I'd like to address that first. The Quebec model is very similar in many ways to the Swiss health insurance model, as it achieves universal coverage through a mandatory purchase requirement similar to, let's say, Ontario auto insurance. If you want to drive a car, you have to buy auto insurance. If you want to live in Switzerland, you have to buy health insurance. And in Quebec, you have to buy drug insurance.
For those people who lack the income to participate in a private market there is either a subsidy or a public insurer in which they are enrolled.
That's a way of achieving universal health insurance or drug insurance coverage that preserves all of the benefits of competition and private delivery of insurance products, and I think it's a much better model than what the other provinces are following.
In fact, it's very interesting to note that Quebec, among all the provinces, has approved far more drugs than have been submitted for review to the CDR than even the CDR itself, and than all other provinces as well. In fact, Quebec spends more on drugs as a percentage of its total public health expenditures than any other province, and yet health expenditures as a total are growing slower in Quebec than in all the other provinces.
That is consistent with research from Frank Lichtenberg, out of Columbia University, who has done significant work showing that medicines have a positive technological substitution value, so that more spent on medicines can lead to net cost savings on other health spending elsewhere. His figures show a dollar spent on new drugs, for instance, can save up to seven dollars on non-pharmaceutical health care spending.