About a quarter of Americans say they've had trouble paying for their prescription drugs; a survey released by the nonpartisan Kaiser Family Foundation finds that many Americans have skipped or rationed their prescription medications, and that 79 percent of adults say prescription costs are "unreasonable."

In America, medicine prices are not regulated by the federal government, favoring a laissez-faire capitalist approach that lets companies set whatever price the market can stand, but high prescription drug costs have caught politicians eyes.

Bernie Sanders recently led a caravan into Canada to purchase cheaper insulin, and a new proposal from the Trump administration would authorize pilot projects to import versions of FDA-approved medicines from Canada, a move that is testing our neighbor to the north's stereotypical kindness.

Importing drugs from Canda might strain their much-smaller population and supply, medical ethicist Art Caplan told Boston Public Radio on Wednesday.

"I think what they're worried [about] is that the drug suppliers are going to say, 'Are these for Canada or are they going into the US, if they're going into the US, we're not going to sell them to you, we've got a contract to supply for Canada, but we're getting bigger bucks supplying the US so forget it,'" he said.

Caplan said Trump's new policy doesn't get to the heart of what caused American drug costs to skyrocket: We don't negotiate drug costs on a unified front. Currently, Medicare is banned from direct negotiations.

"It's kind of sad we'd hire Canada to do our drug negotiations, can't we do them ourselves? Canada gets better prices because province by province they negotiate the rates with drug companies," he said. "We should do that too, we do it a little bit with the VA, we do it a little bit with military medical system ... But we ought to merge Medicare, Medicaid, [Indian Affairs] health service, and any other federal programs, and they ought to be the drivers for the federal drug rate, and sit down and bargain just like Canada does and get the best drug rate."

The Kaiser Foundation survey also found that there is bipartisan public support for allowing the federal government to negotiate directly with drug companies to get a lower price for people with Medicare, a move that drug companies oppose.

Caplan is the Drs. William F and Virginia Connolly Mitty Chair, and director of the Division of Medical Ethics at NYU Langone Medical Center. He’s also the co-host of the everyday ethics podcast.