My favourite band, Rush, released a song called “Freewill” 45 years ago. Geddy Lee probably wasn’t singing about health care, but still managed to nail our whole, if unwritten, national strategy: “If you choose not to decide, you still have made a choice.” Preferred pharmacy (or, provider) networks (PPNs) present this perpetual risk of inertia, despite important – and controversial – needs and concerns for everyone involved.