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Comment by funkymike | Hacker News Reader

> but a potentially bigger issue with the act is that it transfers $3.5 billion of public health spending to medical research.

I would like to see much more public funding going towards medical research, with the stipulation that the results must be open and cannot be patented.

In mentioning this I just had an idea that I don't remember seeing before. I wonder if there should just be a sort of medical treatment lottery for pharma companies. They come up with a treatment, get a patent, and prove it works as normal. Instead of allowing the monopoly however, the FDA could buy out the patent and make it public domain. The pharma company gets a guaranteed and immediate profit (say 50% of the projected total profit over the life of the patent). Meanwhile any company can then produce the drug/device/etc. competing on the quality and price of the treatment, separate from the cost of the research that led to it.

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I think we should definitely experiment with how we incentivize research, but one of the problems with profit is that it's hard to quantify. Basically it's easy for companies to make profits disappear. I.e. Lookup Hollywood accounting.

I read once about a prize based on QALY gained (quality adjusted life years) over current best practices. One of the best parts about this is you could give it for unpatentable advanced like diet/exercise/herbs.

Lots of money is wasted trying to take an unpatentable ideas like intermittent fasting/curcumin and turn them into patentable drugs.

There's nothing wrong with public funding of medical research.

Taking funds away from public health to do medical research is highly questionable.

One of the reasons this happens is conservative economic philosophy. Public health is carried out by the government, while drug sales are carried out by private corporations, and according to conservative economic philosophy, private corporations are better than the government.

The problem is conservative economic philosophy depends on letting a problem get bad enough that the typical customer becomes informed. How many people do you want to get MDR TB before people are sufficiently interested in the topic to become informed enough to make rational decisions in a well-developed market?

I'm not sure people realize how much the public health labs do that would simply never pay, yet saves lives: who's going to speciate and sequence rare, but highly contagious or virulent organisms (like MDR TB) isolated from some one homeless person, who, by virtue of their unfortunate circumstances, serves as a canary in the coalmine of the modern city.

I agree and I wasn't clear enough about that. Moving funds from areas that provide clear tangible results to research that might produce results seems wrong.

The problem with awarding a prize is rather than the market awarding it, some person or persons has to make a judgement call on what prize amount to award. What if two companies come up with similar drugs, but one is slightly more efficacious? Do you just split the prize 70/30? Or 60/40? What if that split doesn't cover the R&D costs?

I can think of a number of ways it could go wrong.

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