You can't just reduce the patent period without reducing the regulatory process that is required to get stuff approved. It would not work otherwise.

I hope we're not on the path to reducing rigorous testing and vetting of medicines in exchange for cheaper prices. Medical science is extremely hard, and verifying cause and effect in a system as complex as the human body takes significant resources.

People want cheap, people want safe, people want well qualified individuals pursuing these advances. What people don't want is higher taxes to enable government funding for this research, and would rather have private investors pick up the tab. And then they scoff at high medicine prices. I'm sure there's some corruption and paper pushing waste going on, but fixing that is not going to remove the need for costly triple blind studies that span years, only to result in failure the vast majority of the time.

That's the cost of good science, and if society wants the fruits, they need to pay for it.

This is exactly correct. Also there is a good incentive structure in there - a well designed clinical trial program will move between phases, collect all data possible to support an application, and have all the relevant data to get a timely approval. The better you do on evidence collection, the sooner you are on the market, and more you have to work with

Note that even if government pays, the costs still exist. Maybe the government can decide researchers are worth less money, but or some such - if they are willing to drive researches in it for money out (everybody is in it for money at some point, as you need to eat and you like other luxuries money can buy: the only question is when it is worth leaving).

> I hope we're not on the path to reducing rigorous testing and vetting of medicines in exchange for cheaper prices

The FDA has extremely long review cycles. To say that this could be not be improved, while still keeping the same standards (or even better ones) is unlikely. Anyway, I don't think it's likely that we will see anyone touching the patent system anytime soon, so it's merely a thought exercise at this stage.

The FDA has a mechanism (market exclusivity) that is intended to compensate for regulatory delays.

The two are interlinked and I believe it would happen naturally in large part. Long patents buttress profits for drug makers, allowing for increased regulatory capture and increased FDA power. The opposite is also true.

With shorter patents, or no patents, the business model changes. What is changes to is hard to predict. However, we can guess that drugs would price out LESS on average due to generics coming in sooner.

In the absence of patents, who is going to pay for the expenses of developing the medicine? It's not hard to predict that smart people don't work for free, nor is specialized lab equipment available for free.

We can also guess that few drugs would come out.