25A046 Health & Wealth by Jim Davies, 11/18/2025

Here on the ZGBlog we try to contrast the present government-infested world with what life will be like when it has all imploded and vanished.

One good example is the industry of health care, of which a key component is pharmaceutical drugs, which can be horribly expensive. That suggests their supply is wildly inefficient and/or corrupt, and R F Kennedy's book on Fauci abundantly confirms the latter.

I have blood that's a bit thicker than it should be, so I use Eliquis, an effective thinner. A three month supply costs $1,800 on Amazon. Generic equivalents have been available for a couple of years past, but the FedGov prohibits their sale in the USA; so I'm buying from India for $135, a discount of 92.5%. Presumably, the manufacturer there is able to make an acceptable profit from that $135, and it includes shipping.

Here's how government bloats the price of drugs, to the benefit of its generous donors in the pharma trade. In the coming zero government society every one of these causes will vanish:

First, the developer Bristol Myers Squib was granted a patent. For several years (17, last I heard) nobody is allowed to compete with Eliquis, so BMS can charge whatever price they like. Patents are a contentious subject, and the US Constitution allows the Feds to grant them, but there it is: an intervention in the market, a distortion of freedom. So only the rather well-off can afford it. Patents punish the poor; open competition would enable rivals to reduce prices.

Second, the FedGov requires developers so submit to years of testing, to gain FDA approval. Now, designing new drugs is expensive anyway, but this artificial requirement multiplies the development costs, hence the sale price needed to recover them and make a decent profit. This is further, drastic and destructive distortion of market freedom. It not only raises the price but kills people who need the drug at once but cannot get it because it's awaiting approval by FDA tin gods. In the coming zero government society, the manufacturer will be responsible for making drugs safe, and will suffer heavy loss of reputation and business if he gets that wrong; the opinion of FDA overlords, who have no stake in the trade, serves no purpose.

Third, government also requires that nobody can buy Eliquis without a prescription written by a physician the FedGov has approved. This is another intervention in the market, another delay and expense and potentially a prohibition. In the coming free society, the customer will read the maker's offer, seek advice if (but only if) he wants it, then go ahead and buy it.

Fourth, the FedGov scrutinizes imports across its borders, and may charge a "customs duty" or tariff. That matters, because Eliquis or its generic equivalent can be purchased from other countries (UK, India, Canada, Australia...) at prices that are (as above) small fractions of the ones forced to prevail in the US by the patent. The border police impose delay and perhaps extra cost. Another distortion of the free market, which will vanish when government does.

Fifth, to offset the obscenely high price it has caused as above, the FedGov creates and regulates a massive insurance industry which has built a convoluted process to make Eliquis available to the less-affluent - because they, too, vote. Insurance is fine if it's voluntary, but this process is complex, expensive and almost unavoidable.

What applies to this one drug for this one patient applies also to many hundreds of drugs for millions of patients, and all of it happens because a non-participant in the market exercises power over the market.

The third chapter of A Vision of Liberty (link at top-right) details how I expect the other components of health-care to be delivered after government has evaporated for want of employees. Care will be just as good or better, but its cost will tumble to a minor fraction of today's level; and it will be a whole heap simpler. That's what a free market always produces.