Cost is the real drug threat

In his radio address, Bush indicated he supported legislation introduced by Sen. Dianne Feinstein (D-Calif.) that would require a valid prescription for online drug sales. That prescription, presumably, would only be obtained directly from a doctor.

That's fine in theory. But it might be a little hard to enforce in light of shadowy drug suppliers plying their trade online from such far-off places as Thailand, China and Eastern Europe.

Then there's the matter of Americans seeking reasonably priced meds from our friends to the north. Canadian law requires that a Canadian doctor either issue or sign off on any prescription.

In other words, you can't just fax your U.S. prescription to a Canadian pharmacy.

Because relatively few Americans have the wherewithal to fly to Manitoba for a checkup, online diagnoses and prescriptions may be the only alternative open to many people in need of specific medications.

Any attempt to shut down such "illegal" online drug sales could result in cutting off medical supplies to Americans in need.

What's the answer? Clearly there need to be safeguards to prevent situations like what happened to Ryan Haight, as well as to protect people from possibly dangerous concoctions offered by fly-by-night pharmacies in Southeast Asia and elsewhere.

But until the U.S. can extend health coverage to everyone and limit drug prices to reasonable levels, many Americans will have no choice but to seek the best possible deal for their meds, and this will often require them to look beyond our borders, via the Internet.

"The pharmaceutical industry doesn't want us to do it," said Jack Hoadley, a research professor at Georgetown University's Health Policy Institute. "This administration doesn't want us to do it. But there are safe ways this can happen."

Since so many people already shop for prescription drugs in Canada, that's the obvious place to start. The Food and Drug Administration should be authorized to certify leading Canadian pharmacies as reliable suppliers of medications.

Pharmacies in other countries would be able to apply for certification as well, but they would be required to demonstrate safety standards that meet U.S. levels.

At the same time, U.S. and Canadian officials should negotiate a treaty that permits U.S. doctors to fax or electronically transfer prescriptions to Canadian pharmacies. This wouldn't necessarily solve the conundrum of uninsured Americans being unable to afford doctors' visits, but it would allow prescriptions to be more easily filled.

Unfortunately, millions of Americans have been priced out of the U.S. healthcare system and will do whatever is necessary, and face whatever risks, to remedy their medical woes.

Bush called on Congress to help "put an end to the illegal sale of highly addictive prescription drugs on the Internet."

But if all he's offering in return is business as usual, that patient's already dead.

Consumer confidential runs Wednesdays and Sundays. Send your tips or feedback to david.lazarus@latimes.com.

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