@Some: I think there's a difference in how we're defining healthcare. I define it as an application of medicine, and medicine is produced by pharmaceutical companies. Even if you're not taking drugs and you're just in for surgery or something, someone had to develop the anesthetic and the anti-septics.
@Ace: That's some dangerous thinking. Essentially you're throwing all the good a company has done and that they could do under the bus because you are personally offended by their business practices. It's not a trivial thing to replace infrastructure and resume work that's been going on for years. As for the taxes, my gut says it can be done, but seeing as more is spent on healthcare than on defense, I'm not really sure what kind of increase we'd be looking at.
@Tomu: This is somewhat similar to the discussion we had in the piracy thread—what is the incentive of innovating or continuing business if your costs are high, your risks are higher, and your reward is lower? And then risk is increased by making the pool of available money smaller?
@Fighteer: I don't think the argument is simply "they're incompatible." The argument made was that it's not feasible for the government to pay for that in such a way that would significantly cut costs.
There's also a fundamental misunderstanding of companies and an overly idealistic view of the free market. Big companies are almost as slow as governments to change. For example, take Blockbuster and Netflix. Blockbuster built its business model on late fees; Netflix completely rewrote that with its digital subscription model. Even if Blockbuster wanted to change to that model, they wouldn't be able to because it would cost too much to tear down and rebuild infrastructure, and so they've effectively died.
Sure, you can say that Blockbuster was awful anyway, and hooray, the market provided for a new niche with Netflix, but this isn't digital distribution. It takes on average 7 years for a pharmaceutical to go from conception to production. Marginal cost is not effectively zero as it is with digital goods, and so physical infrastructure is needed for distribution.
As for divorcing sales from R&D, my friend pointed out that sales aren't figuring out how to make the big bucks; it's about letting doctors know that a product exists to treat certain ailments. Money has to be spent on it, and money has to come from somewhere.
You mention that they'd still need to answer to their shareholders, so I'm guessing that means you don't actually mean you want to socialize R&D fully, and that's something I've been thinking about. Could you elaborate more on that?
@Hopeless: If you look at GSK's annual finance statement for 2011, you can see that the US is actually responsible for about 40% of their world wide revenue*
. There's an interesting statement in there, too, that states that the federal government is already responsible for paying most of that, not the end consumers.