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Comment by JamesBarney | Hacker News Reader

Unfortunately it's really expensive to research and produce drugs and somebody's gotta pay for it. The rest of world isn't willing to so it looks like rich people's insurance is the one that will foot the bill which means lower income people have to wait.

It sucks and it's a inefficient way to fund research but it's better than the alternative where no one funds this research and we (both rich and poor) never get the drug.

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Another alternative is the government funding this research and/or buying the drug directly. This is what was done for the government ordering 30 billion dollars worth of covid vaccines from moderna, pfizer, and j&j.

Governments already fund much of the basic science research needed to find new drugs. That isn't the issue. The real funding issue is with stage 3 clinical trials, which now often cost on the order of $1B each.

In theory we could nationalize the whole industry and have the government run all clinical trials. So the decisions on which drugs to develop would then be based on lobbying and campaign contributions. Would that produce better outcomes than what we're getting now? The government has a poor track record on picking winners.

What the difference between consumers paying for drugs directly or paying taxes that pay for the drugs?

Many. For one the government can now collectively bargain for better prices. They can also subsidize the drug such that its available for everyone who needs it, not just those who have great insurance or who can afford to pay entirely out of pocket. Keeping your working population healthy has massive second order effects on the economy, it would be an investment paying for medical care.

Where does this money come from? The people in this country who make way too much money to notice any decrease in quality of life from this potential tax hit. This country is full of such whales who could front a lot of money for collective good if we thought about things in a more redistributive manner instead of the "screw you I got mine" manner that somehow got perverted into the American way.

If the government is making the drugs how do they bargain for a price?

And if the inefficiency of the government in terms of defense spending is any indication, I’m sure we’d be getting way less for our money than we currently do.

Most analysis of single payer versus the status quo suggest we'd all be saving money hand over fist. Sure the government is not the most efficient, but private companies are often even more inefficient unless you are a shareholder and your metrics for efficiency are profit versus the wellbeing of your customers.

Single payer systems are not more efficient at producing drugs, they just pay less for drugs by virtue of being a monopsony buyer.

If we had a single payer system we would pay less for drugs, but we'd also have less drugs. This is probably a good tradeoff in the short term, and a bad one in the long run.

If you get a disease today that has a significantly better prognosis than 20 years ago, what's the most likely reason? Better drugs. What is only 10% of our healthcare expenses, drugs. I don't think we should be so quick to cut funding to a sliver of healthcare expenses that is driving 90% of the progress.

"Most analyses"?

United Healthcare, the largest US insurer, has more members than the entire population of Canada. Why don't they get better drug prices than Canada?

And in terms of efficiency, please list all the new, innovative drugs the government has brought to market.

If the USPS ran like the DoD, the country would fall apart.

Government is capable of efficiency.

Pharma profits so far could pay for research thousand years into the future.

Pharma companies have profits that are around 13% mostly comparable to other companies of the same size doing lots of r&d.

Pfizer could fund research for two thousand years at only 10 million a year?

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