It's not conspiracy thinking to look at the incentive structures within systems to predict possible negative outcomes.

Of course, there's a moral incentive to not keep people sick, but history shows that we can not rely on people acting morally. The pessimism is justified.

If we expect companies to provide cures over treatments, we at least must allow them to profit as much or more from a cure as they would from a treatment.

I think that’s where you go wrong. There are huge profit incentives for a cure. If a biotech company comes up with a cure they will instantly have the business of every afflicted person on the planet. The market for that and price they can charge will be way larger than a slightly different treatment.

Beyond that, there are labs all over the world funded by public dollars to research avenues to a cure, it’s just way more complicated than effective treatment.

Are you saying people that aren’t taking a monthly biologic injection for example will start coming out of the woodwork for a cure when normally they wouldn’t seek treatment for their malady?

And countries will always pick the best priced possible treatment.

It is when one mischaracterizes the system.

Medical research is not an oligopoly. It is oligopolistic within some domains, but as we've seen with the Covid vaccine, there are at least four nation-state domains (e.g. Russia, China, India and "the West") operating competitively, and within those domains, there are varying degrees of competitiveness (e.g. Pfizer vs. Moderna vs. AstraZeneca).

If you have a cure to something everyone else can only treat, you'll make a money selling the cure and taking your competitors' market share. Because if you don't, they will. It's a classic cartel / prisoner's dilemma problem with the added explosive of a multi-decade patent-protected monopoly for the first mover.