I am so tired of people claiming we pay for drugs twice. A quick look at the grants given out by NIH to investigators in academic researchers demonstrates that the money is given to pre-clinical activities. The track record of academics moving something into clinic is quite poor for a variety of reasons that have much to do with with quality of the translational research. That's where venture capital, biotech, and pharma comes in. And indeed without such investment -- which comes earlier than ever before in the discovery process -- taxpayer support for NIH would not be worth the effort. It's the private investment -- which by the way is now increasingly translational in nature and now involves the development of new drug development tools -- that enhances the NIH investment. Without the private sector we would not have any drugs to pay for at all.
Indeed, without contracts and contracting out in key areas such as genomics, proteomics, high throughput screening, biomarker development, the NIH would not be relevant. It needs and has relied upon constant collaboration with the private sector at all levels. In fact, efforts to bar NIH scientists from consulting and working with private companies has lead to a massive exodus of key researchers to for profit companies where there is more freedom and resources.
The point is, making medicine more altruistic will only make the NIH less vibrant and reduce the number of new drugs.
I wish people would grow up. Things worth having are worth paying for.