture's Dependence on Export Markets

In the on-again, off-again world of US tariffs, no one has more at stake than domestic farmers. For many in the cornfields of central Iowa, farming is a big business, but it's also a way of life — handed down from generation to generation. And this year, Stu Swanson (who farms 1,900 acres of corn and soybeans), says "the corn looks about as good as any I've farmed for 33 years."

US farmers have boosted their productivity in recent years, which means there's more supply than the US food market can absorb. Corn used for things like ethanol can help. Chris Boshart runs the Gold-Eagle Cooperative in Iowa and sees biofuels as a bipartisan solution.

But domestic demand for corn and soybeans alone, whether for food or for biofuels, isn't enough to absorb all that abundant production. Tom Halverson runs CoBank, the largest farm credit bank in the US, and reports that "as far into the future as we can foresee, the agricultural economy of the United States is very, very dependent on access to overseas export markets."

Because of trade uncertainties, he said, those markets haven't been as robust as US farmers need them to be to ensure they make money.