@Flimzy There's something to be said for economies of scale. Also, in a country the size of yours, running a standardised and collective medical system could really be used to do a lot of research. There are many many conditions where we really don't know what the best treatment is: individual doctors judge by their hunches. In a united system, it would be fairly easy to recruit people into massive inexpensive medical trials.

And it would be ethical too: we know that the various treatments work; we just don't know which is best.

See Ben Goldacre's fascinating book Bad Pharma for a full discussion of these ideas.

@TRiG The US has and does do many grand-scale medical trials. Most are complete wastes of money, because they are done poorly or with biased preconceived notions of the outcomes, etc... I'm not sure if socialized care would solve (or could solve) any of those problems... but if it could, it would be another reason for me to be in favor of such a change.

@Flimzy yeah, socializing it is a bit of a two edged sword. On the one hand, it is a common risk with common benefit, so public money towards it makes sense, but you are also faced with the problem that people will abuse public money every chance they get, so you need to safeguard that it is used efficiently

I'm generally a big fan of government subsidized research with requirements that competing organizations cooperate together to get it

and that the results are shared

and then you also get less vendor lockin on research results and thus more competition on manufacture of end product

the goal of government spending should be to reduce common risk through common funding, but still trying to maximize private competition to keep costs down

when it comes to manufacture

(granted doing that in a corruption resistant manner is also less than trivial and requires throwing more money at it than anyone currently wants to, even if it is a net savings)

but then again, it also involves having to get the rest of the world to pay their fair share and/or restricting exports to other countries that don't

many countries have socialized medical programs that "work" because they cost shift to the US. If I have drug XYZ that cost me 10 billion to research but only 10 cents a pill to sell, I'm going to sell it to you if you as a country say I can only charge 11 cents, because I'm still recovering a small part of my costs in research and it would be silly not to, but that means I have to charge far more to cover my development costs in countries that aren't "socialized"

if everyone does it, my research budget vanishes and I no longer can do research

so instead of two countries with 50 cents and 50 cents, you get one with 11 and one with 89

@LCIII Oh, haha, I just got that it was a joke. I think the clay monkey distracted me.

@AJHenderson Drug companies spend far far more on advertising than they do on drug development, though.

That's something else that's banned in many countries: direct to consumer drug marketing.

@TRiG does that hold if you count the development costs of all the companies they beat to market that can't use the research now?

@AJHenderson Dunno, actually.

I know that the European Medicine Board offers (or used to, anyway, when I was studying medicinal chemistry) an extra protection, independent of patents, for some medical devices: it says it won't license anything similar for X amount of time, so companies can protect their investment.

@TRiG that appears it may be a dubious claim by itself too

apparently the way they arrived at that conclusion was to a) only compare to research by the company that went to market and b) combined two different studies in such a way that they more than doubled the estimate of one and nearly doubled the estimate of the other

which seems.... dubious

espeically since both of those studies they referenced were ALSO independent

@AJHenderson I'm pretty sure it's repeated in Bad Pharma, which is pretty meticulously researched.

now granted, that's still an unneccessary expense that could be cut if risk was reduced

because if they didn't have to make up all their research costs for both successful and failed drugs on their occasional successes, then they wouldn't need to advertise agressively either

but the obvious evidence of issues is look at the failure rate on biotech and biomedical companies

it's insane

yes, those that win do win big

but the number that lose it all is stagering

it is currently a high risk gambling game

and everyone tries to hedge their bets, which drives up costs

and it isn't even unreasonable that they do so

but reducing risk is a better alternative

and you reduce risk by sharing it

but in a winner take all market, working with someone else is shooting yourself in the foot