Canada?s premiers , if they have any breath left after complaining about Ottawa at their late July annual meeting, might spare a moment to do something, together, to reduce health?care costs.

　　They?re all groaning about soaring health budgets, the fastest?growing component of which are pharmaceutical costs.

　　41.

　　What to do? Both the Romanow commission and the Kirby committee on health careto say nothing of reports from other expertsrecommended the creation of a national drug agency. Instead of each province having its own list of approved drugs, bureaucracy, procedures and limited bargaining power, all would pool resources, work with Ottawa, and create a national institution.

　　42.

　　But nationaldoesn?t have to mean that. National could mean interprovincialprovinces combining efforts to create one body. Either way, one benefit of a national organization would be to negotiate better prices, if possible, with drug manufacturers. Instead of having one provinceor a series of hospitals within a provincenegotiate a price for a given drug on the provincial list, the national agency would negotiate on behalf of all provinces. Rather than, say, Quebec, negotiating on behalf of seven million people, the national agency would negotiate on behalf of 31 million people. Basic economics suggests the greater the potential consumers, the higher the likelihood of a better price.

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