A second observation from the article is that it illustrates a theme I keep coming back to with my health care posts. That theme is the idea that the fractured nature of payments in the US is one of the key drivers of health care costs. Since in Canada all health care is paid for by the government these problems don't exist. AIDS patients are very expensive to treat and can have high externalities for the rest of society. From the government's perspective almost the entire externality is captured, it bears the costs of treatments, the lost taxes due to illness, costs imposed by new infections, public order costs from drug use outside the clinics, political pressure from fears of a rising AIDS rate, etc. In the US, no single actor feels the effects of all of these externalities. A private company may bear the cost of treatment, but it doesn't see a decline in revenues nor does it feel public pressure by a rising AIDS rate and likely does not bear the cost of an additional infection, it certainly doesn't feel any responsibility for the public order issues of drug injection. The same can be said for the US government, it doesn't necessarily bear the full cost for each infection since the private sector is responsible for some of the payments. While AIDS and drug injections are an unusually clear case of this, it's illustrative of why I think only the government is positioned to fully bear both the costs and benefits of health issues and is the only economically efficient actor to bear these costs, due to the number of costs and benefits that cannot be internalized by other economic actors.
The article contains some striking information on the public health issues involved, one striking number given was this:
Even $50 million spent on drugs, he said, ultimately saves $300 million because roughly 400 people a year avoid infection. (The estimated lifetime cost of treating a Canadian with AIDS is $750,000.)A very powerful argument in favor of these treatments, if they can be backed up, but one that only partially applies in the US, where in many cases the government won't be baring the costs, assuming that the drug addicts will rarely receive retrovirals and the people getting treated are those infected when it spreads into the wider community (through many channels, including prostitution, but also other channels as well).
Another striking statistic specific to HIV infections: