This is one of those comments that make me wish hn gave out a daily use “super upvote”.

I’d only extend that point 2 is true for many cutting-edge treatments beyond simply drug development & is tied to point 1: If you pay doctors top-flight salaries, you get a lot of smart, innovative doctors pushing (at great cost) into the future of medicine.

Similar story with admins working to make care more efficient and also humane, data science teams (yes, big research and academic hospitals have these in spades!) …

America is rich and wants to spend that on medicine. It’s not a conspiracy of oligarchs.