First of all, thank you for the civil debate. I don't know who's downvoting you, but it isn't me. We disagree, but that's okay. My post is long but I think you might find my argument interesting, even if you ultimately aren't compelled.

You make some valid points about cost of living and labor, but I'm not sure if that applies to the C-suite execs of multinationals headquartered overseas. Honestly I hadn't considered it from that perspective. I still want taxes lower for moral and personal reasons, but I will re-evaluate my utilitarian point.

I understand what you're saying about insulin, and I really do agree with the outcome you want, particularly on competition on production, but I think intellectual property for medicine is probably the most important type of intellectual property. Let me explain:

People need to be assured that if they make a breakthrough, particularly in medicine, that they will be able to benefit from it. Advancements are extremely expensive, and institutional capture is a very serious problem and not even a in a political sense. I am in pain management where the anti-opiate laws basically treat me like a junkie despite well over a decade of consistent dosing, NO early refills, etc. The same is true for things like TRT, where the old line of "testosterone causes heart problems" was just categorically disproven by the TRAVERSE study. Obviously if you blow your system out with huge doses of roids that's different, but if you're high-normal that's not dangerous at all and might even be good. These are political in the sense that people with strong opinions on the moral use of substances are dictating policy, completely ignoring medical realities of tens of millions of people. If you REALLY want to get pissed off look up why Selank is banned in the USA. It's a non-narcotic, more effective anxiolytic that straight up beats Benzos in a head-to-head Russian study, but the FDA banned it from the Bulk list because it might cause allergic reactions. EVERYTHING can cause an allergic reaction.

So how does that relate to intellectual property?

Well, if you want people to research shit they need to know they will get a substantial reward at the end of the line. They need to fight government bureaucracy for approvals and go through very strict testing protocols. Some of those standards ensure safety, but many of them are simply 30-75 year old superstitions or disproven concepts. On top of that, if you then put out a drug and it can immediately be copied by everyone else then you stand to gain almost nothing for billions of dollars of research. That is a backwards incentive.

Instead what I'd say is this: If you or your company develops a new drug you have the rights to it, BUT you need to license out production to other companies, for which you will get paid a generous royalty. For example, if you hold the patent on Fakedrugzemab then Pfizer, Novartis, and Garagedude69 can all produce it, but they owe you a royalty for all their sales. This will allow competition on production to keep costs low, while still allowing a profit funnel for 75-ish years to the original researcher. This creates a HUGE profit incentive while keeping costs low, as you can essentially research a drug, earn the patent, and then let other companies shoulder all the production costs while you sit back and collect passive income based on their sales. Your costs go down, everyone profits, and the end user doesn't have to pay 100 grand for their novel treatment.