Most patent owners are not interested in gatekeeping, they are more interested in patent licensing.
That may be true, but it doesn't change the fact that they are by default appointed as gatekeepers. You can get into compulsory licensing situations, which touches somewhat on matters related to the original article, but then you have to assess whether patents have any real, distinct purpose at that point: why not give contributors to a standard or "essential" solution a prize and leave it at that?
Also patents related to pharmaceuticals are not exactly a panacea, even though they may indeed encourage risk-taking amongst smaller businesses. For example, there is a degree of interest in "generic" medicines for purposes other than those for which they were originally intended, including even withdrawn medicines, although I suppose one can argue that this is of niche interest, that the bulk of new treatments come from new discoveries protected by patents, and that the interest in medicines covered by expired patents has only been rekindled by improved technology and techniques to better understand their action.
But still, I feel that a specific justification of patents, along with the privileges they afford, is missing. They may not encourage innovation more than various alternatives for all we know, and I also suspect that the mass issuing of patents is perhaps a way of delegating responsibility for progress in technical domains to a growing circulation of paper bills and is thus reminiscent of the way that a lot of issues are "solved" by policy-makers who do not wish to concern themselves too greatly with the mechanisms involved and their subsequent effects.
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