Stopping Rx Drug Runners

It's simple enough, really -&endash; you get one or two good ideas, and whenever there's a problem, you pick the one that fits best. Consider our president's approach to economics: There is nothing that can't be solved by giving tax cuts to the rich. When there was a federal surplus, the answer was tax cuts for the rich. When the surplus eroded: tax cuts for the rich. Now that we're looking at deficits that are spinning out of control, and threaten to bankrupt our nation until the end of time: make the tax cuts permanent. But, there are some problems that even tax cuts for the rich won't solve. For those, there's a different answer: appoint a committee, and then make sure it can't function. President Bush has pulled this rabbit out of his cowboy hat too often. 

There's the tragedy of 9/11, and some perfectly legitimate questions of how the government failed to protect its citizens. The answer is to appoint a committee to investigate, then hamstring the committee by insisting on a deadline for its report and refusing to give them the information they require. If we fought a war predicated on the presence of WMDs that turned out not to be there, squandering our credibility in the international community, alienating our traditional allies, leading to the deaths of thousands of innocents including hundreds of our own children and leaving ourselves responsible for a dependent nation that we really can't afford to support: appoint a committee to investigate, then hamstring the committee by limiting what they're allowed to investigate to intelligence collection failures (rather than misuse of the information) and not giving them any members with experience in the collection or analysis of intelligence.

If many of our citizens can't afford the drugs they need to stay alive, and discover that right to our north there's a modern nation with a standard of living not inferior to our own, where the lifespan is longer and the medications cost about 70% of what we pay: appoint a committee …

On Wednesday, Feb. 25, the administration announced that it was appointing a committee to investigate the reimportation of drugs from Canada. Canadian drugs cost a fraction of the price of the same drugs in the US. People who live near the border have routinely crossed into Canada to have their prescriptions filled, and cities and states have been trying to buy Canadian drugs in an attempt to hold down Medicaid costs. The disparity in drug prices has been so great and so evident that a requirement that it be investigated was written into the Medicare law that the president signed last December.

The practice of buying Canadian drugs has become so well known and so common that the state of Minnesota has set up a web site, MinnesottaRxConnect, which directs its citizens to two Canadian pharmacies that have been inspected by representatives from Minnesota. Wisconsin has a similar site, which has 3 Canadian pharmacies to recommend. While most of the governors who have advocated reimportantion are Democrats, Tim Pawlenty of Minnesota is a Republican and his position has been endorsed by Sen. John McCain, R-Ariz. Until now, the only response from the administration has been a warning from the Food & Drug Administration that any US citizen found buying drugs from the Wicked Witch of the North is likely to be turned into a toad.

Canada has an anticipated life expectancy of about 79 years, compared with only 77 for the USA. This doesn't sound like an indictment of Canadian medicine. When it comes to healthy life expectancy, the number of years a person can expect to live in "full health," Canada's estimate is 72 years, while the US can't do better than 70. Even for people who believe that the administration isn't leaving any children behind, that WMDs will eventually be found, that the budget deficit will be cut in half once the tax cuts for the rich are made permanent -- thinking that Canadians take bad drugs is a stretch. 

So, President Bush is appointing a committee to investigate. And just to make sure he gets the answer his contributors are looking for, he appointed Dr. Mark B. McClellan, the commissioner of Food & Drugs, to head the group. Dr. McClellan's feelings on the subject are well known. He has been adamantly against importation of drugs and has threatened lawsuits against cities and states that have tried drug importation as a method of budget balancing.

Dr. McClellan's credentials are impeccable. He is a member of the President's Council of Economic Advisors, a member of the Stanford University faculty and has co-authored papers showing the for-profit hospitals are preferable to not-for profit, that HMOs do a better job than paying physicians directly, that there should be caps on malpractice lawsuit awards, and that it's not wise to let patients know their MDs' and hospitals' "Report Cards," the details on patient survival rate.

All too likely, the President's Commission will find, completely objectively, that people are better off not taking any medication because they can't afford the US prices, than taking drugs from Canada which have not been approved by the Food & Drug Administration. Who was it that said "the era of big government is over"? Well, look what's back.

Sam Uretsky is a writer and pharmacist living on Long Island, N.Y.

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