This singular problem point was completely ignored by the rest of the article and in the proposed solutions.

It seems like no matter what drug companies charge, our government MUST pay it. And citizens not covered by the government MUST buy health insurance. The ACA says it is illegal for you not to buy coverage; if you don't there is a fine. If you to not pay this fine (individual responsibility tax), you go to jail.

The case of Nelene Fox shows that HMOs MUST pay for anything, even unreasonable procedures for terminally ill patients.

How can the market function when you MUST PAY?

I'd like to challenge this. Yes, the patent system allows for a time-limited monopoly for the inventor of a drug - but it does not, to my knowledge, in any way "dictate prices" for that drug. That is up to the owner of the patent, who rationally will optimize for profit.

Optimizing for profit does not mean "charging as much as possible", either; it means "charging the amount resulting in the highest net profit". There is the supply and demand curve to take into account here.

Each invention or each venture needs resources. Where do you get those from? One can say, people give something and out of this pot you support something bigger (taxes? charity? venture capital?) , and those who have the idea, the skill, the howto, they go for them. And everyone of them has to support their own families too. So all in all, society gets a profit by having people creating treatment, workers get their profit (time+skill for money), investors get a profit and owners maybe get an overproportial share of, what is being paid for it.

I do not understand how this is a pessmistic view. I just see a lot of people being productive?

But i admit, it is an ideal. In generally i also only hear all the bad stories.

America's lucrative drug market funds research which allows the rest of the world to benefit at no cost to them.

Edit: seem to be getting downvoted because people think I’m saying drug companies do this out of benevolence. Not my intention. I’m saying that wrenching maximum dollars out of America but having little ability to capture returns elsewhere is a mechanism by which new drugs are created and later manufactured as foreign generics

But we have pretty effective medical insurance - after paying initial yearly sum, insurance kicks in and covers 90% of the costs. No massive incomprehensible bureaucracy and fooling around with various charges. It doesn't matter what your employer is, you pay it yourself, it covers you no matter the age, status or existing state.

It can still be costly to encounter something serious, some other countries cover 100% of the costs (but question is the quality and speed of treatment, because if its free, old people with tons of mostly incurable ailments can easily flood the system). If it can properly ruin you, social system steps in.

That's a nice and heartwarming story. But I don't believe it for a second. When those companies want to fund research, they raise money from third parties. Or get it from the government in the form of grants.

No, all that money goes to someone's pocket, and mostly stays there.

Not the big companies. R&D is funded through the sales of current products.

Disclaimer: I work in big pharma, though in discovery research, nowhere near pricing and business decisions. Of course, in my position, it would be great if all pharma invested more in R&D

Indian companies can’t just manufacture patented drugs without a license. There is a judicial process to follow beginning with negotiations with the original patent holder. Only if the patent holder refuses to grant a license and the local manufacturer aspirant can prove there will be a public health crisis without the drug will the courts grant permission to bypass the patent.

http://www.mondaq.com/india/x/772644/Patent/Compulsory+Licen...

https://undark.org/article/hepatitis-c-sub-sofosbuvir-india/

It’s probably better for the world if they lean even further from patents.

I think it’s more likely that it funds higher profits for the companies and all the middlemen. This is just self serving propaganda by the pharmaceutical companies.