Health Costs and the Patent Puzzle
I have long been puzzled as to why countries that are primarily consumers of intellectual property choose to enforce patent and copyright laws, thus paying for things they could get for free. The most plausible explanation I can think of is that they do it because countries that are producers of intellectual property also tend to be rich and powerful, and so in a position to bribe or bully them into going along.
Drug patents present an interesting case. As best I can work it out, the reason drugs are more expensive in the U.S. than in many other places is in part ordinary price discrimination by the drug companies, in part their fear that charging the revenue maximizing price elsewhere would result in countries refusing to enforce drug patents. The difference between that case and others is that drugs provide a basis for justifying wholesale violation of patent rights that is, at least, rhetorically, much more persuasive than for other products. It's a lot easier to say "if you don't want to pay for my book, don't read it" than "if you don't want to pay for my drug, die." Hence the risk that the consuming countries will refuse to enforce patent rights is greater in that case.