A reader writes:

You wrote, "I value the private healthcare system in the US, that, for all its faults, has innovated medicines that have saved my life."

In an otherwise careful and considered response from a philosophical conservative to a program of spending that goes against your grain but you still guardedly support, this passage fell flat. Its based on a shibboleth, the ingrained automatic conclusion by market fetishists that the private sector does innovation better than the the public.  In the case of health care this is simply untrue. From the New Republic:

The single biggest source of medical research funding, not just in the United States but in the entire world, is the National Institutes of Health (NIH): Last year, it spent more than $28 billion on research, accounting for about one-third of the total dollars spent on medical research and development in this country (and half the money spent at universities). The majority of that money pays for the kind of basic research that might someday unlock cures for killer diseases like Alzheimer's, aids, and cancer. No other country has an institution that matches the NIH in scale. And that is probably the primary explanation for why so many of the intellectual breakthroughs in medical science happen here.

So while the private sector is concentrating their medical research money on creating hair or hard-ons, hell bent on finding the next 'lifestyle' drug that doesn't actually save any lives but rakes in the dough, the public sector is spending on the basic research that creates real medical innovation.  I'm quite sure that some of the retroviral treatments you need were the product of the private sector.  I'm equally sure the majority of the basic research paving the way to those medicines was financed by public funds and conducted in public institutions.

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.

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