[cbeach]

I've seen conversations like this before, regarding the heavy cost that Big Pharma levies on treatments for major diseases. And US companies frequently come up in these discussions.

But the alternative, without the massive cashflows, is a world where the research never happens, and the diseases haunt us forever.

The Big Pharma treatments will eventually become public domain, and may inspire other cheaper treatments prior to that.

The fact that these conversations come up frequently is a symptom of the fact that Big Pharma is frequently doing fantastic things. Curing diseases that have plagued humanity for millenia and killed millions.

We have a very bright future. But the future is not free of charge, as we'll continue to require a lot of medical research, and medical researchers have families to feed, like the rest of us. Medicine costs money - there's no escaping it.

In the UK, we sometimes mistakenly imagine that our socialised healthcare system is "free." It's not. It's one of the most expensive in the world, and employs over 2 million people. The component of tax that I paid to fund the National Health Service was £8919 last year - the largest single expenditure of my taxes, and vastly more than I'd need to spend to get private healthcare.

So while American medical pricing is scary and sometimes ruthless, I think we need to put things in perspective and recognise their leadership in medical research - without which, we'd all be in a worse situation.

[kelnos]

What about direct government funding? Isn't that a reasonable alternative? Maybe not a politically-popular one, but I wouldn't be surprised if health care overall would be cheaper under a system where pharma research is done with public money, and then isn't allowed to be patented. Might even in save enough money to avoid much in the way of extra taxes to fund it.

Hell, a lot of medical research is funded (in part) by public dollars, and then the results get locked up behind patents for years, which is gross.

[cbeach]

Having the government direct funds and choose winners and losers seems a lot more dangerous than leaving it to free market forces.

It's easier to corrupt one or two government officials than it is the entire international capital marketplace.

[derivative7]

Most taxpayers don't have cystic fibrosis and hence don't want to pay to have it cured. Not feasible. This hypothetical is kind of lame.

[actuallyalys]

The U.S. government already funds a lot of research including some on conditions (or non-medical problems) that don’t affect the majority so that doesn’t seem to be an actual barrier. Polls tend to show Americans support existing funding [0].

Obviously there is a limit to how much spending the public will support, but I don’t think it’s a complete nonstarter.

[0]: https://www.pewresearch.org/short-reads/2018/07/03/americans...

[matthewtse]

I love this reply.

It's a particularly touchy subject because it involves people's health and the ability/inability to pay for it.

But as a sufferer of a debilitating disease with a miracle drug that costs an arm and a leg, I've become a convert to the US pharma-industrial complex. These drugs take billions of dollars and decades to research--that funding/development isn't going to happen without venture capitalists who shoulder that risk for the profit reward. An equal number of pharma venture capitalists lose all their money, researching dead-end drugs.

I'm incredibly blessed to have both a cure invented during my lifetime and the means to pay for it. But even if I lacked the means, I would still infinitely prefer a world where a cure exists that I need to somehow access, as opposed to a hopeless world with no cure.

[elliotto]

It feels like there's a lack of imagination here. Could you conceive of a world that was successful in its research of drugs, but was propped up by an economic model other than pharma venture capitalism?

[epivosism]

Freedom of choice means you have the right to try to create such a system. As other people can try what they want, VC funding, astrology, etc. It's all legal and competes.

But, if someone is selling a system which doesn't exist yet, but is supposed to be better, but that will only work if we also shut off the one working system first, before knowing... well, I'm skeptical.