You're putting the cart before the horse here. The reason why the other developed nations get cheaper access to to medicine is because of collective bargaining

You're putting the cart before the horse here. The reason why the other developed nations get cheaper access to to medicine is because of collective bargaining from more organized insurance schemes (e.g. single payer), or because of price capping by governments. Not 'because' the US subsidizes R&D through high prices. The US pays high prices because it chooses as system in which that's acceptable, and the pharmaceutical companies design their own pricing around it. If the US stopped the madness, the companies would rebalance their pricing systems. If what you say is true, maybe every other developed nation would have to pay more. I'm skeptical of this entire theory, however. It's not like major pharmaceutical companies just barely breaking even, and are selling their products at a loss in Europe. There is a lot of room for profit margins to be squeezed.