Or perhaps, given that the pharmaceuticals market is immensely profitable, with only a small proportion of profits reinvested in R&D, and carrying immense marketing costs in the US system, with profit seeking deforming research priorities, safety and efficacy testing, and approval, the freerider idea is simply another American myth?

Note, that I don’t subscribe to the infantile idea that pharmacueticals R&D is easy or cheap, just that this claim that the Europeans are piggy-backing research funded by US market profits is just storytelling.

Not quite sure what others could have mandatory insurance. I think it’s only workers of various descriptions.

Insurance premiums are around a nominal 14% of gross income. For employees, the employer has to pay 50% as a “hidden” wage component.

Healthcare is provided to unemployment and welfare recipients through one insurer (AOK) to which the others have to make transfer payments.

For such a long-lived and frequently conservative talking point, there’s little actual evidence to support this. Where’s the regressions, Sebastian?

Claiming that free markets would work better is not “faith-based argument”; it’s based on the overwhelming record of the success of free markets in every industry in which they have actually been allowed to work. My point in bringing up the pre-1965 system is that, relative to the level of medical knowledge at the time, it worked better than what we’ve had since, and would have continued to improve if the damned social engineers hadn’t interfered with it.

And that goes right along with my point that the medical advances we now enjoy- I’ll specify, if our like, those since 1965- came out of a system that at at no stage and in no respect had much resemblance to a free market. The vast majority of the actual science underlying new drugs comes from research directly funded by the taxpayers. Until you and Javier deal with these facts, your arguments appear faith-based rather than empirical.

Of course you can have a bad, inefficient government-based system- that is indeed what we’ve had since around 1965. You’re arguing against a straw man- nobody is claiming that government intervention always and necessarily produces good results. On the other hand, there are in observable fact a number of single-payer systems that produce markedly better results for markedly less expenditure. (Where are the pure free-market systems, or anything even close, so that we can judge their actual performance? More faith-based argument.) If your biggest worry about these is loss of future medical progress, you’ll have to expand your argument quite a lot before I start to share that worry.

Moreover, your dichotomy (good basic research vs. bad me-too drugs) is incredibly simplistic; most of what goes on in the medical innovation business doesn’t fall into either category, so it’s ludicrous to claim that all we’d lose in a socialist system is the me-too drugs.

Your proposed comparison is irrelevant unless you can explain why government investment in basic research is somehow connected to the health care system. Before WWII, for example, the US had if anything a more genuinely capitalist health care system than it does now, but negligible governmetn investment in medical or any other kind of basic science research.

Steve, do you have any evidence for this claim? I’m not trying to pin you down, I’m just genuinely curious about this topic. Do European countries with nationalized health care produce as much basic research as the United States?

And what some examples of some “me-too drugs”? Some potential examples are antidepressants, cholesterol drugs, diabetes treatments, and anti-psychotics. These have mostly been privately produced and marketed, and have generated massive profits. But anecdotally at least, I’ve observed first hand that these drugs have greatly improved the quality of some people’s lives, including the lives of several family members and friends. Wouldn’t shrinking the market in pharmaceuticals reduce the kind of innovation that produced these drugs?

I don’t know what you’re trying to say here.