# The USA Goes Full Single-Payer. How Much Does It Cost, How Much To Raise Taxes, Etc. **URL:** \ **Category:** Factual Questions\ **Created:** [June 27, 2017, 1:45am UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957 "2017-06-27T01:45:25Z")\ **Posts on this page:** 10\ **Page:** 7
**Author:** ![md2000](https://avatars.discourse-cdn.com/v4/letter/m/73ab20/32.png) [@md2000](https://boards.straightdope.com/u/md2000)\ **Post date:** [July 3, 2017, 12:59pm UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/121 "2017-07-03T12:59:06Z")
A good example of “not covered”. For a while, it seemed that some doctor in Italy had discovered a cure for MS. (Doctor Zamboni, which in Canada sounds hilarious and fake - a “Zamboni” is those machines for resurfacing skating rinks.) People were going overseas or to central America to pay for the treatment out of their own pocket, and there was a demand for Canadian plans to pay for it too. The feds and a number of provinces put together a study to try the treatment on a few dozen patients, and after a while, they determined from scientific studies that it was not effective. SO… not covered. If it had been proven effective, then it would have been covered. Not sure how the Italian health care system works; presumably Dr. Zamboni was getting some research grant to study this. So research happens and potential new treatments are explored even in countries with public health care… ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [July 5, 2017, 3:35am UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/122 "2017-07-05T03:35:14Z")
> [@adaher](#): > > Most people don’t contemplate financial ruin over a broken leg or having a baby. [snip] Cancer and heart disease and AIDS should take priority over pushing out babies, and putting someone’s arm in a sling. Have you ever either broken a leg or had a baby? Some people are poor enough that they have three choices for those things: Medicaid, letting the hospital eat the costs, or somehow going without care. If we’re paying for such care for the poor, I don’t see how it’d be so hard to pay for such care for the middle incomes. > [@adaher](#): > > You’re leaving out the fact that California would become even more of a magnet for illegals. They’d go bankrupt in ten years. This sounds like speculation. Do you have numbers? ---
**Author:** ![RickJay](https://avatars.discourse-cdn.com/v4/letter/r/bb73d2/32.png) [@RickJay](https://boards.straightdope.com/u/RickJay)\ **Post date:** [July 5, 2017, 4:06am UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/123 "2017-07-05T04:06:22Z")
> [@SamuelA](#): > > See, right now, the incentives for pharmaceutical companies are just to sell as many doses as they can of something they think people will buy. That kind of free market pressure works well in other industries - but in pharma, it rewards certain bad behaviors. For example, one easy way to make a lot of money would be to repackage heroin as a pill, gin up some studies saying your new pill isn’t addictive and that chronic pain is undertreated, and then to ship it by the metric ton. aka oxycontin. You couldn’t literally do this. The FDA would laugh and then call the police. ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [July 5, 2017, 10:10am UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/124 "2017-07-05T10:10:21Z")
> [@RickJay](#): > > You couldn’t literally do this. The FDA would laugh and then call the police. I named the drug where [this exact thing happened](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/). Oxycontin. That is \*literally \*what happened. Sure, the molecular formula isn’t the same, but the mechanism of action…and the high the users get…is very similar… ---
**Author:** ![adaher](https://avatars.discourse-cdn.com/v4/letter/a/dec6dc/32.png) [@adaher](https://boards.straightdope.com/u/adaher)\ **Post date:** [July 5, 2017, 10:36am UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/125 "2017-07-05T10:36:45Z")
> [@foolsguinea](#): > > This sounds like speculation. Do you have numbers? Here’s a very convincing number: countries that cover illegal migrants the same as citizens= 0. IT’s also accepted economics 101 that you can’t have generous immigration policies AND a generous welfare state. You have to choose. California can’t pay for its welfare state NOW. ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [July 5, 2017, 10:43am UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/126 "2017-07-05T10:43:59Z")
> [@adaher](#): > > Here’s a very convincing number: countries that cover illegal migrants the same as citizens= 0. > > IT’s also accepted economics 101 that you can’t have generous immigration policies AND a generous welfare state. You have to choose. California can’t pay for its welfare state NOW. California can in fact pay for it, but they choose not to match their spending to the taxes their state government levies. They are the wealthiest state in the union! Does California offer the same state welfare services to non citizens? ---
**Author:** ![RickJay](https://avatars.discourse-cdn.com/v4/letter/r/bb73d2/32.png) [@RickJay](https://boards.straightdope.com/u/RickJay)\ **Post date:** [July 5, 2017, 2:13pm UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/127 "2017-07-05T14:13:09Z")
> [@SamuelA](#): > > I named the drug where [this exact thing happened](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/). Oxycontin. That is \*literally \*what happened. Sure, the molecular formula isn’t the same, but the mechanism of action…and the high the users get…is very similar… But that isn’t at all what happened; Oxycontin is not heroin. Saying “the molecular formula isn’t the same” is kind of a major deal because the molecular formula is the central point of what a drug IS. Furthermore, it’s simply false to claim that Oxycontin was just a case of sticking an addictive drug into a pill and lying to the FDA that it wasn’t addictive. The entire point of Oxycontin was to try to reduce how addictive oxycodone was (something that has been known for a hundred years) and in fact the early trials and Stage 3 trials worked rather marvelously. What was not anticipated, though in fairness anyone who knows anything about drug fiends really should have guessed it, was how resourceful people would be in finding ways around its slow-release design - but, as the system is supposed to work, that was discovered during post-marketing studies. ---
**Author:** ![Grim\_Render](https://avatars.discourse-cdn.com/v4/letter/g/a87d85/32.png) [@Grim\_Render](https://boards.straightdope.com/u/Grim_Render)\ **Post date:** [July 6, 2017, 2:03am UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/128 "2017-07-06T02:03:40Z")
> [@Shodan](#): > > For example, the current cost of bringing a new drug to market is [$2.6 billion](http://cen.acs.org/articles/92/web/2014/11/Tufts-Study-Finds-Big-Rise.html). If the government refuses to pay anything more than simply the cost of manufacture, how many new drugs do you expect will be developed? I believe the country developing the most new drugs compared to population is the UK. So probably more than today. (Not counting how the amount currently spent on advertising in the US could be redirected, it being more money than is currently being spent on R&D) ---
**Author:** ![Tee](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@Tee](https://boards.straightdope.com/u/Tee)\ **Post date:** [July 6, 2017, 11:45pm UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/129 "2017-07-06T23:45:45Z")
> [@RickJay](#): > > But that isn’t at all what happened; Oxycontin is not heroin. Saying “the molecular formula isn’t the same” is kind of a major deal because the molecular formula is the central point of what a drug IS. > > Furthermore, it’s simply false to claim that Oxycontin was just a case of sticking an addictive drug into a pill and lying to the FDA that it wasn’t addictive. The entire point of Oxycontin was to try to reduce how addictive oxycodone was (something that has been known for a hundred years) and in fact the early trials and Stage 3 trials worked rather marvelously. What was not anticipated, though in fairness anyone who knows anything about drug fiends really should have guessed it, was how resourceful people would be in finding ways around its slow-release design - but, as the system is supposed to work, that was discovered during post-marketing studies. The point of Oxycontin was to replace the market staple MS Contin which was coming off of patent. The drug never showed true [12-hour effectiveness](http://www.latimes.com/projects/oxycontin-part1/) that it advertised and it was never shown to be less addictive than other opioids. Those two issues combined to create a raging drug problem that did not previously exist, and three Purdue executives were [convicted on criminal charges](http://content.time.com/time/nation/article/0,8599,1645683,00.html) for their roles in marketing the drug as they did. “Drug fiends” are not responsible for the fiasco; they were created by it. It’s an example of how drug research and development is more about protecting revenue streams than anything else. ---
**Author:** ![SamuelA](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@SamuelA](https://boards.straightdope.com/u/SamuelA)\ **Post date:** [July 7, 2017, 2:32am UTC](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957/130 "2017-07-07T02:32:35Z")
> [@RickJay](#): > > But that isn’t at all what happened; Oxycontin is not heroin. Saying “the molecular formula isn’t the same” is kind of a major deal because the molecular formula is the central point of what a drug IS. I disagree and I think you should realize you’re wrong. The effect of the drug - what receptors it targets, and generally what direction it pushes the regulation in - is the central point of a drug. Opiates target a similar class of receptors and thus all have similar effects (and similar levels of addictiveness). Would you agree that if you synthesize a molecule that does almost exactly the same thing as marijuana or testosterone, package it in an ‘herbal supplement’, and sell it, that should be illegal, right? And it is. That’s what bath salts were, and various ‘supplements’ they have sold at the health food store were in fact just a form of oral steroids. (one was called andro, another called superdrol, and there were others) In all these cases the drug molecule has different extra bits on it but it acts like a key to the same lock. Agree or disagree. A key that unlocks your door is the same or different if the part that goes into the lock cylinder is identical (or close enough to still work), but the handle looks radically different? [Previous page](https://boards.straightdope.com/t/the-usa-goes-full-single-payer-how-much-does-it-cost-how-much-to-raise-taxes-etc/789957.md?page=6)