I think the Supreme Court has ruled on several occasions and in recent times that conditionality in transfers between the federal and provincial governments is acceptable. It is, as I said, quite feasible to include community-based pharmaceuticals inside the Canada Health Act and ask the provinces to determine a list of essential medicines. That's not one big national formulary.
If the federal government wished to create one national formulary and one national purchaser, that would require the consent of the provinces, so that's a different ball game. However, the way we've usually done business is through the Canada Health Act or a conditional kind of transfer, and that approach allows the provinces to have flexibility in how they design their health care systems, which could permit, for example, the funnelling of private health insurance premiums or some sort of premium payment through CPP. A model such as you have in Quebec could be okay with this, provided it meets certain conditions, which I would say would be no payment at point of service and no user charges for essential medicines, just as for hospital and physician services. That would be in the spirit of the Canada Health Act. I think it's completely constitutionally permissible.
If the federal government wished to run a big bang federal program, I think that is feasible, but it would have to be voluntary. The provinces would have to agree to participate in it. I would imagine that given their current fiscal situations, most of them would. Quebec may choose not to, but most of them would. I think that would be permissible.