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You can't keep a bad idea down

Thanks to my sometime colleague Rob Port, I see that the Democrats in Congress, feeling their oats, are thinking again of allowing the importation of cheap drugs -- but it's not on their front burner.

This is yet another one of those ideas that sounds good at first, but when you start seeing the details, you realize just how bad an idea it is.

Yes, a lot of drugs are cheaper in other countries than here in the US. And yes, they are often the very same drugs we can get here. And yes, some of them are even made in the US and sent to those other countries.

So, why are they so much cheaper than they are here? How the dickens could it be cheaper to get the drugs through, say, Canada, than just buying them here outright?

The answer is simple: socialized medicine. Those drugs are cheaper in those other countries because the governments of those countries says they will be. The government sets the prices of those drugs, and the manufacturers have a simple choice: sell at those prices, or not do business in the country at all.

The people calling for the re-importation of these drugs are being remarkably disingenuous. They want the government to control the prices of drugs, but they know they can't get the American people to go along with it -- at least, not yet. So they have discovered this solution to get the benefits of socialized medicine, without having to pay the price. It's "socialism lite."

The only problem is that the free market has a way of dealing with such clumsy attempts to manipulate it. One solution immediately springs to mind.

The drug makers put up with the price-fixing in those countries because they still do make a profit, usually off the sales of other drugs. They know that the price-fixing is part of the "cost of doing business" and mark it off as such.

But what happens if the demand for drugs with little or no profit margin (I believe that some are actually sold at a loss) skyrockets? Why, if I was running one of those drug companies, I'd just stop making and importing so much of those restricted drugs. I'd cut back the supply to be enough to just cover the actual Canadian demand (Canada being the most frequent example, and the subject of most of my "prescription drug" spam), with a little safety margin, and then let the Canadians decide if they want to sell to their own customers, or to Americans. It won't take long before the Canadian government itself starts putting curbs on exports of drugs to protect its own citizens, and there goes the supply of cheap Canadian drugs.

And if the Canadian government tries to force the drug-makers to keep up the supply? Then they can simply stop making and importing ANY of the price-controlled drugs. Worst comes to worst, they can simply stop doing business in Canada altogether.

Whenever the government tries to micromanage commerce, it almost always ends the same: the consumers the government is trying to "help" gets screwed.

And that's what will happen in this case.


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Comments (33)

"They want the government t... (Below threshold)
Frank:

"They want the government to control the prices of drugs, but they know they can't get the American people to go along with it -- at least, not yet"

This is the great right wing delusion, that the public doesn't support or want government sponsored healthcare. I think the last poll I read had somethign like 80% of the Americans public suppoting this idea. It's the politicians who won't acquiesce, and the right wing media noise machine who keeps their constituants ill informed

You may be right - all thos... (Below threshold)
Anon Y. Mous:

You may be right - all those things may happen. So what? I find that result preferable to that of the U.S. government being complicit in the whole scheme by having laws banning the re-importation of the drugs. Drop the laws, and let the chips fall where they may. What's the harm to the U.S. consumer?

That 80% figure doesn't sur... (Below threshold)

That 80% figure doesn't surprise me. It's probably the 80% who doesn't understand that one of largest causes of the high cost of health care is government manipulation of the system. They just by the hype of a health care crisis and believe that the solution to a government problem is still more government.

But hey, tax the rich, they can afford to pay for it all.

And yes, some of t... (Below threshold)
Mac Lorry:
And yes, some of them are even made in the US and sent to those other countries.

Rather than some, I believe most of the expensive drugs that are sold cheap in other countries are manufactured in the U.S.

The people calling for the re-importation of these drugs are being remarkably disingenuous.

A better description is "remarkably stupid".

The only problem is that the free market has a way of dealing with such clumsy attempts to manipulate it.

But it's not a free market, as it's being manipulated by socialized medicine as you stated. What one government's interference in the free market causes, U.S. drugs selling for half of what they sell for in the U.S., another government's interference can correct.

U.S. consumers are subsidizing Canada's socialized medicine by paying more for drugs here so that they can be cheaper in Canada. It's because of this subsidy that the Canadian system works as well as it does, and that degree of success leads many to think the U.S. should do the same thing. It won't work here, however, because no other country is going to subsidize U.S. socialized medicine.

The solution is a U.S. export tariff that's applied to all drugs destine for 1st world countries where the price paid for such drugs is below the U.S. price. The drug companies simply won't be able to make a profit selling drugs below market price in Canada, and so, either Canada has to pay market price or not get the drugs. That's the same option many poor folks in the U.S. have, so if it's good enough for them it's good enough for Canada.

Now if you want to lower drug prices in the U.S. then outlaw advertising of prescription drugs. The drug companies spend more on advertising than on research and development, and they only need to spend so much in order to complete with all the other U.S. drug companies. Just level the playing field at zero advertising and no company will lose their competitive position. The drug companies could still have web sites to promote the benefits of their products, so it's not like the information wouldn't be available to the public.

You have to visit a doctor anyway to buy a prescription drug, so the only reason to advertise is to lead patients into thinking some drug is what they need. Doctors should be making that decision, and if someone really wants to take charge of their treatment, they can go on-line and study what drugs are available.

Rather than flat co-pays for prescription drugs, institute percentage co-pays so that the more expensive a drug is, the more consumers pay. This will put price pressure on drug prices.

Frank... where'd you read t... (Below threshold)
ken:

Frank... where'd you read that poll?! I would have to say that 80+% of the polls are worthless.

I totally agree that our hi... (Below threshold)
epador:

I totally agree that our high prices are subsidizing drug costs elsewhere.

One point Mac. If you ban all advertising, then Web Site and ads go belly up. Advertising revenues support many magazines for physicians, as well as now help paper publications and web sites. Of course, altie stuff, since it isn't yet classified as drugs, can still be advertised at will. A lot of marketing money goes through "drug reps" and free samples. Are you going to ban them too? While there are programs to obtain drugs at reduced or no cost for the needy, they require a bit of paper work and time that most indigent folks have trouble negotiating. And most of them don't have Web access unless they can get into the local library. Which is not necessarily secure for your personal information.

Personally, I don't like the current system, but tinkering with only one aspect of it without making other adjustments is just likely to make the whole thing some to a grinding halt.

I say let the consumer have the power to use a certain amount of insurance bucks for drugs any way they want, and then they're on their own after that except for catastrophic or defined chronic illnesses. I bet the market forces there will bring down costs considerably - either by folks dying cause they're wasting their money on Levitra instead of Insulin, or drug costs following market pressures.

The real problem I see is t... (Below threshold)
jpm100:

The real problem I see is that the US is subsidizing the research costs and the production costs for the rest of the world now.

The rest of the world is viewed as a few pills more.

The US gets to pay the high cost of these drugs that make the huge price tag of researching those medicines pay off. Then to make a few more cents, they produce more pills for the price fixed markets and charge somewhere cost to the cost of manufacture.

You want drug research to grind to a halt, introduce price fixing here as well.


Or, we can put trial lawyers under control and get the cost of all medicine under control.

Anyone that advocates natio... (Below threshold)
Gianni:

Anyone that advocates nationalized health care either isnt too informed, isnt too bright or isnt too motivated.


Which is it?

If you ban all adv... (Below threshold)
Mac Lorry:
If you ban all advertising, then Web Site and ads go belly up. Advertising revenues support many magazines for physicians, as well as now help paper publications and web sites.

It comes down to what you want to buy with your prescription drug money, more research and development of even better drugs, or support of various media outlets.

A lot of marketing money goes through "drug reps" and free samples. Are you going to ban them too?

Yes, because the purpose of free samples is to get doctors to prescribe a particular medication. With poor patients, a doctor may prescribe a free drug sample rather than a more effective drug the patient can't afford. I understand the argument that the drug a person can't afford is the worst choice, but by eliminating ruinous marketing costs and making other changes, the price of all drugs will likely drop substantially. Drug companies can still conduct studies that show their drugs do such and such and make sure that that information is available in medical journals and on-line. I doubt there are many doctors in the U.S. who are not on-line.

Personally, I don't like the current system, but tinkering with only one aspect of it without making other adjustments is just likely to make the whole thing some to a grinding halt.

I doubt banning advertising would do anything but improve medicine the U.S. It might not reduce the price of drugs all by itself, but a few other changes would do the trick.

I say let the consumer have the power to use a certain amount of insurance bucks for drugs any way they want, and then they're on their own after that except for catastrophic or defined chronic illnesses.

What else do people use medical care for? I assume you would still cover injuries, otherwise you would be uninsuring the number one cause of medical care for young people.

More and more illnesses that ever can be treated with drugs. In fact, other than for injuries, drugs are often the only effective treatment. We don't want to derail the research and development of new drugs, but there is simply no reason to expend even more money on advertising prescription drugs. The only reason most companies do it is because they must in order to compete with other companies. Years ago such advertisement was prohibited by law, and we would be wise to bring that law back into force.

Mac Lorry said:... (Below threshold)

Mac Lorry said:

Years ago such advertisement was prohibited by law, and we would be wise to bring that law back into force.

I will bet a nice, shiny new dime that the reason such advertisements aren't banned anymore is because the ban was found to be unconstitutional, as were such bans on advertising by doctors and lawyers.

Anon Y. Mous: The cost to t... (Below threshold)
Scrapiron:

Anon Y. Mous: The cost to the American consurer will be death or long term hospitalization. Polls and politicians lie but test of drugs actually imported (within the past couple of years) showed that most of them was not what they were supposed to be or had no medical value. They weren't made in the U.S., they were made in third world countries (which the U.S. will be after another regime of dim's take over), some so contaminated they were instantly dangerous, no slow build up of effects. Seems someone could Google this instead of millions 'learning the hard way'.

One question-<blockq... (Below threshold)
MattG:

One question-


Those drugs are cheaper in those other countries because the governments of those countries says they will be.

Do you have evidence that they cap prices or are you talking out of your arse?

I was under the impression we over regulate them?

I will bet a nice,... (Below threshold)
Mac Lorry:
I will bet a nice, shiny new dime that the reason such advertisements aren't banned anymore is because the ban was found to be unconstitutional, as were such bans on advertising by doctors and lawyers.

And yet smoking ads are banned from TV and beer commercials can't show the actual consumption of the product. Commercial speech does not enjoy the same protection as political speech, which is why such bans and things like the no-call legislation are legal.

Sorry I was a bit harsh. ... (Below threshold)
MattG:

Sorry I was a bit harsh. I just thought it was over regulation -not price capping. Looks like I need to do some research.

why should we (u.s. citizen... (Below threshold)
rwallis:

why should we (u.s. citizens)subsidize the world? I do not believe in socialized medicine, but do not want to support socialized med. in other countries, my solution is to pass a law that would make the price of medicines be no higher than that of the rest of the world would pay. this would shake up the present way of doing business enough for some real change

Mac Lorry said:... (Below threshold)

Mac Lorry said:

And yet smoking ads are banned from TV and beer commercials can't show the actual consumption of the product. Commercial speech does not enjoy the same protection as political speech, which is why such bans and things like the no-call legislation are legal.

INAL, but I think that legislating and enforcing such a ban would require that government show that there was a clear and compelling public interest in banning such ads. Getting back to ads by doctors and lawyers, I believe that's why bans on those ads were struck down at around the same time as the ban on ads for prescription medications was lifted, if it wasn't actually struck down as well.

Getting back to ad... (Below threshold)
Mac Lorry:
Getting back to ads by doctors and lawyers, I believe that's why bans on those ads were struck down at around the same time as the ban on ads for prescription medications was lifted, if it wasn't actually struck down as well.

The controling case is Central Hudson Gas & Electric (1980). Under that case the government can ban commercial advertising if the government's interest in regulating the speech in question is substantial and the regulation directly and materially advances that interest. Being that drug companies spend more on advertising then they do on research and development, and being that consumers can't purchase these products anyway, and being that drug prices make up the majority of medical costs, I believe a ban on prescription drug advertising to reduce drug costs would pass the test imposed by Central Hudson.

Maybe I'm wrong, but if Congress can effectively ban private medicine in this nation it seems they certainly have the authority to ban prescription drug advertising.

The best way to play this s... (Below threshold)
cubanbob:

The best way to play this short term gain game is to limit the selling price to lowest price a drug is sold in Japan, Australia, New Zealand,Canada and the
15 most advanced EU countries. They will either push up their prices overseas to spread out the R&D costs or eventually quit those markets and sell only in the US.

Just on quick question for ... (Below threshold)
marc:

Just on quick question for the socialized medicine/government subsidy crowd:

Why is Lasic eye surgery cheaper than when first introduced?

In fact, expand on that, why has every form of elective medical care gone down in price after the procedure was first introduced?

The solution is a U.S. e... (Below threshold)
Brian:

The solution is a U.S. export tariff that's applied to all drugs destine for 1st world countries where the price paid for such drugs is below the U.S. price. The drug companies simply won't be able to make a profit selling drugs below market price in Canada, and so, either Canada has to pay market price or not get the drugs.

How is this any different from just allowing the re-importation of these same drugs into the US? The outcome (drug companies lose profit, then either make Candada pay market price or pull out of the market) would be the same.

My wife needs a certain and... (Below threshold)
Hugh:

My wife needs a certain and effetive prescription medication for arthritis. Our insurance, as most insurers, will not pay anything for this particular med which, of course, happens to be one of the most effective. Our cost in the US is $195 per month. We get it from Canada for $75.

I'm not sure what the answer is. I imagine, that with much today, the answer falls somewhere in the middle between socialized medicine and huge corporate profits. We're fortunate that we can pay either price but I wonder how many do without because of the price.

How is this any di... (Below threshold)
Mac Lorry:
How is this any different from just allowing the re-importation of these same drugs into the US? The outcome (drug companies lose profit, then either make Candada pay market price or pull out of the market) would be the same.

The drug companies can derail the re-importation scheme simply by limiting the quantity they sell to Canada. Canada won't allow export of drugs that they need at home, and so the scheme fails. Also, drug companies raise the issue that they can't guarantee the quality of re-imported drugs, which likely will be used in court to limit their liability for making a dangerous product. The export tariff doesn't have these problems and also forces Canada to pay U.S. market prices as soon as it goes into effect. Lets see how this model of socialized medicine works without U.S. consumers subsidizing it.

This is a subject of which ... (Below threshold)

This is a subject of which I'm woefully ignorant. I mean I've read a lot, but the problem is discerning truth from fiction. I'll admit I don't know the answer. But recently I've heard we've run into the problem of "fake" drugs coming across the border that are causing harm. And the problem has grown.

But, epador, you say that advertizing revenue supports many magazines, etc. All this TV advertising for prescription drugs is relatively new though. What did they do before?

I've also heard some doctors are exasperated at patients that demand certain drugs they've seen on TV and the doctor won't prescribe them because, for that particular patient, the side effects will outweigh the benefits. The suggestion "talk to your doctor to determine what is best for you" or the warnings "may cause death" doesn't seem to have deterred them.

The only problem is that... (Below threshold)
astigafa:

The only problem is that the free market has a way of dealing with such clumsy attempts to manipulate it.

Okay, so stop making laws restricting reimportation and allow the Magic Market to do its stuff.

Then show us how all this applies to the drug war and farm subsidies. Do neocons believe in the market? Give me one of those no-bid contracts and I'll tell you.

I don't know why I didn't s... (Below threshold)

I don't know why I didn't see this coming, but astigafa misses the whole point. The re-importation of drugs is a PERVERSION of the free market, it is a crass manipulation of it. The whole point of exporting and then re-importing them is to get them out of the control of the free market and under the sway of government forces long enough to artificially fix the price.

What astigafa is proposing is like taking two guys, giving them a thousand dollars, and telling them to take that money and bring back as much as they can in a month. One guy invests it and gets a decent return. The other guy buys a gun and starts holding up banks. By the end of the month, unless he gets caught, the odds are that the second guy will have more money. But IT JUST DOESN'T WORK long-term.

J.

But IT JUST DOESN'T WORK... (Below threshold)
astigafa:

But IT JUST DOESN'T WORK long-term.

As far as you know.

Just what is your training, JT? What's your degree in? Where conferred? Laude? Cum Laude? Magna? Summa? Or are you just very adept at spitting out pre-thought thoughts?

And what is this thing with always addressing me as if I weren't present? "We won't let him join in any reindeer games, right? Right!"

My training? My education? ... (Below threshold)

My training? My education? Utterly irrelevant, asti. Try arguing with my points, not with me.

As far as it working... show me where it HAS. England, Canada, the Soviet Union, Cuba have all tried it, and it's been a dismal failure in all four. Show me where it has succeeded if you want to discuss it.

At that point, I will be bringing up the ethical considerations.

And as far as the addressing... it's a stylistic thing. I'm not quite sure why. It just seems to fit most of the time. Gonna have to give that one some thought.

J.

You're right Jay Tea,... (Below threshold)
Kapow:

You're right Jay Tea,

Exporting and then re-imorting drugs is a PERVERSION of the free market. On the other hand, passing a law here in the US forbiding the largest drug buyers (Medicare and Medicaid) from even negotiating the price of drugs with drug companies is the very essence of a free market. The producer sets the price and you the consumer just have to suck it up. I mean, suck it up or suffer pain, disability or a premature death, that is.

By the by, Mac Lorry is spot on with his observation about advertising and drug companies. Full disclosure: I'm a grad student in the biomed field. The grant that funds our lab is for the design and discovery of novel antibiotics. An alumn from our school who had a very successful career at Eli Lilly - he was instrumental in discovering the new COX2 inhibitor NSAIDS like vioxx and celebrex - came to give a seminar on his life and career. He was asked about the justification for the high prices of drugs. He was very candid. He said that for every dollar spent on RandD, one was spent on TV advertising. Now, there is no need for TV advertising of prescription drugs. Trade advertising is another thing entirely and is essential to make MDs aware of new products. But the TV campaigns are all designed around the "nag" theory of marketing - ie. make kids nag their parents so much that they break down and buy them that toy they jut have to have. Talk to a doctor sometime about this, I think you'll hear a sigh and an admission that the nagging gets pretty old, and maybe even that they do give in sometimes. It's a good way to sell more product, but it doesn't do any good for individual or public health. It does, however, drive up the cost of drugs dramatically.

"the manufacturers have a s... (Below threshold)
InDC:

"the manufacturers have a simple choice: sell at those prices, or not do business in the country at all"

Re-importation will force manufacturers to take the second choice and stop selling outside the U.S. at below market prices. Why should U.S. consumers support all the R&D? Let the Canadians and Indians and Chinese and the rest pay market prices or go without. We have been successful enforcing intellectual property laws in first world countries and somewhat in the third world, and that is for movies and records. Certainly we can do that and more for valuable pharmaceuticals.

"The re-importation of d... (Below threshold)
Anon Y. Mous:

"The re-importation of drugs is a PERVERSION of the free market, it is a crass manipulation of it. The whole point of exporting and then re-importing them is to get them out of the control of the free market and under the sway of government forces long enough to artificially fix the price."

Yes, but your original point was that if the U.S. dropped the ban, the market would react and U.S. consumers would be right back where they started.

So, we can either have a situation where the U.S. government is restricting the freedom of its businesses & citizens within its borders, or one where the Canadian government is forced to do so within its borders. I prefer the latter. And if you believe that either scenario produces the same result for American consumers, then why in the world would you prefer the U.S. government be the one that is limiting the freedom of its citizens?

These comments have been al... (Below threshold)
WCH:

These comments have been all over the board. Most of them largely inaccurate or simply overused polemic.

The problem is real. US citizens are being gouged unbelievably for medications. This has taken several carefully orchestrated approaches. First of all, The FDA has become captive of the big pharmaceutical companies. The regulations have become so labyrinthine, and the incestuous relationships between Big Pharma and the FDA are well known and even more true than admitted. Secondly, Big Pharma has eight lobbyists in Washington for EVERY Senator and Representative.
Yes, that's nearly 5,000 lobbyists. These people are not dumb or lazy, and they are quite well paid. Big Pahrma doesn't spend that kind of money without knowing there is a very good return.

Inordinate amounts of money are spent keeping up this delusion that only the USA can produce high quality medications, when, in fact, the medications sold in this country by Big Pahrma, are largely produced at literally pennies or even fractions of a cent per dose, in very high quality factories in places such as India, Brazil and elsewhere. By limiting free market access, mostly via the FDA and patents, they can, and do, literally charge hundreds of percent markup on these otherwise dirt cheap, foreign manufactured drugs. American physicians and pharmacists who have traveled to these countries professionally often come back open-mouthed at the level of advance these countries demonstrate.

The USA is (or was) one of only two countries in the world to allow advertising of prescription medications in public media. The other one was New Zealand. The amount of money spent, and the absolutely remarkable sophistication of the advertising should leave anyone who understands it in awe of their clout. Then there is the unrelenting onslaught on the physicians. They, like the public, usually have no idea how skillfully they are being led by the nose.

The answer is a simple one that will never come about.

Allow free market forces back into play.

Once this artificial restriction of the market caused by this unholy alliance between agencies of the government and big business is severed, prices will drop like a rock. And quality will be unchanged. And also, just perhaps a bit more sanity will come into the crazed way Americans take pills.

If you think I am wrong, I can give you chapter and verse, example after example of markups, market restriction, obfuscation, and strong arm threat tactics.

For those of you who may be rah rah free enterprise, "conservative", fearful of socialized medicine, etc. This solution could not be closer to the free market principles of this country.

What you have been sold by Big Pharma is their contribution to the DEMISE of the free market system. All the pejorative connotations aside, this is one more disturbing indication of the USA's transition from a representative democracy to (no exaggeration here) fascism. Before you throw rotten eggs, let me remind you of the definition of fascism. "Fascism should more appropriately be called corporatism. It is the perfect union of the state and the corporation. The individual does not count." Attributed to Mussolini, actually written by Gentile.

Listen to Eisenhower's farewell address from January 1961. The government he warned you about is the one you have now. The parallels are more than a little disturbing.

That is, in part, why you pay literally 600% more for the exact same drug, brand name and all, a Canadian does. It has nothing whatsoever with the USA subsidizing other countries' medications. It is amazing how eagerly we keep swallowing this notion. These medications are not sold at a loss in other countries. That is why you pay $10 for a drug in a patented pill form, while the drug itself has been around for centuries, and only costs $.10 in its non patented form. No pharmaceutical company has ever spent a nickel, or needs to, on development of this drug. The drug predates even the concept of pharmacy. I am speaking of morphine. The list goes on. Books have been written about how badly you get ripped off. Why aren't they making the best seller list? Wish I'd have been smart enough to be a Big Pharma person.

Once again, when you and about 100,000 of your closest friends descend upon your representatives in Washington and demand that free and open market forces are allowed in the pharmaceutical industry, the cost of your medications will drop like a rock. This disgusting Medicare drug program passed in 2004 was nothing more than a Big Pharma engineered, complex system designed to stave off any real reform for as long as they can get away with sticking it up the American populace.

Earlier, someone demanded a poster's bona fides. So, by way of that please accept mine. I am a physician with over 35 years experience in prescribing medications (For the guy who demanded the poster's level of achievement, yes, I did graduate Summa Cum Laude). I have listened to Big Pharma presentations, remarkably skillful efforts at manipulating the doctors, and watching new trends in this effort be hatched when too many people eventually catch on to the last big ploy. And I am saddened to see how slowly Americans catch on. They simply have far too little healthy skepticism about their government. Remember the adage: Every governmental agency set up to regulate an industry, eventually become captive of that industry. This has happened big time in pharmaceuticals.

Hope this was of some help, or at least of some interest.

Regards.

WCH, I'll accept your bona ... (Below threshold)

WCH, I'll accept your bona fides at face value, and you certainly sound like an expert in the field. But with all the problems you cite, there are two questions you leave unanswered:

1) Just how does "drug laundering" (filtering our pharmaceuticals through another country's price controls) address any of the problems you discuss?

2) If applying government-set price controls is the solution, why not simply argue for it to be done here in the United States, instead of doing it through the offices of a foreign government?

More than anything else, it's the fundamental dishonesty that bothers me. The people who push for "re-importation" (the fancy term they choose to use, while I think "drug laundering" is a more honest description) simply lack the courage of their convictions to push for cutting out the middleman and fixing the problems ourselves, instead preferring to exploit a foreign country to achieve their goals.

If setting prices for drugs is the solution, then for Christ's sake SAY SO and try to do it here. Don't pull this back-door bullshit, trying to get the benefits of socialism without paying the price. It robs us of the chance for a real examination and debate of the issue.

(The last is not intended to WCH, but more of a general cry of exasperation to those who endorse "drug re-importation.")

J.

Good points. I'll try to re... (Below threshold)
WCH:

Good points. I'll try to respond.

>>1) Just how does "drug laundering" (filtering our pharmaceuticals through another country's price controls) address any of the problems you discuss?

It doesn't. That is not the problem. There is no "drug laundering" or "drug re-importation". These drugs are manufactured for an international market, not manufactured for and in the US, then shipped out to be sold back to us. The end retailers, such as Canadian pharmacies, are simply able to make a profit they are comfortable with at the prices they charge us. As non Canadians, we do not participate in any of the subsidies. This pricing disparity happens in the USA too. I have had compounded drugs (made up by the pharmacist instead of a ready-made pill) charged by one pharmacist at over $1,000 for the same syringe that another pharmacist charges under $300. But at least I had the ability to use market forces to save the $700. With Big Pharma, I don't have that ability, unless I buy in Canada, Australia, Turkey, etc.

>>2) If applying government-set price controls is the solution, why not simply argue for it to be done here in the United States, instead of doing it through the offices of a foreign government?

As I indicated, government-set price controls are not a good solution. As I indicated, if your government can be forced out of bed with Big Pharma and we can get some free enterprise back into our system with a more level playing field, the prices will drop to what the real cost of manufacture and distribution is, often a small fraction of what is currently being charged.

>> More than anything else, it's the fundamental dishonesty that bothers me.

Intellectual dishonesty is not in short supply. It is often truly startling to see how people advocate fairness and openness until some small governmental perk or advantage of theirs is jeopardized. then it is usually, "I don't care if the whole world crashes, as long as I can get mine". The rationalizations are amazing to behold.

>>If setting prices for drugs is the solution, then for Christ's sake SAY SO and try to do it here. Don't pull this back-door bullshit, trying to get the benefits of socialism without paying the price. It robs us of the chance for a real examination and debate of the issue.

Firstly, unfortunately, in a way, we've got a business/government cartel setting the prices now. Secondly, people DO want any perceived benefits of socialism, and they always want someone else to pay the price. Examples abound in our own country. Thirdly, we will never get a real examination of the issues, as they will inevitably be clouded and spun by very wealthy very motivated companies who are a lot more focused and practiced at swaying your elected representatives than the populace is.

That is why my proposed solution of letting true market forces work on a level playing field will never see a glimmer of a chance.

Remember, in the 1980s the average CEO's income was about 20x the average of his workforce. Today it is over 400x. That increase was put in place by lobbying, subterfuge and clever manipulation, not by "creating value" or some similar nonsense catch phrase we are all too often subjected to. How do you propose to stop that juggernaut? Can you say ENRON, or TYCO, or WORLD-COM, or CHEVRON? Then you can also say BRISOL-MEYERS, BAYER, SQUIB, ELAN, etc.

Onward & upward.




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