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The least populous state in the US (Wyoming) has more people than Iceland, which is more than able to exert bargaining power in a cost-effective way.

• sudosysgen 6y ago
  No, because Iceland is a sovereign government, and if they can't find an agreement with drug companies or suppliers, they always have the option of nationalizing them or ignoring patents. They also aren't reliant on funding from the U.S. Federal Government, which is a big deal in this case.
  • bhupy 6y ago
    New York is also a sovereign government and can operate a State-run drug company or supplier, just like they operate State-run universities, and the State-run MTA transportation system. New York can, by law, force companies to accept its prices in the same way that it can enforce Uber and Lyft to charge minimum prices, or employers to pay minimum wages. > They also aren't reliant on funding from the U.S. Federal Government, which is a big deal in this case. Besides Federal highway funding and Medicaid, neither is New York. New York's single payer system can be funded entirely through an increase in its own state tax rate — there's a lot of room to increase taxes back to WW2-levels, and a lot of room to raise the middle class tax-rate to Europe-levels.