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Isn’t most of the actual research done by the NHIC, which is supported with our tax dollars? The pharma companies are basically marketing companies.

Socialize the costs, privatize the profits.

Isn’t most of the actual research done by the NHIC, which is supported with our tax dollars?

Less government research than you think, unless it's the political darling of the day (think AIDS from 1985-1995, or various narcotics in the '70s. Today's darlings are medical devices.)

My company put 23% of net profit back into R&D last year.

A lot of “basic” research is done through NHIC grants awarded to what looks like promising research at our American universities (increasing their prestige, producing quality graduates, etc).

But just because somebody with an NHIC grant figured out that stimulating/blocking a particular receptor MIGHT have a therapeutic effect is a LONG LONG LONG (and expensive) ways away from designing a drug that will do so that has good drug properties, no or low side effects, etc.

If you think pharma companies just take NHIC research and market it as their own; then drug discovery would be so easy that EVERYBODY would be doing it.

Your characterization of them as marketing companies might be true of some of the “giants”, but they get new drugs not from some privileged NHIC pipeline, but from purchasing smaller pharma companies that look to have “hit gold”.

Drug research is a lot like mining for gold. Lots of austerity and hard work before you ever see even a gleam of ‘color’, and striking a ‘mother load’ is a rare event.