By focusing on the “leakage” of drugs and other materials before it gets to the patient, Shanta and Jishnu raise a valid concern about the cancer of corruption in the health sector. In my blog, I did recognize this to be a common problem in some countries. But I would argue that the problem is more acute. If one also considers the information asymmetries that exist between the doctors and the patients, where the decision to prescribe is sometimes “influenced” by the suppliers of the medicines, then we have a situation in which ineffective medicines and medicines with doubtful efficacy as Patel et al. 2005 found in India are being prescribed and administered or excessive prescribed leading to the waste of limited resources and in some cases to negative health outcomes (e.g., chronic use of antibiotics that contribute to the emergence of resistant strains of bacteria or the malaria parasite). And this happens in developed and developing countries alike. Take the case of the US: studies show that financial ties between the pharmaceutical industry and doctors (e.g., free trips and fees paid to attend conferences) can influence the practice of medicine as well as research results (Archives of Internal Medicine, May 11, 2009 & April 26, 2010). I think that the discussion should go beyond the “public vs. private” dichotomy, as what I am proposing in my blog can be delivered equally through public or private channels. But in either channel, systems and tools need to be in place for the appropriate selection, procurement, distribution, prescription and use of medicines. Incentives are important, but well run systems in either public or private channels are critical to deliver the correct medicine to the patient that needs it.