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They were developed by companies that definitely wouldn't have done it if it weren't for the IP rewards.

And your proof for this is . . .? Actually you can have no proof because we have always lived under an increasingly suffocating patent/copyright/trade-mark blanket. Big Pharma is the most profitable industry in the world, surely some restriction on their ability to print money wouldn't harm innovation in the field, in fact maybe the exact opposite is true!

The beast has been growing ever since and has reached scary dimensions by now.

Interestingly (and by "interestingly," I mean "unsurprisingly") the American public disagrees with you. All

It is even trying to consume our health care now â" whether it succeeds at that or not, that it is even trying is bad enough.

Especially since the private sector has been so successful in holding down costs. Why is it that prescription drugs are 10 times as expensive in the US than Canada? Am I really supposed to believe that the entire Canadian is a profit loss? Why is the "fix" to (sometimes) allow reimportation of drugs? Why is it that healthcare is routinely denied (i.e. "rationed")? Why is it I can turn on my television and see an advertisement where a woman is talking about how her insurance refused to pay for catheters, and so she has to buy them from someplace else? The stellar system where private sector bureaucrats decide what treatment to pay for, or if even someone should remain on the insurance rolls? The system where some middle manager decides if my doctor is on a list of approved doctors? The system where premiums are rising 3 times inflation. That system? Oh yeah. Best in the world. If your criteria is costs. Performace? 37th. Overall health? 72nd. Goddamn those "socialist" Swedes.

It simply defies all comprehension, that â" after the decades of mediocrity, outright failures, and spectacular cost over-runs of highways

I don't see any private sector highways. No one is stopping anyone from buying up a bunch of land and paving it. Why not? Especially since every private sector endeavor comes in on budget on time.

, Postal Service

Name the private sector company that has door-to-door residential pickup to any address in the United States, six days a week, for 44 cents, and 2 day shipping for 3 dollars?

Public Schools

Damn those universities.

MediCare

Do you mean the Medicare that is extremely popular , more trusted than private insurance, and is the single largest insurer in the United States? The insurance that can't be revoked? The insurance that the private sector commits the most fraud against? That one? No obviously not. You must be speaking about some other hither-to-unknown medicare.

â" anybody still holds the opinion, that a Government taking over a part of life from private sector will improve it...

obviously isn't blind to the gross abuses and inefficiencies of the private sector.

Personally I love how the insurance companies are saying "ZOMG! The big inefficient, ne'er do well federal government is going to run us out of business!" Wait? The people you just called a walking clusterfuck are going to run you out of business? How fucked up are you then?!

Just like healthcare there or in Canada, the people are paying for it, just in different ways than we do in America

Yes. Bear in mind though, that they don't have the enormous overhead of profit on top of it. Also, the extra overhead of administration in the US healthcare system (employing all those people to check and try to invalidate every claim you make) has to be paid for too. Add to that the way that it's only profitable to provide a service for some people (healthy/live in cities) and not to others (unhealthy, live in countryside), so the service is not equally accessible for all.

Check this graph to see what I mean. Healthcare spend per capita in the US is way above any other industrialised nation and you still have 1/6 of your population uninsured.

Whether you like Michael Moore or not, you need to watch Sicko just to see the UK/French reaction to the idea that people should pay for their healthcare, ask someone for approval evey time they want to go to a doctor, or be refused treatment. Laughter. The US capitalist healthcare system is a failure in every way compared to the European model because some things don't suit a private enterprise approach. I think the internet fibre network pretty clearly falls into this category too.

Why would you avoid routine care when you have purposefully and diligently saved money ahead of time in a tax advantaged savings account specifically to pay for routine health care expenses?

Um, so you can keep that money, or use it for something else like fine liquor?

Somewhat unrelated to your question: my employer outsources the health plan offerings to an insurance broker, and we get a choice of healthcare plans, one of which is an HSA-eligible, high-deductible plan that they push real hard on us (they're even willing to pay us to sign up for it!). The guy from the insurance broker company comes every year at open enrollment season and pitches the plan to us, and he always, always plays up the "fact" that if you don't spend the money you put into your HSA, you get to keep it.

But anyway, the copay in my employer's HSA-eligible account is 20%, twice as much as the regular PPO. I have significant, recurrent medical expenses (knee injury, congenital kidney hydronephrosis that was only discovered at age 29, high blood pressure), and can easily spend the regular plan's max out-of-pocket amount each year. An HSA basically just means that I'd pay about $10,000 a year for healthcare, instead of about $5,000.

So basically, from the point of view of somebody like me, HSAs are a ploy to allow my employer to do a stealth compensation cut, and to allow the insurance companies to better compete for the segment of the population they most wish to serve: the bottom 50% of people who require only 3.4% of the country's medical expenses. That 50% shouldn't be skimping on health insurance for one simple reason: they could suddenly end up in my situation.

These percentage comparisons [about overhead] may be deceptive, because service costs for Medicare beneficiaries are much higher than those for FEHBP enrollees. The two programs might spend the same dollar amounts on administration, but Medicare's spending would appear lower as a percent of claims. Absolute dollar amounts for private insurance administration are difficult to obtain, but one source does produce estimates for Blue Cross Blue Shield plans. For plans operating a PPO on an administrative services-only basis - essentially the way Blue Cross operates under FEHBP - mean administrative costs per member year were $271 in 2002 (Sherlock Company, 2002). Medicare-s costs in 2002, $4.8 billion for about 36 million fee-forservice beneficiaries, were about $133 per beneficiary, or about one-half as large.

(Emphasis added)

So it sounds like the original 3% quoted might be true, but nevertheless misleading due to the higher cost-per-patient expenses of Medicare's older recipients. Regardless, Medicare's per-beneficiary costs were still lower than Blue Cross Blue Shield, which would indicate a national health care service in the style of Medicare could provide lower administrative costs than the private sector.

-Trillian

Why is Socialism such a bad word in the US?

My country pays about $2900 for healthcare per capita and provides universal coverage with that, while the US spends $5700 and still has a large part of it's citizens not covered.

Just some numbers: http://www.kff.org/insurance/snapshot/chcm010307oth.cfm

Interesting research, could I point out that it can be interesting to compare with other countries, for example:
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
http://education-portal.com/articles/Public_Education_Spending_Has_Doubled_in_the_Last_15_Years.html

And what I already said in another post, averages are tricky. ten people spending 11 vs nine spending 1 and one spending 101 gives the same average of spending 11, but the statistics are very different.

I think one of the problems facing the US is it's high and increasing differences in incomes and spending. How can you pay the most in the world for healthcare per capita, and still have a large part of the population unprovided for? Same thing for education.

I don't know if it's the average that counts here. My guess is that it could be that a part of the USA population gets very expensive education and a part gets very cheap/poor education.

I think your "average" might be misleading, in that it consist of a large group above it, and a large group below with, with few on the actual average.

I know that for healthcare in the US, there is a part that can afford it, but pays though the nose, and a part of the population that basically can't, this leads to healthcare that on average is twice as expensive per capita compared to most developed countries.

I don't know the details for the USA education, but I do know that for healthcare the USA spends the most in the world per capita, and still has a lot of citizens who don't even have basic healthcare coverage.
http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
In contrast, here in the Netherlands we have "Basic healthcare", for which each citizen pays about 1000 euros, and which covers basically all illness, but not things like plastic surgery, rehab and such.

I think your average might not mean much.

At least with Obama, he was up front and said "if you make more than $250,000 you might see a tax increase." McCain doesn't even tell you that the $5,000 tax credit you get back for medical insurance probably won't cover the average family of 4's insurance premiums, costing the middle class more. McCain hid a middle class tax hike by not being truthful with the American people.

You're wrong about McCain's plan. The tax credit isn't supposed to pay the entire premium. It's meant to help defray some of the cost.

Furthermore, it really isn't a middle class tax hike, no matter what Obama claimed. For employer-provided health insurance in 2008, the average premium for a family of four is $12,680. [source] Any increase in taxes would come because McCain's plan would remove the tax exemption for employer-provided health benefits. But if a $13,000 benefit were taxed at 35% (the highest marginal rate of federal income tax), then this is still only an penalty of $4,550... which is easily made up for by the $5,000 tax credit. And for those people who don't have a full health benefit from their employer, a $5,000 tax credit would help greatly.

I think that McCain's plan had some good elements, and I hope that Obama and the Congress will consider using some of its ideas in their own efforts.

Obama was up front that we'd all have to make sacrifices, and you know what? It paid off. Obama got a higher percentage of the voters that even make $200,000 or more! It goes to show that even affluent, educated Americans in the higher tax brackets don't mind making a few sacrifices instead of borrowing against our children's future.

I heard Obama say that we'd have to make sacrifices, but I don't understand what that has to do with his policies. He said that 95% of working families would see a tax cut. That's not what I'd call a sacrifice. Perhaps he was referring to budget-tightening measures, but almost all of his proposals increase the budget rather than decreasing it. The only exception I can think of is his Iraq policy, and even there he was talking about a timetable of 18 months or more -- i.e., mid-2010. And even there, a major goal is to redeploy the troops to Afghanistan. It's a good idea, but it doesn't help with the already-bloated budget.

Where are all the so-called "conservative" Republicans, and what did the religious wackos and crazy spending neocons do with them?

One of the main differences between the Bush-Kerry and Obama-McCain contests was that Obama did much better than Kerry among white evangelicals. That Obama can appeal to 'religious wackos' is a great strength. If you ever go out and talk in mixed company, you might want to guard your words concerning them.

Sorry to burst your bubble, but it hasn't worked anywhere

Really?

Notwithstanding the problems with the NHS, the UK has longer life expectancy than the US, lower rates of child mortality, and spends less than half as much on healthcare per head as the US.

And don't forget that private healthcare is available (and cheap too) in the UK, so you could spend the extra $3,400 per year per person you're spending on healthcare on private cover in the UK.

If you're afraid that you can't afford adequate health care for your children, you'll want socialized medicine.

Or, possibly, you're afraid that sometimes other people might - from time to time - be unable to afford adequate health care for their children.

I come from a mid-sized, stable family. I have a good university education. My parents are enjoying (and can afford) their comfortable retirement. I have a roof over my head, a share of a nice vacation property, and a healthy nest egg in the bank. I'm smarter than average; I write and speak fluently; I am adept at mental math. I can write code, work a cash register, operate a linear accelerator, cook on a barbecue, drive a forklift, change a tire, solve differential equations, make a delicious cream of mushroom soup, deliver newspapers, split wood, describe the differences - general and specific - between Old and New World wines, and push a wheelbarrow. I will always be able to find a job. Short of a genuinely global disaster, it's astonishly unlikely I'll ever have to worry about where my next meal or my medical care will come from. And yet I still think socialized medicine is a good idea. What's up with that?

Perhaps I just want to live in a society where I know the other guy isn't worried about getting medical care for his kids. We hold these truths to be self-evident, do we not? In order to be free to pursue happiness, we must first be secure in both our liberty and in our very lives.

Of course, the greedy, grasping Republican in me also wonders if we're not getting ripped off in the United States. For some reason, we pay roughly twice as much per capita for health care as people in Canada, or Sweden, or Japan, or the Netherlands. While I know that those are poor, squalid, backward, unpleasant places to live when compared to the U.S. of A., my wallet still tells me that we ought to be asking some very pointed questions.

http://www.financialsense.com/stormwatch/2005/0624.html

The true CPI hasn't been calculated since 1986.

Gasoline: 1997: 1.04 / gallon. 2007: $3.22 / gallon. 300% in 10 years.
Housing: 1997: 196,000. 2007: $299,000. 50% in 10 years
Medical expenses: http://www.kff.org/insurance/upload/7692.pdf
1990: 2,813. 2007: 7,498.

No way that this is reflected in the "official" annual figures of ~2% per annum.

How does that graph support any interpretation? All it shows are costs - it doesn't say anything about quality or level of care.

I think you parsed his argument wrongly. As I understand it, the argument is that the NHS allows the UK to provide comparable care to the USA at approx. one-half to one-third the cost per capita.

This graph supports that interpretation... http://www.kff.org/insurance/snapshot/images/figure-1.gif

I will not state that the argument is correct or not, only that you misinterpreted it. In my opinion, he is correct in that it is "measurable" as far as an elected official is concerned - he can provide metrics to bolster his claim. Other metrics might be longevity, time spent in hospitals, and so on. That is less the case with a space programme.

Here's some stats from 2003 about per capita spending on health care by nation. If anything, the gap has only widened in those past five years too.

I think you belong on the other forum. I know big tent etc.
The USA spends more in both absolute/per person ($5,711) and percent of GDP (15.2) on health care than any other country. Yet if you look at the outcomes mortality amenable to health care (110/100,000) we're near the bottom. We can't have a system as nice as France's because I don't give $100,000,000 annually political whores.

Virtually 100% of medical advances come from the US. . .

Most of the cost of medical care in the US can be traced to R&D costs.

Of course this will impact the quality of healthcare that people receive. Don't be absurd. Look, as someone who is involved in his family business (12 docs, 100 total employees), the ability of patients to pay is fundamental because healthcare is a business.

Actually, over 50% of parents are using the voluntary television rating system to determine what is appropriate for their children, but fewer than 7% of parents use the v-chip to do their work for them. So the opposite of your argument is true.

More likely, politicians are quick to dictate misunderstood technologies in order to score points with those parents who don't understand the effectiveness until the technology is in their hands... long after the legislation has been enacted.

Negroes will surely welcome this progress, because after homosexuals, Negroes carry more AIDS than any other group.

Blacks are 30 times more likely to have Gonorrhea than whites and 11 times more likely to have it than Hispanics. A large majority of all Americans infected with Gonorrhea are black, despite making up only 13% of the population. Source: CDC

Black women are 7 times more likely to have Chlamydia than white women and 2 times more likely than Hispanic women. Source: CDC.

Blacks are 5.4 times more likely to have Syphilis. Source: CDC.

Blacks are 15.7 times more likely to have congenital Syphilis than whites. Source: Source CDC

Black women are 24 times more likely to have AIDS than white women. Source: OMH

Black men (including gays) are 8 times more likely to have AIDS than white men (including gays). Source: OMH This disparity approximately doubles when gays are excluded. Source: Kaiser Foundation.

Blacks in general are 10 times more likely to have AIDS than whites, and the disparity is growing each year. Among teenagers diagnosed with AIDS, 66% are black. A staggering 67% of new AIDS cases among women are among black women. A study found that 2.2% of all blacks in the US were HIV positive between 1997-2002. AIDS is the 3rd leading cause of death for young African Americans. Source: Kaiser Foundation.

In 2002, AIDS became the #1 leading cause of death for young black in the US. Femicide is another leading cause of death among young black women. Source: Kaiser Foundation.

Negroes will surely welcome this progress, because after homosexuals, Negroes carry more AIDS than any other group.

Blacks are 30 times more likely to have Gonorrhea than whites and 11 times more likely to have it than Hispanics. A large majority of all Americans infected with Gonorrhea are black, despite making up only 13% of the population. Source: CDC

Black women are 7 times more likely to have Chlamydia than white women and 2 times more likely than Hispanic women. Source: CDC.

Blacks are 5.4 times more likely to have Syphilis. Source: CDC.

Blacks are 15.7 times more likely to have congenital Syphilis than whites. Source: Source CDC

Black women are 24 times more likely to have AIDS than white women. Source: OMH

Black men (including gays) are 8 times more likely to have AIDS than white men (including gays). Source: OMH This disparity approximately doubles when gays are excluded. Source: Kaiser Foundation.

Blacks in general are 10 times more likely to have AIDS than whites, and the disparity is growing each year. Among teenagers diagnosed with AIDS, 66% are black. A staggering 67% of new AIDS cases among women are among black women. A study found that 2.2% of all blacks in the US were HIV positive between 1997-2002. AIDS is the 3rd leading cause of death for young African Americans. Source: Kaiser Foundation.

In 2002, AIDS became the #1 leading cause of death for young black in the US. Femicide is another leading cause of death among young black women. Source: Kaiser Foundation.

Negroes will surely welcome this progress, because after homosexuals, Negroes carry more AIDS than any other group.

Blacks are 30 times more likely to have Gonorrhea than whites and 11 times more likely to have it than Hispanics. A large majority of all Americans infected with Gonorrhea are black, despite making up only 13% of the population. Source: CDC

Black women are 7 times more likely to have Chlamydia than white women and 2 times more likely than Hispanic women. Source: CDC.

Blacks are 5.4 times more likely to have Syphilis. Source: CDC.

Blacks are 15.7 times more likely to have congenital Syphilis than whites. Source: Source CDC

Black women are 24 times more likely to have AIDS than white women. Source: OMH

Black men (including gays) are 8 times more likely to have AIDS than white men (including gays). Source: OMH This disparity approximately doubles when gays are excluded. Source: Kaiser Foundation.

Blacks in general are 10 times more likely to have AIDS than whites, and the disparity is growing each year. Among teenagers diagnosed with AIDS, 66% are black. A staggering 67% of new AIDS cases among women are among black women. A study found that 2.2% of all blacks in the US were HIV positive between 1997-2002. AIDS is the 3rd leading cause of death for young African Americans. Source: Kaiser Foundation.

In 2002, AIDS became the #1 leading cause of death for young black in the US. Femicide is another leading cause of death among young black women. Source: Kaiser Foundation.

Cuba has a great medical system...as long as you are one of the elites.

US has per capita GDP 10x of Cuba ( 43,500 vs 4,000 That any comparison can be made between the health care system in Cuba and the US says there is something seriously wrong with the health care system in US, especially because the US spends highest percentage of GDP of any nation in the world

A huge per capita GDP coupled with spending with the highest percentage of the GDP ought to produce the best health care system in the world by an indisputable margin but it doesn't.

Oh, we've got a few reasons for this. (last one's a ~100K PDF)

Drug development is generally not publically funded. It is an expensive, long-term, high risk investment. In 2001, the average cost of developing a new prescription drug was $802 million, and took from 10 to 15 years. That does not include any marketing costs. Yes drug companies spend a ton of money on marketing, eclipsing their spending on R&D. Yes drug companies are highly profitable, high-risk investments generally produce higher return than low risk investments. Investment and advertising seem like things generally associated with free markets.

If you want to argue whether drug companies are sleezy and annoying and shouldn't be allowed to advertise on TV and are filthy rich and should do more to offer life-saving drugs to people who can't afford them, you'll have to find someone else, because I agree with you.

Your assertion that the US has "relatively low levels of access to basic health care" is also true, but unrelated. I have relatively low levels of access to a Ferrari. That doesn't mean the automotive industry is not a free market.

You are correct that even a capitalist like me can not cure viral disease. But neither can any other economic system. But what about productivity lost for conditions for which there are known treatments? In Canada, the median wait time to get treatment from a specialist is more than 17 weeks (see page 25 in this study, warning, it's a PDF). That's 17 weeks of reduced productivity for patients with conditions that have known treatments.

The economics of the US healthcare industry are complex. The Hippocratic Oath is often at odds with the economic desires of those who provide care. Crafting public policy that works for patients as well as providers is where all the action and debate is at, not whether the US healthcare industry is a free market or not.

"Moot" is a neat word, used correctly.

From Care.org, hunger facts:

More than 840 million people in the world are malnourished -- 799 million of them live in the developing world.

More than 153 million of the world's malnourished people are children under the age of 5.

Six million children under the age of 5 die every year as a result of hunger.

I'd say that those simple facts make famine something more than a historical problem. You are correct in one sense though, technology has made it so we "could" help these people.

In the case of pandemics, technology actually works the opposite. Faster, and easier, worldwide travel means a more widespread communication of viral or bacterial agents in a smaller time frame. In present day, Influenza takes more time to show symptoms that would cause enough alarm to effect quarantine. In 1918-19 worldwide travel was still via ocean vessels, which took considerable time to get from point A to point B, yet that pandemic was responsible for 20-40 million deaths.

In the case of AIDS, while you seem to think it's in "long-term decline," the numbers from the CDC for the years 2000-2004 (http://www.cdc.gov/hiv/resources/factsheets/At-A- Glance.htm) show that for this time the cases of AIDS diagnosis and people living with AIDS increased each year, and this is just in the US. Admittedly, certain segments have had declining new cases... prenatal transmission, and injection drug users.

As for public awareness, (from http://www.kff.org/kaiserpolls/pomr050806pkg.cfm): "significant percentages of Americans still think HIV might be spread through kissing, sharing a drinking glass and touching toilet seat -- 37%, 22% and 16% respectively."

while health spending accounts and direct negotiating drive prices downward

Again, another misunderstanding you have - The national debt is a credit line extended to US corporations backed by the rest of the world.

My guess (and it's a guess mind you) is that 2 to three times that is about average.

I'd say it is highly likely that evolution has slowed down over the past couple of hundred years. As we learn to treat more and more genetic diseases, less pressure is placed on removing those genes.

On those genes, maybe.

In 2002, there were 845.3 deaths per 100,000 people.

14.94 of those were fatalities due to motor vehicle crashes.

Humans were not optimally adapted, by life on the African savannah, to controlling several tons of vehicle attaining speeds in excess of sixty miles an hour.

While not all motor vehicle accidents can be avoided by the victim, it seems likely that genes for reaction time, eyesight, and especially risk-taking vs. risk avoidance may play some role in determining differential likelihoods of being involved in a fatal motor vehicle accident.

So I would expect that evolution continues to work.

That is a bit of an over-reach. There is no mention of an ISP searching a computer for prohibited files. Also if you were paying closer attention, it only says the the ISP must offer to block pornographic websites. The Kaiser family foundation reports that 70% of teenagers between the ages of 15-17 have accidently gone into a pornographic website, additionally 23% have said that it happens often. Information can be found at http://www.kff.org/entmedia/upload/14095_1.pdf I would submit to you that the parents of these children should have the right to be able to keep this pornographic material out of their home. These parents need the right to be able to have their children not exposed to sexual content that creates unrealistic expectations of sex.

"There are 43 million uninsured Americans - 4 million more than when the current administration took office. George W. Bush will reverse this trend by making health insurance affordable for hard-working, low-income families." Source:

Bush-Cheney 2000 website

Reality?

In the first two years Bush was in office, the number of uninsured American increased by nearly four million. Since Bush took office, health insurance premiums have risen by an average rate of 12.5 percent per year. According to a major study, "widespread adoption [of Bush's major health care plan] could drive up the annual deductible paid by workers." Source:

U.S. Census Bureau, 7/8/04; Kaiser Family Foundation, 4/04; USA Today, 4/25/04

Another Healthcare promise:

"George W. Bush will establish the 'Healthy Communities Innovation Fund' to provide $500 million in grants over five years to fund innovative projects addressing targeted health risks, such as childhood diabetes." [Source: Bush-Cheney 2000 website]

Reality?

Bush never established this fund. Source:

The Philadelphia Inquirer, 1/20/04

Environmental promise:

George W. Bush "will also ensure that the federal government, which is the country's largest polluter, complies with all environmental laws." Source: Bush-Cheney 2000 website

Reality?

For the past three years, the Department of Defense has requested that Congress exempt it from environmental laws and regulations like the Clean Air Act of 1970. The exemptions were requested despite the fact that the Environmental Protection Agency has thus far declined to apply the policies to the military training facilities in question. Source:

Government Executive Magazine, 4/6/04

Education promise:

George W. Bush will "fully fund the Pell grant program for first-year students by increasing the maximum grant amount by more than 50 percent, to $5,100." Source:

Bush-Cheney 2000 - Education website

Reality?

President Bush has frozen the maximum Pell Grant at $4,050 in his FY 2005 education budget. This is the third year in a row that Bush has frozen or cut the maximum Pell Grant. Source:

House Committee on Education and the Work Force 2/2/04

Welfare promise:

"To encourage states to help families in crisis, Governor Bush will provide states an additional $1 billion over five years for preventative services to keep children in, or return them to, their homes whenever safely possible." Source:

Bush-Cheney 2000 - Child Welfare website

Reality?

Bush has proposed allowing states to use the federal funds currently earmarked for foster care room-and-board payments to be used for preventative services. In exchange, states must accept a spending cap on the amount of foster care funding they receive. Sour

The survey does NOT imply that parents are "simply not worried about video game violence."

It states that 89% of parents are very, or somewhat concerned about inappropriate content in entertainment media, and 34% of parents rate TV as the medium they are most concerned about. It says nothing about their other concerns, and how strongly they rate them.

Reading the survey, it is possible to reach the conclusion that somewhere between 5% and 89% of parents are very or seriously concerned about video game violence. Hardly a level of confidence that should be used for a headline!

Nonsense. Patents make it possible for corporations to create life-saving technology and saves lives. Pharmaceutical companies raise capital from the marketplace for research and development and regulatory testing, not because shareholders are happy to volunteer funds for R&D, but because they hope the company will make a profit. If the company could not make a profit, the R&D and development wouldn't get done, and the products would be brought to market. If the company didn't have patents, competitors would simply free-ride on the R&D and compete with them using their own work. No profits, no product, no life saving drugs.

Life saving drugs, such as tetracycline and a host of antibiotics, leukemia fighting drugs, and lifestyle preserving drugs such as Prozac and many others are the product of, not deterred by, the patent system.

Of course you're right, so far as life-saving drugs are really developed solely by privately-financed R&D. The reality, however, is very different.

Indeed, a recent study found that, for the top 5 best-selling drugs currently on the market, fully 80% of the money which funded their development was put up not by the pharmacutical companies which own the patents, not by private investors, but by the federal government in the form of research grants. More generally (and for which I can find a link to back me up), between 70 and 90 percent of important drugs are developed with significant government help, and a whopping 38% of all health-care related R&D is financed by the federal government. (Government grants are heavily skewed towards basic research; thus we can expect that this displaces drug discovery research much more than eg. engineering type R&D for new technology in hospitals.) All the government gets back for their tremendous investment (other than a healthier society, which, of course, is their main goal), is a $50 patent fee.

Obviously pharmacuticals still spend a tremendous amount of capital and incur large risks to take the final steps to bring a drug to market and test its safety and efficacy. (The government grants go more to the basic research end of things.) Indeed, you are right in suggesting that the current "free-market" drug development system would completely collapse if pharmacutical companies did not have the monopoly profits of patents to cover their capital investments. Nor could the system survive without government grants at their current, tremendous levels; while the pharmacuticals are certainly not struggling to keep afloat at the moment, their profit rewards are generally commensurate to the risks they incur from the share of development they actually do finance.

What you should realize, however, is that the current system is not a free-market at all. It is so heavily subsidized as to transcend mere "corporate welfare"; instead it is really a huge socialist enterprise with a quasi-capitalist front-end tacked on. The solution, as impossible as it is obvious, is to remove the privatized delivery system and let the entire drug development pipeline be financed, and controlled, by government and academia. In other words, let science for the public good be run by scientists and the public, and not by businessmen.

Thing is, as every developed country in the world except the US has realized, our ethical conception of medicine inherently clashes with capitalist motives. There are only two ways for an entity to profit from offering health care:

1) by killing poor people.
2) by being a broad enough entity that it can reap the benefits of providing health care without charging for it.

#1 is obvious if you think about it for a while: if you charge the rate which the market will bear for live-saving treatments, then obviously some people will be unable to pay. If you think this does not go on in America today then you are very badly deluded.

#2 refers to the fact that having a healthy population is essential for economic growth and a stable society. However, hospitals and pharmacutical companies are not broad enough to benefit from the fact that healthy people can provide a net economic positive while sick or dead people cannot. Our current system has a cobbled-together kludge to fix this: most people's health costs are borne by their employer, who *does* reap (some of) the economic and social benefit of them being healthy.

The problem with this is that it only works for people who are currently employed in a job good enough to pay benefits. The 50 million uninsured in America are mainly young people--children, students, and those with entry level jobs. The economic and societal benefit they will provide later in their lives is often contingent on their remaining healthy today, but the current system can't recognize this.

This is without even getting into the problems of the very poor: of the one-in-five children under 5 years old who lives beneath the povery line; of the mentally ill homeless who could provide a positive benefit to society if they could only recieve treatment. (Less than 50% of those below the poverty line recieve Medicaid, and it rarely provides more than emergency room care; a full 36% are completely uninsured, and thus obviously unable to pay for any medical care whatsoever. Uninsured In America, pg. 22, very large pdf.)

The current system is completely broken, but it will take more than just patent reform to fix it