You're asking a very bold question. I will try to put my brain to work answering this.
I will say that there is some specific need for some specific segments of the population. Whatever model you have—and I think our colleagues from Veterans Affairs mentioned this—there will have to be a place for adjusting the formulary and the approach to some segments of the population.
I think the ambition of having first nations and Inuit take more control over their own programs would have to be thought about and accommodated. For example, right now with the Assembly of First Nations we are doing a joint review of the NIHB program to get their perspective not only on the pharmacy benefits but on all benefit areas to try to adjust and deal with a systemic issue they may be facing in one region, or involving one benefit.
I think we should not lose the ability to engage the nations in the program. This is as far as I can go.
I will say that one systemic issue we are facing is that this is a national program. We operate in 13 jurisdictions. Often we will have clients complaining about having difficulty accessing some products or services in one province, because suddenly the provincial plan will have made a decision to start to cover them and the other clients will want to get them changed from non-insured.
We are not there yet. The non-alignment of the formulary between provinces and territories has caused some difficulty for clients trying to access our program. For us to always have to monitor that is a challenge, because in the end we want to facilitate access to the drugs that the clients may need.
I don't know whether I answered your question—