The Liberals' plan, meanwhile, remains a work in progress. Finance Minister Bill Morneau promised in his spring budget to create a national drug agency that would develop a list of medicines to be covered, and then work with the provinces to help drive down costs through bulk purchases.

But he was (as politicians like to say) 'perfectly clear' that the best approach to pharmacare might not be pharmacare as such, but rather some plan to fill in the gaps in existing coverage — for the self-employed, for example, who don't have insurance, or for small companies that can't afford to provide drug plans to their employees.

On Wednesday, the Liberals said they were committed to introducing a national pharmacare plan — although they didn't quite commit to the specifics in Hoskins' report. Prime Minister Justin Trudeau said he accepted the report, calling it a "foundation" for a national pharmacare program.

His health minister, Ginette Petitpas-Taylor, said she hadn't read the report when she tabled it in the Commons. She promised to carefully review the recommendations and work with the provinces and others in the health care field to consider next steps.

Realistically, those next steps can't happen until after the election. The current prime minister, or the next one, would have to meet with the premiers to work out a plan.

Could the premiers be convinced?

Liberals insist Trudeau is well-positioned to do that, despite his recent confrontations with Conservative and conservative-minded premiers over energy policy and the federal carbon price.

Still, health-care costs are the single largest budget item for every province. Hammering out a deal to reduce prescription costs might be enough of a priority for the premiers to convince them to cooperate with Trudeau — even the ones who see him as an opponent rather than a teammate.
Hoskins insisted that further delay is not an option. There's been plenty of that already; he pointed out that every report done on Canada's health care system in the last half-century recommended a national pharmacare plan.

The current arrangement, Hoskins said, is putting too many Canadians in a terrible bind. The cancer patients who need specialized drugs that are covered in every province but the one they live in. The families forced to move to a new province to ensure that a drug their child needs to stay alive is covered.

Drug costs are continuing to rise. An election is coming.

Eric Hoskins thinks the time is right. The timing of his report might even be better.

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