_______________[A] Quebec’s resistance to a national agency is provincialist ideology.

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[A]Quebec’sresistancetoanationalagencyisprovincialistideology.OneofthefirstadvocatesforanationallistwasaresearcheratLavalUniversity.Quebec’sDrugInsuranceFundhasseenitscostsskyrocketwithannualincreasesfrom14.3percentto26.8percent!

[B]OrtheycouldreadMr.Kirby’sreport:“thesubstantialbuyingpowerofsuchanagencywouldstr engthenthepublicprescription-druginsuranceplanstonegotiatethelowestpossiblepurchasepricesfromdrugcompanies.”

[C]Whatd oes“national”mean?RoyRomanowandSenatorMichaelKirbyrecommendedafederal-provincialbodymuchliketherecentlycreatedNationalHealthCouncil.

[D]Theproblemissimpleandstark:health-carecostshavebeen,are,andwillcontinuetoincreasefasterthangovernmentr evenues.

[E]AccordingtotheCanadianInstituteforHealthInformation,prescriptiondrugcostshaverisensince1997attwicetherateofoverallhealth-carespending.Partoftheincreasecomesfromdrugsbeingusedtoreplaceotherkindsoftr eatments.Partofitarisesfromnewdrugscostingmorethanolderkinds.Partofitishigherprices.

[F]So,iftheprovinceswanttorunthehealth-careshow,theyshouldprovetheycanrunit,startingwithaninterprovincialhealthlistthatwouldendduplication,saveadministr ativecosts,preventoneprovincefrombeingplayedoffagainstanother,andbargainforbetterdrugprices.

[G]Ofcoursethepharmaceuticalcompanieswillscream.Theylikedividedbuyers;theycanlobbybetterthatway.Theycanusethethreatofremovingjobsfromoneprovincetoanother.Theycanhopethat,ifoneprovinceincludesadrugonitslist,thepressurewillcauseotherstoincludeitontheirs.Theywouldn’tlikeanationalagency,butself-interestwouldleadthemtodealwithit.