A reader writes:

In response to another reader's dissent you said:

"Two-thirds of pharmaecutical research is done by the private sector. There's no question that they cannot replace the NIH, but their research should not be dismissed as hair and hardons. Their work is more geared to treatments for specific diseases, and is vital."

Your counterargument misses the fundamental point.  The basic research is what fuels scientific discovery and medical innovation.  This is where people like McCain and Palin showed their real ignorance (or real cynicism) when they mocked fruit fly research.  What they failed to grasp, or pretended not to grasp for political gain, was that fruit fly research is responsible for almost all of the developments in the field of genetics in the last 50 years. 

Money directed at a specific disease or a particular cure is rarely well spent.  NIH and just about every unbiased medical and scientific authority agree that breast cancer charities and other disease charities are essentially a waste of time from a scientific standpoint.  First, they don't generate nearly enough capital to make a difference.  Second, they are too narrow in scope to ever achieve anything approaching a groundbreaking discovery.  Human health would be greatly improved if bureaucrats, special interests and politicians would stop trying to direct research and let those who are qualified determine the most promising areas of research upon which to focus.  It is far more common for basic research to lead to unintended discoveries that greatly improve drugs and treatments for specific diseases than it is for research focused on a specific disease to provide a medical breakthrough. 

As for "two-thirds of pharmaceutical research" being done by the private sector, well, that's not really research.  It is product development.  Private sector pharmaceutical product development is severely limited in its scope and seeks only to find a profitable widget.  As a person who has worked at a number of medical device and pharmaceutical companies, I can tell you that you have no idea the number of promising drugs/treatments the private sector develops that are scrapped because the margins aren't good enough.  The private sector cares only if the drug/treatment is effective and safe enough to be approved and profitable enough to be worthy of development. Scrapping a vastly superior drug/treatment that might not have the same profit margins is not seen as anything but good business to them.  It's not uncommon for pharmaceutical companies to by promising startups just so they can shelve potential treatments that might compete against their mega successful drugs.  Now, obviously, I'm speaking in generalities and not every pharmaceutical executive or company behaves in this manner, but this is standard operating procedure for the vast majority of pharmaceutical companies.

As for the private healthcare system in the US, that really has nothing to do with private sector drug development.  Even if we had a public healthcare system, there would still be a profit incentive for private companies to develop drugs/treatments.  Those of us who could afford private care could still receive it, and those who could not afford it would also have access to treatment.  It's great that pharmaceutical companies have developed HIV drugs that have kept you healthy and alive. The world is far better with your rational voice in it.  But are you willing to state that because of your economic status you are more deserving of life-saving retro-viral drugs than someone who is economically disadvantaged?  This is the reality of our current health care system.  While the current system might make the private sector larger profits, thereby fueling a smattering of better drugs/treatment, it does so on the backs of those who are dying because they cannot afford the drugs/treatments they need to stay alive. Public healthcare might lead to less profit motive for the private sector and fewer drugs/treatments developed, but it would do so while ensuring that everyone received access to life-saving healthcare, and theoretically, would save the government a substantial amount of money that could be given to NIH to fund more research which would more than makeup for any decrease in private sector productivity.

The core issue is whether we can treat drugs as products like any other, i.e. products that are restricted by price. This means that the poor will get worse treatment than the rich. As long as basic care is guaranteed, I can live with the inequality, and I do not see the government's role as ending it.

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