Shopping north

Whatever overhaul is applied to the rising costs of health care generally and prescription drugs specifically, an adviser to Gov. George Bush in Bangor Monday warned, the regulatory process will ensure that a couple of years of review will pass before it is implemented. It is a sobering thought as candidates, presidential and congressional, outline their plans for solving this problem. One response was found this week at Eastern Maine Healthcare.

The adviser, Gail Wilensky, former chief of the Health Care Finance Authority under the governor’s father, presumably knows what she’s talking about. If so, Maine’s political candidates not only should be describing what sort of plan they would support long-term to provide coverage for rapidly rising drug costs, but what they would do in the meantime as well.

The short, popular answer on prescription drugs these days is: Go to Canada, where drug prices are up to 80 percent lower than in the United States. Though even its strongest advocates would agree this is less a policy than a way of persuading drug companies that their U.S. customers are tired of subsidizing the drugs for the rest of the world, it does provide lower prices over the short term while policymakers work out a longer-term approach.

The EMH plan, through its for-profit subsidiary, Affiliated Healthcare Systems, has reached an agreement with a Canadian pharmacy to reimport U.S.-approved prescription drugs. The International Prescription Drug Parity Act, co-sponsored by Rep. John Baldacci and passed recently in Congress, makes this plan easier which, if successful, will be copied by many others along the U.S.-Canadian border. It will, anyway, until the Canadian government gets fed up with Americans benefiting from their pricing system and irritating the pharmaceutical companies, which, in turn, will try to raise prices in Canada.

Though EMH and others could establish agreements without the parity act, its passage tells the Food and Drug Administration, which oversees the sale of prescription drugs, that barriers to these lower-cost medicines should come down. Given the number of holes in the line against reimporting prescription drugs now – from busloads of seniors, to state-encouraged programs in Vermont to Internet shopping – the FDA may have received that message already.

Canadian imports are a temporary fix to a basic unfairness in the way drugs are priced. Americans with the least protection through government or health-maintenance organization pay the most. The rising costs of drugs and their increased use for an expanding number of illnesses are driving these people to poverty. Congress will not devise anything like a major reform of the system this year, leaving the uninsured and underinsured increasingly looking across the border.