Here's where I stand:
True
I doubt it. My sense of things is that there are dozens of companies we've never heard of, who don't innovate shit, and have perfectly healthy balance sheets and don't want anything to change so they lobby the fuck out of politicians to make sure nothing changes, and if anything does change, it's only to make their business even more cushy.
I wouldn't accuse you of saying something like that. But yes, R&D certainly wouldn't justify their prices.
If by "they" you mean the companies themselves, I don't think the answer is quite that black and white. A lot of public grants go to researchers at universities, and some grant money gets mixed up with private investments that are linked to pharma companies, and while there are some strings attached it's usually a stretch to say "they" (the pharma companies) are "engaged" in that research. I'm not saying these companies don't have research departments, but I've not heard of anything worthwhile happening in those labs. I could be wrong, but I get a distinct impression that private researchers are MLS whereas the minds in academia are Champions League caliber.
It's not black and white though, as I said, so I'm sure there are some rockstars in private research and some flameouts in academia, and of course due to all the public-private partnerships and the way research gets funded, the line between "them" and not-"them" is blurry.
I can agree with you that innovation DOES happen. I don't think I can agree that the innovation is rightfully "theirs" when it's more often the innovation of some grad students.
I agree. Patents incentivize investment in invention, but not necessarily the invention itself.
I still find it immoral for someone to be able to monopolize life-saving or livelihood-saving treatment.
I'm not against the patent system, I'm against capitalistic mechanisms that deprive people of the care they need. In this particular case, I think monopolies on drugs (whether it's a patent or whatever the fuck orphan thing Shkreli was exploiting) are immoral. There has to be a better way to reward innovation, and a better way to reward people who are willing to pay for research even when the research itself doesn't pay off. Those are losses I'm fine with socializing, and I don't believe these losses are so great that the only way to offset them is by depriving people of the care they need.