As I mentioned, both of those options would make drugs less profitable, which would lead to fewer advances in technology. Prohibiting the reimportation of drugs can be a sensible policy.
> It is horribly unjust for Americans, many of whom have no or poor health insurance, to be forced to pay more money than anyone else on earth for prescription drugs.
Unfair, perhaps, but unjust? Fixing this problem would either require selling to everyone at American prices (which could also be described as unjust), or selling to everyone at the lowest prices available. Both options would be less profitable that the current system, which would slow the rate of advancement in drug development.
> [Maybe] the government should step in and take the lead role in drug development.
That can also be a sensible policy, and the American government already does fund a considerable amount of drug development.
They do, however, have free health care. You do understand the difference, right?
No, it isn't as good as most paid care. So what?
> Pharma, which spends disproportionate amounts of money on direct marketing to consumers,
What's "disproportionate"? You do know that marketing includes free drugs for poor people, MD education, and the ads that tell people that there are treatments for their illnesses/conditions, right? Which of those do you find objectionable?
> can't produce the medications we need cheaply and efficiently, that represents a market failure,
Does it? I'd like a pony, but the fact there isn't one in my front yard isn't actually a market failure.
If you think that you can develop anti-biotics for less, go for it. You'll get rich, you'll save people's lives, and you'll drive those evil drug companies out of biz.
You were planning to go through the FDA right? (Of course, if you can fix the FDA, then all new drugs become cheaper.)
> and the government should step in and take the lead role in drug development.
What rational govt that has pension/retirement obligations would spend money on a drug that significantly increased lifespan?
> the NIH doesn't need to make a profit
The NIH has no skin in the game. If it screws up, no big deal. In the rare cases where someone finds out, NIH defenders will swing into action. If Merck screws up, folks lose their jobs, stock value goes down, etc.
The NIH is driven by interest groups. Pharma is driven by what folks will actually spend money on. I know which one I think accurately represents what people value....
Insurance companies are somewhat driven by what their customers want. If 20% want something, it tends to happen. Govt bureaucrats, not so much, and Congress rarely passes laws for 20% of the population.
It is horribly unjust for Americans, many of whom have no or poor health insurance, to be forced to pay more money than anyone else on earth for prescription drugs. If Big Pharma, which spends disproportionate amounts of money on direct marketing to consumers, can't produce the medications we need cheaply and efficiently, that represents a market failure, and the government should step in and take the lead role in drug development. Research could be done through the NIH grant system and the results could be given away, unpatented, to the entire world. We could get the same results for less money, as the NIH doesn't need to make a profit and has no stock holders to answer to. It could even serve to improve our global reputation, showing the US to be a force for good in the world.