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Comment by kolbe | Hacker News Reader

I know everyone pictures the kid with a broken arm getting it set when they hear about socializing medicine, but all I picture is the US paying large corporations to make more people OD on opioids.

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One factor is that if you're on disability/Medicaid, you can get $1000 worth of Oxycontin for a $3 copay.

Those pills in turns have a street value of $10,000.

This stream of federal drug money is¹ one big driver of the opioid epidemic. In some parts of the country, a huge part of the population is on disability, and it's hard to say no this kind of money.

¹ Or at least was. The system has probably tightened a bit the last 5-10 years.

We don't have socialized (single-payer) medicine but we are still over-prescribing painkillers. Why do you think socializing medicine would change this? Do countries that have single-payer healthcare have more or less problems with heroin and prescription drug abuse?

less, for several reasons

- in the US system, treating symptoms instead of the underlying cause is easier for the doctor and more profitable in the long run.

- "an ounce of prevention is worth a pound of cure"; less patients that wait until pain is unbearable (due to its cost) which then need different treatment.

- less conflict of interest that affect what doctors prescribe

- there is only one buyer, with a strong negotiation position, potential profits are capped

Also with one buyer they are more keenly aware of when one particular drug or class of drugs spikes in usage.

Many of these points apply to socialized medicine as well. Take Germany for example:

- "an ounce of prevention is worth a pound of cure"; less patients wait until pain is unbearable and as a result doctors are inundated a lot of mildly sick people (who probably didn't need a doctor).

- Treating symptoms instead of the underlying cause is easier for the doctor who is inundated with people that have mild sniffles and aches.

Hence, a lot of my German friends were prescribed "spa time" in the hopes that it would clear itself up before getting a "real" prescription if spa time didn't work.

I believe countries with single-payer healthcare have less problems with this, but they also have very different cultures around the amount of healthcare and drugs they provide. I can't see it being politically viable to impose single-payer-style restrictions on access to healthcare in the US any time soon.

Also, the US does more drugs, per capita, than the rest of the planet - unless those numbers have changed recently. It's probably a cultural thing, in some regards. We love our drugs.

Because there would be an endless supply of government money for rehab centers. Already the ACA has spawned an entire addiction market in Florida.

https://www.nbcnews.com/feature/megyn-kelly/florida-s-billio...

1 in 3 Americans are prescribed opioids in any given year. 80% of the world opioid supply is consumed by the USA.

I can't say whether opioid prescription rates have an inverse relationship with single-payer healthcare, but the USA has astonishing rates of opioid prescription compared to the rest of the world.

I'm sure the US could mess it up that badly, but it doesn't have to be that way.

Really? Take a look at everything else the federal government does and tell me it could possibly end up being anything better.

Sure, but that's the choice of people electing anti-government wreckers and crass opportunists, like that guy charging his security detail to stay in his own hotels. It's also the country that went to the moon. Your choice.

The US is not the country that went to the moon. That was their grandparents. The US is their poor, obese, undereducated, and overconfident offspring.

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