> Seriously?

Yes, seriously. I get that you are smart, but there are smart people in the world with different outlooks than yours.

> 1- I was not the one claiming that the rest of the world is ripping off American drug companies.

You brought up foreign drug companies, as if their existence proves American IP laws aren't needed for drug development. The reality is that the biggest market is America. Roche is a Swiss company but America makes up nearly half of its revenue, way more than Europe, despite Europe being larger on PPP measures and its own home country. You can't write off America and say that other countries will still invent drugs, because they are inventing drugs on the basis of American laws.

> - the (obvious) point is that R&D isn't the major cost expense

It is indeed a major expense, one of many. If a company spends more on taxes than on personnel it doesn't mean personnel aren't extremely important.

> who said anything about marginal?

Me. And you when you said that pharma companies were still profitable selling in other countries.

Obviously the companies are profitable in other countries, in the sense that they are not losing money on each sale. It doesn't follow that they could make money if every country compensated them as if they were the marginal customer.

An airline will sell me a seat at the last minute for $40 rather than let it go empty. That doesn't mean that they are cheating people who paid $400 when booking months ago, or that there is a way of operating the airline by selling $40 seats to everyone and we only need to get tough with our airline companies to force nirvana to happen.

Please take into account that this is discussing how many people will be killed to protect/improve profits.

Emotional language like this used to work on me. But since I am no longer in middle school, it doesn't. Sorry.

Adults recognize that life and death decisions are made every day based on money. All procedures and drugs have some break-even point. Doctors can retire instead of putting in more years because they are done. All sane medical systems have a threshold at which it no longer becomes worthwhile to do a medical procedure even if necessary to save someone's life.

If you are going to whinge about "what is ethical," let's point out that no one is stopping you from discovering the next great wonder drug. No one. Go do it. And give it away. Or whatever you want. No one is stopping you from doing this. Oh, you don't want to do that? It's much easier to instead tell the people who actually do the life-saving work how to run their lives? Well, okay, I guess that is easier.

You can't yank out the rug from underneath the pharma industry and just assume that it will continue to deliver results. If you want to think you are being "ethical," then stop messing with a system that is continually adding things to the public store of knowledge when you don't know what you are doing. The drugs going off-patent each year are amazing. I have family members who would not be functional without some of these drugs. If some pinhead had decided 40 years ago to put a spoke into the industry's wheels because they didn't like the word "profit" these generics might not be available.