Outside view: A bad plan

By LESLIE CARBONE, A UPI Outside View Commentary  |  Feb. 6, 2003 at 1:01 AM
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FAIRFAX, Va., Feb. 5 (UPI) -- On May 30, 1997, 49-year-old Ruth Millar was stabbed to death from behind while she stood drying the dinner dishes in her Victoria, British Columbia, home. Her killer was her 24-year-old son Aaron.

Aaron Millar had suffered from schizophrenia for about two years before he plunged a ceremonial sword through his mother's turned back and into her heart, but the family had been unable to obtain a popular and promising anti schizophrenia drug -- olanzapine -- because of Canadian British Columbia's restrictions against it.

Under Canada's health system, the government makes up a "preferred drug list," deciding which drugs it will purchase, and then barters with pharmaceutical companies for the lowest price. Canadians have to obtain permission from provincial bureaucrats to access certain drugs; of which olanzapine is one in British Columbia.

The practice is part of the reason why Canadians pay less for prescription drugs than Americans.

It's also part of the reason why Aaron Millar never received olanzapine, despite the fact that just three months before killing his mother, he was arrested in Victoria for cutting satellite cables -- while wearing camouflage gear and a gas mask and wrapped in tin foil to stop the incessant alien messages that he thought played in his head.

While he was in jail, a court-ordered psychiatrist determined that Millar was delusional and paranoid but that he was not having thoughts of violence. As there were no treatment facilities available for him, the court released the untreated Millar to his mother's care.

Nightmares like the Millar family's are just one reason why it is so appalling that U.S. politicians like West Virginia's Democrat Gov. Bob Wise are trying to impose Canadian-style prescription drug price restrictions here.

"We want West Virginians to pay the same price as the people in Canada," declared Wise, who ceremoniously and fittingly dropped threatening letters to the chief executive officers of several major drug companies into that ubiquitous symbol of the government's level of competence in delivering critical services -- the big, blue U.S. Postal Service mailbox.

"I am putting you and your colleagues on notice that the tactics being employed or being contemplated by the industry you represent are unacceptable to me and to the citizens of the state of West Virginia," Wise wrote the pharmaceutical chief executive officers.

"I believe that most other governors agree with me, and I am prepared to enlist their support."

That's a scary proposition for Americans, who might have to do without needed medications if Wise gets his way. Does "the same price as the people in Canada" that Wise wants West Virginians to pay include the price of inadequate and inaccessible health care and all its attendant woes? In Canada, not only does the government decide which medications to put on its "preferred drug list", effectively rationing health care, but it also takes drugs off the preferred list, meaning that patients who become dependent on certain needed medications can suddenly lose access to them.

That not the only way that restricting drug availability in the name of saving money hurts patients. Drugs are a convenient and cost-effective form of preventive medicine because they can keep health problems from worsening and thus requiring more expensive, inconvenient, and often painful procedures later.

Canadians coming regularly to the United States in search of the medical care they can't access at home could be spared the trip if only the drugs they need had been available to them in the first place.

Finally, if cost restrictions make drug research and development unaffordable, American pharmaceuticals will simply cut back on providing new medications.

New drugs are very expensive to manufacture. Pharmaceutical companies have to recoup their initial research and development costs through the prices of the medications they market; otherwise, they wouldn't be able to continue offering newer drugs to the people who need them.

It is not a coincidence that the United States provides 50 percent of the world's drug research, while Canada contributes a paltry 2 percent. America's relatively free market nurtures drug development, while the Canadian medical system squelches it.

The United States provides half the world's drug research, the world as a whole will suffer if American pharmaceutical companies reduce drug research and development. Indeed, Canadians should probably be joining with concerned Americans in opposing the Wise's unwise idea.

If American drug manufacturers close down or cut back, where will Canadians go then for the treatments they need?

A wise person learns from his own mistakes and those of his neighbors, but a governor named Wise sees only the lower initial drug prices that America's northern neighbors pay, not the price in human pain and suffering, nor even the higher medical costs that sometimes result from the inability to access medicine when it can do the most good.

In the matter of prescription drugs, West Virginia's governor is not truly wise at all; he is simply penny-wise and pound-foolish.

(Leslie Carbone, former director of family tax policy at Family Research Council, is the author of "Slaying Leviathan: The Moral Case for Tax Reform."

("Outside View" commentaries are written for UPI by outside writers who specialize in a variety of important global issues.)

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