More VAT within the health sector would systemically lead to more responsibility. VAT "translates" into more market laws in many cases. Patients who know what is good for them usually seek it. The possibilities are there. However, pharmaceutical industrialists, insurance companies and banks who depend on their constituencies often ensure that utopias are maintained. Managers want to avoid taking on more VAT obligations and responsibilities. This could substantially increase the wealth of too many people far too quickly. People do not like science to be held accountable for applying their research projects. The issue of "human rights" could come into play here. But the fact is: that science must serve society, and its misuse must be actively combated.