To take the internet domain registration metaphor further, it also requires a centralized value authority (google) in order to be navigable. In some sense, Google's primary task is spam filtering---analogous to efficacy guarantees---which enable efficient information gathering.
I don't argue that the FDA is an efficient structure for doing efficacy testing, I just think punting the value discovery/marketing process to vague distributed processes isn't a good answer.
I think the supplement market is a great example as well. Many low value treatments saturate the market and the responsibility for making decisions is democratized and difficult. Canonical sources of efficacy information might not be needed as barriers to entry, but reputation, trust, and canonization are valuable heuristics in decision making processes and this leads to power.
I don't argue that the FDA is an efficient structure for doing efficacy testing, I just think punting the value discovery/marketing process to vague distributed processes isn't a good answer.
I think the supplement market is a great example as well. Many low value treatments saturate the market and the responsibility for making decisions is democratized and difficult. Canonical sources of efficacy information might not be needed as barriers to entry, but reputation, trust, and canonization are valuable heuristics in decision making processes and this leads to power.
If Google doesn't link you, you die.