It's one of the main reasons we talk about it being a comprehensive drug coverage plan. Bulk buying is one piece of it, but the other piece is the evidence and forum decision-making, which is to say, putting together the national formulary or the national list of selected medications that would be part of the national pharmacare. There are various models that have been put together to do something like that.
For example, in B.C. there is the therapeutics initiative where they use evidence to decide which medications are the ones that make the most sense to be included in some kind of program, or for physicians to be prescribing. You need that aspect to decide which medications should be a part of the plan. It's not the insurance companies that should be making that decision. One option could be to have a body that would both administer pharmacare and make those types of decisions, taking into account the evidence that does exist.
There are various models out there. There was a recent proposal called Pharmacare 2020 and there's something in there that talks about the type of body that would make that type of decision. I agree, it shouldn't be the insurance companies making those decisions. It should be an evidence-informed body that would make those decisions and also take things like cost into account.