Good point. Even if your health insurance is public, someone, somewhere is figuring out what can and can't be paid for.
One of the reasons other countries spend less on healthcare, compared to the US, is that they just don't pay for certain things (drugs, procedures, etc). The US is a bit more lax when it comes to this and that results in higher costs.
In Canada, we have a drug insurance tax (in Quebec at least, I'm unsure if this is a federal thing) so we clearly pay for drugs. I don't know the extent of what we do pay for, but surgeries and most everything is paid for by taxes.
Even breast reduction is covered if a doctor judges that it's for health reasons.
You pay for production. All of the research cost and business risk in going to market with the drug in the first place is paid by Americans. You're welcome.
One of the reasons other countries spend less on healthcare, compared to the US, is that they just don't pay for certain things (drugs, procedures, etc). The US is a bit more lax when it comes to this and that results in higher costs.