Maybe we can agree if people in positions like Larry Ellison's or Elon Musk's were hoarding money with the intention of funding medical research, setting up entities that make it difficult-to-impossible to blow it all on buying a Hawaiian island or lifting a car into space for entertainment, then we wouldn't be having this exchange.

If you look at the latest news stories about Memorial Sloan Kettering (ProPublica is a place to start) and conclude that the government should minimize involvement in medical research for the betterment humankind Because Competition... you will certainly find plenty of friends, I suppose

I'm not saying competition is good for medical research, but having done medical research I am well aware of the unbelievable rate at which crappy papers are being published. And then when you try to publish a paper you're expected to somehow address all these previous crappy papers... We simply need some alternative to the current system and they are all being drowned out because they simply cant compete funding-wise.

Also, think about Elon Musk with 22 billion (https://www.bloomberg.com/billionaires/profiles/elon-r-musk/). His entire wealth is what governments currently waste on crappy medical research every couple months.

Lets say NIH is producing 99.99% crap (about 1 in 10k papers is useful) at ~$30 billion per year. Elon musk could set up MIH (Musk Institutes of Health) that is 100x more efficient (producing 1/100th the papers, but that are "only" 99% crap) for ~$300 million/year. After 73 years, about one human lifetime, the fund would be bankrupt. That's why I say you need to accumulate at least a couple hundred million dollars to hope to have an effect.