I think it's a great question.
I think there would have to be a lot of follow-up work about exactly how that body would be constituted, with representation from provincial decision-makers and other kinds of experts. We'd need to do a lot of thinking about how exactly that would look and how its independence would be protected from both outside and within government. I think a lot of careful work would be required.
The basic point to take away from my remarks is that there's a question of scale and capacity in Canada given the silos that exist. You see private insurance and some of the big ones in the United States—Kaiser Permanente comes to mind—that do have the capacity to critically evaluate evidence as it accumulates over time. I would venture to say that is not the case for private insurers and most provincial decision-making bodies in Canada.
We need to scale up for that reason and to improve our capacity both to negotiate better prices and to better appraise the information as it's coming, building on this approach I think CADTH has, but which is undergoing some rethink around these new kinds of rare disease therapies, as well.
We need to scale up and build capacity first, and a national body seems the right approach. Then we'd have to do a lot of careful work about how to constitute that with the appropriate representation. I should add that this feeds into the underlying legal issue around constitutional responsibility around health care, and that to some extent this would drive how this body would be created at the national level, as well.