This all assumes that the government will do an equal or better job spending money than companies that rely on spending that money well to exist.

What will actually happen is that the government department of repurposing drugs will be efficient once and then get their budget reduced and never be efficient again. Next time they'll make sure to spend every last cent and not worry about the over budget boondoggle that's three years late because their job isn't to get stuff done, it's to make sure politicians can say their doing something on the campaign trail.

Notice I was sure to include ‘revival of corporate R & D divisions’ in the argument? Bell Labs is the archetype - if corporations can do a better job of applied R & D, let them. If corporations are upset about publicly funded research generating open-source discoveries that upset the monopolistic apple cart, that’s not an argument about improving efficiency - that’s an argument about maximizing profits and investor return, not for efficient new drug discovery or old drug repurposing.

The real question is, what is the metric of ‘success’ - improved public health for the entire population at low cost, or bloated returns for pharmaceutical investors?

> The real question is, what is the metric of ‘success’ - improved public health for the entire population at low cost, or bloated returns for pharmaceutical investors?

This is a false dichotomy and this kind of zero sum thinking is exactly the root of so much misunderstanding of economics that's all the rage these days (and probably forever).

Wealth is created by innovation, not transfered. "Rent seeking" is wealth transfer but most companies provide a service that is more valuable than what exists without them.

The goal of capitalism is to allow the capitalist to increase their profits by improving the public good. "Public good" being measured by what people are willing to spend their money on. It isn't to increase the capatalists profits at all costs. The entire idea is built on exploiting the capitalist's impulse to increase profits to also serve the public good.

>This all assumes that the government will do an equal or better job spending money than companies that rely on spending that money well to exist.

We know they do because before the government took over the job, the nascent medicine industry would sell you literal poison.

In fact, you can see today what an unregulated pharmaceutical industry looks like. It's the supplements aisle at your local supermarket. The place where you can buy literal homeopathy sugar pills, and various completely unstudied compounds and other scams. You can buy turmeric for hundreds of dollars a pound.

If private industry was better than the government at managing drugs, the American supplements industry would mean we should have dramatically better health outcomes and dramatically cheaper healthcare

Neither are true.

> We know they do because before the government took over the job, the nascent medicine industry would sell you literal poison.

We also know that some reports of poisoned industries in the past were exaggerated (and politically capitalized to lobby monopolistic regulations). This wasn't exclusive to medicine.

> The place where you can buy literal homeopathy sugar pills, and various completely unstudied compounds and other scams.

Presuming that these aren't actual cases of fraud - if they were, they'd already be illegal in a private market, regardless of the FDA - how many are actually buying these? Not many, I presume. For those that are, I think better informing them is much better solution, not only to combat innefective drugs, but also to strengthen trust on actually effective treatments. That said, homeopathy seems more like a yet-to-be cracked down case of fraud, regardless of regulations.

> If private industry was better than the government at managing drugs, the American supplements industry would mean we should have dramatically better health outcomes and dramatically cheaper healthcare.

Why? USA's healthcare system is an overly bureocratic, poorly regulated (not as in lacking in regulations, but that the regulations that exist are bad) goliath. It's closer to a government-funded system, except stupid. It's not an example of a government-free system, but how private actors do their best to exploit existing and lobbied soon-to-be regulations in their favor.