Severe poverty is getting better by some measures, but it's also becoming ever more scandalous because it is now so easily avoidable.

What is really nice about the Health Impact Fund is that it is a win-win, something that without much cost to anyone makes a lot of people better off.

With the Health Impact Fund, the innovation is paid for separately, through publicly funded health impact rewards, and the product is sold at the cost of production to all. Here, the cruel injustice of preventing the poor from buying at cost - evidenced by today's suppression of the trade in generic versions of patented medicines - would no longer be needed.

If the Health Impact Fund were to be instituted, a single company would be in charge of a medical product all the way from its conception to the health improvements realized by actual patients. The company would be paid for health impact, and it would have to arrange the entire pipeline in between - all the steps of invention, of clinical testing, of getting marketing approval in many different countries, of wholesalers and retailers and prescriptions and so on - in a holistically optimal way.

You can get an ice-cold Coke for around fifty cents in most developing countries, not just in the major population centers, but at the most remote and surprising places. The logistical challenges to resupplying all these outlets are enormous - and yet, the entire system works with incredible efficiency as is confirmed by the price of the product.

Our Supreme Court has lifted the practice of buying legislation to the level of a constitutional principle by repeatedly protecting corporate spending for and against political candidates, as well as promises and threats of such spending to bribe and blackmail such candidates, by appeal to the free-speech clause of the First Amendment.

Whatever we, as prospective participants unaware of our specific features, would desire society to be like is what, morally speaking, we ought to institute.