The thing with the HRIA was that as a condition of receiving funding, all the work, including work in progress, had to be submitted to a searchable database so that everyone else receiving funding could see the work and use it to advance their own work—because above anything else, we had a mandate to get advances and therapies to the patients as quickly as possible. The HRIA still allowed for patent filings, but everything, everything, was cross-licensed for the length of the patent, for a statutory fee that went into effect only after a product went to market.
As Sci-Fi does, the myriad variables are expertly set by the author. The way this world is constructed, tho, feels so very familiar & in a way that seems beyond the norm for comparably radical imaginings.