One of the most enduring things is Canadians’ pragmatism. People have strong values, and big aspirations, but they also like to anchor themselves and their governments in two truths. First, that often you can’t do everything you might want to do, so you need to set priorities. Second, that you should find the simplest, least costly way to accomplish a public policy goal.

For a few years, I’ve been doing polling on the idea of a national pharmacare program. The work I’ve been doing on this issue is for life and health insurance companies in Canada – the companies that offer workplace, group and private health benefits programs. Obviously, they have a strong interest in how this policy develops – it’s a big part of their business, and could have a major impact on their plan members, who are their customers.

These companies have been advocating for a pharmacare program that covers the cost of prescriptions for those who have no benefit plan.

This would be an expensive program for the government, but really helpful to those struggling with the cost of living and the cost of their uninsured medicines.

The surveys I’ve done on this policy topic have reminded me of Canadian values and Canadian pragmatism.

First, there is a lot of public support for making sure that those who have no drug coverage, have their medicines paid for by government.

Given a choice between a program that would cover everyone the same way, and one that targets those who have no coverage at all today, Canadians favour a targeted approach. For one thing, they would rather government spend only as much money as is needed.

The large majority of those with drug plans in their workplace or as part of another group, feel well served by the plans they have now. The average plan user reports that their household saves hundreds of dollars every year in prescription costs, as hundreds more on eyecare and dental care. Many also use their plans to access physiotherapy, massage, mental health, and other health services.

Most experts seem to agree that any government plan that was designed to cover everyone in Canada would inevitably include a lot fewer drugs than the typical workplace benefit plan covers now.

So, for the roughly 27 million people who use benefit plans today, the choice of federal policy comes down to: a bigger, more expensive government plan that would actually reduce drug coverage, or a smaller, considerably less costly plan to provide coverage for those who have no benefit plan today.

It’s shouldn’t be a surprise to anyone that Canadians prefer a tailored program that finds gaps and fills them – it reflects the value system and pragmatism of Canadians. Why spend more money to leave many Canadians with fewer benefits than they have now?

In the coming days, the federal government will bring forward it’s legislation in this area. The NDP have been pushing the Liberals hard for the bigger program that would displace workplace benefit plans and cost, according to some estimates, $40 billion dollars. It’s possible the Liberals will do as the NDP demands, or take a tailored approach and risk losing the support of the NDP, at a time when the Liberals can ill afford to face an election.

If a careful read of public opinion is taken into account, the government will know that the public will prefer an approach that spends only what is needed, to help those in need, and does nothing to reduce the coverage that millions of people have right now.