I wonder why there's a linear relationship in that spending graph? It seems that health spending is rising faster than economic growth (even accounting for an aging population) where I am, as well as the UK and the USA (I don't know the other data). The graph suggests that health spending should rise linearly with GDP, and that the US is somehow special. But spending is rising faster than GDP growth as well as rising faster than aging (and illness) would suggest. JerichoHill. I don't know if I like patent-infringement being described as a subsidy. It seems like the wrong term. Big Pharma doesn't spend more on R&D because of patent knock-off. And (work with me here), patent knock-off doesn't represent lost income, because the medicine wasn't affordable. If (say) India were to stop using knock-offs and forgo medicine instead (or develop their own), Big Pharma wouldn't be affected. So, it seems like the wrong word. The developing world is free-riding off of the R&D, for sure. And patent violation becomes more of a problem as the incomes rise to the point where they actually could pay for the medicine. However, medicine is a public good. It seems to me that patent violation is a way of actually lifting those segments of society out of poverty. Once they are rich enough to do their own R&D, they'll start protecting patents. At that point, everyone wins.