Companies are actually much better than governments and other bureaucracies at organizing in a holistically efficient way the extremely complex path from the examination of molecules all the way to the delivery of medicines to patients. Already in the conception and selection of research projects, companies would anticipate all the challenges down the line that they will need to overcome in order to achieve actual health impact. Bureaucratic organizations, by contrast, are notoriously bad at this sort of optimizing.

Social rules are susceptible to moral analysis. This is, again, relatively familiar in the domestic case, where we now condemn slavery as unjust. And when we affirm this judgment, we're not merely saying that all those people who owned slaves were unethical people; they shouldn't have done that. We do believe this, but that's only part of the point. We also believe that the fugitive slave laws were unjust.

Countries compete in offering easy working conditions to their banks. In many jurisdictions, you can deposit money anonymously with no questions asked, even if the accepting bank knows that it derives from criminal activities.

Because present procedures by design favor the affluent, the poor are being increasingly marginalized. And because the poor are so marginalized, they can exert little influence on institutional design decisions. We need to break out of this vicious spiral and create momentum in the opposite direction.

We live in a world where economic positions - income and wealth - are very unevenly distributed, and this leads to the widespread persistence of poverty.

In order to prepare for meaningful change, we have to look at both sides of the problem. We need to examine the output of our political system, which is often very hostile to the poor abroad and hostile also to the poor and middle class domestically. And we must also look at the procedures through which this output is produced.

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.