I think when you look at the selective medicare payments, the ventilator contracts, and the price of the 'recommended' patent-drugs like Remdisivir... it quickly becomes apparent that our public incentive structure is profoundly broken.
You don't have to have recommended patent-drugs unless, of course, they are the best option. Sometimes the newer drugs really are better.
In many countries, they do. In some (like Brazil and India), they even rebelled and fought for their right to do so at some point (saving lives of people in other countries by the way).
I mean, in theory, all governments should care, but some are corrupted, and some have been designed to work against the best interests of the patient.