Cutting health care deal with Quebec

The idea of global trade is taking a beating this month. Ten thousand protesters are converging on Washington, D.C., to assail the International Monetary Fund and World Bank like they did in Seattle. For those demonstrators, the symbol of international markets is a sweatshop in Indonesia where poor children manufacture $169 basketball sneakers for over-privileged American kids, thereby turning NBA players into bigger multi-millionaires and corporations like Nike into billion-dollar marketing behemoths.

One sometimes forgets the underlying premise behind free trade, which is old as the caravans that exchanged gold for frankincense and myrrh during biblical times. That is, often your neighbor is better at making something you want, or needs something you have. In our neck of the woods an obvious commodity is health care.

As a Canadian official put it, the American free enterprise system is great at “saving people.” If you’re dying of cancer or need a heart bypass operation, this is the place to come. Canada’s universal health system is superior at providing basic medical care to all its citizens. The United States currently has 44 million people with no health insurance. As a result of government price controls, the same prescription drugs developed by U.S. pharmaceutical companies are sold for less in Canada.

In 1994, President Clinton proposed that the United States adopt a Canadian-style universal health care system, but couldn’t get a Democratic-controlled Congress to even bring the measure to a vote on the floor of the Senate or House. More recently, Canada’s national health system has been strained by budget deficits and complaints about Third World-class medical treatment. Alberta has proposed breaking with Ottawa and setting up its own for-profit medical system, which critics warn is the first step in “Americanizing” Canada’s national health plan. While U.S. border residents travel to Canada to buy cheaper prescription drugs and benefit from less-expensive procedures like laser eye surgery, the Ontario provincial government recently sent more than 600 breast and prostate cancer patients to clinics in Buffalo, Cleveland and Detroit.

Which begs the question.

Obviously, there are advantages and disadvantages to both the American and Canadian health care models. Neither country is likely to run up the white flag and adopt the other’s system. Why not cut a deal that plays to the strength of each?

In fact, such an idea is being kicked around between health officials in Quebec and the governors of New England’s northern-tier states. Maine Gov. Angus King, New Hampshire Gov. Jeanne Shaheen and Vermont Gov. Howard Dean have approached Quebec Premier Lucien Bouchard about the possibility of a cross-border regional health compact. Under the deal, New Englanders would be able to make mail order purchases of cheaper Canadian prescription drugs. In return, seriously ill Quebec residents would gain greater access to U.S. medical facilities. Dennis Bailey, King’s spokesman, said the proposal still is percolating at the staff level on both sides of the border.

Dave Lackey, a spokesman for Sen. Olympia Snowe, who is cosponsoring one of several measures now before Congress establishing a new prescription drug benefit for seniors, said the Quebec compact is “an interesting concept, but just one of several ways being discussed to permit Mainers to obtain cheaper prescription drugs.” Rep. John Baldacci, like Snowe, is “open” to the compact idea, but was hopeful that Congress will adopt national legislation addressing the problem of high drug prices. Baldacci supports a measure that would permit U.S. pharmacies to import less-expensive Canadian drugs. Rep. Tom Allen is the author of a proposal that would empower seniors to buy drugs at the same discount price manufacturers charge the government and large health maintenance organizations.

A spokesman for Quebec’s Health Ministry, Alain Vezina, told the Washington Times that a date for a bilateral meeting to discuss the cross-border proposal is being arranged, but not yet set. Allowing Canadian pharmacies to fill U.S.-written prescriptions would require a change in provincial law and the backing of Quebec’s college of pharmacies. A spokesman for that group told the Times the college would agree to U.S. mail-order drug sales only within the framework of a comprehensive health care pact.

It’s been 12 years since Ronald Reagan and Canadian Premier Brian Mulroney signed the U.S.-Canadian Free Trade Agreement. Since then, international trade between the two nations has multiplied several times. An exchange that raises the health and medical care of citizens on both sides of the border would seem a reasonable next step.

John S. Day is a Bangor Daily News columnist based in Washington, D.C. His e-mail address is zanadume@aol.com.