Off patent drugs are fungible in the sense that if Tylenol starts charging too much I can buy acetaminophen from anyone. Drug patents only last about 10 years. Fix evergreening at the patent office and your concerns are taken care of. Fixing evergreening is a much smaller action than cannibalizing an entire industry, which should be a last resort.

Makes sense to me. If evergreening is fixed, then theoretically in ten years time every drug on the market right now could be available as a generic at generic prices.

I think there's a lot of other great options on the table too. For example, we could form an international alliance with countries like Canada, Germany, UK, Japan... If a drug is legal/approved in one of those countries not only is it approved here automatically but we can also buy drugs from those countries.

We could further lower the barrier to entry for patients to get drugs by forcing the least dangerous varieties to be over the counter. For example, there's little reason an Albuterol inhaler requires a prescription. It's basically impossible to OD on and is not addictive.

Even if these specific ideas aren't the right solutions, I think we've been forced into a false dichotomy of basically the status quo or nationalization. I think we can be much more creative.

Hey since you seem to be familiar with the "evergreening" process, would you mind weighing in on my question above? [0]

[0] https://news.ycombinator.com/item?id=22184942