It's not black and white- in pharma there are notable sources for investment that are not private, e.g. for orphan diseases that would otherwise not see enough investment due to lack of profitability.

But here's a mechanism to mobilize private capital for those diseases that are. Again, the investment needed boogles the mind, around 10B currently, for a single drug.

You're asking someone to pay that money and allowing others to reap the rewards. Why wouldn't everyone want to be the one who didn't pay the money?

Some will surely exist. We already have public funding for things that are not particularly profitable. The question is if it will net a better system overall.

Even with the current system everything older than X years is public. That means we should have better care options available then anything X years ago. And that keeps increasing.

People talk about capitalism as if there is a choice; as if Gravity might not pull us towards earth.

I do however like the imagery from the parent of a big collection of people working for a decade to produce one (1) drug and then burning all that infrastructure and training down and then being shocked when someone with no infrastructure or training or history in drugs comes along and somehow produces it but outsells the original.

This may surprise socialists, but you can set up a pharma company yourself right now that makes all its research open.

I agree, but man, getting the money to make the world a better place goes through the capitalists right now so unfortunately that's the game. Can't fix the problem without fixing the system. (I'm not like hardcore marxist or anything, but incentives shape everything; have to fix the incentives)

This may surprise extreme altruists but there are people who genuinely care about profit motives and are only willing to make the world a better place at a price. I don't see software engineers in advertising and finance quitting their jobs en-masse to work for teach for america, doctors without borders, etc.

Also, the bulk of the cost of manufacturing a drug lives in the scientific & engineering exploration space, which we should incentivize.