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I may be ignorant on this, but don't many of those countries benefit by the r&d funding happening in the US?
https://www.urmc.rochester.edu/news/story/4233/u.s.-slipping...
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Bringing new drugs to markets is expensive: https://en.wikipedia.org/wiki/Cost_of_drug_development (These costs include the other 90% of drugs that have probably failed at some development stage)
So assuming Gilead spent per drug 10% more than the company that spent more in that list, they recovered the whole development cost in a single year. Most industries don't come even close to that.
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> Creating a public institution with no pressure to make profit is a disaster waiting to happen. This is the model many rich country healthcare runs on, and provides measurably better outcomes for less expenditure than the US.
I may be ignorant on this, but don't many of those countries benefit by the r&d funding happening in the US?
The story goes that in China, doctors used to be paid for keeping you healthy. When you got sick, they didn't get any money anymore. This sounds to me like a system with the proper incentives.
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You are jumping from one extreme to the other. Creating a public institution with no pressure to make profit is a disaster waiting to happen. You can certainly keep a 'competitive' environment which is regulated with incentives. And I do agree healthcare needs this, and shouldn't live purely by the free market.
You can have a competitive environment without a profit motive. You judge on results, not profitability.
We talk about AI optimized to create paper clips accidentally running amok and turning the world into paper clips. Why isn't profit a similar problem? Government agencies are just AI running on meat. Give them success parameters different than raw profits.
Honestly, why can't we see this as just a variant of the instrumental convergence problem?
this is why can't have nice things. why doesn't goldman sachs just grow humans and harvest their organs?
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You are jumping from one extreme to the other. Creating a public institution with no pressure to make profit is a disaster waiting to happen. You can certainly keep a 'competitive' environment which is regulated with incentives. And I do agree healthcare needs this, and shouldn't live purely by the free market.
You can have a competitive environment without a profit motive. You judge on results, not profitability.
This is one of the downsides of mobbing, shaming and regulating away outrageous prices. If pharma companies can't charge you in the ballpark of a lifetime's earnings for a one-shot, one-shots will be less compelling to them compared with treatments you have to take twice a day for the rest of your life.
Mobbing and shaming are absolutely part of a free market economy, as they manage information flow and create downward pressure on demand, and they punish bad actors. Regulation is essential because lo and behold, empirical evidence shows there are a number of situations where the magic free market completely fails at providing good outcomes. Good outcomes in the sense of, you know, achieving human-level fairness and progress, not shuffling money efficiently. There's a lot about power imbalance and access that would be a whole other topic that make these stupid dollar computations meaningless in any effective sense.
> If pharma companies can't charge you in the ballpark of a lifetime's earnings
You're being downvoted because this just shows how completely fucked this worldview is when reducing everything to dollars and cents. Not only is it a completely anti-human worldview, it's only consistently applied by corporations when they want to get their profits out of the poor souls they help with their magnanimous, oh-so-arduous drug development processes. Because you can bet when the shoe is on the other foot, and corporations fuck the environment and poor people en masse, nobody wants to do those calculations, because it would bankrupt whole industries (like coal and plastic manufacturers).
Thats why "we the people" need to have large part in developing new drugs and the care of people, this is nothing that can be left to the "market" in some hope that it will "work out".
[1] https://www.thebalance.com/who-funds-biomedical-research-266...
[2] https://other98.com/taxpayers-fund-pharma-research-developme...
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I may be ignorant on this, but don't many of those countries benefit by the r&d funding happening in the US?
Most R&D, in the US as elsewhere, make massive use of public funds.