This winter some Long Islanders will be heading to Canada for a day or two. Not to visit beautiful Quebec City, or to stroll the Rue de Catherine in Montreal, or even to see the polar bears which no longer hibernate in our warmed winters and wander hungry into Hudson Bay towns. No, these are trips of necessity. They're heading north to buy prescription drugs at far more affordable prices.

Most democracies have price controls of some kind on prescription drug costs. In the United States, pharmaceutical manufacturers invested some $400 million over the last two election cycles to lobby and campaign against government efforts to reign in drug costs. In the past 10 months, a series of public and private studies have shown that Americans are being fleeced in two ways.

Americans pay far more than Canadians and Mexicans for prescription drugs in general. A typical prescription in Maine costs 72 percent more than in neighboring Canadian provinces. In Vermont, the cost is 81 percent higher. Even more disturbing, a coalition of respected, nonpartisan New York advocacy organizations has demonstrated that individual New York senior citizens are typically charged more than twice the prices prescription drug makers receive for their most favored customers. The most favored customers, include HMOs, the federal government and large insurance companies. Healthy pharmaceutical profits are being made on the backs of our seniors and others who are often uninsured for prescription drugs.

Fortunately, federal laws allow individuals to bring a three-months' supply of prescription drugs into the United States. Sympathetic Canadian doctors have been willing to write required prescriptions for Americans who've made the trip up in their own cars. In the past several months we've seen the new phenomenon of organized bus convoys heading north to help seniors and others get the medicines they need to stay healthy or to get well. Public Citizen, Citizen Action and other groups have had sold out bus trips leaving from Rochester, Albany, Binghamton and other upstate cities. I'm told that trips may be organized by some senior groups from Nassau and Suffolk later in the winter. The same phenomenon occurs in states bordering on Mexico where drug costs are even lower than in Canada.

There are several bills in Congress to address both the high drug prices and the price differential between large and small customers. Nothing seems to be going anywhere. This spring, Maine created a commission to negotiate prescription drug prices on behalf of its citizens. This puts more purchasing power behind individuals and it's the right idea, but on too small a scale.

We need a comprehensive Medicare drug benefit that uses its huge bargaining power to reduce drug prices for all seniors. Then we need to expand Medicare to all Americans, increasing the size of the risk pool to lower costs across-the-board. That would end our mad health care crapshoot and keep grandma off the bus.