>>Pharmaceuticals kickbacks to the doctors was around 4 billion last year. These kickbacks are not going away anytime soon - For pharmaceutical and medical device companies it's just the way they do business.
Not "kickbacks," but "payments" of which a majority is for payments to physicians and organizations to undertake patient research that big pharma cannot conduct itself. Another big chunk is to take reputable speakers to conferences to assist with peer review.
If that $4B wasn't paid, then there'd be little if any clinical research in the US leading to reduced stature of universities and facilities, local conferences would decline in stature, and the Swiss and other Europeans would be delighted to pick up the slack.
"... They ne'er cared for us
yet: suffer us to famish, and their store-houses
crammed with grain; make edicts for usury, to
support usurers; repeal daily any wholesome act
established against the rich, and provide more
piercing statutes daily, to chain up and restrain
the poor. If the wars eat us not up, they will; and
there's all the love they bear us."
-- Shakespeare: Coriolanus, Act 1, scene 1
