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House Bill

Bill C-64

44th Parl. 1st Sess.
June 03, 2024
Pharmacare Act

  • Her Excellency the Governor General recommends to the House of Commons the appropriation of public revenue under the circumstances, in the manner and for the purposes set out in a measure entitled “An Act respecting pharmacare”.

    This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and provides the Minister with the power to make payments, in certain circumstances, in relation to the coverage of certain prescription drugs and related products. It also sets out certain powers and obligations of the Minister — including in relation to the preparation of a list to inform the development of a national formulary and in relation to the development of a national bulk purchasing strategy — and requires the Minister to publish a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products. Finally, it provides for the establishment of a committee of experts to make certain recommendations.

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  • Yea (180)
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Context: House Hansard - 323 - Jun/3/24
Mr. Adam van Koeverden
  • Jun/3/24 6:11:24 p.m.
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  • Re: Bill C-64 
Thank you, Madam Speaker. There is not only heckling but also unnecessary interruption. I will use my remaining time to talk about diabetes and those living with diabetes. Diabetes is a disease with no cure. There is a treatment, and it is thanks to Canadian science, which is something that our government supports. Canadian scientist Frederick Banting and his team came up with an interim solution, I suppose we could call it; it is a treatment for diabetes that allows diabetics to live. Without it, diabetics would not have the opportunity to live fulfilling lives, but we still need to fight for a cure. Before we get there, we should also ensure that we reduce inequality and inequities in the populations impacted by diabetes. There is a really interesting infographic from the Public Health Agency of Canada. Anybody who is watching this debate might be interested in how diabetes and inequality intersect in Canada. I was actually very surprised to learn that diabetes and employment status are related; there is a positive correlation between them. When people are employed, they are less likely to suffer from diabetes and live with diabetes. When people are permanently unable to work, they are more likely to have diabetes, which means that they naturally have a lower income. It is the same for education level, surprisingly. Almost 10% of those individuals with less than a high school education will have diabetes or prediabetes throughout their life; for university graduates, that goes down to between 3.5% and 6.1%. There is also a positive relationship within income quintiles. All five income quintiles are associated with a positive relationship. As income goes up, people are less likely to have diabetes. Therefore, providing folks living with diabetes with free access to medication, to insulin and to supports for managing their illness is also an affordability measure that would make a difference for a lot of Canadians. Diabetes also affects people disproportionately in different categories. There are complex social and environmental behavioural factors that result in inequalities in the burden of diabetes between certain populations in Canada. The prevalence of diabetes is 2.3% higher among South Asian Canadians, and it is 2.1% higher among Black adults. For indigenous adults, the prevalence of diabetes is similarly staggering, at 1.9% higher for first nations Canadians living off reserve. Inequities experienced by first nations, Inuit and Métis populations are a direct result of colonial policies and practices that included massive forced relocation, loss of lands, creation of the reserve system, banning of indigenous languages and cultural practices, and the creation of the harmful residential school system. Unaddressed intergenerational trauma adds to the ongoing challenges faced by indigenous peoples, and providing them with a reliable and affordable treatment for diabetes would support affordability. This would also reduce the number of times people with diabetes have to access health care as a result of their illness. People with diabetes are more at risk of all sorts of life-changing health crises, such as a heart attack or stroke, kidney failure, blindness and amputation. At this very moment, there are about 3.7 million Canadians, or 9.4% of our population, who have been diagnosed and have to manage their condition for their entire life. If members can believe it, in 2015, 25% of Canadians with diabetes indicated that they followed their treatments to a T, but they were affected by cost; in some cases, those Canadians were rationing medications to save money. Therefore, a quarter of the people who are following their treatments are affected by cost. There are other Canadians who are undiagnosed, and there are Canadians who are not following their treatments. We need to make sure that they live a healthy and fulfilled life, and one way to do that is to ensure that they have access to this vital medication. About one out of three people is living with diabetes or prediabetes today in Canada, and rates of diabetes are ever rising. It is estimated that, by 2028, over 13 million Canadians, or 32% of the population, will have diabetes or prediabetes. Through Bill C-64 and the work of the national framework for diabetes, we can improve aspects of preventative care as well. We can do this through information sharing and knowledge transfer, while also ensuring that those living with diabetes have access to insulin and other diabetes medications. This is a cost-saving endeavour. The Conservatives have continually referred to this as a spending program, as if it would not be invested directly in the health of Canadians. Not only would it be invested in their long-term health outcomes, but it would also be invested directly in their affordability. It would support affordability, and, as I pointed out, that is something that is positively correlated with other risk factors. We introduced the national framework for diabetes in 2022 to align multisectoral efforts to reduce the impact of diabetes in Canada. The framework comprises about six interdependent and interconnected components that represent the range of areas where opportunities to advance efforts on diabetes could and will be beneficial. Bill C-64 would support people living with diabetes, whether through improving access to the medications they need or giving them the tools they need to have a better quality of life in Canada. We are here for Canadians. Our plan to provide universal coverage for contraception and diabetes medications would be transformative, and I still have faith that the Conservatives will see the light and recognize that this is a very popular and worthwhile endeavour. We should all get behind national pharmacare for Canadians.
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Context: House Hansard - 323 - Jun/3/24
Mr. Adam van Koeverden (Parliamentary Secretary to the Minister of Environment and Climate Change and to the Minister of Sport and Physical Activity, Lib.)
  • Jun/3/24 6:06:32 p.m.
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  • Re: Bill C-64 
Madam Speaker, it is an honour to rise this evening to discuss the bill before us, Bill C-64, an act respecting pharmacare. We can all agree, or I hope we can all agree, that Canadians should have access to the right medicines at an affordable price regardless of where they live in our country. That is precisely what Bill C-64 would do. It represents the first phase toward a national pharmacare plan, starting with the provision of universal single-payer coverage for contraception and diabetes medications. This legislation is an important step forward to improve health equity, affordability and outcomes and has the potential of long-term savings to the health care system and for all Canadians who use it. In budget 2024, we announced $1.5 billion over five years to support the launch of national pharmacare and coverage for contraception and diabetes medications. The single most important barrier to access to contraception in Canada is cost. For example, the typical cost for select contraceptives in our country for an uninsured Canadian woman is up to $25 per unit, or $300 per year, for oral birth control pills and up to $500 per unit for a hormonal IUD, which is effective for five years. It occurs to me that if oil and gas companies were going to start selling diabetes medications, insulin or contraceptives, the Conservatives might be all for it. It seems like they are the only group, the only organization, and the only affordability measures the Conservatives can come up with are supports for oil and gas. However, Canadians have lots of expenses, and one of the main expenses associated with inequality and inequities in our society is their medications. We are here to help. Some populations are disproportionately affected by the lack of coverage. Women, people with low incomes and young people, all of whom are more likely to work in part-time or contract positions and thereby not have access to a drug plan, often lack access to private coverage. One study found that women from lower-income households are more likely to use less effective contraceptive methods or no contraceptive method at all as a result of their lower-income situation. Bill C-64 would ensure that Canadians have access to a comprehensive suite of options when it comes to contraceptive drugs and devices, because improved access to contraception improves equality. This means that every woman in Canada would have the ability to choose the contraceptive that is best for her, regardless of her ability to pay. This would contribute to her right to have bodily autonomy, which is what this government fully supports. Sexual and reproductive health is a priority for this government. This is reflected in Bill C-64, as I have mentioned, but it goes beyond that in other significant federal initiatives. Our government is committed to improving the sexual and reproductive health outcomes for all Canadians, and this includes helping to ensure access to a comprehensive suite of contraceptive drugs and devices for everyone. By working with provinces and territories and guided by the principles within Bill C-64, we can make this a reality. The proposed Bill C-64 lays the groundwork for that process, and through it, with collaboration with provinces and territories, we are helping to fight for affordability for all Canadians. By passing this legislation, collectively, we can all continue to build on the momentum we have already achieved. I looked into this. Pharmacare in Canada is deeply popular with people who vote for all parties. It is almost 90%, in fact. This is something I expect all members of Parliament to get behind. It is something a lot of Canadians support, regardless of party. An hon. member: Oh, oh! Mr. Adam van Koeverden: Madam Speaker, there are a lot of reasons to heckle in this House. Perhaps the Conservatives disagree with me on some key issues, but I find it really remarkable that they want to heckle and tell me that we should not be fighting for Canadians to have access to the drugs they need in order to live healthy and fulfilling lives. It really is remarkable and just re-emphasizes that if oil and gas was selling insulin and IUDs, the Conservatives would be the first ones to line up and say that we need to support these companies. It does not seem like they are really in it for Canadians, particularly lower-income Canadians, who are struggling with their bills. It is clear to me that the Conservatives only care about the oil and gas lobby. In fact, I think they are trying to put the oil and gas lobby out of business. With the time remaining, I would like to—
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Context: House Hansard - 323 - Jun/3/24
Mr. Kevin Lamoureux
  • Jun/3/24 6:05:51 p.m.
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  • Re: Bill C-64 
Madam Speaker, I believe there is at least one province, possibly even more, that has acted on the issue of contraceptives. We will find, as I said, that there are different policies in different provinces, and so forth. What is really important to recognize is that Bill C-64 would help an estimated nine million people in dealing with contraceptives. When we think about diabetes medications, we are talking about over 3.5 million people. That is a lot of good reasons to get behind this legislation and ensure there are some standards across the nation.
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Context: House Hansard - 323 - Jun/3/24
Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)
  • Jun/3/24 5:49:02 p.m.
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  • Re: Bill C-64 
Madam Speaker, I will be splitting my time with the member for Milton. I want to address what I would suggest is the ultimate potential assault on health care by the Conservative-Reform Party of Canada. For the record, to be very clear, one needs to look at what the member for Abbotsford said today, which has been repeated in many different ways by different members. I have often talked about the hidden Conservative-Reform agenda. I personally see health care as an important issue going into the next federal election, and my intention is to point out the contrast. When I say that the Conservative Party has crazy policies, we should think about them saying that the federal government has no constitutional role. One would think they were separatists, like the Bloc. They believe the federal government should just be an ATM machine, hand over the cash and say nothing about health care because the federal government has no role to play. Both the Conservatives and the Bloc believe that there is no role for the federal government to play in health care. Then, they say that it is a constitutional God-given right that provinces are the only ones that have anything to do with health care. That is absolutely wrong. I would ask members to cite a Supreme Court of Canada decision that says that the Canada Health Act is in violation of the Constitution. I would like members to tell me which premier or which province took the government to the Supreme Court and had a favourable ruling on that issue. The simple answer is that it has not happened. That is why the Conservative spin of misinformation continues to flow, and that is most unfortunate. Unlike the Conservative Party, Liberals understand and value the important role that the federal government in Ottawa plays. In terms of the pharmacare program, it is interesting to hear from different opposition members, the Conservatives and the Bloc, as they have that unholy alliance on Bill C-64 for different reasons. We have well over 100 policies on pharmacare, depending on what province people are in or which company they work for. There are many different types of policies facing the pharmacare issue. The idea of a national pharmacare program is nothing new. The Prime Minister is moving the issue forward. That is what Bill C-64 is all about. It recognizes there is a need for the national government to work, where it can, with provinces, to develop a national pharmacare program that has similarities in all regions of the country. The way I see it, there are two areas where we are focusing a great deal of attention today. I see it as a step forward. I believe that provinces will continue to look at what is being proposed and will come on board. The arguments I hear from the Conservative Party today are the types of arguments one would have heard generations ago regarding health care when public health was brought in. Those are the types of arguments of deniers. I suspect we will never hear the Conservative Party saying they are going to get rid of the Canada Health Act. Maybe a good opposition day motion would be what people have to say about the Canada Health Act and whether they support it or not. Mrs. Cheryl Gallant: You could ask when you are in opposition. Mr. Kevin Lamoureux: Madam Speaker, the member across the way says that we cannot propose a motion of that nature because we are not in opposition. Maybe in 10 years, or whenever it might happen, we will have the opportunity. I suspect that even Conservative reformers, the very far right, would recognize that Canadians treasure and value the health care system we have today. They see it as a part of our Canadian identity. The federal government played a critical role in that. It was the Province of Saskatchewan that led the way in ensuring that the federal government here in Ottawa would be able to expand upon it so that all Canadians would be able to benefit by it. Bringing forward the idea that if someone has diabetes, no matter where they live in Canada, they would have public assistance in terms of those medications and have public support, I see that as a positive thing. Today, the reality is that it depends on what province and what sort of private insurance that someone may have, maybe not as much of a deductible. It varies across the land. Many Canadians do not even have the opportunity to have virtually any subsidy, in terms of the medications required for diabetes. It has been reported that just over 3.5 million Canadians are dealing with diabetes today. I heard that as many as 25% of those individuals reported that because of the cost, they are not taking all the medications they should be taking to deal with their diabetes. What is the consequence of not being able to take the medications? It could mean someone could prematurely lose their eyesight and become blind. It could mean having an amputation as a direct result. Again, affordability depends on the province where a person lives or on the company the person works for. We have a national government saying that it believes this is a wonderful, positive step forward to see strong national leadership in providing this medication. This would profoundly change, in a positive way, the lives of many Canadians in every region of the country, including all provinces. This is factual. This would ultimately put us in a better light moving forward. This should come as no surprise. We have had different social groups, such as unions, come to Parliament. They have been advocating for it. We have had a standing committee deal with it. We have had it incorporated into budgets. We have had statements from ministers of finance in regard to this, and the Prime Minister has been talking about it for a number of years. I have brought forward many petitions on the issue. There is no surprise here. If members actually consulted with their constituents, they would find that there is a wide spectrum, in terms of appetite, for the federal government not only to continue dealing with this, but also to consider other possibilities. Why is it that the Conservative reformers feel that the federal government's role in health care should be diminished? They are not only against pharmacare but also against the dental plan. They are also against the commitment to provide $200 billion for 10 years for future generations of health and to provide the cash resources to support provinces. That is what I hope to be talking a lot about in the next federal election in 16 to 18 months. I believe that a vast majority of Canadians are behind this policy.
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Context: House Hansard - 323 - Jun/3/24
Mr. Warren Steinley
  • Jun/3/24 5:48:17 p.m.
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  • Re: Bill C-64 
Madam Speaker, I do like the little cute condescension from the NDP: “when he reads the bill”. The bill, Bill C-64, is four pages. I did read the bill. It is really cute when they have that passive-aggressive tone. It is adorable. If they sign on and if they do take the universal single-payer coverage, what are his constituents going to say when their coverage is less than what they had before? What is he going to say to 27 million Canadians who are losing better coverage because they are going to add coverage that is not as good as what they have right now? They would have a lot of explaining to do to their constituents when they try to take away the coverage they have right now and give them less coverage.
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Context: House Hansard - 323 - Jun/3/24
Mr. Taylor Bachrach (Skeena—Bulkley Valley, NDP)
  • Jun/3/24 5:47:16 p.m.
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  • Re: Bill C-64 
Madam Speaker, the member for Regina—Lewvan was quite adamant that health care delivery is the purview of the provinces. I think that when he reads the bill, Bill C-64, he will be delighted to find that, in the pharmacare proposal that we are debating today, the delivery of pharmacare is delivered by the provinces. The other thing I think he will be quite delighted with is the fact that provinces will have the ability to sign on or not to sign on with the pharmacare plan that is being debated. I think the only challenge he is going to have is that, when the Province of Manitoba and the Province of British Columbia sign on and when their residents start receiving free contraception and free diabetes medication and devices, the residents of his province, his constituents, are going to start asking why they are not able to tap into the benefits of universal pharmacare. I would just ask him what he is going to say to them in those situations.
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Context: House Hansard - 323 - Jun/3/24
Mr. Warren Steinley (Regina—Lewvan, CPC)
  • Jun/3/24 5:34:15 p.m.
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  • Re: Bill C-64 
Madam Speaker, it is pleasure to rise to speak to Bill C-64 for a second time. I spoke at second reading of this bill on Thursday evening, and I am happy to speak to third reading of the pharmacare pamphlet. I would like to repeat some of my remarks made during my speech at second reading. I have asked, time and time again, for any of the NDP-Liberal costly coalition members to tell me how many provincial ministers asked for a pharmacare bill at a federal-provincial-territorial meeting. Not one of the Liberal ministers, Liberal members or NDP members actually answered me. Quite frankly, they did not want to say out loud that the answer is zero. This was not at the top of a wish list for any of the provincial health ministers. I have been talking with our health minister in Saskatchewan. He still has no details about what this pharmacare pamphlet would look like or how it would affect the people of Saskatchewan. The biggest fear at the provincial level is that coverage would lessen in Saskatchewan. They have done a good job of building health care back up in Saskatchewan after the nineties, when the NDP ruined health care in Saskatchewan, which I will get to later in my speech. The provincial health ministers are asking, “Where are the details?” We have talked about how the federal Liberal government continues to bring in bills without any consultation. We have seen it in agriculture, in oil and gas, and even with the budget. At the agriculture committee on Thursday, I asked the agriculture minister about who he consulted in the ag sector when it came to increasing the capital gains tax exemption from a half to two-thirds. I have not gotten a straight answer from a lot of the Liberal ministers at committee, but to that minister's credit, he said that he did not even know that it was in the budget. A senior minister in the government did not know what was going to be in budget 2024. I have had the honour of serving in the Government of Saskatchewan, and I know there is quite a process to get a budget approved. It goes through Treasury Board finalization, then through cabinet finalization, then through caucus finalization, and then back to cabinet for a final sign-off. My colleague, the member for Abbotsford, who gave a great speech, was in government, and I think he probably saw most of what was going to be in the budget before it came out. When a senior minister who has been here for a long time, some might say too long of a time, admitted that senior ranking Liberals did not see the budget before it came out, I was dumbfounded. It was unbelievable. It does not surprise me, then, that this bill was brought forward with very little consultation with anyone. We all know this was signed off on, on the back of a napkin, to placate the junior NDP partners, so they would prop up the corrupt government for years, or at least until the member for Burnaby South gets his pension. We know what this is about, and it is to ensure that the NDP-Liberal costly coalition stays in power. This is the price Canadians are going to pay. Right now, 27 million Canadians are anxious about losing some of the health coverage they have right now as they have health coverage that they want to keep. I will admit that 1.1 million Canadians are under-insured or do not have insurance. Why does the government not focus on that? We could have had something rolled out that supplemented the provincial government programs. Instead, the costly Liberal coalition government always wants to be the one that rides in on the white horse, saying, “We are going to save you. We have a national plan.” We have a national day care plan. A friend of mine is now number 300 on the wait-list in Regina, which is not that big of a city. The government has made day care spots less available in my city of Regina, Saskatchewan. The federal government has a dental plan that no dentist wants to sign off on. I have a letter from the Saskatchewan Dental Hygienists' Association, where 99% of dental assistants and dental hygienists are female, and there was not one consultation with any of those stakeholder groups about what they should do or if they thought the dental care plan was a good idea. Once again, there was no consultation. This is a recurring theme. We have a national lunch program for which the Liberals did not do any consultations with any school boards. In Regina, there are a lot of great corporate citizens who donate a lot of money to lunch programs. When we got together as a group and talked about this, I asked if anyone knew how many lunch programs were in our city. The Regina Food Bank covers some programs. Mosaic Market covers some programs. Nutrien covers some programs. If we put all those programs together, we could do a lot of good and almost get to where we need to so all kids could have food when they go to school. There was no consultation on that either. The Liberals just come in on their white horses and think they are saviours. It is almost like someone over there has a God complex, one might say. They always want to be the one walking in and saving people, but they do not work with anyone else across the country. Let us get to the pharmacare program. Once again, it is a pharmacare program, with no consultation, that no one asked for at a provincial level. My friend for Winnipeg North talked about how health care is not within provincial jurisdiction, but it is. Health care delivery is within provincial jurisdiction. He knows that, as he is a former MLA. Money transfers come from the federal government, but the day-to-day operational delivery of health care is one hundred per cent a provincial jurisdiction. He knows that. It is interesting for the Liberals to bring in a national program, or a pamphlet, really, that covers two things, and then act like they are the conquering heroes. Who asked for this at a provincial level? I hope my friend from Winnipeg North will ask me a couple questions about that. There is one more thing when it comes to health care in our country. The biggest threat to health care in Canada is whenever there is a provincial NDP government. The NDP in Saskatchewan devastated health care. When it was in government, it closed 52 hospitals in my province. It closed 1,200 long-term care beds in Saskatchewan during the nineties. It fired 1,000 nurses, hundreds of doctors, and rural Saskatchewan was divided. The NDP is the pioneer of our two-tiered health care systems. In Saskatchewan, there is much different health care if someone is in rural Saskatchewan compared to urban Saskatchewan. The NDP went so far as to close the Plains Health Centre hospital in Regina. It was one of the best hospitals in the city and was the newest hospital. The NDP closed it because it was servicing too many rural Saskatchewanians. It was unbelievable. We now have a government in B.C., an NDP provincial government, that is pioneering a pharmacare program, but it has it backward. It is giving B.C. residents free drugs that are killing them, instead of having a plan in place to give residents affordable drugs that would be life-saving. That is what B.C. is doing right now. Instead of putting money toward life-saving drugs, the Liberals want a safe supply, which I do not think exists. They continue to spend taxpayers' dollars in British Columbia to give drugs to people who are killing themselves with those drugs. That is so opposite to what a government should be doing. The Liberals want to come in like they are champions of pharmacare. They should talk to some of their B.C. cousins about what is going on in that province. They should take some of the money they are spending putting illicit hard drugs on the street, and maybe supplement that with some programs that would give drugs to people that would help save their lives instead of end their lives. I would end with one more conversation about how consultation is so disregarded by the government. Obviously, the NDP are going to vote for this terrible piece of legislation. The Liberals will vote for it. One thing I would say to members is to please consult with the health ministers of the provincial governments because Saskatchewan is doing a great job. It has diabetes coverage for everyone up to age 25. We have a $25 cap on senior drugs, a program that helps seniors make sure they get the medication they need. Provinces are in charge of the delivery of the health care system. Please let them keep that in their domain, and do the proper thing and consult with the health ministers in this country.
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Context: House Hansard - 323 - Jun/3/24
Mr. Francesco Sorbara
  • Jun/3/24 4:52:08 p.m.
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  • Re: Bill C-64 
Madam Speaker, I was just saying how important contraceptives are to nearly nine million women in this beautiful country we live in, nearly one-quarter of the Canadian population. Contraception, also known as birth control, is used to prevent pregnancy, whether it is required for family planning, medical treatment or overall reproductive health. Improved access to contraception improves equality, reduces the risk of unintended pregnancies and improves reproductive rights. The single most important barrier to accessing contraception in Canada is cost. For example, the typical cost for select contraceptives for an uninsured Canadian woman is up to $25 per unit, or $300 per year, for oral birth control pills, and up to $500 per unit for a hormonal IUD, which is effective for five years. Some populations are disproportionately affected by the lack of coverage. Women, people with low incomes and young people, all of whom are more likely to work in part-time or contract positions, often lack access to private coverage. One study found that women from lower-income households are more likely to use less effective contraceptive methods or no contraceptive method at all. Although most drug plans list a range of contraceptive products, unfortunately only a fraction of Canadians are eligible for prescription birth control at low or no cost through a public drug plan. Bill C-64 would ensure that Canadians have access to a comprehensive suite of contraceptive drugs and devices, because improved access to contraception improves health equality. This means that every woman would have the ability to choose a contraceptive that is best for her, regardless of her ability to pay. This would contribute to her right to have bodily autonomy, which is what this government fully and fundamentally supports. In addition, ensuring access to a comprehensive suite of contraceptive drugs and devices at no cost to the patient can lead to savings for the health care system. British Columbia implemented this policy at the provincial level last April, and studies from the University of British Columbia suggest that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. In the first eight months of that policy being in place, more than 188,000 women have received free contraceptives. Sexual and reproductive health is a priority for this government. This is reflected in Bill C-64 but, as I have mentioned, it also goes beyond that to other significant federal initiatives. As part of budget 2021 and budget 2023, the Government of Canada has continued to demonstrate its commitment to improving access to sexual and reproductive health care support, information and services for Canadians who face the greatest barriers to access; and to generating knowledge about sexual and reproductive health for health care providers. Since 2021, the sexual and reproductive health fund has committed $36.1 million to community organizations to help make access to abortion, gender-affirming care and other sexual and reproductive health care information and services more accessible for underserved populations. An additional $16.7 million has been provided to the Province of Quebec. Budget 2023 renewed the sexual and reproductive health fund until 2026-27. This initiative has funded 21 projects and is currently funding 11. The sexual and reproductive health fund is providing $5.1 million to the University of British Columbia contraception and abortion research team for a 25-month project from March 17, 2023, to March 31, 2025, entitled the “Contraception and abortion research team access project, advancing access to abortion for under-served populations through tools for health professionals and people seeking care”. As a segment of the project centres on contraception, the project has partnered with the Canadian Pharmacists Association to develop educational resources that support pharmacists prescribing contraception and assist pharmacists in understanding and tailoring their approach for indigenous and racialized populations, including youth and other underserved populations. With the support of the University of Toronto youth wellness lab, the project will also engage with family planning professionals, for example pharmacists, family physicians, obstetricians, gynecologists, nurses, midwives and social workers, to optimally design affirming and judgment-free services and contraception information care by, with, and for youth. Additionally, the medical expense tax credit has been included to include more costs related to the use of reproductive technologies, making conception more affordable. In conclusion, our government is committed to improving the sexual and reproductive health of all Canadians. This includes helping to ensure access to a comprehensive suite of contraceptive drugs and devices for all Canadians. By working with provinces and territories, and guided by the principles within Bill C-64, we can make this a reality. As we move forward, Liberals will continue to work with the provinces and territories, indigenous peoples and other stakeholders to ensure we get this right. The proposed Bill C-64 lays the groundwork for that process and would guide our collaboration. By passing this legislation, we could continue to build on the momentum we have already achieved. We are well on our way and I look forward to working with all parliamentarians to realize the next phase of Canadian health care. Whether it is dental care; the Canada child benefit; $10 day care and the national learning strategy; helping the almost 3.7 million individuals who have diabetes; or providing dental care for seniors, and now moving into another segment of the population, which I believe is individuals with disabilities, we are going to be there and have the backs of Canadians today and into the future.
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Context: House Hansard - 323 - Jun/3/24
Mr. Francesco Sorbara (Vaughan—Woodbridge, Lib.)
  • Jun/3/24 4:48:28 p.m.
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  • Re: Bill C-64 
Madam Speaker, it is always a pleasure to rise in the House. Happy Monday. I hope that we and our respective families are doing well. Before I begin, I wish to say that I will be sharing my time with the member for Winnipeg Centre this evening. I am happy to speak today regarding Bill C-64, an act respecting pharmacare. It is another step for our government to make life more affordable for Canadians and provide the services that they need at this point in our term, and something that I am very proud of as a member of Parliament. Before I get into my formal remarks, this weekend I was reminded of the work we are doing in helping Canadians, including the wonderful residents that I have the privilege of representing in Vaughan—Woodbridge. Close to my constituency office is one of the regional roads in the city of Vaughan in York Region, Weston Road. Along Weston Road, there are three signs that are placed up by our local dentists, all accepting the Canadian dental care program. Much like what is contained in the contents of Bill C-64, an act respecting pharmacare, here we have another foundational piece that is assisting Canadians in my riding and across the country. We know that over two million seniors have been approved for the dental care plan, and that over 120,000 have actually visited dentists. I have had many conversations with the seniors in my riding over the weekend who have used the plan and are very happy about it. Along that vein, we are introducing a bill on pharmacare that will again help Canadians, 3.7 million of them, who have diabetes. We know that diabetes costs our health care system north of $30 billion a year. There are real savings in doing what we are doing and also taking preventative steps and providing contraceptives for Canadians. This bill sets out the principles that will guide our government's efforts to improve the accessibility and affordability of prescription medicines and support their appropriate use. It also underscores the importance of working together with provinces and territories to make national pharmacare a reality for Canadians. We can all agree that Canadians should have access to the right medicines at an affordable price regardless of where they live. That is what Bill C-64 does. It represents the first phase toward a national pharmacare, starting with the provision of universal single-payer coverage for a number of contraception and diabetes medications. This legislation is an important step forward to improve health equity, affordability and outcomes and has the potential of long-term savings to the health care system. In budget 2024, we announced $1.5 billion over five years to support the launch of national pharmacare and coverage for contraception and diabetes medications. I will highlight how important this is to Canadians and, specifically, how important access to contraceptives is to almost nine million women—
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Context: House Hansard - 323 - Jun/3/24
Mr. Brad Redekopp (Saskatoon West, CPC)
  • Jun/3/24 4:33:29 p.m.
  • Watch
  • Re: Bill C-64 
Madam Speaker, Liberals like to wrap themselves in the Canadian flag and proclaim themselves the great deliverers of health care in our country. It gets better. Allow me to read from former Liberal prime minister Paul Martin's 2004 election platform, which he infamously called a “fix for a generation”: “The priorities of a Liberal government begin with publicly funded, universally available health care. There is simply no other issue of such vital significance to Canadians. Liberals are proud of their founding role in making medicare a national priority.” That sounded pretty good. It continues on, stating, “The objective of a Liberal government will be to agree with provinces and territories on a national pharmaceuticals strategy by 2006.” I would say that was a fail. That was former Liberal prime minister Paul Martin's 2004 election platform: a “fix for a generation”. Needless to say, national pharmacare did not happen in 2006. In fact, it is a full 20 years, a full generation, later, and we have a health care system that has fallen apart under the current NDP-Liberal government in Ottawa. Having broken our publicly accessible universal primary care system, we now have a Liberal Prime Minister who is setting his eyes on taking a wrecking ball to yet another part of our health care system. Why? In this backward town we call Ottawa, where common sense goes to die, Liberal logic says that if it is not broken, they need to break it. What are the NDP-Liberals breaking today? It is the systematic dismantling of Canadians' access to their prescription drugs and treatments that are vital to their health. Just like 20 years ago, when that former Liberal prime minister brought disaster after disaster to primary health care, breaking it for a generation, if we follow our current NDP-Liberal Prime Minister down this path, our prescription drug system will forever be broken for generations to come. Rather than calling this a “fix for a generation”, I would say the fix is in. It is against this backdrop of our broken primary health care system that Canadians need to take a good, hard look at this legislation. Bill C-64, the so-called pharmacare bill in front of us today, is not what the NDP or the Liberals are advertising. It is neither the implementation of universal prescription drug coverage, nor will it improve the options for the two items it promises to cover: contraception and diabetes medications. Instead, it goes out of its way to destroy Canadians' already pre-existing insurance coverage, provincial drug plans and freedom of choice in medication when pursuing treatments. First, let us talk about federal-provincial relations. It is interventionist NDP-Liberal governments that use their control over the purse strings to force provinces into impossible decisions on patient care. Every time a premier tries to improve health care in their jurisdiction, the Liberal Prime Minister of the day will threaten to cut off health care funding to the province. Let us say a province wants to establish a few clinics offering MRIs outside of a hospital. To the Liberals, this is a mortal sin, and it cannot be allowed. Earlier this year, the federal Liberal Minister of Health fined my home province of Saskatchewan $1 million for allowing MRI clinics to operate in 2021. This was an innovative idea that increased the number of MRIs performed at a lower cost. It was brilliant, but not so fast. The NDP-Liberal government saw that as a mortal threat and fined the province. As these clinics are still functioning because they are common sense, we can expect the fines to continue. How ridiculous is that? The answer is as simple as it is sad. They actually do not want the system to get better. They do not want better outcomes for people. The NDP and the Liberals learned long ago that as long as the health care system is broken, they can campaign in elections as the great protectors and saviours of the system. Canadians are not going to fall for that again. Remember, this whole thing depends on the federal government convincing the provinces to go along with this scheme, something we already know the Liberals are not good at doing. Is this bill not doing something good? There is a second important thing to understand. This so-called pharmacare legislation will not bring universal prescription drug coverage to Canadians. Subsection 8(2) of the legislation, Bill C-64, under the heading “Discussions” says: The Minister must...initiate discussions...with the aim of continuing to work toward the implementation of national universal pharmacare. Let us break that down. What does the legislation require the minister to do? He must initiate discussions. That is fair enough. What do those discussions do? They have the aim of continuing to work towards a goal. Is that the big reveal? The minister is required to talk to some people to work towards an ideal. That sounds like every scam artist running a Ponzi scheme. Schmooze as many people as possible, and sell them on an idea that is nothing more than smoke and mirrors. This legislation is literally that: smoke and mirrors, conning Canadians into thinking there is a pot of prescription drug gold at the end of the rainbow. It is not prescription drug gold at the end of this legislation. In fact, every single Canadian would be just that much poorer if and when this gets implemented because it is a direct attack on Canadians' private health insurance and drug coverage. Did members know that, according to The Globe and Mail, there are 102 government drug programs operating today, along with 113,000 private insurance programs? Statistics Canada reports that 79% of Canadians currently have health insurance that includes drug coverage. The completely independent Parliamentary Budget Officer analyzed how much it would cost Canadian taxpayers if universal pharmacare were implemented. Their analysis is that pharmacare would cost about $40 billion every year. More importantly, that would be about $13 billion more than is being spent today. Let us keep in mind that pharmacare would replace existing public and private drug plans. Generally, private health care plans have better coverage than public ones. That would leave most people worse off. Therefore, overnight, four out of five Canadians would lose the prescription drug coverage they have through their employer, union, school, spouse, parent or provincial government plan. The federal government is paying for it, which means we are paying for it through increased taxes. Either way we look at this, it would result in a multi-billion dollar spending increase paid for by us. Those who would really benefit from this are private companies who provide insurance to their employees because today the companies are paying for private drug insurance. Once this program kicks in, they could cancel those programs because the government would be paying for it. That would save those companies significant dollars. Essentially, it would be a transfer of dollars from the federal government directly to those companies, which is paid for by us. Of course, the NDP-Liberals always love increasing taxes on unsuspecting Canadians. The other thing they love doing is limiting our choices to fit their narrow world view. There are two classes of drugs that the NDP-Liberals choose to cover in this so-called pharmacare bill: contraception and diabetes medications. Let us talk about diabetes. Most people know that insulin is a shot given to diabetics to control their blood sugar levels, as needed. However, do people know that metformin is a prescription diabetes pill that is taken once or twice daily to help the body control its blood sugar properly, reducing the need for insulin? Do people know that metformin is prescribed commonly as a treatment for people before they have diabetes? With a daily treatment of metformin, that person may never develop diabetes, and that daily metformin is a dirt-cheap alternative to very expensive insulin. It keeps pre-diabetics from developing the disease, and it costs pennies, compared to insulin. Metformin is not covered. What about Ozempic? We have all heard of Ozempic as the wonder weight-loss drug, but that is simply a side effect of being a diabetes drug that acts on the pancreas to control blood sugar. We also know that the best way to avoid type 2 diabetes is to be a healthy weight and to not be obese. Ozempic does that, but Ozempic is among the most expensive drugs on the market at about $75 a dose. Ozempic and metformin are used to prevent the disease of diabetes. Does that mean the NDP-Liberals are purposely going to deny treatment to those folks to prevent them from developing diabetes and are going to wait until they get the full-blown disease? How is that fair? Should that not be a decision for the patient and the doctor, and not for some bureaucrat in Ottawa? Innovative Medicines did a comparison of the access of drugs covered by private insurance versus those in public plans. The results are as shocking as they are sad. In Canada, private insurance covers twice as many drugs as provincial plans do. The bottom line is that this bill, Bill C-64, proposes to take away people's private drug plan. That is what single-payer means. The result is that private companies and anyone else currently providing drug coverage in a benefit plan would cancel those plans and would force Canadians onto the government plan. Canadians would be stuck with a slimmed-down plan and would be forced to pay out-of-pocket for the rest. After nine years, it is clear that this NDP-Liberal government simply is not worth the cost to Canadians' health. It has broken our primary health care system, and now with this so-called pharmacare legislation, it is setting out to break prescription drug coverage for 80% of Canadians who already have private insurance. Conservatives will not stand idly by while the NDP-Liberals systematically break our country. If we form government, we would undertake the task to fix the immense damage this costly coalition has done. We would axe the tax. We would build the homes. We would fix the budget, and we would stop the crime. Let us bring it home.
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Context: House Hansard - 323 - Jun/3/24
Mr. Kelly McCauley (Edmonton West, CPC)
  • Jun/3/24 4:18:57 p.m.
  • Watch
  • Re: Bill C-64 
Madam Speaker, I will be sharing my time with my colleague from Saskatoon West, or as we fondly know him, the member from Saskatoon West Edmonton Mall. I rise on Bill C-64, which is officially called an act respecting pharmacare. I have two other names for it. One is the proper Liberal name of the bill, which is “fake news to satisfy the gullible NDP caucus act,” and then the longer title is the NDP “I hope no one notices we said we would force an election unless we got a comprehensive and entirely public pharmacare program but sold out for little act.” I am being a bit sarcastic here, but this is the truth. The government has repeatedly stood in the House and said it is extensive pharmacare, but it is not. It is two items. The NDP members have constantly stood up with their colleagues across the way in the senior partnership, or the radical wing of the NDP, and said it is comprehensive pharmacare that is single pay. Despite what they would have one believe, it would just cover two items. It does potentially cover diabetes drugs and birth control, but we do not know the details. What it would not do is cover the chronic diseases Canadians are suffering from most. The top ones are hypertension, osteoarthritis, mood and anxiety disorders, osteoporosis, asthma, obstructive pulmonary disease, ischemic heart disease, cancer, dementia and, rounding out the top list, diabetes. Only one item would be covered out of the major chronic issues that are diseases or afflictions hurting Canadians. Where is the coverage for those? It is nowhere to be found, which is why the government and other people in the House should not be calling it a pharmacare act. The Liberals can name it a potential pharmacare act down the road, but they should not be misleading Canadians into believing that this is a pharmacare act. I asked where the coverage was for hypertension. Eight million Canadians suffer from this. Four million Canadians have osteoarthritis, two million have osteoporosis, and four million are suffering from asthma. How many of them would be covered by this so-called pharmacare act? The answer is zero. Two million Canadians are suffering from obstructive pulmonary disease. Not one would be covered. On ischemic heart disease, 2.4 million Canadians are suffering from this. Not one would be covered under this plan. Forty per cent of Canadians will be diagnosed with cancer in their lifetime, with 250,000 new cases every year. Not one would be covered under this so-called pharmacare act. For dementia, 750,000 people are affected, and not one would be covered. Where is the coverage? I want to get back to my admittedly snarky comments about the NDP. I want to quote the National Post, which reads, “NDP members drew a line in the sand by passing an emergency resolution at their policy convention in Hamilton...that says the party should withdraw its support if the Liberals do not commit to ‘a universal, comprehensive and entirely public pharmacare program.’” If one looks up the word “comprehensive”, the definition is, “complete, including all or nearly all aspects of something”. Is this all or nearly all aspects of pharmaceuticals? No, of course it is not. Anne McGrath, the New Democratic Party's national director, “said getting a bill that has teeth will be her party's biggest priority as parliamentarians return to the House of Commons”. Canada has about 9,000 approved pharmaceutical drugs. The bill would cover maybe 200, so where are the other 8,800? Anne McGrath further stated, “Weak legislation is not going to be acceptable to New Democrats”. Maybe 200 for diabetes and birth control out of 9,000 seems to be acceptable. She said, “It has to be strong. It has to have teeth. And I feel like that resolution gave [the NDP leader] and the caucus a lot of bargaining power. It gives them a lot of strength.” I wonder when my colleagues in the NDP are going to be withdrawing their support. They probably will not. One issue I brought up in an earlier question is that a large majority of Canadians are covered, but some are slipping through the cracks. Some are not covered, and some are only partially covered, but they are covered by the province. Alberta, for example, covers most of the items brought up. Essentially, B.C., Quebec and Ontario do as well. Pretty much every province, except one or two in Atlantic Canada, covers diabetes or birth control for low-income Canadians. However, they are not covering the other items of importance, such as hypertension and some of the others. The initial phase of this is going to cost about a billion and a half dollars. That money could be better used, by either giving it to the provinces for rounding out the services or, better yet, focusing on Canadians afflicted with rare diseases. A couple of families came to my office. Their young children were suffering from SMA, spinal muscular atrophy. It is a horrible disease. Generally, it is a death sentence by the time the child is two years of age. At about the time the children of these two families in Edmonton were diagnosed, a new drug had come out; it is called Spinraza. I have to give points to the pharmaceutical companies for how they come up with these names. Spinraza does not cure the disease, but it extends life to about 18 years old. Children would not have a great quality of life, but they could live to their late teens. When Spinraza came on the market, Rachel Notley's NDP was in power in Alberta. We went to the local MLAs in the NDP to see if we could speed up coverage for the drug in Alberta; however, the NDP refused to look at this. The same NDP that says it is a line in the sand that it will force an election over refused to help this family. When the provincial United Conservatives were elected, Tyler Shandro was the health minister. He was much maligned, and I am sure a lot of it was probably deserved. However, he managed to get Spinraza approved for the family within two weeks. It is a very expensive drug. Along came a better drug called Zolgensma. I truly believe it is a miracle drug. With Spinraza, children would spend about a month a year in intensive care, getting spinal taps and everything, for their treatment. Instead of that, Zolgensma is one shot in the arm. It seeks out the bad gene and copy-pastes the good gene over, basically stopping the disease in its track and giving the children a chance at a strong life. It would be about $45 million a year to treat everyone afflicted with this, everyone born every year in Canada. This is where the government should spend this money. It should focus on that. It should not be spending money to replace programs that already exist. About 60% of Canadians have a program delivered through work. Instead of subsidizing that 60%, it should look after people like this in need. These two families had to fundraise for this drug. Ryan Reynolds, who was in Deadpool, helped fundraise for these two families. Luckily enough, a corporate benefactor came through and provided for everyone in Canada. This is an example where that billion and a half dollars could be better spent. Another couple in my riding had a child suffering from PKU, which is a rare inherited disorder. It causes a buildup in amino acid in the body and prevents it from metabolizing protein. Children cannot have protein. It costs $5,000 a month out-of-pocket. The government should look after covering this. Twenty-seven million Canadians already have coverage through work. This Liberal single-payer plan is going to subsidize either the companies that are already paying for this or big pharma. It is funny that big pharma just got an extra tax for too much profit through the Liberal government, a temporary Canada recovery dividend to attack big pharma, which it is now going to subsidize. It could also subsidize companies directly, including Loblaws. At the same time as it is demonizing Loblaws in the House, it will end up subsidizing it. Therefore, I do not support the act as it is. There are better ways to do it than the way the Liberals and NDP are doing it.
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Context: House Hansard - 323 - Jun/3/24
Mr. Mark Gerretsen (Kingston and the Islands, Lib.)
  • Jun/3/24 3:52:47 p.m.
  • Watch
  • Re: Bill C-64 
Mr. Speaker, it is an honour to rise to speak to such an important piece of legislation, our national pharmacare bill, Bill C-64, which was introduced by the member for Ajax, the minister responsible for health care. In my opinion, this particular legislation is a long time coming. When health care, what Canadians have become accustomed to in Canada, was first introduced many decades ago, I think that there was always an expectation that Canada would follow suit with a pharmacare piece of legislation. Indeed, it is my understanding that Canada is the only country in the world that has a health care plan that does not also have a pharmacare plan. I think that it is incredibly important that this piece of legislation is here. I have been listening to the debate over the last number of weeks regarding this particular bill, and I have found it quite interesting what I have heard in the House about it. For starters, I want to say that it is a piece of legislation that I see as a starting point. It is a point at which we can start to implement a national pharmacare plan, in particular to help some of the most vulnerable Canadians get access to medications they need. I will address that point in more detail in a moment. More importantly, this is a starting point in the sense that we will start by having two major medications that Canadians use, medications for diabetes and contraceptives for individuals who require them. I say that because I know that almost four million people in Canada are currently using medications for diabetes. This piece of legislation, even though it is only a starting point covering two specific medications, would certainly have an impact on so many people in our country. With the portion that is just for diabetes, that is nearly four million people on its own. Bill C-64 would establish a framework, and that is the important thing. It is a framework toward a national universal pharmacare plan in Canada for certain prescription drugs and related products, including free coverage of contraception and diabetes medication, as I have already mentioned. The bill would also provide that the Canadian drug agency work toward the development of a national formula to develop a national bulk purchasing strategy and support the publication of a pan-Canadian strategy regarding the appropriate use of prescription medications. I think that the part regarding the bulk purchasing strategy is so incredibly important because this is where Canadians would see the benefit of having a national pharmacare plan. The idea that we can, as a whole country, purchase medications in bulk would give us that purchasing power that I think is needed to be able to make the purchases at a fair price, a price point that we as Canadians will ultimately be paying for through our taxes. Finally, the last part of the bill is that, within 30 days of receiving royal assent, the minister would need to establish a committee of experts to make recommendations regarding the operation and financing of national universal single-payer pharmacare. The committee would be required to provide its report of recommendations to the minister no later than one year after the bill receives royal assent. As I indicated earlier, when one talks about a program that is this big and this complex, it is important to have that proper oversight and to have a committee of experts making recommendations to the government on how to proceed. When we talk about the number of people who would be impacted by this, I find the conversation in the House to be really interesting, and this is something I alluded to a few moments ago, because it would be a benefit that everybody would be covered under the program. The reason why I say that is that I think it is very easy to make comments, such as I have heard from Conservatives in particular, that so many people are already covered. There are already people who are covered under their private plans. I think about 80% of people are covered in one way or another. However, not everybody is covered in the exact same way. For starters, at least 20% of people are not covered under any plan, and these would be the most vulnerable because these are people who would have to go to the drug store to pay for their medication out of pocket. On the other end of the spectrum, there are a lot of people who are fully covered, and there are some really good plans out there. There are some really good employers. There are some really good institutions that provide plans to their employees and family members that are going to cover a lot, up to, in many cases, 100% of the cost of medication. Then, there is everything in between concerning what the coverage is and how much coverage there is. This is why it is so important that we talk about universal coverage. Sure, 80% of people might have some degree of coverage, but not everybody is covered the exact same way. I think it is extremely important that everybody has the same basic universal coverage. When we look at the way we are treated when we go into hospitals, everybody is treated the exact same way. At least, it is supposed to be this way, and it could be argued that provinces are setting up things differently. If we go into a hospital emergency room, we will see triage. The hospital will determine the critical nature of a person's visit, how quickly a person needs to be dealt with, and everybody is treated the exact same way. Most importantly, when we are done and when we leave the hospital, we just go home. There is no one asking for a credit card or a billing address. We have the luxury of having a health care system that covers everybody, which does not ask people to pay when they are in, quite frankly, what would be their most vulnerable state. I think one of the problems with my generation, and generations after mine and a few before, would be that the idea of having to pay for medical care seems almost foreign. It certainly does to me. I never think to myself, “Wow, I should go get this checked out, but what's it going to cost me to do that?” That is never something that enters my mind. Members can just imagine that, if I were living in the United States, for example, there would be a lot of people who actually have to make that choice. They say, “Well, I should get checked out, but what is it going to cost me to do that?” This is one of those luxuries that we have with a single universal health care system such that we have here in Canada. It is not something that enters our mind because I think we believe, as a society, that there is a certain onus to take care of each other when it comes to our health care, which is what our health care system provides, notwithstanding the fact that we could get particular about what different provinces are attempting to do now. However, that is the reality of the situation. When we talk about pharmacare and the drugs that we also need to be healthy, we have to ask ourselves why they are not treated the exact same way. What I see with the bill before us is an attempt to move in that direction. There are two very important, or at least very popular, medications that a lot of Canadians use to start with. This comes from the same premise that, when somebody needs to take care of diabetes, for example, or somebody wants access to contraceptive medication, they should not have to filter into the equation of the decision whether they would have to pay for it, for starters, as 20% of the population would, or how much of it they would have to pay for. They should not have to ask, “Do I have to pay for a portion of it? Does my coverage only cover 60%, and so I have to pay 40%? Does that make it worthwhile to do this?” Canadians should not have to think that perhaps they could go against their doctor's advice and not get the medication because they think they will be fine. These questions should not be asked by Canadians. There are a lot of seniors out there who rely on a lot of medications who should not have to say, “I have to make a decision between getting the medication I need or buying food.” They should not be making those choices, and they should not be saying that maybe they will only take half the dosage they have been prescribed because at least then they are still taking something but are not spending as much. When we talk about health care and pharmacare, it is my position that it should be treated in the same way that we talk about health care and accessing care in terms of going to see a physician or going to the hospital. That is why I think the pharmacare bill is so important, because, as I said, it certainly does not cover every drug. It actually covers only two very important and widely used drugs, but it sets the framework for how things can evolve from here. One of the things I find really interesting, when we are having this discussion about universality and the fact that it is just two pieces of very important medication, is what I have been hearing from Conservatives to this point. They are getting upset over the fact that it would not cover a lot and a lot of people would not be covered. They are basically saying that more should be invested. I have heard the member from Battle River—Crowfoot talking about how we are not doing enough. Nonetheless, they will still vote against the bill. I cannot help but wonder why they are saying we need to do more, but then are against the idea fundamentally. I do not know whether Conservatives are doing what we have seen them do a number of times before, which is to start by talking about a piece of legislation and trying to critique it all day long, only to then vote in favour of it when the time comes, or whether they have a plan for universal pharmacare that is even more ambitious than this one. I find myself somewhere in between, trying to figure out what they are really trying to get at with this. At the end of the day, we know that this is something that would help Canadians. We know, and I strongly believe, that the concept of having a universal pharmacare system, in the long run to cover many more drugs, is certainly my goal. That would be to the great benefit of all Canadians. The legislation is a huge step forward in delivering better health care to Canadians. As I said, it lays out the plan for universal single-payer coverage for contraception and for diabetes medication. This would mean nine million women and gender-diverse Canadians all across the country could get access to the contraception and reproductive autonomy that they deserve. Notwithstanding the fact that lately we have heard some Conservatives start to talk and to reopen discussions about reproductive autonomy from decades ago, the reality is that we believe that when somebody makes choices about what to do with their body, in particular when it comes to reproductive aspects, they should be able to make those choices. A woman should be able to make those choices. In my opinion, the government should be there to support them in making whatever choice they think is the best for them as an individual. Although the piece of legislation before us, as I previously said, would not cover every medication, or a lot more medication as I would ultimately like to see, it certainly would be a starting point, a place to begin. It would be a place to lay the groundwork. It would be a place to engage the experts to provide feedback as to how we could move forward. It would allow us to start somewhere significant, given the number of Canadians it would affect, and then from there, to grow. I am really looking forward to the day when we can say that our pharmacare and the medications that Canadians depend on so much will be treated in the exact same manner that we see in the rest of our health care system, in particular when we go to visit a doctor or we have to go to an emergency room, as I described earlier. I really hope Conservatives vote in favour of this at the end of the day, despite some of what I have been hearing. This is a great opportunity to show the country that the bill is not something we will make political and that it is something that truly would benefit many Canadians. It would help the 20% or so of people who might not have some degree of coverage. It would equalize the very well-off people with some of the most vulnerable in our communities by saying it does not matter what one's socio-economic status is and it does not matter what one's income level is. We respect the fact that all Canadians should have access to the medications they need so badly, and that their doctors, through our health care system, could provide it to them.
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Context: House Hansard - 323 - Jun/3/24
Ms. Heather McPherson (Edmonton Strathcona, NDP)
  • Jun/3/24 1:49:17 p.m.
  • Watch
  • Re: Bill C-64 
Mr. Speaker, I want to acknowledge that today is the fifth anniversary of the National Inquiry of Missing and Murdered Indigenous Women and Girls, Two-Spirit and Gender-Diverse People. We need to acknowledge today that the government is failing to address the genocide against indigenous people, and that is failing both indigenous people and all Canadians. I certainly hope that the government prioritizes those calls for justice, knowing that to date we have only achieved two of the 231 calls for justice. Today we are here to speak about Bill C-64. Today is, as my leader, the member for Burnaby South mentioned, historic. It is not just historic because of pharmacare. I do want give a shout-out to the Edmonton Oilers, who are now going to the Stanley Cup finals as of yesterday. It was a very big day. I also want to start by saying how grateful I am to our leader. Our leader, the member for Burnaby South, has been a strong advocate for pharmacare for years. Instead of just being an advocate, he rolled up his sleeves, got to work, worked with the Liberals and he forced the Liberals, against all their historic votes, to put this framework in place. I am so grateful to be a New Democrat today. I am so grateful to work with such a strong leader. I am also extraordinarily grateful to all the advocates who have done so much for decades to move this forward. I want to start by talking a little about one of my constituents, Pat. He came into my office, and he had a challenge. We are really proud of health care in Canada. Canadians should be proud of our public health care system. However, when Pat came into my office and talked to my team and I, he told us that he had been able to see a doctor and he had been referred to a specialist. The specialist was able to give him treatment. The problem was that the medication for his treatment cost $400, and he did not have that $400. While our health care system is a point of pride, thanks to the health care system that Tommy Douglas developed, Pat was able to get part way there, but he was unable to get the treatment that would actually help him. It was never supposed to be this way. When Tommy Douglas envisioned our health care system, pharmacare was always supposed to be part of that system. We know that Canada is the only country that has a medicare program that does not include pharmacare. It does not make any sense that we will treat Canadians to a certain point, but that we will not get them over the finish line without access to medication. Today is an opportunity to make pharmacare a reality for millions of Canadians and to lay the groundwork to create a fully universal pharmacare system for all Canadians. It is truly historic. Pat is not alone. A few months ago, I sat and listened to Albertans share their challenges and experiences at a pharmacare round table in Edmonton. One after another, Edmontonians stood up and they talked about how the lack of prescription coverage had affected their lives, how they had to juggle their bills and how they had to worry about groceries, utilities and rent, on top of their prescriptions. They had to make choices about which of those things they can afford. As members of Parliament, sitting in this place, every one of us has a health care plan that covers our medication. However, for so many Canadians who do not have that access, this is game-changing. This is the difference between paying their rent and taking care of their health at the same time. It was not just lower-income Canadians who were speaking out for pharmacare. Business leaders and health care professionals were all speaking about how important pharmacare was for them and why they wanted the government to move fast on this. I spoke to a paramedic who shared his experience providing emergency care and transportation to hospital for people who could not afford their prescriptions, people who would be doing well if they had taken their medications appropriately, if they had not thought about cutting their pills in half, if they had not thought about taking a pill every second day. Those decisions that people are making are impacting their health, which in the long run have large costs on our health care system as well. Doctors are so frustrated that their patients are not getting better because they cannot afford the treatment. Small business owners, despite paying more than minimum wage, can not possibly pay their employees enough in order to afford their medications. A couple months ago, I sent out a mailer on pharmacare, as we all do in this place. I wanted to know what people in Edmonton thought about pharmacare. The response from constituents in Edmonton Strathcona was overwhelming. Ninety three per cent of people indicated that they were in favour of a universal pharmacare program and only 5% indicated that they were unsure or opposed. This mirrors national polls that put support for implementing a national pharmacare program to provide equal access to prescription drugs for everyone in Canada at 87%. Last year, an Alberta-wide poll found that 74% of Albertans supported universal pharmacare. As the president of the polling company noted, the overwhelming support in Alberta for a federal program like this was surprising. He said, “Getting three-quarters of a population to agree with any piece of public policy these days, it is a bit astounding. It's very popular in Alberta.” He added that approval of the idea largely crossed all demographics and all regions of the province. Canadians understand and they know that we must care for one another. We must take care of each other, and universal pharmacare is a promise to take care of each other. This legislation is not the end point; it is just the beginning but a very important beginning. We need the bill to create the mechanism for a full-fledged universal pharmacare system that covers all Canadians. No matter how young or how old, no matter where they live and no matter how they make their living, all Canadians have the right to prescription drug coverage, and this legislation is critical in getting it for them. The legislation is always going to be critical, but, right now, with coverage for contraceptives and diabetes medication, these two classes of drugs would impact millions of Canadians. For example, nearly four million Canadians are affected with diabetes, a disease that impacts every aspect of their lives. In my province of Alberta, individuals with diabetes have had to fight the provincial government repeatedly to ensure they get the care they need and deserve. The bill would means that people living with diabetes may finally be able to put those battles aside and finally have hope for their future. By treating diabetes with devices and supplies on the same terms as the prescription medication, this legislation would save diabetics hundreds, if not thousands, of dollars each year. With regard to contraceptives, we know the impact of contraception on women across the country and how vitally important this is. Manpreet Gill, the president of the Edmonton Zone Medical Staff Association and associate professor in the division of General Clinical Medicine at the University of Alberta, has written about the importance of contraceptive coverage to health and especially health care in Alberta. Dr. Gill states: The cost of hormonal therapy (including for birth control) and intrauterine devices (IUDs) is a barrier for Albertan women to receive medically necessary care.... It also perpetuates unfairness in the system, resulting in unplanned and unwanted pregnancies. Universally available contraception would reduce the number of abortions, reduce economic stress on young and poor women and improve child and maternal health. It is estimated that 40 per cent of pregnancies in Canada are unplanned and it seems obvious that those who cannot afford contraception cannot afford to have a child. The current patchwork system in Alberta is blatantly unfair. First, it is obvious that birth-control costs are primarily borne by women while men bear no such equivalent costs.... Secondly, while it is true that private plans cover birth control, it is worth considering two facts that this reveals. One, birth control reduces the costs to a private health plan, that’s why it is offered, and two, those that most [have that] need [are unable to] access...it. As a woman, as a mother and as a mother of a daughter, I want my daughter, and every daughter in our country, every daughter in this world, to have access to the entire range of reproductive health care, including contraceptives. A system that provides access to some, those who can afford care, while denying access to others is not a system that I can support. Reproductive health care is health care, period. Finally, I want to thank all the advocates across Canada who have worked so hard and so long to create this legislation. I want to thank Chris and the powerful advocates at Friends of Medicare in Alberta, who have worked not months, not years, but decades for this universal pharmacare. I want to thank the Canadian Labour Congress, the Alberta Federation of Labour and all the labour leaders, organizers and members across Canada who have put the needs of all Canadians, regardless of union membership, at the forefront of their campaigns for pharmacare. We are here today because of the hard work of so many Canadians and so many leaders in our country. I continue to be delighted and honoured to work with all those leaders to ensure we get this over the finish line.
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Context: House Hansard - 323 - Jun/3/24
Mr. Peter Julian
  • Jun/3/24 1:30:29 p.m.
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  • Re: Bill C-64 
Mr. Speaker, the Bloc Québécois appears not to be answering the question. A vast coalition of two million Quebeckers told the Bloc Québécois to vote in favour of Bill C-64. Its members are critical of Quebec's existing plan. I am quoting them because it is important. I am referring to the Union des consommateurs, the Fédération interprofessionalle de la santé du Québec, the Centrale des syndicats démocratiques, the Confédération des syndicats nationaux and the Fédération des travailleurs et travailleuses du Québec, which, on behalf of two million Quebeckers, are calling on Bloc Québécois members, who are members for Quebec after all, to listen to them and take action by passing Bill C‑64, which the NDP introduced in Parliament. Let us be clear. I am quoting a coalition that the Bloc Québécois seems unwilling to listen to. We are asking the federal government not to give in to the provinces and territories that are asking for an unconditional right to opt out with full financial compensation. This coalition is saying that we need to pass Bill C‑64 and we need these negotiations. Why does the Bloc Québécois insist on blocking this bill and refuse to listen to Quebeckers who want it to pass?
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Context: House Hansard - 323 - Jun/3/24
Mr. Luc Thériault (Montcalm, BQ)
  • Jun/3/24 1:27:24 p.m.
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  • Re: Bill C-64 
Mr. Speaker, as my colleague has clearly demonstrated, Bill C‑64 is much more the expression of an election agreement than of a bill. Why? That would be because a bill of this scope would have required prior coordination, at least with the nation that put a system in place 30 years ago. Here in the House, the Quebec nation has been symbolically recognized on two occasions, but the moment that that has a legislative impact, it is out of the question. The National Assembly unanimously agreed that it wanted the right to opt out with full compensation to improve its plan. What is so hard to understand about that? My colleague clearly demonstrated that. The worst part is that, in addition to the first phase of the bill, the government intends to implement something with no accountability. Has anyone ever seen a Canadian prime minister lose their seat in an election because of health care? It has never happened. Why? Because health care has never been their jurisdiction. In Quebec, however, governments have fallen over health care. The government wants to meddle in the affairs of others, and with no political accountability, to boot. What does my colleague think about that?
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Context: House Hansard - 323 - Jun/3/24
Mr. Peter Julian (New Westminster—Burnaby, NDP)
  • Jun/3/24 1:24:27 p.m.
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  • Re: Bill C-64 
Mr. Speaker, I am quite fond of the member, but she just said that we need to listen to Quebeckers. However, as the Bloc Québécois members should know, the largest coalition in Quebec's history, namely two million people under the umbrella of all the central labour unions, the Centrale des syndicats du Québec, the Centrale des syndicats démocratiques, the Confédération des syndicats nationaux, the Fédération des travailleurs et travailleuses du Québec, the Union des consommateurs and all the allied groups around the Fédération de la santé et des services sociaux, is calling for us to pass this bill, Bill C‑64. The coalition members have been very critical of the current program in Quebec, including the fact that there are user fees for the drugs and many people are not covered. There are a lot of problems with the current situation. This broad coalition that the Bloc Québécois seems to refuse to listen to, says the following: We are asking the federal government not to give in to the provinces and territories, which are asking for an unconditional right to opt out with full financial compensation. The coalition members want to have the NDP's public, universal pharmacare program. I have a very simple question. Why is the Bloc Québécois refusing to listen to Quebeckers?
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Context: House Hansard - 323 - Jun/3/24
Mrs. Marilène Gill (Manicouagan, BQ)
Mr. Speaker, I have risen three times today because I was so eager to speak. I am pleased to speak today at third reading of Bill C-64. We have been debating this bill for a long time. Clause-by-clause study took place last week, but we do need to wind up the debate at some point. Before continuing with my speech, I would ask my colleagues to respect my right to speak and not talk over me. First, to make things clear, if they are not already, the Bloc Québécois's position has not changed one iota: We are against Bill C-64. I would like to remind my colleagues of the purpose of the bill. Obviously, a bill can have several different purposes, depending on which side we are on. Sometimes it may seem like a bill has a noble goal, but that may not be the case. I would like to talk about something that is totally obvious to me but that people tend to forget when we get into these debates. Bill C‑64 addresses one of the 27 items in the agreement that the Liberals reached with the NDP in 2022 to stay in power by forming a sort of coalition with the NDP. This may have been in the NDP's best interests, although maybe it will want to argue that point. I would like to remind the House of the wording of the second item in this agreement: “Continuing progress towards a universal national pharmacare program by passing a Canada Pharmacare Act by the end of 2023”. They want to “continu[e] progress”. We often hear similar phrases in the House, phrases like continuing to move forward, continuing progress or continuing to do something. That is all very vague, in my opinion. I would imagine that pretty much anything we do is progress, even the bill we are currently discussing. Perhaps that covers the disagreement there was between the Liberals and the NDP on this issue. As members know, the Liberals dragged their feet on introducing this bill. This bill was in the works for years. They were talking about it in 2022. It was introduced on February 29. They could not agree on the cost of the measure. Of course we would like to see a pharmacare act, but perhaps not at all costs, if my colleagues will pardon the pun. This bill was introduced on February 29, at the very last minute, to save the agreement and to save the Liberals. I might add that it was also to save the NDP. I must say that I did not hold my breath at the time. A moment ago, I talked about the purpose of the bill. I think that this bill was introduced purely for the purpose of garnering votes. It could have been introduced sooner, but there was an agreement. The NDP would not want to bring the government down. That is why I was not surprised when the bill was introduced this year, one year away from the election, just before the budget. I also get the feeling that it may have been because the government is short on ideas. I have spoken many times about the government's lack of vision. It has been eight, almost nine, years since the government came to power. It will have been 10 years by the time the election comes around. I have noticed that the House is copying the debates taking place south of the border. Take the debates over contraceptives and diabetes medication. It is not that I am not happy to see my colleagues across the aisle and next to me tackling the official opposition, to use a soccer term, here in the House over a woman's right to do what she wants with her own body. I was not unhappy about that. However, it is being done for the purpose of gaining votes. There is one party in the House that wants to limit women's rights. This may resonate with some people, even me, but it should not be done for that purpose alone. In fact, maybe it was entirely arbitrary. The government did not know what to do, what to propose. It desperately wanted pharmacare, but it had no idea what it really wanted to do, so it thought about what could help it win votes. It figured that it could take certain debates from the U.S. bipartisan system and copy them here to pit the good guys against the bad guys. In short, I am not saying that these billions of dollars that will be spent by the government are a form of pre-election advertising, but that is what it looks like. Again, Quebeckers and Canadians need to be aware of the partisan agenda hidden behind this bill. There is a hidden objective. I think it takes a certain kind of courage to oppose a bill that seems virtuous. That is what we are being told: If we do not vote in favour of the bill, it is because we are against it. I, of course, am 100% in favour of a woman's right to choose and all methods of contraception. I am a member of the Bloc Québécois. I speak on behalf of Quebec. I am not against the provinces' positions. I do not mind if they decide that the federal government can interfere in their jurisdictions. That is their choice, and I respect it. At the same time, that is not what I want for Quebec. That is why the Bloc Québécois proposed the following amendment in committee: Despite subsections (1) and (2), a province or territory may elect not to participate in national universal pharmacare, in which case that province or territory remains unconditionally entitled to receive payments in order to maintain the accessibility and affordability of the prescription drugs and related products already covered by its public pharmacare. Our amendment concerns the ability to opt out with full compensation from the pharmacare program. It was not debated because we could not debate it in committee during clause-by-clause study of the bill. It was not rejected either. I would say that what happened is even worse: It was ruled inadmissible. I wish I could avoid talking about the reasons the committee chair ruled the amendment inadmissible, but I think it is important to go over them because this is just another clear demonstration of bad faith, in my opinion, and the federal government's disregard for the jurisdictions of the provinces and Quebec. It was argued that the amendment required a royal recommendation, which is false. What we were told is that it will generate additional costs and that, since we are an opposition party, it requires a royal recommendation. I hate to say it, but that is absolutely false. The amendment did not require a royal recommendation, because the funds had already been committed by the government. The Bloc Québécois's amendment was therefore legitimate and admissible. This is not the only time that government members have made arguments that do not hold water and that are merely a pretext to interfere in Quebec's jurisdiction. The government did the same thing in the case of Bill C-35, which deals with the child care program. As far as I am concerned, this is not only a sign of disrespect toward Quebec, it is basically an insult, because over the decades, Quebec has built a social safety net that is the envy of North America. We have pharmacare, as well as dental coverage for young people. We have free education and early childhood centres. We have made some huge social advances. In this case, the federal government is digging in its heels and refusing to allow Quebec to opt out unconditionally with full compensation. As I see it, Ottawa is refusing to recognize Quebec's decades of leadership in this area. The same thing happened with child care centres and Bill C‑35. What is more, the federal government is doing all this without having jurisdiction over this area or having any expertise in care and social services. Quebec is being denied something we have every right to request by a government that lacks both expertise and jurisdiction. The government has no compunction about turning us down, but at the same time, it has to follow our example with a view to “continuing progress”, as they put it so eloquently. I have no problem with the federal government continuing progress, but I do not want this progress to come at Quebec's expense. As I said before, Quebec already has a public pharmacare plan for part of the population that the government introduced nearly 30 years ago. I need to repeat this because I think some people have trouble hearing it. This is not the case with everyone, but in the House, it is true of nearly the majority. As far as Canada is concerned, it is trying to catch up. It is behind by 30 years, so now it is encroaching on our jurisdiction. It may be more. We also have a private plan offered by employers, to which workers contribute as well. No one in Quebec lacks pharmacare coverage. People need to stop spreading falsehoods. The choice was made by Quebeckers. It was not Ottawa that made this choice, it was Quebec. Our plan is also paid for by Quebeckers. The federal government did not give a red cent for this plan. We know what is right for us. We do not need someone else to tell us. We are capable of taking care of ourselves. We do not need paternalistic Ottawa trying to manage a pharmacare plan in Quebec without expertise, without legitimacy and without experience. I keep thinking that what the Bloc Québécois is asking from the federal government is simple and it makes sense. We are asking the federal government to take care of its own responsibilities, such as foreign affairs, defence and fisheries. It seems to me that the federal government has enough responsibilities. It has more than enough things to take care of. Perhaps that is not sexy enough for the government. I should ask that question. Is that sexy enough for the government? Health and education are the two areas that affect people the most. Of course, health is a matter of major importance. We talk about the things we care about. If we are not alive, then nothing else matters, obviously. Health is important. These are the two budget items that are most important for Quebec. The government knows that, for years now, its health transfers have been insufficient. They are shrinking down to nothing. It knows all that. If the government reduces the transfers, the burden will fall heavily on Quebec and the provinces. Who gets the blame when there is a shortage of care and services? Quebec and the provinces, obviously. Jean Chrétien understood this well. He bragged to the G7 that all he had to do to balance the budget was reduce health transfers. He said that Canadians would look for someone to blame, but that they would not blame the federal government, because health is under Quebec's and the provinces' jurisdiction. They are the ones who would be cutting health care and education. For him, it was simple: Canadians would take it out on the provinces. The federal government would be able to achieve a balanced budget, and no one would hold anything against it. The provinces would pay the price, both literally and figuratively. It always comes down to this, unfortunately, but as a separatist, I have no other choice. I am a separatist and I am pragmatic. It always comes down to the fiscal imbalance. The federal government collects more money than it needs to fulfill its responsibilities, while the provinces and Quebec are not collecting enough to manage their own jurisdictions. They are short of money, which gives the federal government an opening to spend money on things under Quebec's and the provinces' jursidiction. It is unbelievable. It is like the federal government is stealing from the provinces and Quebec. It is strangling them. If they meet certain conditions, it will back off and let them breathe again. We would not thank anyone who is strangling us for stopping. We understand that interference is always done with a purpose. I mentioned this earlier, but it is still the same thing with the government and its minions. The federal government swoops in like a saviour, slapping its flag on cheques, which it tosses around like confetti, and the cavalry of government members run around, trumpets blaring, trying to solve the problems it created itself. In fact, the more I think about it, the more I like that image. It has definite educational value. However, although we may be laughing over it, it is a hard fact. While the government is gaily running around, it has forgotten why it was elected. Perhaps it does not know. Perhaps it has forgotten. When a government has no vision, it may take a peek in the neighbour's yard, looking for direction. Again, interfering in areas of provincial and Quebec jurisdiction has a purpose for them. In fact, the purpose is twofold in this case: one, to keep the government in power, and two, to prepare for the next election. Until we gain independence, Quebeckers will have to fight to make sure this government respects us, respects our expertise and experience and gives us what is ours, meaning our money and, of course, control over our own jurisdictions. It will also have to respect the fact that we have our own pharmacare program. Quebeckers are capable of discussing amongst ourselves, at home, and improving our pharmacare plan with our experts, based on our experience and our wishes. It is not up to the federal government to tell Quebeckers what to do. We refuse to let our own tax money be used against us and at our expense. One way to respect us is to vote down Bill C‑64. I may be a member of the Bloc Québécois, but I am not the only one who says so. The Quebec National Assembly has said it too. Christian Dubé, Quebec's health minister, pointed it out the day before the bill was introduced. We do not want this bill. We do not want the federal government to encroach on areas of Quebec's jurisdiction. I would remind the House that the National Assembly alone speaks for all Quebeckers. In closing, I would therefore like to let the voices of Quebeckers be heard through the unanimous demands of the National Assembly for compensation to be paid to Quebec. That is what the Bloc Québécois has asked for, because the Bloc Québécois speaks on behalf of Quebeckers. The motion unanimously adopted by the National Assembly on June 14, 2019, reads as follows: THAT the National Assembly acknowledge the federal report recommending the establishment of a pan-Canadian pharmacare plan; 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; 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 was back in 2019, so the Quebec government made its position clear quite some time ago. Today, I am still trying to be a voice for the National Assembly. I hoped that the federal government would respect Quebec's decision to refuse to join the federal plan, for example, in the motion put forward at the committee studying Bill C‑64. We respect the provinces that want to take part in the program set out in the bill, since coverage is rather inconsistent across Canada, but in Quebec, everyone is covered by a pharmacare program. It is up to us to decide what we want to do next. It is not up to the federal government.
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Context: House Hansard - 323 - Jun/3/24
Mr. Damien Kurek
  • Jun/3/24 12:41:56 p.m.
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  • Re: Bill C-64 
Mr. Speaker, it is interesting how calling out the failures of the NDP not only offends New Democrats, but offends Liberal members of Parliament. It truly is telling of the level of absurdity that this place has descended into, when simply calling out the failures of this so-called confidence and supply agreement, this coalition, this poorly negotiated agreement that has propped up one of the most corrupt governments in Canadian history, that NDP and Liberal members would become so offended when we bring forward some things, including talking about the history of those parties. I will be happy to address some of the failures specific to the Liberal Party here in short order, for that member specifically, but it seems like that they do not want to hear those things because they are simply offended that somebody would dare question their pre-eminence. I will get into the substance of Bill C-64 in just a moment, because the context of it is so important. The Liberals, backed up by the New Democrats, do not want an opposition in this place. That is why the Liberals bought off the NDP. That is why we see so often that the Bloc Québécois are quick to go with them. They want an audience, not an opposition. This is a sad state of affairs. This place has a long democratic tradition, where we should be able to discuss the affairs of the nation and have meaningful debates. Whenever somebody suggests very valid points of criticism, such as those I brought forward to the previous Liberal member, like our concerns about the impact that Bill C-64 would have on the coverage of many Canadians, the government's response has been to ask us to trust it. Many Canadians over the last nine years have clearly communicated their concerns to me and many of my colleagues. I know that many Liberals are hearing the same thing. As I have travelled across the country, in airports or in communities that, in some cases, are represented by Liberals, I have heard from individuals saying they have lost trust not only in the Liberals, but also in the way that the Liberals, propped up by the NDP, have conducted themselves over the last number of years. There is an erosion of trust in our institutions. For the government to ask us to trust it is not good enough, when there a real risk that 97% of Canadians, who do have some form of drug coverage currently, may be at risk of losing some of those benefits. That is a real concern for so many Canadians. In this circumstance, the government has promised much and has truly delivered very little. Government members will stand up and bluster about how great this is and whatnot, but when it comes to what Canadians actually need, they are failing to deliver. A clear proof point on that front comes from the government's work with provinces. The Prime Minister was quick to brag about going around the provinces to deliver his agenda. However, when it comes to the history and the way that this federation was built, health care is provincial jurisdiction. Now, the federal government does play a role in the federal health transfer. We have seen on that front that there is a litany of failures. In fact, the Prime Minister promised to tear up the previous agreement that would have actually resulted in more funding dollars, because it was tagged to inflation, than the agreement that the Prime Minister went around the backs of different provinces to sign. He was quick to talk and puff up his chest, yet he has not met with premiers since those initial discussions, despite saying it was so important to meet with the premiers nearly a decade ago. We have even seen how different provinces are treated differently. There are some provinces that the Prime Minister has been quick to suggest the government is happy to work with and other provinces that they may not like the party that those people in that province elected. It is not a conversation around whether they should or should not like a particular political party. The government is quick to dismiss any province that would bring forward legitimate concerns. When the government tries to go around the provinces, it ends up ultimately putting Canadians and the care that Canadians expect and deserve at risk. There is no question that we need to address some of the challenges when it comes to health care. That is why Conservatives have been talking so significantly about some of these things, including making sure that Canadians have access to care, especially when there is a shortage of family doctors. There are so many doctors who are not eligible to work in Canada today because there is no clear process for recognition. The solution to that is very simple. We need leadership that will bring the country together, to figure out that path forward so that what could be tens of thousands of doctors could actually get to work delivering the care for Canadians, following that Hippocratic oath that they took when they entered medical school. That would be good news for everybody because it would address a shortage. It would increase productivity. One of the challenges, and it is interesting because one does not hear the Liberals talk very much about this, is that we have a massive productivity challenge in our country. When one has wait-lists, when one has long processing times, and this is not limited to health care but includes permitting for houses, benefits, name it, if there is a delay, it has a negative effect on productivity. However, it is specifically impacting productivity on our national workforce when it comes to health care. Canadians are being forced to wait. A constituent of mine waited three years for a hip replacement because they were in their 40s. Because of the processes and the hoops that they had to jump through, they had to stop working and there were family challenges associated with that. Again, these other parties do not want to hear some of this stuff, because they would rather simply stand on an empty promise than actually address the real challenges that are facing our constituents. When it comes to productivity, if we can address some of those things, we will see our national productivity increase, and we will provide more doctor and nurses. It makes sense that one has a nurse that is trained at an institution and has the training that is required to deliver the quality of care that is acceptable in this country. The proposal that the Leader of the Opposition has brought forward, which he has called the blue seal plan, would give certainty in a process that currently has no certainty. That is just common sense. For somebody who is looking for opportunity, looking for a future, looking to build what used to be known as the Canadian dream, which has been so much eroded under these Liberals, there would be certainty. A physician, a nurse or another health care provider could come to this country and have certainty. What the Leader of the Opposition has talked about is that within 60 days they would be given the thumbs-up or thumbs-down so they could get to work or at least know then, going forward, what upgrading and what training needed to be done so that they could deliver that care that, obviously, they want to give to Canadians. It is truly a shame that there are so many talented immigrants in this country who are not able to do the work that they trained so hard to do. That is an absolute disgrace, yet, with some political will, some collaboration and working with provinces, as opposed to pitting them against each other like what the Liberal government does on a daily basis, we could see solutions and better outcomes for Canadians. There are serious concerns that I hear about, and I know many of my colleagues do as well. Because of the potential impacts of the passing of this bill, there would be an erosion or outright dismantling of private drug plans. That includes publicly funded drug plans that are delivered by private companies, as everybody in this place, and all public servants, the 400,000 of them or so, are experiencing, as well as with provincial and other levels of government. In this process, we have not heard clarity. The Liberals will say that they addressed that at committee. Yes, it was asked. The questions were asked, but the answers were not given in any way that would provide certainty. What does this mean? The bill talks about being single-payer, which may be simply fanciful language from the Liberals to appease their coalition partners in the NDP and means nothing. I would suggest that this is just as bad, because it is abusing the democratic process and just speaks to the poor negotiating tactics of the leader from Burnaby South, but we will leave that, because I think I addressed that appropriately in the beginning of my speech. This could practically mean that private companies would then be changing the way that they deliver those specifics. It would put employee benefits at risk, including when somebody signs up for a job. When somebody signs a contract for work, the benefit package is a part of the compensation package. The Liberals have not done their job or their homework in terms of making sure that all the i's are dotted and the t's are crossed, as the saying goes. What they are doing could put some of those things at risk and directly impact the ability of Canadians from coast to coast to coast to access the drugs they already have. That could mean simple issues, such as the pharmacist saying, well, this certain drug is not covered, but this one is, or outright not being able to get it covered altogether. This can be a huge issue in some cases. Further, it could scrap coverage plans, and there is no question that it will force Canadians onto the government plan. We see this as well when it comes to the dental care plan. We have yet another example where there is big talk but little in terms of actual deliverables for Canadians. In fact, it is interesting. When we listen to the Minister of Health, he talks about how many people have signed up for the program. Even last week, he said how many people had registered for potential appointments. The language he used was truly a cop-out. If the government want to deliver health care for Canadians, then it should get to work and work with provinces to ensure that provincial plans can be complemented and whatnot. However, that is not what the Liberals did. They signed an agreement, seemingly on the back of a napkin, to keep the NDP happy. This does not fulfill the promises and the objectives that they so publicly brag about. The result is a very real potential that, in terms of outcomes, Canadians will not be better off after the Liberals have tried to fix the problem. This is the case when it comes to drug coverage, as we are debating today; when it comes to dental care, as has been and will continue to be debated; and when it comes to so many of the other things that the Liberals have promised. What is the solution? Well, first and foremost, we need leadership in this country that will bring provinces together to address the challenges we face in ensuring that Canadians can get the health care they need. That includes mental health care. This is incredibly relevant when it comes to this conversation because the Liberal Party promised that there would be a Canada mental health transfer, yet we are now several years into a mandate and that promise has not been delivered on. I guess it was not negotiated on the back of a napkin in this confidence and supply agreement. This speaks to how little the Liberals care about ensuring that Canadians have access to the care they actually need. We need leadership in this country so we can make sure that every Canadian can, in fact, have those better health outcomes and that Canadians can, once again, start to trust the institutions that we have worked so hard to pay for over multiple generations in this country. I look forward to being able to answer questions on this and ultimately ensure that we get answers for Canadians.
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Context: House Hansard - 323 - Jun/3/24
Mr. Yasir Naqvi
  • Jun/3/24 12:29:52 p.m.
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  • Re: Bill C-64 
Mr. Speaker, I want to thank the member for Don Valley East, who had the honour of serving in the provincial legislature. He will remember when we worked together to create OHIP+, which started providing universal access to pharmacare for young people, which was a game-changer. It was unfortunate that Doug Ford gutted that program. The member for Don Valley East is absolutely right. Our number one job and responsibility to Canadians is to make sure that we make their lives easier, and the way we make their lives easier, whether it is affordable child care or seniors being able to access a dentist or dental hygienist to look after their oral care, is to have programs available to make their lives better. That is what we all hear at people's doors. Those are the kinds of things people are concerned with, and that is the job we have been given. In particular, in this Parliament, as we come out of the once-in-a-lifetime pandemic that we all lived through, so many structures within our society have been shaken as a result of the pandemic that we have to do this extra work, whether it is through Bill C-64 bringing pharmacare into our country, through $10-a-day child care, a Canadian dental care program or the unprecedented investment that we are making in our public health care system to ensure that Canadians know that their government is actually paying particular attention to their day-to-day needs, and this is exactly what we are doing.
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Context: House Hansard - 323 - Jun/3/24
Mr. Yasir Naqvi (Parliamentary Secretary to the Minister of Health, Lib.)
  • Jun/3/24 12:02:37 p.m.
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  • Re: Bill C-64 
Mr. Speaker, it is my privilege today to begin the debate at third reading stage of Bill C-64, an act respecting pharmacare. The legislation, as people know, is a priority for the government. It would establish the fundamental principles for implementing a national pharmacare program in Canada. Additionally, it would outline our plan to work with participating provinces and territories to deliver universal single-payer coverage for various contraceptives and diabetes medications. This is an important step toward a national universal pharmacare system, as well as a historic event in the evolution of health care in Canada. The core principles outlined in the bill are accessibility, affordability, appropriateness and universality. Accessibility ensures that Canadians can access pharmaceuticals regardless of location or income, while affordability aims to minimize financial barriers. Appropriate use prioritizes patient safety and health outcomes, while ensuring the sustainability of the health care system. Last, the legislation would advocate for universal coverage across Canada. These principles would shape our collaborative efforts with provinces, territories and indigenous communities to establish national universal pharmacare. Our government has repeatedly and consistently demonstrated our commitment to public health care. Budget 2023 announced $200 billion over 10 years to better support the health and well-being of Canadians with a strong and effective health care system. More recently, in budget 2024, we committed $1.5 billion over five years to launch the new national pharmacare plan. The plan would help provide support for Canadians seeking access to contraception and for those living with diabetes. Let me focus some of my time on contraception. Canada has more than nine million women of child-bearing age, who account for nearly a quarter of our population. For many of them, access to safe and reliable contraception is essential. It would grant them the autonomy to be intentional about their family planning and pursue their aspirations for the future. This may involve advancing their education or their careers, delaying starting a family until they feel prepared or choosing not to have children at all. Affordability has been recognized as the primary obstacle in accessing birth control. This can lead to individuals' not using it consistently and may discourage them from opting for the most reliable method available. Consider oral contraceptives as an example. This type of birth control is priced at roughly $25 per month and carries a typical use failure rate of 9%. Compare this to IUDs, which cost up to $500 per year. Although IUDs are a higher initial investment, they provide coverage for five years and have a use failure rate as low as 0.2%. Women should be able to make the choice between different types of contraception, regardless of whether they can afford it. Many Canadians are just simply not in a position to pay for these upfront investments. For example, a young, part-time worker who does not have drug coverage from their employer would struggle to pay for a $500 IUD. With limited income from sporadic employment, which is typical for many young adults, even the monthly prescription cost can present a significant financial burden. This is the reality for many Canadians, and it is a reality I have heard from some of my constituents in Ottawa Centre. One study indicated that women and girls from lower-income families tend to use less-reliable contraceptive methods or opt out of using contraception altogether. This disparity emphasizes how socio-economic factors intersect with access to reproductive health care, identifying gaps in our health care system and perpetuating cycles of systemic inequality. Additional research has even shown us that providing contraception through public funding can actually result in public cost savings. The University of British Columbia estimates that implementing no-cost contraception has the possibility of saving the B.C. health care system around $27 million per year. Recently, I had the opportunity to meet with Planned Parenthood Ottawa in my community of Ottawa Centre. Our conversation focused on a broad range of issues, but in particular we spoke of the impact Bill C-64 would have on the health of women here in our community. What became clear to me in that conversation was that contraception is not merely a matter of personal choice. It is an integral aspect of health care. It is a fundamental aspect of reproductive health, and it plays a pivotal role in advancing gender equality. It was also made clear to me that, by ensuring affordable access to contraception, this legislation would advance gender equality. Preventing unintended pregnancies would enable more Canadians to participate in the economy, which would result in greater prosperity for all. This is crucial for building a more equitable society where everyone has the opportunity to thrive. I want to thank Planned Parenthood Ottawa for the good work it does, day in and day out. I was really happy to speak to its representatives recently to let them know of a funding grant it is receiving to continue doing this important work in our community. I am thankful for them for meeting with me and for educating me further on the impact Bill C-64 would have on women here in our community and across the country. Moving on to the impact on diabetes, we can apply the same cost-saving principle that I was speaking to in the case of contraception to medications that treat diabetes. Diabetes is one of the most prevalent chronic disease in Canada, impacting 3.7 million individuals at present. There are projections that this number will continue to grow. Many of us know someone with diabetes and have seen the devastating effects it can have on a person's quality of life. While diabetes has no cure, treatments are available to control it. These treatments are not always affordable or accessible to those who need them. We know that 25% of Canadians with diabetes have identified that the cost of their medications has impacted their ability to stick to their treatment plans. Neglecting proper management of this disease can result in devastating consequences. When we made the announcement introducing Bill C-64, I was honoured to join the Minister of Health and many community advocates, who have been working in this area for some time, at the Centretown Community Health Centre, which is also located in my community of Ottawa Centre. Prior to the announcement, we met with some of the social workers, the primary health care practitioners and nurses who work at the Centretown Community Health Centre, which is a fabulous institution in my community. In fact, I used to serve on the board of the Centretown Community Health Centre some time ago. When we met, we talked about the impact of this legislation. With regard to diabetes, we spoke to a specialist there who told us countless stories of individuals who she meets, and treats, who ration their diabetes medication. They are unable to afford the cost of their medication due to their current circumstances. It was made clear that, when diabetes is not properly managed, it can result in severe complications, such as heart attacks, strokes, blindness and even amputation. In 2018, the total cost incurred by the health care system due to diabetes was estimated to be around $27 billion, a figure that we can expect to increase to $39 billion by 2028. These figures emphasize the urgent need for effective measures to mitigate the impact of diabetes and its associated costs on both individuals and the health care system as a whole. Independent of the legislation, the Government of Canada revealed its plan to collaborate with the provinces and territories to establish a diabetes devices fund. This initiative aims to guarantee that individuals with diabetes will have access to the essential medical devices and supplies they need to manage their treatment, including syringes, glucose-monitoring devices and insulin pumps. This, along with the framework outlined in Bill C-64 for universal single-payer coverage for first line diabetes medications, would prevent any person living with diabetes in Canada from having to ration their medication or compromise their treatment. These actions will benefit all Canadians by helping diabetics control their disease, making it less costly to treat over time. I want to address the concerns that pharmacare might affect private drug coverage, something that came up in the conversation when we were considering this bill at committee. Bill C-64 does not mention private drug insurance or regulate any of its activities. I want to be really clear about that. Our work with provinces and territories to offer universal single-payer coverage for contraception and diabetes medications would benefit all Canadians needing those drugs, regardless of their insurance status. Since the initiative is focused, benefits provided by private insurance are expected to remain unchanged. That choice remains in place. As the two examples just mentioned show, the high cost of medication has become a pressing concern for too many people in Canada. For them, access to affordable medication is still a major challenge. When medicare was first introduced in the 1960s, prescription medicines played a smaller role in the overall health care system. They were primarily administered in hospital settings, and those distributed beyond hospital confines were generally low in cost, but that is not the reality today. Today, medicines are a vital and regular part of maintaining one's health. We know that roughly 1.1 million Canadians lack access to private or public drug insurance. That is approximately 2.8% of our population. In 2021, Statistics Canada found that one in five adults in Canada did not have the insurance they needed to cover the cost of the medication. In other words, 21% of adults in Canada face out-of-pocket drug costs that create a financial burden. This can lead people to forego their basic needs, such as food or heat, or even lead people to ration their medications or choose not to fill their prescriptions at all. Canadians should not have to choose between buying groceries and paying for medication. Being forced to make choices like these has serious consequences. Whether they are skipping meals or doses of medication, or opting to go without, sets off a chain reaction of adverse effects on the health of individuals and can heighten the strain on our health care and social support systems. We can do better and we must do better. While it entails a financial commitment, the alternative, which is not investing in our pharmacare, would result in far more severe health and financial repercussions, as we can see with the two examples I presented earlier. It is worth also noting that Canada has one of the highest per capita rates of prescription drug usage globally. Despite recent improvements, the elevated drug costs and the fragmented nature of drug coverage pose significant barriers for many individuals in Canada when it comes to accessing the prescription medications they need. In acknowledgement of these concerns, in December 2023, our government announced plans to advance the establishment of a Canadian drug agency, in short the CDA, with an investment of $89.5 million over five years, starting in 2024-25. The CDA will be built from the existing Canadian Agency for Drugs and Technologies in Health in partnership with provinces and territories. The Canadian Agency for Drugs and Technologies in Health publicly announced its transition to the CDA on May 1. Canada's drug agency, or CDA, will play a central role in leading and coordinating initiatives designed to improve the sustainability and readiness of Canada's drug system for the future. Bill C‑64 sets out three main tasks for the CDA. Initially, the agency would prepare a preliminary list of prescription drugs and related products to guide the establishment of a national formulary. This formulary would outline the range of prescription medications and associated products that Canadians should be able to access under the universal, national pharmacare. Additionally, Bill C-64 would entrust the agency with formulating a national bulk purchasing strategy for prescription drugs and related products in co-operation with partners and stakeholders, including provinces and territories. This plan would explore methods to lower the cost of prescription drugs, which could help alleviate financial pressures for both individuals and the health care system. The agency would be required to finalize both the preliminary list and the strategy no later than the first anniversary of the day on which this act receives royal assent. Last, the agency would aid in the publication of a pan-Canadian strategy concerning the appropriate utilization of prescription drugs and related products. This report would be released within one year of the bill receiving royal assent. Canada's drug agency would also be obligated to provide updates on the progress of implementing the strategy every three years. As we know, national universal pharmacare cannot be accomplished without the contributions of the provinces, territories and indigenous peoples. Given Canada's size and diversity, each province and territory has unique needs and specific challenges. To establish a national pharmacare program that is both effective and fair, it is crucial to foster strong collaboration between the Government of Canada and all partners. Each stride toward national universal pharmacare will be made hand-in-hand with these partners. Future funding to support pharmacare will be allocated to provincial and territorial governments by way of bilateral agreements. This funding would supplement, rather than replace, existing provincial and territorial investments on public drug benefit programs. In the immediate future, we will draw insights from ongoing initiatives as we persist in our efforts to enhance accessibility and affordability for all Canadians through a national pharmacare program. Since August 2021, for example, our government has been working with the Government of Prince Edward Island to reduce drug costs for patients through the improving affordable access to prescription drugs initiative. Since then, P.E.I. has expanded access to over 100 additional medications on its roster of covered drugs, including treatments for cancer, heart disease, migraine and multiple sclerosis, just to name a few. As of June 1, 2023, P.E.I. lowered copayment costs to $5 for nearly 60% of commonly prescribed medications for its residents. As a result of this initiative, within the first nine months alone, P.E.I. residents have saved over $2.8 million in out-of-pocket costs for over 330,000 prescriptions. In addition to the progress being made on a regional level, I am happy to also share some of the work being done on a national level to support our pharmacare efforts. Bill C-64 builds on the work we have done to make drugs for rare diseases more accessible. In March 2023, we launched Canada's first-ever national strategy for drugs for rare diseases. Supported by federal funding of up to $1.5 billion over three years, this strategy aims to enhance accessibility and affordability for medications for rare diseases, ensuring they are in reach for those who need them. It marks the beginning of a national approach seeking to meet the need for drugs used in the treatment of rare diseases. As my time is winding down, I want to say in conclusion that, in Canada, it is our belief that everyone should receive prompt access to the health care they need, when they need it, irrespective of financial needs. This principle is a core Canadian belief, and we are dedicated to defending it. Bill C‑64 is a major step forward in our commitment to guaranteeing all Canadians access to affordable, high-quality drugs. Our plan for universal coverage of contraception and diabetes medications would be life-changing for individuals, families, society and our health care system. While there is a lot of work ahead, we have already made substantial progress, from regulatory modernization to enhancing access to drugs for rare diseases, establishing Canada's drug agency and collaborating with the provinces and territories. Passing this legislation would allow us to build on this momentum. We stand at the threshold of a new era in Canadian health care. We should seize this opportunity to invest in a stronger Canada. I thank members for their attention. I encourage all members of the House to vote in favour of Bill C-64.
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