第四段主题与第三段主题做减法得出的差额决定供选择的42题目主题为：

　　recommended the creation of national institution. 在备选答案中找到以该词为主题的段落，即C

　　第五段：What does “national” mean? Roy Romanow and Senator Michael Kirby recommended a federal-provincial body much like the recently created National Health Council.

　　主题词：Roy Romanow and Senator Michael Kirby

　　主体动作：recommended a federal-provincial body much like the recently created National Health Council.

　　第六段：But “national” doesn’t have to mean that. “National” could mean interprovincial----provinces 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 province-or a series of hospitals within a province----negotiate 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.

　　主题词：national agency, interprovincial—provinces

　　主体动作：combining efforts to create one body.联手建立一个组织

　　would be to negotiate better prices, if possible, with drug manufacturers. 如果可能与药品公司协商价格。

　　the national agency would negotiate on behalf of all provinces.国家型组织代表所有省份协商价格。

　　the national agency would negotiate on behalf of 31 million people. 国家型组织代表三千一百万人协商价格。

　　the greater the potential consumers, the higher the likelihood of a better price.潜在消费者越多，价格会更加合理。

　　第六段主题与第五段主题做减法得出的差额决定供选择的43题目主题为：would be to negotiate better prices, if possible, with drug manufacturers. 如果可能与药品公司协商价格。

　　the national agency would negotiate on behalf of all provinces.国家型组织代表所有省份协商价格。

　　the national agency would negotiate on behalf of 31 million people. 国家型组织代表三千一百万人协商价格。

　　the greater the potential consumers, the higher the likelihood of a better price.潜在消费者越多，价格会更加合理。在备选答案中找到以该词为主题的段落，即G

　　第八段：A small step has been taken in the direction of a national agency with the creation of the Canadian Co-coordinating Office for Health Technology Assessment, funded by Ottawa and the provinces. Under it, a Common Drug Review recommends to provincial lists which new drugs should be included. Predictably and regrettably Quebec refused to join.

　　主题词：national agency, the Canadian Co-coordinating Office for Health Technology Assessment, Common Drug Review

　　主体动作：A small step has been taken in the direction of a national agency with the creation of the Canadian Co-coordinating Office for Health Technology Assessment, funded by Ottawa and the provinces. 已经采取了一定的措施目的是建立一个加拿大医疗技术评估协同办公室，由渥太华和其他省份资助。

　　drugs should be included.要包含药品。

　　Quebec refused to join.魁北克拒绝加入。