The federal Veteran’s Administration gets a discount on prescription drugs. So does Medicaid. And so does the Pentagon. And so do health maintenance organizations and other insurers. And so do Canadians and the general public of every industrial nation on the planet — except for the United States.

Here, the highest drug prices around are charged to people who lack the clout of insurance-company size or the willingness of government to act. In Maine, that price disparity is deadly.

Lawmakers who have been paying attention have heard enough stories, in session or in their home districts, of Maine people who must choose among which drugs to take because they cannot afford to buy all the ones their doctors say they need. They choose between their medication and this month’s rent; between a heart drug and food. The result is that many people do not take the medication they need; they get sicker and need more intensive and expensive care; or, sometimes, they die.

State Sen. Chellie Pingree has drawn nationwide attention by courageously pointing out the obvious: that there is no good reason for Maine residents to pay 30 percent or 50 percent or 70 percent more for the same drug in the same quantity that Canadians pay. Her proposal would set drug prices in Maine according to those in neighboring Quebec, where Mainers already are going to save on medicine.

(This fight is also being carried out in Congress, not coincidentally by Maine Rep. Tom Allen, who wants Medicare receivers to get a negotiated discount on their drugs. Congressional opponents say such pricing is harmful to drug company profits — which currently are breaking records — and, besides, is un-American. Another on the long list of groups that get discounts? Congress itself, which can enjoy small co-payments because of the discount negotiated through the Federal Employees Health Benefits Program.)

Gov. Angus King is wary of Sen. Pingree’s proposal for several reasons. He is worried about a long, expensive court fight with the pharmaceutical industry. He is concerned about the availability of drugs in Maine and the effect of controlling prices on the state’s biotechnology industry. First, the industry is going to be unhappy with whatever Maine does; something this important is worth trying to work with industry to enable more people to afford medicine, and, failing that, fighting for in court if Maine must. Dr. Cliff Rosen on today’s Op-Ed Page ably answers the governor’s second and third concerns. Dr. Rosen’s experiences with patients and as a researcher make him among the few people in Maine with a broad range of experience and perspective on this issue. He makes the following observations:

“Are there large drug manufacturers who plan to leave the state with thousands of employees following behind? Will the companies bully the federal government to stop funding basic and clinical research in Maine? … These fears, raised by recent advertisements and lobbying efforts are aimed at intimidating leaders in this state. But if these dire predictions were backed up by reality, why is biotechnology alive and well in Canada? In fact, I have spent the last five years working as a consultant for one of the most innovative biotech firms on the continent; a public private partnership headquartered in Canada.”

Maine is not alone in its fight to lower drug costs. A dozen other states have legislation that, in one form or another, attempts to hold the line on price increases. The reasons for this have nothing to do with creeping government authority and everything to do with the fact that, unlike many things people buy, medication often is not an option. And far from the government controlling health care, the current trend in health care price increases has health care controlling government, and business, too, for that matter. If you don’t believe it, look at the recent debate over how Maine was going to pay its Medicaid bill, look at how recent university-system budget increases have mostly gone to health care, look at the cost increases businesses with three or five employees are facing because of health care.

However reluctant Congress may seem to take up drug prices as an issue, the lead by the states eventually will place this debate where it will be most effective — at the national level, in Washington. But the only way to get it there is for states like Maine to declare decisively that its residents deserve access to medication. The bill to do that is on the governor’s desk.