The use of the words "drug" and "policy" together highlights some of the inconsistencies and ironies in healthcare delivery in Canada. Not that the legislators and the government mandarins don't try to create and implement policy, but events (and the pharmaceutical industry) are always one step ahead so the policy-makers find themselves in the role of "follower" rather than "leader." It is time to re-examine the current approach to decision-making about pharmaceuticals and to identify a process that allows all Canadians to receive the care that was promised with the passage of the Canada Health Act.