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> In fact you could argue it's in the best interest of drug companies to keep us sick!

This assumes there's only one drug company. If company A's medicine heals me an company B's medicine does not then I chose company A's and company B's goes out of business.

So no, a drug company does not have an incentive to keep me sick.

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And how do we know which is effective given the current flaws of the system and the various conflicts of interest....?

The current system is imperfect, but it's not outright fraudulent. In general, if a company claims "Drug X gives 10% more pain relief than aspirin", they have to support that claim with evidence, which can be reviewed (and contested, if the methodology, outcome, or other factors don't support the claim).

That's not to say there aren't improvements that can be made: All Trials [1][2] is one campaign to improve the system.

[1] https://en.wikipedia.org/wiki/AllTrials

[2] http://www.alltrials.net/

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