659. Can Marty Makary Fix the F.D.A.?

For 50 years, the healthcare industry has been trying (and failing) to harness the power of artificial intelligence. It may finally be ready for prime time. What will this mean for human doctors — and the rest of us? (Part four of “The Freakonomics Radio Guide to Getting Better.”) SOURCES:Bob Wachter, professor, chair of the department of medicine at the University of California, San Francisco.Pierre Elias, cardiologist, assistant professor of biomedical informatics at Columbia University, medical director for artificial intelligence at NewYork-Presbyterian Hospital. RESOURCES:A Giant Leap: How AI Is Transforming Healthcare and What That Means for Our Future, by Bob Wachter (2026)."Epic Systems (MyChart)," by Acquired (2025)."Detecting structural heart disease from electrocardiograms using AI," by Pierre Elias and Timothy Poterucha (Nature, 2025)."What Are the Risks of Sharing Medical Records With ChatGPT?" by Maggie Astor (New York Times, 2025)."Will Generative Artificial Intelligence Deliver on Its Promise in Health Care?" by Bob Wachter and Erik Brynjolfsson (JAMA, 2023).The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, by Bob Wachter (2015). EXTRAS:"The Doctor Won’t See You Now," by Freakonomics Radio (2025)."How to Stop Worrying and Love the Robot Apocalypse (Update)," by Freakonomics Radio (2024). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Zeke Emanuel (a physician, medical ethicist, and policy wonk) has some different ideas for how to lead a healthy and meaningful life. It starts with ice cream. (Part three of “The Freakonomics Radio Guide to Getting Better.”) SOURCES:Zeke Emanuel, oncologist, bioethicist, professor at the University of Pennsylvania. RESOURCES:Eat Your Ice Cream: Six Simple Rules for a Long and Healthy Life, by Zeke Emanuel (2026)."Nutrition Science’s Most Preposterous Result," by David Merritt Johns (The Atlantic, 2023). EXTRAS:"Is Ozempic as Magical as It Sounds?" by Freakonomics Radio (2024)."The Suddenly Diplomatic Rahm Emanuel," by Freakonomics Radio (2023)."Ari Emanuel Is Never Indifferent," by Freakonomics Radio (2023)."What’s the “Best” Exercise?" by Freakonomics Radio (2014). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

After five years, Levitt is ending People I (Mostly) Admire, and will start hosting the occasional Freakonomics Radio episode. We couldn’t be happier. SOURCES:Steve Levitt, co-author of Freakonomics and host of People I (Mostly) Admire. RESOURCES:"How to Help Kids Succeed," by People I (Mostly) Admire (2025)."Feeling Sound and Hearing Color," by People I (Mostly) Admire (2024)."Richard Dawkins on God, Genes, and Murderous Baby Cuckoos," by People I (Mostly) Admire (2024)."Arnold Schwarzenegger Has Some Advice for You," by People I (Mostly) Admire (2024)."Drawing from Life (and Death)," by People I (Mostly) Admire (2023)."Yuval Noah Harari Thinks Life is Meaningless and Amazing," by People I (Mostly) Admire (2022)."Is This the Future of High School?," by People I (Mostly) Admire (2022)."Does Death Have to Be a Death Sentence?," by People I (Mostly) Admire (2022)."Sal Khan: 'If It Works for 15 Cousins, It Could Work for a Billion People.'" by People I (Mostly) Admire (2021)."Jared Diamond on the Downfall of Civilizations — and His Optimism for Ours," by People I (Mostly) Admire (2021)."Amanda & Lily Levitt Share What It’s Like to be Steve’s Daughters," by People I (Mostly) Admire (2021)."How Rahm Emanuel Would Run the World," by Freakonomics Radio (2020).The Levitt Lab. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

It regulates 20 percent of the U.S. economy, and its commissioner has an aggressive agenda — faster drug approvals, healthier food, cures for diabetes and cancer. How much can he deliver? (Part two of “The Freakonomics Radio Guide to Getting Better.”) SOURCES:Marty Makary, commissioner of the Food and Drug Administration. RESOURCES:"Clinical Trials Affected by Research Grant Terminations at the National Institutes of Health," by Vishal Patel, Michael Liu, and Anupam Jena (JAMA Internal Medicine, 2025)."What the evidence tells us about Tylenol, leucovorin, and autism," by Matthew Herper (STAT, 2025)."I Run the F.D.A. Pharma Ads Are Hurting Americans." by Marty Makary (New York Times, 2025).Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health, by Marty Makary (2024). EXTRAS:"Are You Really Allergic to Penicillin?" by Freakonomics Radio (2025)."How to Fix the Hot Mess of U.S. Healthcare," by Freakonomics Radio (2021)."Bad Medicine, Part 3: Death by Diagnosis," by Freakonomics Radio (2016). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

We all want to stay sharp, and forestall the cognitive effects of aging. But do brain supplements actually work? Are they safe? And why doesn’t the F.D.A. even know what’s in them? (Part one of “The Freakonomics Radio Guide to Getting Better.”) SOURCES:Marty Makary, commissioner of the Food and Drug Administration.Peter Attia, physician, author, and host of The Peter Attia Drive.Pieter Cohen, associate professor of medicine at Harvard Medical School, physician at the Cambridge Health Alliance. RESOURCES:"Protein Powders and Shakes Contain High Levels of Lead," by Paris Martineau (Consumer Reports, 2025)."Accuracy of Labeling of Galantamine Generic Drugs and Dietary Supplements," by Pieter Cohen, Bram Jacobs, Koenraad Van Hoorde, and Céline Vanhee (JAMA, 2024).Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health, by Marty Makary (2024).Outlive: The Science and Art of Longevity, by Petter Attia (2023)."Revealing the hidden dangers of dietary supplements," by Jennifer Couzin-Frankel (Science, 2015). EXTRAS:"China Is Run by Engineers. America Is Run by Lawyers." by Freakonomics Radio (2025)."How to Fix the Hot Mess of U.S. Healthcare," by Freakonomics Radio (2021). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

One Yale economist certainly thinks so. But even if he’s right, are economists any better? We find out, in this update of a 2022 episode. SOURCES:James Choi, professor of finance at the Yale School of Management.Morgan Housel, personal finance author and partner at the Collaborative Fund. RESOURCES:The Art of Spending Money: Simple Choices for a Richer Life, by Morgan Housel (2025).“Popular Personal Financial Advice versus the Professors,” by James J. Choi (Journal of Economic Perspectives, 2022).“Media Persuasion and Consumption: Evidence from the Dave Ramsey Show,” by Felix Chopra (SSRN, 2021).The Psychology of Money: Timeless Lessons on Wealth, Greed, and Happiness, by Morgan Housel (2020).“In Bogle Family, It’s Either Passive or Aggressive,” by Liam Pleven (Wall Street Journal, 2013). EXTRAS: “Harold Pollack on Why Managing Your Money Is as Easy as Taking Out the Garbage,” by People I (Mostly) Admire (2021).“People Aren’t Dumb. The World Is Hard,” by Freakonomics Radio (2018).“Everything You Always Wanted to Know About Money (But Were Afraid to Ask),” by Freakonomics Radio (2017).“The Stupidest Thing You Can Do With Your Money,” by Freakonomics Radio (2017). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Behavioral scientists have been exploring whether a psychological reset can lead to lasting change. In this update of a 2021 episode, we survey evidence from the London Underground, Major League Baseball, and New Year’s resolutions to look at accidental fresh starts, forced fresh starts, fresh starts that backfire — and the ones that succeed.  SOURCES:Katy Milkman, professor at the Wharton School.Andy Byford, former commissioner of Transport for London.Ferdinand Rauch, economist at the University of St. Gallen.Hengchen Dai, professor at U.C.L.A.’s Anderson School of Management.Bob Tewksbury, former big-league pitcher. RESOURCES:“A Large-Scale Experiment on New Year’s Resolutions: Approach-Oriented Goals are More Successful than Avoidance-Oriented Goals,” by Martin Oscarsson, Per Carlbring, Gerhard Andersson, and Alexander Rozental (PLOS ONE, 2020).“A Double-Edged Sword: How and Why Resetting Performance Metrics Affects Motivation and Performance,” by Hengchen Dai (Organizational Behavior and Human Decision Processes, 2018).“The Benefits of Forced Experimentation: Striking Evidence from the London Underground Network,” by Shaun Larcom, Ferdinand Rauch, and Tim Willems (2017).“Framing the Future: The Risks of Pre-Commitment Nudges and Potential of Fresh Start Messaging,” by John Beshears, Hengchen Dai, Katherine L. Milkman, and Shlomo Benartzi (NBER, 2016).“The Fresh Start Effect: Temporal Landmarks Motivate Aspirational Behavior,” by Hengchen Dai, Katherine L. Milkman, and Jason Riis (Management Science, 2014).“Holding the Hunger Games Hostage at the Gym: An Evaluation of Temptation Bundling,” by Katherine L. Milkman, Julia A. Minson, and Kevin G. M. Volpp (Management Science, 2013).“The Resolution Solution: Longitudinal Examination of New Year’s Change Attempts,” by John C. Norcross and Dominic J.Vangarelli (Journal of Substance Abuse, 1989). EXTRAS:How to Change: The Science of Getting from Where You Are to Where You Want to Be, by Katy Milkman (2021). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

A series of academic studies suggest that the wealthy are, to put it bluntly, selfish jerks. It’s an easy narrative to embrace — but is it true? As part of GiveDirectly’s “Pods Fight Poverty” campaign, we revisit a 2017 episode. SOURCES:Jim Andreoni, professor of economics at the University of California, San Diego.Nikos Nikiforakis, professor of economics at New York University in Abu Dhabi.Paul Piff, associate professor of psychology at the University of California, Irvine.Jan Stoop, associate professor of applied economics at the Erasmus School of Economics. RESOURCES:"Are the Rich More Selfish Than the Poor, or do They Just Have More Money? A Natural Field Experiment," by James Andreoni, Nikos Nikiforakis, and Jan Stoop (National Bureau of Economic Research, 2017)."Exploring the Psychology of Wealth, 'Pernicious' Effects of Economic Inequality," (PBS NewsHour, 2013)."Poverty Impedes Cognitive Function," by Anandi Mani, Sendhil Mullainathan, Eldar Shafir, and Jiaying Zhao (Science, 2013)."Higher Social Class Predicts Increased Unethical Behavior," by Paul Piff, Daniel Stancato, Stéphane Côté, Rodolfo Mendoza-Denton, and Dacher Keltner (PNAS, 2011)."Relative Earnings and Giving in a Real-Effort Experiment," by Nisvan Erkal, Lata Gangadharan, and Nikos Nikiforakis (American Economic Review, 2011)."Experimenter Demand Effects in Economic Experiments," by Daniel John Zizzo (Experimental Economics, 2009)."Impure Altruism and Donations to Public Goods: A Theory of Warm-Glow Giving," by James Andreoni (The Economic Journal, 1990)."Privately Provided Public Goods in a Large Economy: The Limits of Altruism," by James Andreoni (Journal of Public Economics, 1987)."A Positive Model of Private Charity and Public Transfers," by Russell Roberts (Journal of Political Economy, 1984).Pods Fight Poverty Campaign on Give Directly. EXTRAS:“How to Raise Money Without Killing a Kitten,” by Freakonomics Radio (2013). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

All sorts of people have put their mark on Messiah, and it has been a hit for nearly 300 years. How can a single piece of music thrive in so many settings? You could say it’s because Handel really knew how to write a banger. (Part three of “Making Messiah.”) SOURCES:Charles King, political scientist at Georgetown University.Jane Glover, classical music scholar, conductor.Katharine Hogg, musicologist, head librarian at the Foundling Museum.Susannah Heschel, religion professor, chair of Jewish Studies at Dartmouth College.Mark Risinger, teacher at St. Bernard’s School.Michael Marissen, professor emeritus of music at Swarthmore College, author of Tainted Glory in Handel’s Messiah: The Unsettling History of the World’s Most Beloved Choral Work. RESOURCES:Every Valley: The Desperate Lives and Troubled Times That Made Handel’s Messiah, by Charles King (2024)."Why These Christmas Songs Could Only Be Written in America," by Eli Lake (The Free Press, 2024)."Reflections on Bernstein’s 1956 “Messiah,”" by Mark Risinger (Leonard Bernstein Office, 2022).Handel in London: The Making of a Genius, by Jane Glover (2018).Tainted Glory in Handel's Messiah: The Unsettling History of the World's Most Beloved Choral Work, by Michael Marissen (2014).“Handel’s Messiah,” performed by The London Symphony Orchestra (2007). EXTRAS:"Making Messiah," series by Freakonomics Radio (2025). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In the 18th century, Handel relied on royal patronage. Today, it’s donors like Gary Parr who keep the music playing. In this bonus episode of our “Making Messiah” series, Parr breaks down the economics of the New York Philharmonic. SOURCES:Gary Parr, senior managing director and on the management committee at Apollo, philanthropist. RESOURCES:"A Notoriously Jinxed Concert Hall Is Reborn, Again," by Michael Kimmelman (New York Times, 2022)."Apollo’s New Guy Is a Legend in Banking, a Novice in Buyouts," by Sonali Basak (Bloomberg, 2017).“Handel’s Messiah,” performed by The London Symphony Orchestra (2007)."Racial/Ethnic and Gender Diversity in the Orchestra Field," by James Doeser (League of American Orchestras).Parr Prize for Excellence in Teaching Shakespeare. EXTRAS:"Making Messiah," series by Freakonomics Radio (2025). Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.