Question: I need the experts to settle a dorm-room argument for me. I know that there are plenty of reason to be annoyed with big pharmaceutical companies, but I found myself defending them a bit when talking to a friend. This friend of mine was convinced that the pharmaceutical industry (and the whole healthcare industry, actually) is just a scam. He’s completely convinced that, if medicines were less strictly regulated, we’d have small shops making medicine in back rooms and we could make our own in our kitchens and that, somehow, everyone would be better off and would have access to more affordable medicines. This is nuts, right? Please tell me this is nuts.

Answer: Well, it’s sort of nuts. First things first, though: there already are small businesses mixing, measuring, and dispensing medicines. Pharmacies around the country, including lots of small mom-and-pop pharmacies, do exactly the tasks that your friend is describing.

But there is a reason that we have large pharmaceutical companies and strict government regulations regarding prescription medications. We won’t get into the politics here, but we will give you some key facts and background.

We need medicine: about 70% of Americans are on at least one prescription drug. And making medicine isn’t easy (while trained pharmacists can bring some of the process to small shops, your friend’s vision of people mixing medicine at home is a bit of a stretch). Researching it is even tougher. Part of the debate surrounding pharmaceutical companies, profits, and patents on medicines is that pharmaceutical companies say they need to generate lots of income to offset the high costs of researching and developing new drugs. Experts estimate that it can take $800 million to bring a drug to market; drug companies claim figures as high as $2.6 billion.

And research and development is not something that you can do at home. As in some other industries (such as those that work with sensitive technologies), the pharmaceutical companies use clean rooms–secure, sterile spaces–to carefully conduct research and tests. Typical commercial and residential spaces may not be suited for delicate research, say experts in air quality and safety.

In short, not everyone can do what the big pharmaceutical companies do. They spend big on potential breakthroughs, not all of which pan out. And when they succeed, they bring new medicines into being that can change lives. This doesn’t mean that there isn’t plenty of room for healthy debate on a host of related issues, of course: it just means that your friend’s particular brand of utopia remains more than a little bit of a long shot.

“Medicine is not only a science; it is also an art. It does not consist of compounding pills and plasters; it deals with the very processes of life, which must be understood before they may be guided.” — Paracelsus