It's not a government that enables it, it's a government that enforces it through laws that guarantee and endow a local monopoly. Whenever you have an endowed monopoly without substitutes, you have extremely high prices. It's econ 101 and will happen 100% of the time (that's why I call it enforcement instead of enablement). If the government just got out of the way, the price of insulin would plummet.
What's stopping US companies from competing based on price? There's multiple producers of insulin in the US. Why do you need a foreign company to undercut them? If an international market would fix it, why doesn't the national market fix it? Why doesn't one of the US companies charge less than the others?
Because of price fixing among the 3 big insulin providers, which is only possible in an environment where competition is heavily constrained by monopoly powers (or in this case, oligopoly powers) endowed by governments through the patent system.
If we have an international free market that encourages 10+ competitors that aren't banned from producing insulin due to patents, then price fixing becomes impossible.
So if government just got out of the way (in this case - patents and banning imports), you could import cheap insulin from anywhere and the problem would be completely solved.
So you think it's an accident that pharma corps make lots more money under the regime enforced by government? Or, possibly the pharma corps have engineered this situation politically (ie 'buying' politicians in some way - campaign donations, advisory jobs, etc).
Why else would gov arrange things this way of not at the direct [but covert] behest of the pharma corps? Do you think they're doing it (having overinflated prices for age-old life-saving medicines) to help citizens?
It's as you say - crony capitalism and corporatism. The politicians/government are corrupted and bought by pharma corps to create a situation where competition and the free market is stifled, which leads to high prices as the inevitable consequence. It's a principal-agent problem in the context of having a large state/government with extensive powers to interfere in private business.
You see this playing out everywhere; e.g. agriculture subsidies in rich countries, which just serves as protectionism for domestic farmers at the expense of poor-country farmers. The fundamental causal factor here is the large and powerful state - private, autonomous actors will always try to corrupt and co-opt the state's powers for their own benefit (whether that's farmers, pharma corps, oil companies, hedge funds, tech firms, or whoever), so laying the causal blame at their feet is misguided since their attempts to do so are inevitable. It's a government problem.
