For drugs one of the fundamental problems is that there is close to zero competition. Getting FDA approval to manufacture an already-approved drug should be muc

For drugs one of the fundamental problems is that there is close to zero competition. Getting FDA approval to manufacture an already-approved drug should be much closer to a rubber stamp. Patent lifetime should be closer to 3-4 years instead of 20+, and that whole hack of a superficial tweak renewing the patent needs to be eliminated. Then things wouldn't be so bad if drug manufacturers charged whatever the market would bear (there should also be one transparent price, none of this opaque "negotiated" price fixing). The 3-4 year period where a new life saving drug has been created and approved but is still cost prohibitive for most many would be gristly, but the impedance mismatch has to accrue somewhere and the current solution we've defaulted into is to claim wide access while allowing drug companies to perform wealth extraction (modulo what the "insurance" cartel can be guilted into paying for).