I do not want to sound as though I am in favor, overall, of the parasitic and broken American medical system. However, substantial investment in medical research matters a lot even when the first round of beneficiaries are the rich.

The number of major advances in genetics, in reproductive health, in cancer treatment, in mental health pharmacology, in reconstructive surgery, etc, all because rich people wanted to make sure that their fetuses were healthy and blond or that their skin moles were promptly removed or that they had constant access to anxiety medications that mixed well with a martini are legitimately vast.

I think it is a mistake to look at the amount of money going into American medical research and conclude that because rich people benefit first that it does not therefore make the world a healthier place.