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This paper explains how the current architecture of the pharmaceutical markets has created a misalignment of financial incentives and public health that is a central cause of harmful practices. It explores three possible solutions to address that misalignment: taxes, increased financial penalties, and drug pricing based on value. Each proposal could help to partly realign financial incentives and public health. However, because of the limits of each proposal, there is no easy solution to fixing the problem of financial incentives. [ABSTRACT FROM AUTHOR]

In the late 1960s and 1970s, countercultural entrepreneurs in the United States sold paraphernalia for enhancing LSD trips or for smoking marijuana at small stores called head shops. These accessories of alternative lifestyles provided hippies with a totemic material culture they could call their own. Head shop owners hoped their countercultural wares and atmosphere would provide hippies with desperately needed public spaces where they could gather in peace without being harassed. More importantly, these entrepreneurs believed their products allowed people to alter their minds – and even their societies – through meaningful drug use. In addition, many head shops made vital contributions to the movement to undermine, reform, and eradicate America’s drug laws. While these businesses were not opposed to turning a profit, their communitarian idealism and political engagement contradict the common charge that so-called hip capitalists were little more than apolitical sell-outs and dupes. Both head shops and the marijuana legalization movement helped each other achieve remarkable levels of financial and political success in the middle of the 1970s. In contrast to their predecessors of the late 1960s, many head shops of the late 1970s embraced profit and financial growth and deemphasized radical politics and counterculture. By the end of the decade, head shops numbered an estimated 30,000 and organized their own trade groups and meetings. Eleven states even decriminalized minor personal possession of marijuana in the 1970s. Although head shops had always faced scrutiny from police and concerned private citizens, it was only at the end of the 1970s that parents’ groups and legislators began to coordinate a national campaign against the so-called “commercialized drug culture” they attributed to these countercultural entrepreneurs. Consequently, the crusade against head shops represented one of the first salvos in the cultural and legislative War on Drugs of the 1980s. [ABSTRACT FROM PUBLISHER]