Yes, I'm a policy pragmatist. I realize that in the Canadian context a national pharmacare program is still a way off—or yes, pragmatist, or pessimist, I suppose.
I think the national formulary is a way forward. Dr. Menon just alluded to a recommendation that Bob Evans and I have recently written about in a book forthcoming from the IRPP on policy challenges in Canada. We wrote the chapter on drugs and health care more generally. Our recommendation for Canada is to start with a national drug plan based on the five leading chronic diseases in Canada: diabetes, hypertension, high cholesterol—you can pick your favourites.
If you started with the big classes and had a national formulary around those essential medicines, within those classes exactly as Dr. Menon is referring to, I think you'd build toward a national pharmacare program, and I don't think the issues around what would go into the basket of drugs to treat hypertension, cholesterol, diabetes, etc., would be as hotly contested.