That's pretty far from true. Using rich people to pay for product development is a well-developed modern technique, and it can definitely work well. But we didn't get, say, the smallpox vaccine because Jenner said, "I wonder what I could do for very rich people?" Most early Internet work was done for the sake of public benefit; the rich-person version was Compuserve, which was basically an evolutionary dead end.
Moreover, plenty of things made for rich people stay as solutions for rich people. And some are only valuable because they are priced so only rich people can have them. Note the entire luxury goods market, for example. You could look at houses and cars as well: because those markets focus a lot of their product development on rich people, the non-rich end up with hand-me-downs that don't suit them very well.
I'm wondering how it would work otherwise. Should someone buying a new car who is thinking about its entire lifecycle optimize for fuel efficiency? Resale value? Ease of maintenance? Something else? I suppose a house should be designed so that it could easily be split into apartment units? It doesn't seem impossible to get wealthy people to consider these things, similar to how they consider the effect of the products they buy on the people in the supply chain and on the environment, but it would require a lot of research and marketing.
On the other hand, long-term planning like this is hard to do effectively. It seems like a lot of charity efforts specifically targeting the poor turn out not to be very cost effective, compared to the best approaches highlighted in GiveWell. It's hard to be confident that your average startup would achieve anything more than just showing good intentions.
Good question. I think a lot of rich-person spending is essentially buying status. So I think trying to get them to consider the ways their new dream home could be later retrofitted to suit the poor is working in contradiction to the motives. It is exciting to me when goods with some public benefit also become status goods, though; the Prius and the Tesla are examples of that.
I agree that do-goodery is hard. Of course, so is producing value in a for-profit context; I'm not sure which is relatively harder.
That's just not true.. There are numerous diseases which only affect the most poor and downtrodden citizens that are being worked on by thousands of 'first world' scientists.
With the obvious axioms that anyone with 1st world single-payer insurance behind them, or, say, the Gates foundation, isn't poor, could you give some examples?
The Perlstein Lab is a Public Benefit Corporation in the Bay Area looking for lysosomal deficiency drug candidates. A ton of research scientists are working on obscure diseases at university.
> Moreover, we suggest that orphan drugs have greater
> profitability when considered in the full context of
> developmental drivers including government financial
> incentives, smaller clinical trial sizes, shorter
> clinical trial times and higher rates of regulatory
> success
The original statement was that we don't develop treatments for diseases unless they affect rich people, the existence of orphan drug markets and regulations is evidence that we do develop these treatments.
