Marco hovered in front of the display cases at a San Ysidro dispensary on January 24th waiting for those in line ahead of him to make their selections. He said he'd had a doctor's recommendation for cannabis but it expired and, with only a little money to spend, he would grin and bear the new taxes imposed on New Year's Day at San Diego's licensed marijuana outlets, medical user or not.

He said he was in the market for a gram of quality indica flower and could spend about $15, plus tax. He said cannabis helps him unwind when he gets home from work, adding that it also helps him shift from being mired in the negativity of the news of the world to being focused on a healthier outlook, a posture of appreciation. (Marco didn't want his last name published because it might complicate things in his job with the county government.)

"Right now,” he said, “I'm kind of tolerating [the new tax] to have access.”

The cost for everybody — recreational or medicinal user – is up 15 percent now. That's a state excise tax, the kind of levy you'll find on alcohol and tobacco. But medical marijuana patients can save nearly 13 percent in taxes – 5 percent in city of San Diego excise tax and 7.75 in state sales tax – but only if their dispenser agrees to the deal.

An informal survey finds that some dispensaries will honor a doctor's recommendation, only if it is current, to waive the 12.75 percent in state sales tax and the city excise tax. Yet others are requiring medical clients to display a so-called MMIC, the medical marijuana identification card issued by the county at a cost of $100, or $50 for people enrolled in Medi-Cal.

Marco joined me in doing some quick math. If he bought $100 in cannabis products, state excise tax included in the price, he'd save about $13 in taxes as a medical marijuana patient. So to recoup the $100 fee for the official medical marijuana identification card, he would have to spend somewhere around $800. At $15 per high-quality gram, including the state excise tax, and at an estimated rate of consumption of about four grams a week, it would take Marco a little more than three months to make up for the fee for the MMIC. Is it worth it?

The fact is, said Heidi Lowe of the county Office of Vital Records and Statistics, which issues the identification card, the whole thing is voluntary. No medical marijuana user is required to acquire the identification card and no dispensary is required to request one from the customer. (An informal Reader survey found some licensed dispensaries to require the ID and others to be okay with a current doctor's recommendation.)

Marco, who said he did not join in when his friends in high school used marijuana, called it a major, important “discovery” for him during college. He questioned why the legions of marijuana patients who are devastated physically and financially by catastrophic illness, many of them in near-constant pain, now must pay an extra tax just because their medicine is legal for one and all. “There's always a catch,” he said. "And those [disabled] people are going to get whacked."