Merck wants to charge Americans $700 for a drug that costs $18 to produce.

That is a ratio of around 39.

The fact that the US government paid for the development of this drug adds a second kind of unfairness to the issue, but we should not hammer too much on that, lest people suppose it is OK to gouge on a life-saving drug in countries that didn't fund its development.

The US should do what more advanced countries have done: set up a national medical system, fund it well, and empower it to negotiate the price per dose.