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If these things really boost life expectancy that much, this sounds like a textbook case for eminent domain.


I'm no fan of the patent system, but "patent system promises spoils for coming up with great new drug, companies comes up with great new drug, companies gets spoils" is exactly how it's supposed to work. Yes, it's sucks that you have to pay, but that's how you incentives getting the wonder drugs invented in the first place. (I have my own take on this, but if anything this is a 'textbook case' in favour of the patent system.)

Eminent domain would still require fair compensation to the company, so you'd have to pay them more or less what they'd lose from not having the patent anymore.

(Though I think the term you might be looking for is 'compulsory licensing' or so? Not sure.)


Depending on how transformative the effects are (and the price drop possible upon genericisation) then there could be a compulsory licensing trade to do here.

The drug companies are presumably pricing optimally for profit (but not for maximum public benefit, for which the optimum price is ~0). You could calculate the net present value of the drug companies' total profits attributable to the patent, add on 10% as a bonus, and pay them off. If the welfare gains of having cheap drugs are genuinely greater than the value of the patent to the holder, this would be win/win.


Citation needed for the idea that zero is the optimal price for public benefit. Among other issues, I expect medication compliance would be higher when the patient has to pay for the medication.


I think we probably have data on that (at least in general). That is assuming people react to out-of-pocket payments, and not to how much their insurance or the NHS etc is paying.


That is exactly what I have in mind. "Eminent domain" doesn't mean just taking things with no recompense, but I don't think the company should be entitled to profit maximization at the expense of literally billions of people worldwide.


Eminent domain would be on a jurisdiction by jurisdiction basis. No country has 'billions of people'.


It adds up to the same thing in aggregate.

But also, if you change it to "millions of people", the point is no less valid.


India and China each have billions of people.


India and China both have about 1.4 billion each.

To say 'billions', I'd assume you'd want at least 2?


If this research was done fully via the public system in the first place, it would be an easier nut to crack. I mean, some of it is already, and that’s the absolute worst scenario: the public paid for it via taxes, and now has to pay for it privately after the fact.


The public isn't paying for the phase 2 and phase 3 trials.


Imagine that incentive for R&D.

“If you invest hundreds of millions and it turns out to be life changing, we’re going to seize it”


Eminent domain implies fair compensation.

The point is that you don't get to withhold the drug from people to maximize profits.


Wouldn't fair compensation more or less be equivalent to medicaid paying for the drug? And if so, why eminent domain it?


No. Fair compensation means that the company doesn't end up with a loss, and gets rewarded, but it doesn't mean "give them as much money as they could otherwise extract by exploiting the monopoly that the patent gives them on the market".


Doesn't seem fair to me.


And withholding access to drugs that would extend everyone's lifespan by several years to maximize profits doesn't seem fair to me either. In fact, it's outright sociopathic.


These drugs are covered for the people whose lifespans would be extended by having them! They pay nothing! The situations where insurers/medicaid don't want to pay are more marginal cases. And even then, it's like, 1/5 the cost of child care in a major metro and only getting cheaper. If you're going to use an extraordinary mechanism to seize private property, it better have outsized impact -- seize surface parking lots and sell them to developers to build more housing.


The people can wait seven years for the patent to expire.


Patents are a form of artificial monopoly that only exists because the people (acting through their government as a representative of their will) decided to have them, and did so because they presumably are a net social benefit. Consequently, governments are not obligated to treat them as sacrosanct, and most certainly not in a case where they are not beneficial to public interests.


It's a social contract between the people and the enlightened. The people always win on a long enough timeline. But the deal is there should be some sliver of reward for a brief window of time to those who bring permanent light into our lives.


The "enlightened" are the scientists who actually developed this stuff, not the CEOs and corporate shareholders collecting economic rent from other people's hard work who pocket the vast majority of the profits. If we only had to fairly pay the people who actually did the useful work and not all the capitalist deadweight, these drugs would be orders of magnitude cheaper.


And you think scientists should be working for the communists instead of the capitalists? Well that's fine too. Scientists are like spoils of war. Scientists were treated well and able to do a lot of good work when they were all employed by the soviet state. Maybe not as good as the Americans did. They also seem to be doing well over in China. But just because you don't like someone or how they do business, that doesn't make them deadweight, and no I don't think you know how to get products to consumers cheaper.


Let's not assume self‑interested corporate monopoly rents are a necessary precondition for innovation, and let's drop the romanticized notion that statutory patent terms by themselves constitute a just moral bargain, because history shows substantial discovery emerging from publicly funded science, mission driven nonprofits, collaborative consortia, open licensing, prizes, and advance market commitments, so we should test which incentive mixes work rather than presuppose one. Your "people always win on a long enough timeline" line doesn't answer the moral question of avoidable deaths, irreversible morbidity, or financial ruin before expiry; inevitability ≠ adequacy, and harms incurred during exclusivity remain morally chargeable. Commercialization does not require locking invention behind maximal (often crude, lengthy) IP, there are workable paths via milestone or frontloaded prizes, targeted or indication specific exclusivities, compulsory or voluntary licensing, patent buyouts, tiered pricing, and public manufacturing backstops; optimal mixes will and should differ across high‑income vs low and middle income country purchasing power. The "7‑year wait" is factually thin: statutory patent term is ~20 years from filing, while effective market exclusivity depends on regulatory data protections, biologic exclusivities, secondary or evergreening patents, litigation delays, and manufacturing barriers; patients routinely face restricted access even after nominal expiry. We also shouldn't conflate discovery scientists with development firms, nor firms with shareholders; in practice, salaried scientific labor is often alienated from downstream pricing power while financialization channels can parasitically extract surplus that need not translate into new R&D. Because many medicines and virtually all software have low marginal production cost relative to monopoly price, large deadweight losses arise when willing buyers are priced out, a staggering public welfare loss (and no, "deadweight" is not necessarily a synonym for "people you dislike"). Reading int_19h's rent‑extraction critique as a demand for Soviet central planning, and pivoting to talk of scientists as "spoils of war", is a straw man and a red herring that dodges the pricing structure at issue. If you want to defend the patent regime as a "social contract," we need to see the reciprocal side, access safeguards, anti‑evergreening enforcement, affordability commitments, otherwise it's a moral bargain in name only. Claiming membership among the "enlightened" means actually shedding light on these failures.


Go vomit words at someone else. I didn't even read it lol


Noted. Given your 'Go vomit words' reply, I'll keep this short. In the spirit of good will, I'm happy to engage with anyone who wants to discuss the substance of the argument in good faith, including you, if you ever decide to change your mind. And, just as a reminder, there's no need to keep responding unless you're ready for a serious conversation.




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