When you have a mixed economy, the people with the gold will be making a lot of the rules. This is inescapable. You want to fix it, unmix it.

If you have competition, you are going to have advertising. This is also inescapable. Monopolies don't need to worry about getting customers.

It costs hundreds of millions sometimes to get a drug through the FDA process. This comes out of the company's pocket, not the government's. If the drug fails, that money is gone. Under these circumstances, the drugs that pass need to create huge profits to keep the company going. Maybe reforming the FDA process so it isn't so onerous would be a step forward. Maybe focus more on safety and transparency of research and testing, and let doctors and customers decide for themselves more on effectiveness and use.

^The Pharma companies used to pay our MD as much as $500 (didn't go to the MD directly but to a fund that he could use for professional expenses) to follow him around the Clinic for a day or two including lunch where they discussed a lot of things and the M.D. taught the drug reps a lot about the research and how treatments worked, etc., etc. I used to coordinate those and collect the monies for deposit into Foundation accounts. My boss would then be able to use that money for educational purposes for himself and his staff or to pay for professional meeting lunches, etc. My boss was a world renowned expert in Clinical Pharmacology and cholesterol-lowering drugs. He knew how to milk Big Pharma. It was a symbiotic relationship.^

Do you think that $500 was wasted? Did the pharaceutical companies learn nothing from this experience? If you think about it, if all that company cared about was greed and profit, they wouldn't have spent that $500 to learn from the doctor at all.

I know the scenario I put up at the end of my post is not what you want. But before people wreck what is arguably the most advanced medical system on the planet, solely because someone's making money at it, think hard about what you're going to replace it with. There really are only two choices.

Historically the Left has been very good at demolition. Not so hot on reconstruction. Very few people under communist systems thought they were going to end up with what they got after the "revolutions."