The critical issue is not only equitable access to some program, but it's the drugs that are in that program and whether they are equitably meeting the health needs.
The issue is, would it be better or worse with a national program than the current patchwork—I use patchwork in the descriptive sense, not as a value judgment—of that territorial and provincial system that exists in Canada?
I would have thought that an argument could be sustained that people with, say, fairly rare and expensive-to-treat diseases might be better served under a national program, because of the large buying power that would have. The power of a program representing the interests of 35 million people has considerable influence. While you're right that the public health impact is really important, my experience of working in a national program is that a lot of the agonizing has been to make sure that people with rare diseases—there might be 100 or less in the country—were looked after.
I didn't mention it in my talk, and again just for the record, there is an act of grace arrangement that exists around the national pharmaceutical benefits scheme in Australia, whereby individuals who believe they're seriously disadvantaged by non-coverage of a particularly expensive drug can apply directly to the minister, who can perform an act of grace payment to cover it. Therefore, I think there are other mechanisms that can sit under the umbrella of a national program.