Dean Kamen has some lengthy thoughts on innovation that are well worth reading. As the article notes, besides the Segway and the world's first stair-climbing wheelchair, "His innovations include the first wearable infusion pump, a portable kidney dialysis machine, a more flexible stent, one of the world's most advanced prosthetic arms, and many other devices used in the treatment of diabetes, heart disease, cancer and other conditions". Kamen's core point is that innovation is expensive. You can't stop rewarding innovators and expect to have as much of it.
There's often a sort of implicit dichotomy in discussing health care innovation: you have academics, and then you have greedy people. Academics do a lot of important work. Greedy people steal that work, and make a fortune that they don't deserve.
But there's no question that Dean Kamen knows how to produce real and important innovation--his inventions are, if not saving lives, dramatically improving their quality. If he demands to get rich in return for doing this--very rich, filthy rich, obscenely, rolling around in piles of $100 bills rich--then this strikes me as a good bargain. But I think for a lot of people it isn't. The injustice of his demands for profit rankles more deeply than the miracle of his inventions can soothe. If they have to risk some innovation in order to wring this profit out of the system, and distribute the goods he's already produced for us more widely, they're fine with that tradeoff.
I'm not. And I don't think this is a gap we can bridge by discussing the thing. We're doomed to keep getting angry at each other.
Ezra Klein might reply, with justice, that Dean Kamen is an interested party: he would like to get paid as much as possible for his inventions. But this does not, of course, mean that he is wrong. More on why I think ignoring the businessmen in favor of the "experts" is such a bad idea later.