Prescription Drugs: 1-9-04 U.S. will Prosecute Cities & States that import cheaper drugs from Canada, say dangerous

[dmcowen674]

1-9-2004 FDA Chief Vows Action on Drug Import Ban

WASHINGTON - The Food and Drug Administration isn't ruling out legal action if cities or states defy its ban on importing cheaper drugs from Canada, Commissioner Mark McClellan said Friday.

Montgomery, Ala., Mayor Bobby Bright said Friday that he won't back down.

Montgomery has been allowing its 4,100 city employees and retirees to buy drugs from Canada for about a year, saving up to $500,000 so far, he said.

"Our first preference is to try to work directly with the cities and states," McClellan stressed.

But when pressed, he added, "I'm definitely not ruling out legal action if necessary to assure safety."
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What's the matter with you Canadiens? Taking Drugs that are not just cheaper but dangerous too?



12-13-2003 U.S. May Overwhelm Canadian Pharmacies

Government gets a lot bigger.

I'm confused, I though Republican was for smaller Government?

11-125-2003 Senate Approves Sweeping Medicare Bill

Republicans relished their political triumph on an issue that Democrats have long exploited in political campaigns.

Bush sees signing the bill as fulfilling both his and many lawmakers' campaign promises.

"Modernizing Medicare will make the system better and enable us to say to seniors we kept our promise," Bush said after visiting Army troops Monday at Fort Carson, Colo.

 

[Genesys]

i think the Republicans did it so they could take credit for it during the campaign next year.

 

[Witling]

I'm not sure what the intent was. No doubt someone is making a heap of money off of it. I think it will take some experience to figure out what the actual effects are. The drug plan is very complicated. I'm not very hopeful about the trial plan to let private companies compete against the government plan to a limited extent. They've picked metropolitan areas (so much cheaper to administer). I hope it will not be bait and switch, i.e., private plan works well initially, government bows out, private plans start to harvest the helpless fish. I'm not predicting that, but I worry about it.

I find the argument that some kind of drug plan is better than none, persuasive until proven different. Neither the Republicans nor the Democrats could get a "perfect" bill through Congress.

 

[CADsortaGUY]

Originally posted by: Genesys
i think the Republicans did it so they could take credit for it during the campaign next year.

Or it served to take the issue away from the Democrats who have used it as a ploy for years.

This issue is being discussed in many other threads but to appease Dave....

I don't think it'll hurt or help in the short-term. Long-term though it could cause real problems as it's just another entitlement which won't ever go away or get smaller.

CkG

 

[DealMonkey]

I think the bill is fundamentally flawed. Nobody will probably notice it until Seniors are forced to make some hard choices come 2006, long after next year's elections, interestingly enough. It's also yet another huge waste of taxpayer $. Seniors would be better served by allowing them to import medications from Canada/Mexico instead.

BTW, if this bill is as flawed as I think it is, there could be some serious backlash effect against the AARP and Republicans for pushing this steaming turd through. But hey, that's just my opinion. In the short-term the Repubs can shift another traditionally democratic issue into their column. Along with education.

 

[wizardbud]

All you need to know is that the drug companies like this bill.
There has to be a reason for that.

 

[BaliBabyDoc]

I don't think it'll hurt or help in the short-term. Long-term though it could cause real problems as it's just another entitlement which won't ever go away or get smaller.

Actually it will hurt a lot in the short term. Most drug companies have discount cards (many of which are free of charge) . . . now the government will issue a drug company-sponsored discount card for a fee. Furthermore the people really having a hard time paying for medicine will get no real assistance until 2006. In the meantime we can expect drug cost inflation to continue at a rate of 15%+ per year for the foreseeable future. By the time the benefit kicks in, not only will drugs be more expensive but more people will be collecting Medicare benefits (which were already expensive) plus the new drug benefit.

Nothing substantive has been done about the shrinking number of providers willing to take new Medicare patients. Doctors are still complaining about the bureaucracy (caused by Medicare AND private insurers) not to mention the crappy reimbursement for most services.

I imagine Big Pharma and the insurance industry will give sizable contributions to the GOP . . . which I guess is good or bad depending on your political persuasion.

 

[SuperTool]

It will help...
drug company shareholders. There is a provision in there that prohibits the government from negotiating lower rates.

 

[Wolfdog]

It doesn't go far enough to eliminate the problems with medicare/caid. Throwing money at the problem is just going to make it a even more expensive problem. The real problem is that healthcare is just getting way too darn expensive here in the US. If you can actually afford to go to the doctor, rue the day he prescribes you a drug. Legal drugs in this country are a rip off. Overcharging you so much you have to bend over at the pharmacy. They should do away with health plans and coverage from private companies altogether and go the way most of the world has. Healthcare for everyone. Cut off the needless beaurcracy and paper trails miles long. Now that I think of it, that would hurt the paper industry too.

 

[CADsortaGUY]

Originally posted by: wizardbud
All you need to know is that the drug companies like this bill.
There has to be a reason for that.

ANY drug plan would be good news for Drug companies. Now one could argue that since price caps weren't included in this bill that it's "better" for drug companies but that still doesn't mean that Drug companies wouldn't benefit from a drug bill that would have contained a price cap as it's still a gov't backed contract for sales. There are many issues and problems that putting pricecaps on the industry would cause. I'm not fully against the caps but IMO they still wouldn't "fix" anything as the companies would still find ways around the caps.

BBD - I was commenting on the economics of it all since the other threads have dealt with the actual care it's providing. I took this thread(by Dave) as an economic thread since he commented on big gov't vs small gov't. But I also think your statements on how it will "hurt" aren't that substantial since the full details of the plan arent know....yet. Once the full details are out - then we'll be able to further debate what the short-term/long-term implications are for coverages and such.

CkG

 

[dmcowen674]

Originally posted by: CADkindaGUY

Originally posted by: wizardbud
All you need to know is that the drug companies like this bill.
There has to be a reason for that.

ANY drug plan would be good news for Drug companies. Now one could argue that since price caps weren't included in this bill that it's "better" for drug companies but that still doesn't mean that Drug companies wouldn't benefit from a drug bill that would have contained a price cap as it's still a gov't backed contract for sales. There are many issues and problems that putting pricecaps on the industry would cause. I'm not fully against the caps but IMO they still wouldn't "fix" anything as the companies would still find ways around the caps.

BBD - I was commenting on the economics of it all since the other threads have dealt with the actual care it's providing. I took this thread(by Dave) as an economic thread since he commented on big gov't vs small gov't. But I also think your statements on how it will "hurt" aren't that substantial since the full details of the plan arent know....yet. Once the full details are out - then we'll be able to further debate what the short-term/long-term implications are for coverages and such.

CkG

Thanks CAD, yes I was mainly aiming at the Economic impact of this and Bigger Govt picture.
So do you favor bigger Government?

You even commented on Republicans taking it on as what was a Traditionally Democratic issue. Hillary was Humiliated by Republicans just a few years ago on this and now suddenly they are the Senior's Knights on White Horses huh?

This would dilute the hold of what was Democratic Voters. Interesting tactic, will it be enough to brainwash voters next year remains to be seen. Can't wait for all those Commercials saying we (Republicans and Administration) did this and we did that.

 

[CADsortaGUY]

Originally posted by: dmcowen674
So do you favor bigger Government?

Buahahahahaha!! Do I even need to answer this?

You even commented on Republicans taking it on as what was a Traditionally Democratic issue. Hillary was Humiliated by Republicans just a few years ago on this and now suddenly they are the Senior's Knights on White Horses huh?

HillaryCare was a different beast. But yes there is alot of politicing here with this bill...IMO. Taking this issue away from the Dems is big - precisely because the Democrats have been singing this tune for years and have used it against Republicans by saying they don't care about seniors and etc. I'm not sure that trumpeting this is going to have as big of effect politically as taking away the negative bleating about "not caring about Seniors".

CkG

 

[BaliBabyDoc]

I also think your statements on how it will "hurt" aren't that substantial since the full details of the plan arent know....yet. Once the full details are out - then we'll be able to further debate what the short-term/long-term implications are for coverages and such.

Essentially all of my statements about what "hurts" are related to CURRENT issues with Medicare and drug costs. Considering this legislation will have minimal effect on increasing providers for Medicare recipients (rural providers/hospitals will get more favorable terms but it will do little to change the tide in refusing new Medicare patients) or the current/rising costs of medications . . . clearly my statements are beyond substantial . . . they are central. Orin Hatch claims they've been working on this bill for 15 solid years to improve Medicare and provide a drug benefit.

"This bill is an extraordinary day for seniors and indeed all Americans," said Senate Majority Leader Bill Frist. "The legislation we just passed is consequential, it is far reaching. ... It is epochal in the sense it modernizes Medicare to provide 21st century care for our seniors."

That's not a good omen.

It is the largest expansion of Medicare since it was created in 1965, although most of its provisions won't take effect for several years. The drug benefit, for example, does not take effect until 2006. Before that, seniors will be able to purchase, within six months, a discount card that could provide 10 to 25 percent off prescription drugs.

I repeat Medicare needed repair BEFORE expanding. The drug benefit does nothing to restrain costs . . . in fact, the legislation explicitly prohibits Medicare from negotiating for lower prices. Furthermore, the discount card was often free (granted each drug company had their own card).

"This is the end of a Medicare program that forces seniors to choose between food on the table and the medicine that they need," he said.

Nope, if your olanzapine costs $500/month but your disposable income is less than $100 . . . that discount card doesn't help much even at 25%. Granted, there aren't many seniors on Zyprexa but there are plenty on an ACEI, diuretic, statin, ARB, and synthetic hormones (everything except estrogen/progesterone).

 

[dmcowen674]

Originally posted by: CADkindaGUY

Originally posted by: dmcowen674
So do you favor bigger Government?

Buahahahahaha!! Do I even need to answer this?

You even commented on Republicans taking it on as what was a Traditionally Democratic issue. Hillary was Humiliated by Republicans just a few years ago on this and now suddenly they are the Senior's Knights on White Horses huh?

HillaryCare was a different beast. But yes there is alot of politicing here with this bill...IMO. Taking this issue away from the Dems is big - precisely because the Democrats have been singing this tune for years and have used it against Republicans by saying they don't care about seniors and etc. I'm not sure that trumpeting this is going to have as big of effect politically as taking away the negative bleating about "not caring about Seniors".

CkG

"Buahahahahaha!! Do I even need to answer this?"

So how big does it have to get before you say it is too big? Does Bush have to declare he is Imperial Dictator, declare permanent Marshall Law and re-name the U.S.?

 

[CADsortaGUY]

Originally posted by: dmcowen674
"Buahahahahaha!! Do I even need to answer this?"

So how big does it have to get before you say it is too big? Does Bush have to declare he is Imperial Dictator, declare permanent Marshall Law and re-name the U.S.?

I've already said it's too big. That's why I thought your question was funny, but thank for taking things to an illogical extreme.


BBD - I've repeatedly stated that the whole thing is in need of REAL reform. And the "hurt" comment was about the bill - not the current state of Medicare.

CkG

 

[dmcowen674]

Here is some local Georgia reaction:

11-26-2003 Impact of Medicare drug plan is uncertain

Local medical providers and senior citizens weren't sure whether to rejoice Tuesday after the U.S. Senate approved a massive, hotly debated Medicare bill. The legislation provides prescription-drug coverage for some patients, but could also turn part of the government's health care system over to the private sector.

David Cook, executive director of the Medical Association of Georgia, suspects many of the 54 senators who voted for the bill don't have a clue what they've enacted.

"Personally, I thought this bill was going to be something to help the poorest of the poor," said Roger Ray, 71, of Gainesville. "But it doesn't look like the people who really need it are going to get much benefit."

It's a question that leaves Ray with conflicting emotions. "Many of our poor seniors have drug bills of more than $400 a month, and they're only getting maybe $600 a month from Social Security. They need help," he said.

"But as a very conservative Republican, I'm concerned. With the addition of this entitlement, the (federal) deficit is going to be much larger. I'm at a loss to explain how Congress expects to pay for this."

 

[BaliBabyDoc]

BBD - I've repeatedly stated that the whole thing is in need of REAL reform. And the "hurt" comment was about the bill - not the current state of Medicare.

I'm at a loss to figure out why you cannot see what this bill means. According to the GOP from Bush the Lesser down to local political hacks . . . this bill IS Medicare reform. The drug cost question has been answered . . . albeit poorly for the people that need the greatest assistance and at a terrible toll for all taxpayers. The structural failings of Medicare have been fully addressed. Medicare is on the road to modernization (drug benefit 2006 and competition 2010). The Democrats have no political power (or will) and the GOP has already printed mass mailings with "MISSION ACCOMPLISHED."

In essence, the pharmaceutical industry and healthcare establishment (hospitals/insurers) now have a guaranteed place at the trough with the defense/industrial complex.

Even the notion of decreasing the federal government's Medicare tab (through enrollment in private plans) is BS, b/c the government will PAY insurance companies to take Medicare recipients. When the subsidies stop, private providers will have no incentive to take anyone but the healthiest (and youngest) recipients. As they age, invariably private providers will drop their coverage or make coverage so expensive that seniors will be forced to leave. Invariably these people will return to Medicare . . . which puts us right back where we started . . . except of course for the pigs feeding at the trough.

 

[CADsortaGUY]

Originally posted by: BaliBabyDoc

BBD - I've repeatedly stated that the whole thing is in need of REAL reform. And the "hurt" comment was about the bill - not the current state of Medicare.

I'm at a loss to figure out why you cannot see what this bill means. According to the GOP from Bush the Lesser down to local political hacks . . . this bill IS Medicare reform. The drug cost question has been answered . . . albeit poorly for the people that need the greatest assistance and at a terrible toll for all taxpayers. The structural failings of Medicare have been fully addressed. Medicare is on the road to modernization (drug benefit 2006 and competition 2010). The Democrats have no political power (or will) and the GOP has already printed mass mailings with "MISSION ACCOMPLISHED."

In essence, the pharmaceutical industry and healthcare establishment (hospitals/insurers) now have a guaranteed place at the trough with the defense/industrial complex.

Even the notion of decreasing the federal government's Medicare tab (through enrollment in private plans) is BS, b/c the government will PAY insurance companies to take Medicare recipients. When the subsidies stop, private providers will have no incentive to take anyone but the healthiest (and youngest) recipients. As they age, invariably private providers will drop their coverage or make coverage so expensive that seniors will be forced to leave. Invariably these people will return to Medicare . . . which puts us right back where we started . . . except of course for the pigs feeding at the trough.

"I don't think it'll hurt or help in the short-term. Long-term though it could cause real problems as it's just another entitlement which won't ever go away or get smaller." -me
"BBD - I was commenting on the economics of it all since the other threads have dealt with the actual care it's providing. I took this thread(by Dave) as an economic thread since he commented on big gov't vs small gov't." -me
You seem to fail to understand that I haven't been talking about the specifics of the Bill when talking about "hurt"- but rather made comments on the Economic impact as Dave was trying to get at.

I understand you are claiming that by supposedly doing nothing to help it somehow "hurts"...but that isn't the case. Leaving things the same...until things kick in, isn't "hurting"...it's just not changing it. "Hurting" would be for it to cause more problems...well this bill isn't the cause the problems you claim are currently present and the immediate changes aren't big and significant.
I don't like this sort of bill(drug entitlement) - ANY way it's presented. REAL reform has not happened...all they did was to throw money at it...and the Democrats didn't think enough was thrown at it. Real reform would be taking this and all other entitlements and putting means testing and other guidelines in place to help those who CAN'T help themselves...and not just leave things wide open for those that won't take care of themselves. Our gov't isn't supposed to provide your daily existance...it's a entity that provides for the economic structure and other basics.

This bill, like I said, is "just another entitlement which won't ever go away or get smaller." This(as with any Drug bill) doesn't focus on the people it is aimed at. Yes they will get some "help" but it goes beyond that. It's wide focus to include all is stupid when only a fraction of the seniors actually want/need more/better coverage.

CkG

 

[BaliBabyDoc]

I understand you are claiming that by supposedly doing nothing to help it somehow "hurts"...but that isn't the case. Leaving things the same...until things kick in, isn't "hurting"...it's just not changing it. "Hurting" would be for it to cause more problems...well this bill isn't the cause the problems you claim are currently present and the immediate changes aren't big and significant.

A 50yo man comes to the ER complaining of fatigue, nausea, shortness of breath, and a squeezing pain that radiates from his chest up through his left arm and jaw. Atypical muscle spasm? Hypochondriac? Angina? Heart Attack? I'm not sure . . . so I decide to order:
1) EKG (tomorrow)
2) cardiac enzymes (next week)

After telling the patient everything is going to be OK, I retire to the lounge to catch the end of the UNC-UConn basketball game. Within minutes . . . another damn page. Seems my nerd medical student had already ordered the EKG and cardiac enzymes. My patient is in the early stages of an acute myocardial infarction (transmural according to the EKG). For treatment, I order:
1) MONA (morphine, supplemental oxygen, nitroglycerin, and aspirin) tomorrow
2) clot buster like TPA next month
3) angioplasty plus placement of a drug eluting stent next year

In the meantime, I tell the patient that he doesn't need to worry b/c my inaction will not hurt him. Despite my less than timely diagnosis and intervention, his condition couldn't possibly get worse. In fact, my assessment and plan is cheaper and healthier . . . he can forget all that stuff about losing that 90lbs, giving up the two pack a day habit, exercising more frequently than his daily 8 sets of 12oz curls, or taking his medication for high cholesterol, high blood pressure, and diabetes.

That damn sneaky med student (let's see how much she likes her low pass grade) already ordered MONA therapy and the patient is feeling better. He decides to leave AMA (against medical advice) b/c some twit told him there was nothing to worry about. He returns DOA by EMS . . . according to the medical examiner it was a massive AMI previously diagnosed by a MD in the ED who is now officially and legally SOL.

 

[CADsortaGUY]

Originally posted by: BaliBabyDoc

I understand you are claiming that by supposedly doing nothing to help it somehow "hurts"...but that isn't the case. Leaving things the same...until things kick in, isn't "hurting"...it's just not changing it. "Hurting" would be for it to cause more problems...well this bill isn't the cause the problems you claim are currently present and the immediate changes aren't big and significant.

A 50yo man comes to the ER complaining of fatigue, nausea, shortness of breath, and a squeezing pain that radiates from his chest up through his left arm and jaw. Atypical muscle spasm? Hypochondriac? Angina? Heart Attack? I'm not sure . . . so I decide to order:
1) EKG (tomorrow)
2) cardiac enzymes (next week)

After telling the patient everything is going to be OK, I retire to the lounge to catch the end of the UNC-UConn basketball game. Within minutes . . . another damn page. Seems my nerd medical student had already ordered the EKG and cardiac enzymes. My patient is in the early stages of an acute myocardial infarction (transmural according to the EKG). For treatment, I order:
1) MONA (morphine, supplemental oxygen, nitroglycerin, and aspirin) tomorrow
2) clot buster like TPA next month
3) angioplasty plus placement of a drug eluting stent next year

In the meantime, I tell the patient that he doesn't need to worry b/c my inaction will not hurt him. Despite my less than timely diagnosis and intervention, his condition couldn't possibly get worse. In fact, my assessment and plan is cheaper and healthier . . . he can forget all that stuff about losing that 90lbs, giving up the two pack a day habit, exercising more frequently than his daily 8 sets of 12oz curls, or taking his medication for high cholesterol, high blood pressure, and diabetes.

That damn sneaky med student (let's see how much she likes her low pass grade) already ordered MONA therapy and the patient is feeling better. He decides to leave AMA (against medical advice) b/c some twit told him there was nothing to worry about. He returns DOA by EMS . . . according to the medical examiner it was a massive AMI previously diagnosed by a MD in the ED who is now officially and legally SOL.

Nice try...but it isn't the same deal. Yes there are some who actually need the help right now and they are getting some help. Like I said - the problem with ANY of the Drug bills was that they didn't focus on those that actually needed the help - they all seem to be big broad based bills with loads of entitlement waste. So no - your little story is silly since their current problems weren't caused by this bill or any other bill. Are these people still in need? yes - but their current "hurt" isn't exacerbated by this bill..although some claim it'll "hurt" them in the long run, but that is merely speculation at this point.
Now again, since some don't seem to want to read what I've said. The whole entitlement system needs reform so it can be refocused on those who actually NEED the help - ESPECIALLY MEDICARE and SS. You know ... the whole "help those who can't help themselves instead of those who won't help themselves" thing.

CkG

 

[Mean MrMustard]

I'm confused, I though Republican was for smaller Government?

LOL...

When did you hear this?

Last I heard, conservatives were. Neo-cons on the other hand...

None of the major parties are for smaller gov't. Cut spending, what the hell is that? The only difference between Republicans and Democrats is where the money's spent PERIOD. What makes people think Republicans like a smaller gov't is that they like to give tax cuts. Well, here's a news flash: You can cut taxes all you want but unless you cut spending, it will come back to bite you in the ass. But, but, but... tax cuts are meant to tame the beast (tighten the belt, so it speak)! Well, it doesn't matter if you don't care about running deficits!

Fiscally responsible... my ass.

 

[Jhhnn]

Pure pork and politics. It's so weird and confusing that nobody understands it, and won't take effect until well after the election, for good reason. The Bushies can claim a victory for seniors even when there isn't one.

If it follows the usual route for neocon economics, and nobody can tell quite yet, it will help the wealthiest seniors, drug companies, HMO's and health care consultants while leaving everybody else with diddly... except huge interest payments on more theft from the treasury...

The Bush Admin is remarkable in their ability to refernce night as day while getting folks to believe it's true- "Healthy Forests", "Clear Skies", "No Child Left Behind", "War On Terror", "Aids Initiative", and so forth. Just because it has a catchy name doesn't mean they're telling the truth, or actuallly doing what they claim...

 

[BaliBabyDoc]

So no - your little story is silly since their current problems weren't caused by this bill or any other bill. Are these people still in need? yes - but their current "hurt" isn't exacerbated by this bill..although some claim it'll "hurt" them in the long run, but that is merely speculation at this point.

I forgot . . . analogy only works when people have a clue. My story (which actually has prompted a major initiative throughout the nation to improve ED cardiac triage/diagnostics) is a prime example of what happens when problems are improperly assessed and then inadequately addressed. Unless you watch a lot of Star Trek or Terminator (x) then your comment is a non sequitur . . . it's impossible for current problems to be caused by this bill . . . a premise that does not exist in my example. But by definition, the financial woes of Medicare . . . not to mention the absence of a drug benefit . . . were certainly created by previous bills. In fact, GOP cheerleaders repeatedly cited previous Medicare reforms as failures due to the lack of a drug benefit.

The current hurt is much like many situations "some people will fare better others will fare worse". People without prior knowledge of discount cards will get 10-25% off. Of course, buying a universal card would be lame if all of your drugs come from the Evil Empire (Pfizer) or if the negotiated discount through the card provider is actually LESS than your current mix of discount cards. Naturally, the Bush Regime has created a new bureaucracy within Medicare to explain what Medicare is doing. In fact, the advertisements started several months ago. I couldn't understand why the government needed to advertise Medicare help since the vast majority of Medicare recipients were well aware of what it provided. Apparently Bushies were confident they would prevail . . . by hook or crook.

You are quite right. . . I'm speculating that creating a huge permanent entitlement within a huge permanent entitlement program may turn out badly. Of course, speculating that it will turn out well is perfectly reasonable.

 

[chess9]

That isn't a Medicare bill, it's corporate welfare for the drug companies and HMOs.

Very, very few seniors will ultimately benefit from the bill and it's very expensive. From a purely fiscal standpoint it is an irresponsible step into a deep void.

All the voodoo economics students of the '80's have now graduated I see.

-Robert

 

[dmcowen674]

More concerns over availability and prices of Drugs:

12-13-2003 U.S. May Overwhelm Canadian Pharmacies

This week, New Hampshire's state government announced plans to purchase some drugs from Canada. And representatives from a dozen states met with six Canadian drug companies in Atlanta to discuss business possibilities. So far, only Springfield, Mass., has a program that allows its employees to purchase Canadian drugs.

"I think even if half the people talking about buying from Canada did it, there would be problems," said Hicks, whose company is based in Winnipeg, Manitoba.

The city of Boston, which this week announced a plan to buy drugs from Canada, asked his firm to handle prescriptions for a pilot program open to roughly 7,000 of its current and retired employees.

"It would be exciting ? and frightening," said Hicks. "That would be a lot of stress on our operation."

While they want business to keep increasing, they aren't sure how to handle a massive influx of new customers ? or even whether they could. They also don't want to taunt the pharmaceutical industry, which is already limiting supplies to Canada to discourage the sales. Hicks said he would need to know that before making any major commitment to expanding the business. He and Kula fear that if the Canadian business grows exponentially, drug companies will take even more drastic measures to cut supply and they don't want to put Canadian clients in jeopardy.

"I don't want to cause a drug shortage," Hicks said.

If the drug companies did cut off Canada, the government could break patents and allow generic production, Kula said. But he's not sure either the companies or Canada wants to get to that point.
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Nothing like a free open market