RALLYING CRIES DISTINGUISH POLITICAL CANDIDATES

Now that 2016 is finally here we can at last look forward to getting on top of the political election calendar. Too much may have been made of the campaign already. However, the Iowa caucuses are less than a month away. The New Hampshire primary follows on February 9, just ahead of a series of electoral events leading to "Super Tuesday" when 12 states attempt to clarify their preference among our presidential aspirants. All of these events ultimately lead to national party conventions in Cleveland and Philadelphia in July when our choices are reduced to two. By the time we ultimately arrive at the election on Tuesday, November 8, we will all be exhausted, but we will finally know who is going to lead us during the next four years. In the mean time we attemptr to sort through more than a dozen candidates searching for reasons to select one over the other.

All contestants are busily trying to set themselves apart from each other, a chore not easily accomplished. During the Middle Ages competing entities used flags for the purpose of identification. By looking at a flag, observers were able to identify the status, association, or religion of the flag bearer. In war banners were used to help soldiers identify friends or enemies. Today political competitors have replaced banners with slogans used on posters and bumper stickers. In "How to win any election" Joe Garecht tells us that every campaign needs a message, issues that support the message, and an effective campaign slogan . "Slogans need to be easy to remember, short enough to be said in one breath, and snappy enough to say over and over again." Where combatants used to identify with the flag of their compatriots, today's voters identify with their chosen candidate  through her or his campaign slogan. In a way these taglines become a rallying call-to-action, and they can be used in support of or in opposition to specific candidates. Our electoral history is awash in memorable campaign slogans. Many of these reflect the values of society at the time. The Memorabilia Website of Duke University's Collections Library lists an impressive collection of presidential campaign slogans and catchprhrases. Some of these are quite memorable, pointed, and some are even risque. I selected the following to help us ease into what is sure to confront us this year.

One of the earliest rallying cries came from Patrick Henry, founding father, attorney, planter and politician who became the first post-colonial governor of Virginia, who is best remembered for his "Give  Me Liberty of Give Me Death" speech.

In 1789 George Washington, a reluctant candidate at best, used a poster with the slogan: "Let's Try it. See What Happens."

William Henry Harrison and running mate John Tyler made "Tippecanoe and Tyler Too" part of history.

In 1852 Franklin Pierce, running against incumbent  President James Polk, came up with: "We Polked You in  '44. We Shall Pierce You in '52."

John Fremont, running in 1856, used the slogan: "Free Soil, Free Labor, Free Speech, Free Men and Fremont."

Abraham Lincoln's slogan in 1860 was: "Vote Yourself a Farm." During his re-election campaign in 1864 this changed to: "Don't Swap Horses when Crossing Streams."

In 1884 James Blaine, running against Grover Cleveland who had been accused of fathering an illegitimate child in 1874, ran the slogan: "Ma, Ma, Where's My Pa?"

In 1884 Republicans attacked the opposition for views against prohibition with: "Rum, Romanism and Rebellion."

Herbert Hoover ran using the catchphrase: "A Chicken in Every Pot and a Car in Every Garage."

Hoover ran against Al Smith in 1928. One of the issues debated was prohibition. Proponents were called "drys," opponents were referred to as "wets." A popular tagline during that election became: "Vote for Al Smith and Make Your Wet Dreams Come True."

FDR used various battle cries and became the recipient of slogans opposing his election as well. In 1932 FDR used: "Happy Days Are Here Again." Alfred Landon retorted in 1936 with: 'Life, Liberty and Landon." Wendell Wilkie, running in opposition in 1940 ran posters stating: "Roosevelt for Ex-President." Some of the latter's supporters also circulated literature proclaiming: "No Man is Good Three Times."

Everyone remembers Harry Truman's "Give Em Hell, Harry," and Eisenhower's "I lIke Ike."

In 1960 even prostitutes got into the act proclaiming: "Nixon or Kennedy, We don't Care Who Gets In!"

Goldwater's run for office generated pro and con slogans like: "Goldwater - In Your Heart You Know He's Right."  "In Your Guts You Know He's Nuts."

The 1972 election campaign opposing Democrats saw: "Acid, Amnesty and Abortion for All."

Jimmy Carter flaunted his background in 1976 with bumper stickers that said: "Not Just Peanuts."

Ronald Reagan was the first one to come up with: "Make America Great Again." (Donald Trump adopted the slogan for his own campaign and is actually trying to trademark it.)

Many of us still remember Bill Clinton's slogan: "It's the Economy Stupid," and Barack Obama's: "Yes, We Can!"

This year we should look forward to some new slogans. The better ones, other than the one Donald Trump "borrowed" are:

Ben Carson - "Heal, Inspire, Revive."

Carly Fiorina - "New Possibilities. Real Leadership."

Ted Cruz - "Reigniting the Promise of America."

Bernie Sanders - "A Political Revolution is Coming.

Marco Rubio - "A New American Century."

Rand Paul - "Defeat the Washington Machine. Unleash the American Dream."

Mike Huckabee - "From Hope to Higher Ground."

Jeb Bush - "Jeb!"

Candidates missing from this list have not quite come up with a succinct battle cry most of us can remember.

If history provides a guideline, our message to the candidates should be: "keep it simple," or come November we will have forgotten how you tried to help us focus.

were called "drys," 

FUELING XENOPHOBIC HYSTERIA FEEDS FASCIST ELEMENTS

On December 7 Donald Trump, Republican frontrunner in the presidential election contest, announced that he was calling for "a total and complete shutdown of Muslims entering the United States until our country's representatives can figure out what is going on." His words elicited a firestorm of reaction from domestic as well as foreign pundits. Leaders in both political parties chastised him for making un-American statements. The British Parliament is considering a motion banning him from entering the U.K.. Business associates operating in the Middle East are removing Trump's name from branded properties . A previously scheduled meeting between Trump and Netanyahu was cancelled. And across the globe the GOP frontrunner is being referred to as a Fascist demagogue. Donald Trump says that he does not care, that what he said needed to be said. Upwards of 60% of potential Republican voters appear to agree. He apparently anticipated some of the reaction, and his proposal was obviously designed to feed into a growing Islamophobia permeating the country.

While Trump may have unleashed a political firestorm among mainstream politicians, his remarks mirrored similar utterances coming out of a growing number of far-right populist, nationalist or outright Fascist parties dotting the political landscape in Europe. Many of the elements leading to the development of Fascist parties across pre WWII Europe  are again in evidence. During the run-up of World War II political movements were focused on similar concerns far-right parties agitate about today: The economy, unemployment, immigration, a loss of national identity, and a loss of traditional values. While anti-semitism was a unifying factor for far-right parties during the first three decades of the 20th Century, Islamophobia has become the unifying factor during the early part of the 21st Century.

In our country political demagoguery may eventually be absorbed in platforms of one of the major political parties. In most European countries electoral systems allow fringe movements to organize their support in to political parties with real power. Today in Europe proto-Fascist parties that are anti-Islam, anti-Semitic, and anti-European Union have already become the second or third largest parties in a belt of formerly liberal societies that runs from Norway and Finland  to The Netherlands and France. In Hungary, where the nationalist Fidesz Party already governs, Jobbik, the more extreme and most obvious neo-Nazi party in Europe continues to gain in strength. Prime Minister Viktor Oban , already referred to as a dictator and the "Donald Trump of Europe," continues his movement to the extreme  right in an effort to thwart Jobbik's ascendance. In Poland a new right wing populist government controlled by the "Law and Justice Party" recently took steps to cancel previous appointments of judges to its Constitutional Tribunal, which rules on all legislation. In France Marine Le Pen's Nationalist Front took 30% of the vote in recent regional elections, positioning herself well for an anticipated challenge  in the upcoming 2017 presidential elections. It took collaboration between President Hollande's Socialists and past President Sarkozy's center-right "Les Republicains" to keep her from dominating the election.

The point is that the world is a dangerous place today, but our reaction to the dangers that seem to be lurking around every corner is potentially as dangerous as what we are trying to protect ourselves from. What we may now look at as political theater fed by powerful demagoguery can quickly deteriorate into mass hysteria and morph ideas into political power and control over public resources. While we yearn for a rebirth of traditional values, we tend to lose track of our core values. Witness Europe where ideas similar to those expressed by Donald Trump ultimately developed into political parties with real power running on platforms specifying desires to expel their Muslim population, register Jews and Muslims alike, stop the flow of refugees, reverse the influence of the European Union and its Parliament (one-third of which  now consists of far-right ant-E.U. representatives), restrict democratic values, and essentially reverted to the situation after the Weimar Republic in 1933 Germany. The Nazis who took over never won an election. However, their demagoguery acquired the support that eventually led us to World War II and the deaths of over 60 million people.

Political bluster and grandstanding can produce outcomes we don't imagine, and over which we could easily lose control. If you think that that can't happen here, just remember: we used to ostracize Catholics, we shamelessly allowed anti-semitism to fester and sent thousands of would-be Jewish immigrants back to Germany where most were exterminated, we interred our Japanese citizens, and if we follow Donald Trump's suggestions we will soon make life for our Muslim citizens a living hell.

Hitler's brown shirts were not very educated. They were storm troopers. When he released them  during the night of November 9, 1938 to execute a coordinated attack on Jews throughout Germany - during what was later dubbed as "Kristallnacht" - he destroyed the lives of millions of people and set the stage for what would become his "final solution." When I observed the raucous standing ovation Trump received in South Carolina when he announced his proposal I could not help but feel that he could have asked these people to do anything he wanted, and they would have complied. As we read this mosques are being firebombed,people are attacked, knifed and killed, businesses are being defaced and destroyed, and patriotic Americans are having their lives ruined.

My parents were living 300 miles from the center of activity in Germany in 1938. They were helpless to do anything about it, but they suffered the eventual consequences when my grandfather was enslaved and ultimately killed by the Nazis. We still have a choice. We need to use it, or we may wake up one morning regretting we didn't.

THE ONLY THING WE HAVE TO FEAR IS FEAR ITSELF

Our 32nd President, Franklin Roosevelt, spoke these words during his inaugural address in 1933. Within a decade our government would turn back thousands of Jewish refugees, desperate people fleeing a terrifying blood thirsty regime. We argued that they posed a serious thtreat to our national security, and we essentially returned them to Germany where many would be exterminated by the Nazis. Later in 1939 we rejected a proposal to allow 20,000 Jewish children to come into the country for safety. Three years later Roosevelt signed Executive Order 9066 which resulted in interring nearly 120,000 citizens of Japanese descent while some of their offspring died on the battlefield fighting on our side during the war. At the time well over 80% of residents polled supported Roosevelt's turnabout. Politics trumped what was once a sensible expression of opinion in line with a set of values our country had always stood for. Since that time we have generally expressed regret for what we did back then. However, 70 years later we apparently still have not learned from it.

The terrorist acts in Paris where 130 people died at the hands of, mostly home-grown, criminals are stirring up the same type of political grand standing as what preceded our entry into World War II. More than half of our governors and most candidates running for president have grabbed onto heightened security concerns, misdiagnosed the facts, and again targeted a group of desperate refugees while identifying members of a specific religion to make political points, vastly under estimating real security threats.

This time around our focus is on Syrian refugees and followers of Islam. The House of Representatives passed a bill establishing a pause in resettling Syrian refugees until our vetting process has been reviewed. Mind you, currently refugees admitted to the U.S. undergo between one and two years of screening by multiple intelligence agencies, the State Department and the Department of Defense. Since 9/11 we have resettled 387,938 refugees from majority Muslim countries. Only 2 of these have subsequently been arrested for suspect activities. While pandering to their political base, and while trying to outdo each other, political candidates are falling all over each other making pathetic, pathological, xenophobic statements. Ted Cruz and Jeb Bush are suggesting that going forward we should only admit Christian refugees. Trans-Humanist Party candidate Zoltan Istvan suggested that small microchips could be implanted under the skin of Syrian refugees as part of the process admitting them into the U.S.. Donald Trump wants to close down or monitor all mosques, place Syrians into internment camps in Syria, send Syrians already processed and in the country back, and register all Muslims into a database. Chris Christy pronounced that he would not even make exceptions for orphans under the age of five. In the mean time Ben Carson, at a campaign stop in Mobile, Alabama, referred to Syrian refugees as "rabid dogs."

As the inflammatory rhetoric escalates and becomes less and less American, it is worth observing that the terrorists in Paris mostly carried French, Belgian and Moroccan passports. Given the vetting time it takes before refugees are allowed into the country, it would be highly unlikely that terrorist groups could muster the patience required to infiltrate their flow and smuggle anyone into the U.S.. The real security risk rests with people who carry passports from countries we typically trust and for which we don't require visas. The political pandering does not only undermine security threats we should focus on, the rhetoric has a way of inflaming those who don't think for themselves. As French writer and philosopher Voltaire noted centuries ago: "Those who can make you believe absurdities can make you commit atrocities." Two weeks ago armed protesters showed up at a mosque in Irving Texas, which underscores the point that we should deescalate the discourse before it really gets out of hand.

Finally, one can't escape the fact that, since the attacks on the World Trade Center, we have experienced well over 360,000 gun related killings. In a way these acts of violence resemble a form of domestic terrorism that resulted in more devastation and agony than what we are currently observing internationally. However, these "terrorist" acts don't seem to elicit the same level of outrage. To combat terrorist acts within our borders, the Bush administration suggested in 2007 that we pass a law denying people who we suspect might engage in terrorist activities from purchasing guns and explosives. Almost nine years later this bill still has not passed Congress. Recently Senator Dianne Feinstein and Representative Peter King reintroduced this legislation, which is now dubbed the "Denying Firearms and Explosives to Dangerous Terrorist Act of 2015." The point they make, convincingly in my view, is that if we deny people on our "no fly list" from boarding our planes, we should keep them away from explosives and firearms. Unfortunately the lunatic fringe at the helm of the NRA Institute for Legislative Action, the NRA's lobbying arm which manages its Political Action Committee, and which maintains its grasp over a cowardly Congress, has succeeded in keeping this sensible legislation from becoming law. Their aggressive arm twisting, presumably not by intent, but certainly in effect, appears to support domestic terrorism. Perhaps we should begin re-defining who our real enemies are.

THANKSGIVING - Be grateful for what you are taking for granted.

A few days from now we will celebrate one of our favorite holidays, Thanksgiving. Contrary to popular belief this holiday, initiated in Plymouth Massachusetts in 1621 and not picked up again until President Lincoln made it a national holiday in 1863, is not just celebrated in the U.S. Many countries, including Italy, Brazil, Korea, Vietnam, India and China celebrate harvest. Canada remembers the arrival in 1578 of British explorer Arthur Frobisher who threw a meal for his crew when they, barely, made it to Canadian shores. The Netherlands celebrates in honor of the pilgrims leaving Leyden for the new world. Liberia celebrates American style, but without the turkey.

Many countries generalize popular gratitude. Our Thanksgiving dinners often feature a simple question: "What are you thankful for?" Even though we should expect this conversation, we are often still caught off base. Aside from family focused experiences and feelings we are grateful for, we might consider expressing gratitude for some of the so-called simple things we have in our lives.

If you have a roof over your head - Be thankful!

   In the U.S. more than 3.5 million people experience homelessness each year. This includes 2.5 million children, and 16% of homeless adults are veterans.

If you are having a great meal with family and friends, and if, by chance, you are serving one or more of the 52,000,000 turkeys consumed in our country each Thanksgiving day - Be grateful!

   805 Million people in the world are chronically under-nourished. 18,000 Children die every day from hunger and malnutrition.

If you have clean water and if you are able to enjoy hot showers - Be thankful!

   63 Million people (1 in 10) lack access to safe water. 2,000 Kids under the age of five  die each day from diseases related to contaminated water. That is 1 every 21 seconds! 1.8 Billion people who have access to a water source within 1 kilometer, but not in their house or yard, consume on average 20 liters per day. In the U.S. we use 600 liters a day, which is the highest in the world.

I am certain we can come up with many other experiences we take for granted, and which we could give some intellectual and emotional perspective. The point is that most of us are better off than a substantial number of people in the owrld. While recognizing that even in the U.S. 48 million citizens live below the poverty line - 16 million of which are childeren and 5 million seniors - almost all of us are taking things for granted many others can only dream of. We should be grateful for living where we are and for everything we take for granted. Due to the accident of birth or the ability to choose you are living in one of the most comfortable places in the world, whatever its faults and however much we bicker over how to distribute our resources. We are lucky. After all, the odds of being born American, according to a 2005 W.H.O. report, are only 5%. In fact, given what is involved in the reproductive process, the odds of you coming into the world at all are only about 1 in 400 trillion (Harvard study.)

Finally, certainly not last, we should be thankful for the bravery displayed by the men and women we sent into harm's way. They face danger every day. Many of them will spend the holidays away from their family in the various war zones we are still, and again, involved in. Some of them will pay the ultimate price defending all the things we are thankful for.

With that in mind I think we should all read and re-read the prayer Eleanor Roosevelt carried with her throughout Worl War II:

Dear Lord,

Lest I continue

My complacent way,

Help me to remember that somewhere,

Somehow out there

A man died for me today.

As long as there be war,

I then must

Ask and answer

Am I worth dying for?

Go look at yourself in a mirror and answer the question.

Happy Thanksgiving!

GOP CANDIDATES REBUKE DEMOCRATS FOR PARIS ATTACKS

It did not take long for GOP candidates to blame the Democrats for the terrorist attacks in Paris.

Several of these were illustrative of an ignorant mindset not worthy of intellectual discourse.

Carly Fiorina has an uncanny ability to manifest selective memory. Not only does she re-imagine her professional past at H.P., she also forgets that had George Bush et al not engaged Iraq and Sadam when they did, none of this might have happened. Sadam Hussein was an intolerant and cruel dictator. However, he would not have tolerated Isis. Removing him upended the balance of power in the region. We deliberately banned his mostly Sunny military professionals from continuing to operate. Most of them ended up fighting with Al Qaida and Isis when the Shiite forces filled the void. Fiorina's rant that she is "angry that Barack Obama and Hillary Clinton declared victory in Iraq abandoning our hard-won gains...." which somehow made them responsible for "the murder, the mayhem, the danger,the tragedy that we see unfolding in Paris," is ignorant. George Bush prepped our exit from Iraq while still President. Her lack of understanding of historical context, and her inability to analyze facts, make her entirely unprepared to even run for the presidency. Ignorance is a curse. She should leave that garbage where it belongs, in her head.

Donald Trump's suggestion that the Paris attacks would have been a much different situation had the vistims been armed with guns, is outright stupid.

If this is the best the GOP can come up with we can only hope that our citizens wake up. We can not afford this level of degenerate thinking to rise to a leadership level in the country.

SHOULD WE CONSIDER ADOPTING A SINGLE-PAYER HEALTHCARE SYSTEM?

This is the time of the year when many of us need to consider our health insurance options. Given the steep increases in premiums, this may also be when we re-confront the discussion about what kind of health insurance system our country should ultimately adopt. Since we are in the midst of a poliktical election cycle as well, the pundits argue publicly for and against the Affordable Care  Act (a.k.a. Obamacare), the desirability of adopting a single-payer healthcare system as prevalent in virtually all developed countries, or to stick with the market based private insurance system we supposedly have even under Obamacare.

Single-payer national health insurance, also known as "Medicare for all," is a system in which a single public or quasi public agency organizes healthcare financing, while the delivery of care remains largely in private hands. Under a single-payer system all residents of the U.S. would be covered for all medical necessary services, including doctor, hospital, preventive, long-term care, mental health, reproductive healthcare, dental, vision, prescription drug and medical supply costs. In the 1950s U.S. health statistics were world class: Infant mortality among the lowest, life expectancy among the highest, and health care costs about average. One by one other nations - like Denmark, Sweden, Australia, the U.K., Canada and Taiwan - adopted national health programs. By the end of the 20th century the U.S. was the lone holdout for private, for profit health insurance. Its health statistics lagged behind dozens of countries, while costs soared to twice the average in other wealthy nations.

The U.S. spends 16% of GDP on health. This compares to 8.5% in the U.K. and Australia, and significantly less than 16% in most developed countries. Of eleven nations studied by the World Health Organization and the OECD the U.S. ranked lowest on accessibility, efficiency, and healthy lives outcomes (mortality related to medical care, infant mortality, and healthy life expectancy at age 60.) A similar study done by the Commonwealth Fund in 2014 confirmed these conclusions.

Many countries have realized huge savings by evicting private insurers and eliminating the reams of expensive paperwork they require from doctors and hospitals. Aetna keeps 19 cents of every premium dollar for overhead and profit. U.S. hospitals devote 25.3% of total revenue to administration, which reflects the high cost of collecting patient co-payments and deductibles, and fighting with insurers. Obamacare will  direct an additional $850 billion in public funds to private insurers, and boost insurance overhead by $273.6 billion. Yet, it will leave 26 million citizens uninsured, and similar numbers with such skimpy coverage that a major illness will bankrupt them. By contrast, insurance overhead in single-payer systems takes only 1-2 percent. Proponents estimate (and argue) that moving to a single-payer system would save about $400 billion a year on paperwork and administration.

The controversy surrounding the single-payer system does not seem to focus on the desirability of achieving universal coverage, it is largely concerned with the means of getting there. Thus far the arguments have not changed much over time. Proponents suggest that the system provides universal coverage; diminishes the administrative load on healthcare professionals; significantly lowers cost; eliminates the need for insurance companies; and requires only one buyer which would improve efficiency while providing substantial negotiating power.

Those opposed retort that the system would be government controlled, effectively converting everyone in the system to government employees; would diminish the incentive to pursue research and development; force higher taxes with fewer benefits; contribute to drug abuse; and promote a rising demand for welfare.

This conversation ties into the ongoing dispute over raising the Medicare eligibillity age to help pay for the benefits most of us paid for during our working life. The trust funds paying into Social Security and Medicare are estimated to dry up by the early 1930s. One argument being floated is that raising the eligibility age will over time allow us to free up resources that could be used to achieve universal coverage along the lines of Switzerland's market based system (Avik Roy, Forbes, December 12, 2012). While these discussions continue, we might keep an eye on the outcome of a single-payer "ColoradoCare" proposal Colorado is placing on their 2016 ballot, which is designed to replace Obamacare with a new single-payer system (at a cost of $25 billion per year.)

Fareek Zakaria, a political centrist, journalist and author with a regular program on CNN, answers our opening question as follows: "There is absolutely no question that when we look at the ability to provide good healthcare at an affordable price, lower levels of massive inequality in healthcare outcomes or provisions,  a single government payer and multiple private providers is the answer."

While we may be tempted to add our two cents to the discussion, real change will require political courage, which Washington appears to be lacking. It is easier to express contempt for Obamacare than it is to come up with an alternative. In the mean time we just need to suck it up and pay the premiums, unless we are lucky and old enough to go on Medicare.

PURCHASE PRESCRIPTION DRUGS FROM ABROAD? WHY NOT?

A few weeks ago drug company Turing Pharmaceuticals raised the price of a toxoplasmosis drug, Diatrim, from $13.50 to $750 per tablet, an increase of 5,000 percent. This medication is used with other medications to treat a serious parasitic infection of the body, brain, or eye or to prevent toxoplasmosis infection in people with HIV. Turiing's CEO Martin Shkreli explained that the company needed to make a profit on the drug. The price increase meant that the annual cost of treatment for people who need this medication will be anywhere from $336,000 to $635,000 depending on the patient's weight. The uproar this news caused has led to renewed concern about meteoric price increases in the pharmaceutical industry, generating an aggressive dialogue among political candidates, while resurfacing the question why Americans should not purchase their medications from abroad - especially Canada - since the price for medications in most developed countries is significantly lower than in ours.

It is not difficult to understand why many are tempted to purchase their medications elsewhere. We pay the highest prices in the world for our prescription drugs. Take for example the popular acid reflux drug Nexicum. An insurer in the U.S. pays on average $215 per customer. In the Netherlands the same prescription costs $23. A 30 tablet supply of Abilify costs $711 at Walgreens, but only $200 in Canada. A 10 capsule dose of Tamiflu sells for $112 in the U.S., and less than $50 in Canada. The IMS Institute for Healthcare Informatics, in a 2012 study, estimated that U.S. residents spend about $900 per year on prescription drugs, while the average Canadian spends $420, and Europeans spend on average $375.

During the 1990's travel agencies began organizing bus trips into Canada for seniors who wanted to purchase cheap brand-name drugs. These trips continue to be popular. It is technically illegal for individuals to importy drugs into the U.S. However, officials tend to use enforcement discretion and allow participants to bring in up to a 90-day supply of medication for personal use if they can provide documentation from their U.S. physician.

When I decided to research the viability of purchasing medications from abroad, I thought I would make the case for legalizing their importation. Given the vast differences of drug prices between us and the rest of the world this seemed logical. However, after digging into the subject matter it became clear to me that the issue is not that simple, and that falling in line with politicians who are shooting from the hip to effect legalization could generate troubling advice for people who react to cost alone. 

One reason for not allowing importation of prescription drugs is that the FDA won't be able to guarantee the safety of drugs coming in from a foreign country. This includes Canada. Drugs from foreign pharmacies are not subject to the agency's jurisdiction, could be mislabeled, counterfeit, or otherwise adulterated. Legality aside, bus tours taking passengers to brick and mortar pharmacies in Canada are pretty safe. However, these tours are only practical for residents of border states. The rest of us depend on web-based pharmacies, many of which are illegitimate, and often sell counterfeit drugs.In 2007 the FDA seized 9,600 websites and more than $41 million worth of illegal drugs worldwide. Many sites claimed to be Canadian. However, a sting operation discovered that only 15% of drugs claiming to be Canadian were actually from Canada. The remaining 85% came from 27 different countries. In 2011 the National Association of Boards of Pharmacy reviewed more than 8,300 online pharmacies. Just over 3 percent proved to be legitimate.

Anyone deciding to still take a chance on web-based pharmacies to save on the cost of prescriptions should access one of the following sites. They are designed to help insure that you are dealing with a legitimate online business:

VIPPS - the Verified Internet Pharmacy Practice Site.

CIPA - the Canadian International Pharmacy Association website.

PharmacyChecker

Any of these accredit online pharmacies, and PharmacyChecker also claims that their pharmacies offer drug prices that are up to 80% lower in price than those in U.S. pharmacies. In short, buyer beware. Know who you are dealing with.

Of course this still begs the question: Why do Americans pay two to six times more than the rest of the world for brand-name prescription drugs?

Other countries feature single payer nationalized healthcare systems. They contyrol pricing by negotiating as a single entity with pharmaceutical companies. Their governments essentially decide who can sell what at what price. In the U.S. companies negotiate with individual insurance companies, hospitals and private plans, resulting in an unregulated market driven pricing structure. Besides, by law the federal government-run Medicare system cannot negotiate with the pharmaceutical industry. If Medicare were allowed to negotiate directly, as one of the largest buyers of prescription drugs, it could potentially drive the prices of drugs down. The Veterans Administration has that ability, and within the V.A. system drug prices are 10% to 20% lower than elsewhere. Finally, pharmaceutical companies claim that the average cost of developing a new drug is about $1 billion. Since they are forced to sell at lower prices abroad, U.S. consumers pay higher prices to make up for reduced revenue from foreign sales.

Meanwhile all of us are well advised to do our homework, research the legitimacy of web-based pharmacies, recognize that there is a lot of fraud in the system and, perhaps, just contact several local pharmacies to find the best price.