44th Parl. 1st Sess.
April 16, 2024 10:00AM
- Apr/16/24 11:13:04 a.m.
- Watch
Madam Speaker, there is no denying that Quebeckers’ interests are absolutely the same as those of everyone else in the country. Everyone wants access to a health care system that works properly for all.
As for the questions surrounding drug insurance, I have had some really good conversations with Minister Dubé in Quebec. There is a clear spirit of co-operation.
If one goes looking for a fight or problems, they are easy to find, but the idea is to find solutions and a way to work together to resolve the situation, to improve people’s health across the country. For example, it is absolutely essential that we take into account the indicators for Quebeckers, so that we can compare and contrast how things evolve in their system and how they evolve in the other provinces and territories. This is a very good thing to do, and it is also good to see where the federal money is in the plan. That is why it is more important to co-operate than to pick a fight.
179 words
- Hear!
- Rabble!
- add
- star_border
- share
Madam Speaker, after what I have heard, I would like to begin my speech by commenting briefly on the answer given by the Conservative health critic, with whom I serve on the Standing Committee on Health. In his answer, he spoke strictly about the jurisdictions of Quebec and the provinces and made no mention of what kind of additional funding the Conservatives would provide for health transfers. If I understood him correctly, basically, the only real option Quebeckers have is the Bloc Québécois.
On one hand, we have the Liberal Party, which says that it will give the provinces money but only on its own terms and while infringing on their jurisdictions. The Liberals are duplicating programs and efforts. On the other hand, we have the Conservative Party, which says that it will not bother the provinces and will respect their jurisdictions but it will not give them a single cent more. That is the choice facing Canadian voters, except in Quebec, where they can vote for the Bloc Québécois.
I will begin my speech with a brief comment, and I hope that the Minister of Health will listen carefully to what I am saying. He always talks about the great discussions that he has with the Quebec health minister. I will come back to that a little later.
I want to begin by saying that in June 2019, the Quebec national state, through its National Assembly, with a single voice and across party lines, responded to this desire to implement coast-to-coast pharmacare. The National Assembly and the national state of the people of Quebec have not changed their position on this issue. The motion that was adopted the day after the Hoskins report reads as follows:
THAT it reaffirm the Government of Québec's exclusive jurisdiction over health;
THAT it also reaffirm that Québec has had its own general prescription insurance plan for 20 years;
I should point out that it has now been nearly 28 years.
THAT it indicate to the federal government that Québec refuses to adhere to a pan-Canadian pharmacare plan;
THAT it ask the Government of Québec to maintain its prescription drug insurance plan and that it demand full financial compensation from the federal government if a project for a pan-Canadian pharmacare plan is officially tabled.
That is what is going on right now. This motion was moved in June 2019. The House passed a motion twice on recognizing Quebec as a nation. When we respect a nation as a national state, by allegedly giving it more than mere token recognition, then the least we can do is avoid the kind of heavy-handed approach taken by the current federal Liberal minister of health. We have to sit down respectfully with the people who administer a plan, which is not perfect.
In fact, I imagine that if the federal government was being stingy with the health transfers, it was because it wanted to funnel some of the money into pharmacare and dental insurance. We will talk about that later. In this case, the government should have come and sat down to see who has the expertise, learn how the Quebec system operates and arrange to provide the full compensation that Quebec is calling for, with no strings attached. In that regard, we need to stop all the speculation around what Quebec wants to do with the money.
Quebec’s health minister was very clear when he said, “we have no problem adding this money to the drug insurance program. But it has to be without conditions. It is not up to them to decide what the best drug coverage is for Quebeckers”.
His intention seems pretty clear. There is respect for Quebec symbolically. They call Quebec a nation to avoid looking foolish. When it comes down to it, though, this must not have any legislative consequences, period. The debate could end here if full compensation were offered. The bill provides for a list to be prepared. Earlier I asked the minister if he knew the list of drugs covered in Quebec, but he did not wish to answer my question. Do members know how many drugs are covered by Quebec’s drug insurance plan? The answer is 8,000. I wanted to bring this 792-page list, but I found it a bit heavy.
These sorcerers' apprentices would have us believe they will arrange all this in no time at all. They will create the Canadian drug agency while in Quebec, there is already infrastructure. Ottawa has so much money that they are going to create another structure. There will be a duplication of structures. Is the Institut national d'excellence en santé et en services sociaux, or INESSS, not doing its job properly? It has been 28 years since Quebec has been making decisions, analyzing all the elements at a molecular level and determining whether these elements, many of which are innovative, are to be reimbursed. They are included in the list. Whether we are talking about the public part or the private part of this mixed plan, everyone has access to the same drugs.
This would have been a great opportunity to respect the Quebec nation. The Quebec national state and all its parties are asking for the same thing. The leader of the NDP, that progressive party, is lecturing us. He is completely out to lunch, though, when he says that the health problem in Quebec has to do with the fact that the government has not invested enough in health care. The Government of Quebec increased its budget by 50%. It has enacted reforms to try to do more with less. It implemented a number of reforms and a lot of structural modifications in an effort to achieve greater health efficiencies.
We have a partner that has not been putting enough money on the table. Then, a few years later, this same partner has the nerve to say that Quebec does not know how to manage its own health care system and tries to explain how it should be done. The first thing that partner should do is hand over the money. That would be a good starting point. Quebec's current resistance to all this federal interference should not be that hard to grasp. It is easy for the Prime Minister to say that he does not care about jurisdictions. The Prime Minister does not care about the Constitution. Well, let him reopen the Constitution, then. We will see if he really does not care. The government likes to lecture everyone else, but cannot even take care of its own people. That is the federal government. I will come back to that.
One might think this bill was well-intentioned, but the road to hell is paved with good intentions and the devil is in the details. I asked only one question: How many prescription drugs will be covered by the national public pharmacare program with a single universal payer? Will Quebec's list be used? Will Quebec have to take any prescription drugs off its list? Will INESSS be made redundant, or will it be able to continue doing its good work? Why is a Canadian agency being created to supersede the process we have in Quebec? We are not getting any answers to these questions. However, the minister claims he has maintained a very good dialogue with Quebec. I gave an example. I think the minister is having a dialogue of the deaf, where he listens only to himself and not the other party.
It seems to me that it was quite clear when Quebec's health minister, Christian Dubé, said, “we have no problem adding this money to the drug insurance program. But it has to be without conditions”. He then added the following:
The government is not only refusing to give us the money we asked for in health transfers, but it also wants to interfere in an area under Quebec's jurisdiction. The federal government knows full well that this is a provincial jurisdiction. We have had our own pharmacare program since 1997. That is almost 30 years. We also cover the widest range of prescription drugs of all the Canadian provinces.
The federal health minister just told us that he has very good conversations with him, even though the Premier of Quebec felt it necessary to hold a press conference to tell the federal Liberal government—which is in a coalition with the NDP and was not so centralist before the NDP got involved—to mind its own business. The minister just told us this morning that they have very good conversations, but when we stand up in question period, we are told that we are trying to pick a fight. All we are saying is that the federal government should mind its own business. We are only relaying the message from the National Assembly of Quebec, not from a single party but from all parties, on pharmacare.
The reason Ottawa has money in the first place is because of the fiscal imbalance. Well, we are going to enhance our own program. I challenge anyone here this morning to prove they could do a more competent job managing our program than those who are doing it right now in Quebec City. I challenge anyone willing to make that claim to go make their case to those managing the program and prove that they have the competence. I am talking not only about provincial competence in the jurisdictional sense, but also about incompetence. In that respect, I have a short list I will return to later.
Bill C-64 has put the cart before the horse, as the saying goes. Today, rather than sitting down, holding a summit, talking to people, looking at what was being done and coming up with something of substance, the government announced an intention of putting something in place. However, it did not talk to anyone, it is not open to anything without conditions, and it is saying that Quebec must march to the beat of Ottawa's drum.
This is not well intentioned; this is a political deal to stay in power until October 2025. That is what this bill is really about. That is what is behind it, because no one could be this keen to jump into as sensitive and critical a field as pharmacare.
Drugs in 2024 are not like they used to be in 1996 or 1997. We are not talking about codeine or Tylenol. We are talking about innovative molecules that often give rise to treatments that could potentially allow patients to avoid surgeries and transplants. A case in point is Trikafta for cystic fibrosis. Patients can take two pills and a glass of water a day, instead of being hospitalized for 280 or 320 days a year, instead of having to get a lung transplant. This drug needs to be covered. How will the list be compiled, and how can we trust the federal government, which starts things but then walks away?
After all, this is the government that pilfered from the EI fund and from workers and that never did the right thing by returning the money. This is the government that dumped the federal deficit on the provinces and cut health transfers in the mid-1990s. Jean Chrétien travelled the world, boasting to the G7 countries that all he had to do to balance his budget was cut health transfers and that the best part was that people were protesting in front of the Quebec National Assembly, not in front of the Parliament of Canada. That is what the federal government is like.
It is creating a program now, but how many years will it be before the government disengages because it got the math wrong, it is unable to manage the program properly, and the infrastructure is cumbersome and redundant, when the money should be on the ground, going directly to patients as quickly as possible?
The minister delivered a very nice speech, saying the governments get along really well, the principles are sound, the Quebec government wants to co-operate. In reality, the Quebec government's response was to ask Ottawa to mind its own business.
The federal government is not even capable of handling its own affairs properly. Think about the whole F-35 saga or the lack of investment in defence. Think about Phoenix, the borders, passports, asylum seekers. The national emergency stockpile was empty when the pandemic hit. The Global Public Health Intelligence Network had been dismantled and was ineffective at the start of the pandemic. The federal government should mind its own business and clean up its own house before lecturing us.
It lectures the provinces about health care management, but it is the worst employer for federal health employees. Communities under the federal government's jurisdiction are neglected. The funding Ottawa provides for public health care is insufficient, to be sure, but the federal government treats its employees worse than the provinces do. How it can then lecture anyone, I just do not know.
The bill seeks to put in place principles, and then, based on these principles, a list will be compiled. After this list is compiled, an agency and then a committee will be established. The government is so clueless about where it wants to go with this that it is tabling a bill to create a committee that will make recommendations for rolling out pharmacare. Bravo.
The Bloc Québécois is not opposed to state pharmacare. It already exists in Quebec. It is far from perfect, there are positives and negatives, but it does guarantee minimum coverage. What we are calling for is what the National Assembly has always demanded: the right to opt out with full compensation. Given how long Quebec has been administering pharmacare, if there was a real need elsewhere, I imagine others would have followed suit. However, that was not the case. We are going to ensure that no one is ever allowed to dismantle our system or reduce our coverage.
Medication is currently free for people aged 18 and under. The system is not perfect, of course, and there are certain fees involved. However, if we had the money, we could increase free coverage without compromising on the list of drugs we cover.
Does the federal government really know how much it is going to cost to make everything free from the first dollar invested? I am not sure these sorcerers' apprentices really know what they are doing. Based on the reaction of the National Assembly and the Quebec government, I am certain the federal government has never sat down with them to have a serious conversation about it. Quebec's example and expertise are not going to be on the agenda as the government implements its system.
2507 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/16/24 12:15:14 p.m.
- Watch
Madam Speaker, I would like to thank my colleague for the points he raised in his speech.
As a progressive jurisdiction, Quebec is recognized as having a stronger social safety net than what exists in most of Canada, including its drug insurance plan, child care program, housing and so forth. This is not by chance; it is clearly the result of the battles waged by Quebeckers over decades.
That being said, there are many Canadians who have fought to expand and strengthen the health system in the rest of Canada. I am proud of the work done by the NDP on pharmacare. We have major concerns when it comes to the promises made by the Liberals. We feel we have to make sure to expand the pharmaceutical services that Canadians are entitled to.
Does my colleague agree that Canadians should have these services? As the NDP said, should there be negotiations with the Government of Quebec?
156 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/16/24 12:17:33 p.m.
- Watch
Madam Speaker, my colleague from Montcalm's speech was extremely interesting.
I have been listening to all this and observing the federal government's spending spree in provincial areas of jurisdiction over the past few weeks, which is obviously terrible. I wonder if the real problem we are having with this bill and with the way the NDP-Liberal government is behaving by investing in provincial areas of jurisdiction is not a tax collection problem. Quebec collects taxes from us taxpayers so it can provide services within its jurisdiction; the federal government also collects taxes for services within its jurisdiction, and it always says it has too much and will give some back, but with conditions.
Is the problem we have with the bill not the same problem we have with every bill that encroaches on the provinces' jurisdictions? In the end, is the solution not simply for the federal government to stop taking more money out of Quebeckers' pockets than necessary?
Perhaps Quebeckers should finally make the decision to leave Confederation.
172 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/16/24 12:18:48 p.m.
- Watch
Madam Speaker, no one will be surprised to hear me say that, by continually oppressing us, by not recognizing that we are a national government, by making sure that any recognition is merely symbolic and has no legislative impact at all, the federal government is making sure that, one day, Quebeckers will decide to take control of their own affairs and make Quebec its own country.
66 words
- Hear!
- Rabble!
- add
- star_border
- share
Madam Speaker, to begin, I will respond to my colleagues from the Bloc Québécois, because they do not seem to have read or listened to the Quebeckers who support this bill.
I will start by reading the statements issued by the Centrale des syndicats démocratiques, or CSD, the Confédération des syndicats nationaux, or CSN, the Centrale des syndicats du Québec, or CSQ, and the Fédération des travailleurs et travailleuses du Québec, or FTQ. These labour federations represent one million Quebeckers. When we factor in the families of these workers, these federations represent more than one-third of Quebec's population.
The labour federations said that they:
...welcome the introduction of a pharmacare bill by the federal government to lay the foundation for a future universal public pharmacare program. Several aspects of this bill are encouraging, including the fact that it takes into account the principles of the Canada Health Act (public administration, comprehensiveness, universality, portability and accessibility), maintains long-term federal funding, covers birth control and diabetes medication, and includes first dollar coverage.
I also want to quote the leaders of the labour federations. First, Luc Beauregard, secretary-treasurer of the CSQ, had this to say:
Quebeckers deserve better. They need a universal public pharmacare plan as soon as possible.
Next, Magali Picard, president of the FTQ, said this:
With the rising cost of living, many Quebeckers are struggling to make ends meet. Every year, more than one person in 10 goes without prescription drugs because they cannot afford them. That sort of situation should not be tolerated. Medication should be free, because no one chooses to be sick and to need medication.
I would like to mention that “[t]he labour federations believe that Quebec is misguided in calling for an unconditional right to opt out.”
Caroline Senneville, president of the CSN, had this to say:
We feel it would be unacceptable for Quebec to receive federal funds unconditionally in order to maintain a dysfunctional and unfair system...
Finally, Luc Vachon, president of the CSD, had this to say:
It is unacceptable for a person's health to depend on their income or to be up for negotiation. Quebec has its own system, but it discriminates against those with lower incomes. A real universal public system must guarantee everyone the right to easily access medication. There is a strong consensus in both Quebec and Canada on the implementation of a universal public pharmacare program, and the time has come to move beyond constitutional squabbling so that everyone has real access to affordable medication.
Again, the leaders of Quebec's largest labour federations have been clear. They represent more than one-third of Quebec's population.
We just heard the Bloc Québécois's arguments against this bill. I am asking them very nicely to listen to Quebeckers rather than assuming that they know what Quebeckers think. The Bloc Québécois does not like to hear that this bill represents what Quebeckers really want. The reality is that these are the voices in Quebec that the Bloc Québécois should be listening to.
It is no secret that Quebec's current system is not working. People are falling through the cracks. This bill, which the NDP pushed for and which is before the House because of the NDP, will make a difference in the lives of Quebeckers and Canadians across the country.
That is my message to my Bloc Québécois colleagues. It is difficult to be against Bill C-64 after hearing all those people who have looked at it and want us to move forward with it. They want us to help those who have trouble paying for their diabetes medication, as well as the low-income people who are falling through the cracks. It is something worth thinking about. I hope that my Bloc Québécois colleagues will hear these voices and act accordingly by voting in favour of the bill. They cannot just be reactionary like the Conservatives.
First, I want to about the impact of pharmacare. A little over three years ago, I brought forward, on behalf of the NDP caucus, the Canada pharmacare act. This would have made a difference in the lives of Canadians from coast to coast to coast. There were 120,000 Canadians who wrote to their members of Parliament, hundreds of them wrote to each Conservative MP and systematically the Conservatives and Liberals voted against that bill, which would have established, on the basis of the Canada Health Act and its five principles of universal health care, pharmacare in Canada.
For me, this is poetic justice. Three years later now, because of the NPD's pressure, the work of the leader of the NDP, my colleague from Burnaby South, our health critic at the time, the member of Parliament for Vancouver Kingsway, and the entire NDP caucus, using our weight and our pressure in a minority Parliament, we have actually achieved something that will make a significant difference in the lives of people.
The Conservatives have said that diabetes and contraception is only a start, which is very true, but the reality is that when we talk about diabetes medication, the cost of having diabetes, which is a profound health challenge, can be up to $900 a month. I cited a little earlier that a resident of Burnaby, B.C., Amber Malott, pays $900 a month.
Each and every Conservative MP has in their riding 17,000 people to 18,000 people who would be impacted by this significant move forward in Canadian health care. They would benefit from that. The ones who are paying anywhere from $100 a month to even $900 a month finally have that burden taken off them.
The Conservatives have signalled they want to gut it. They blocked the bill last week and refused to even have it brought to the floor of the House of Commons. They have indicated that they will try to block and destroy this legislation at every step. We have to ask the question, why? Is it just weird ideology, is it just their extremist leader or is it the fact that they have not even read the legislation and have not consulted their constituents? If they talked to 17,000 people or 18,000 people in each of their ridings, they would find those constituents saying that we need to adopt legislation, that they cannot continue to pay $200 a month, or $500 a month or $900 a month for medication, that they simply cannot afford to put food on the table or keep a roof over their heads and pay for this medication at the same time.
If the Conservatives consulted their constituents, they would hear overwhelmingly from those 17,000 people or 18,000 people that this would make a difference in their lives. I certainly will be going out to Conservative ridings and consulting their constituents, because they seem unwilling to do so. For them to block the bill and to say that they do not even want it discussed on the floor of the House of Commons indicates their extremism within—
Some hon. members: Oh, oh!
1227 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/16/24 2:26:17 p.m.
- Watch
Mr. Speaker, when it comes to housing, Quebeckers have been cheated by this government since 2019. We represent 22% of the population, yet have received only 14% of the funding and 6% of the affordable housing. Despite all this, the housing minister is giving lessons today. He told the press that, in his opinion, the government is acting in good faith and it is the provinces that should agree to do things differently. It is the federal government that needs to do things differently. It needs to stop shortchanging Quebeckers.
Is the government going to give us our fair share in housing immediately instead of lecturing everyone and playing sorcerer's apprentice with our—
115 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/16/24 2:28:13 p.m.
- Watch
Mr. Speaker, we are Quebeckers and we are minding our own business. When we talk about housing we are told that the little Quebec Liberals need to mind their own business. When we stand up in the House and talk about ensuring that no child goes to school on an empty stomach, we Liberals from Quebec are told to sit down and mind our own business. However, when a prime minister from a foreign country comes here from another continent, we are told we need to listen to him. People would do well to listen to us because the 35 members from Quebec stand up for Quebec and for Canada and we will continue to do so.
117 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/16/24 2:39:45 p.m.
- Watch
Mr. Speaker, I will reiterate something my colleague knows full well: Quebec is secular and Canada is secular. That is a fact. We are working with that.
What I do no understand is that when we, as Quebeckers, want to speak to Quebec's issues, the Bloc Québécois tell us to mind our own business. The Bloc members tell us that every time. Now they are jumping for joy because a foreign leader came here to Canada and told them what to do. Someone comes from another continent and we have to listen to him.
I will repeat this to my colleague with all due respect: We are 35 members from Quebec elected by Quebeckers; we are proud Quebeckers, and we will always stand up for Quebec.
131 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/16/24 2:40:25 p.m.
- Watch
Mr. Speaker, there are 32 members from Quebec who support the will of Quebec's National Assembly. By supporting the challenge to Quebec’s Act respecting the laicity of the State, Ottawa is really challenging our model for living in harmony.
Quebeckers want the separation of church and state. We have moved on. I am sure this is not easy to understand for members who fight to ensure that the House begins with a prayer every day. However, Quebeckers have chosen secularism. Religion is private and the state is public.
I would like a straight answer from the minister. Why is his government opposed to secularism?
107 words
- Hear!
- Rabble!
- add
- star_border
- share
- Apr/16/24 2:41:03 p.m.
- Watch
Mr. Speaker, let us be clear. This is about a group of Quebeckers who went to court to defend their rights under the Quebec Charter of Human Rights and Freedoms and the Canadian Charter of Rights and Freedoms.
If Quebec appeals before the Supreme Court of Canada, we will be there, as we have mentioned several times over the past year, to intervene and participate in these important discussions pertaining to the Canadian charter and the Quebec charter.
78 words
- Hear!
- Rabble!
- add
- star_border
- share
- menumenu
- notificationsnotifications
- home
- mailmail
- searchsearch
