So V ote

May/30/24 2:46:03 p.m.
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Mr. Speaker, there it is. I wondered, as they continually put down our country, who they want us to be and what they want to emulate. Now we know that they prefer to have a United States model, for example, of health care. I was down south a couple of months ago with my partner, and an individual fell over. When they came conscious after I called 911, their concern was not their health; their concern was money, that they did not have the money for care. I do not want to live in that country. On this side, we will fight for public health care, we will fight against the cuts the Conservatives want to bring to our health care system and we will make sure that every Canadian gets access to the care they need.

137 words

May/29/24 11:13:13 p.m.
Watch
Re: Bill C-64

Madam Chair, first of all, for Dylan and Kim, I appreciate the member's advocacy. I cannot imagine how difficult that circumstance is, and that is exactly what we want to shut down. This is precisely why we are acting on pharmacare. One very important question we have is about which model to use. We have a pilot in P.E.I. that is working very well, which is based on a fill-in-the-gaps model. The model that Bill C-64 is based on is a universal model. We are now looking at those two models in a real-world setting to see which one is best to use as a delivery mechanism for all drugs. We have a committee that will be looking at that over the next year, which will really paint that path forward. These are very active matters of consideration, and this is one of the reasons it is so important that we establish that bedrock, which is the legislative foundation for pharmacare in Bill C-64, and take this action. In this way, we can make sure that we get to help families such as that of Dylan and Kim. That is envisioned in Bill C-64, and very much in my heart and in my mind as we are working on this.

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May/29/24 11:10:10 p.m.
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Madam Chair, in the first order, I want to say to the member and to Noor and her family how sorry I am that she is going through this, and how dreadfully difficult it would be to get that diagnosis and live with that condition and then have to worry about medication on top of it. We do have action on drugs for rare diseases. We are negotiating now with provinces to try to identify what drugs we can look at to help folks who have a rare condition and need rare drugs so they can get help dealing with these extraordinary costs. One of the reasons it is so important that we take the collective action we are taking with pharmacare and take these steps is that we need to get to a world where everybody gets the medication they need and they are not in the kind of situation that the member described Noor is in.

158 words

May/29/24 9:38:57 p.m.
Watch

Madam Chair, I want to thank the member for St. Catharines for his work and for his advocacy, in and out of public life. It is tragic when we see folks, who have not received the dental care that they need, wind up in an emergency room or wind up with an urgent health care situation that could have been avoided. Two weeks ago, I was in rural New Brunswick talking to a dentist who said, “I know exactly who does not have coverage in my community. I know that, on some given Saturday, that person is going to wind up in an emergency room, and I am going to get a call to go in and give care urgently, pro bono, away from my family, to try to fix that situation, hoping that it is not grievous for that individual.” I think that the member is talking about a situation very similar in St. Catharines. Not allowing people to have dental care is not just a matter of dignity, of somebody having a proud smile that makes them feel good about who they are and gives them confidence to be out in the world. It is fundamentally an issue of prevention. People who do not get good oral health care wind up with bad health outcomes. They cost our health system an inordinate amount of money. That is why I am so encouraged. The member asked for an update, and I gave it to the House earlier. We have seen more than 120,000 claims and over 100,000 seniors in just over three weeks. We are seeing, as of July 8, a new portal. We already have 10,500-plus oral health professionals who have signed up to this plan. I think we are going to see a real growth in that number. We have seen two million seniors signed up. Next month, we are going to be opening it up to persons under 18 and folks with disability who are currently on a disability tax credit. It would mean that, by next year, everybody, all nine million Canadians who do not have oral health care, will have coverage. One may ask why this was not done at the start of our health care system. Well, at the beginning, when we were starting so many decades ago with a national health care system in this country, it was thought that oral health was just a matter of cosmetics and that it was not essential health. Of course, science and data have evolved. We know that a myriad of diseases, illness and conditions is caused by lack of oral health. Oral health is health, and that is why it is so essential that we continue to make progress to make sure that every Canadian is covered.

469 words

May/29/24 9:08:10 p.m.
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Mr. Speaker, I believe it was Teddy Roosevelt who observed that many people sit on the sidelines and cast criticism, and he noted how easy that is to do. It requires no talent or ability to sit from the sidelines and cast criticism, or to mock or attack those who try to make things better. I think it is owed to every Canadian that every member in the House stands in their place and offers solutions. I can tell members that when it comes to health care, I have heard nothing. The only thing I have heard from the Conservatives is what they will not do. They will not do dental care. They will not do pharmacare. They have not said what they are going to do with the investments we are making elsewhere in the health system in mental health and other areas. What is their plan for those who are uninsured? What is their plan for those who are in need? What is their plan when 70% of chronic disease and illness in this country, most of the things that fill our hospitals, are preventable? They have no plan. Their only plan is to criticize our action, to phone around and hope they can stop a dentist from participating so we do not get the political credit of a senior getting dental care. Then we wonder why people get cynical about our profession. This should be a place where we debate solutions, where we have, lined up against each other, two plans to make things better in this country. Their way has been tried. It's the idea of trickling things down, cutting taxes for the most affluent and crossing our fingers for everybody else. We recognized that Adam Smith's invisible hand was not enough. We learned it sometime around the 1800s. We need social safety nets. We need strong health care. We need to make sure that as people are competing and participating in our marketplaces, they are not allowed to fall through the cracks. That does not happen by doing nothing. It does not happen by cutting. It happens through hard work and the courage of action.

362 words

May/29/24 8:53:10 p.m.
Watch

Mr. Speaker, of course abortion care is absolutely essential health care, and all women should have access to it no matter where they are in the country. There are still options in New Brunswick, but not enough of them. This is a conversation I have had with Minister Fitch with respect to the clinic that has been referenced. That is obviously under provincial jurisdiction, but there have been instances where we have withheld, because of actions taken on this issue, transfers under the Canada Health Act, but I would like to be able to fix this, again, with co-operation. It is essential that women have access to the care they need. Also, we talked about pharmacare and what we are doing—

123 words

May/29/24 8:50:37 p.m.
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Mr. Speaker, obviously, what happened in long-term care facilities across the country was devastating coming out of the pandemic, and that is one of the reasons that in our supply and confidence agreement, we have an agreement to move forward with the safe long-term care act. I look forward to working in an expeditious manner with the member opposite to realize its fulfillment.

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Context: House Hansard - 309 - May/6/24

May/29/24 8:49:47 p.m.
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Mr. Speaker, I have talked with Minister Hindley in Saskatchewan, and we had a conversation about the essential nature of public care. That is where we have to be, and I want to see that done through collaboration and co-operation. I think that is the best way to get there. It is going to be the continued approach, but the Canada Health Act is my responsibility, obviously, to enforce, and keeping care public is essential.

76 words

Context: House Hansard - 300 - Apr/16/24

May/6/24 3:44:19 p.m.
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Mr. Speaker, this is a concrete proposal to move pharmacare forward in this country. The drugs are two classes of drugs. They represent more than 80 different medical drugs that deal specifically with diabetes and contraceptives. It is part of a broader suite of actions that we are taking, such as, for example, drugs for rare diseases. I am currently having conversations with every province and territory about how we can take action on drugs for rare diseases so that folks with rare diseases can get access to the medications they need. It is part of what we have done on bulk purchasing to realize $300 million in savings for Canadians across the country. It also builds on the work that we are doing with a pilot in P.E.I., where we have been able to get copays down to five dollars there, saving seniors hundreds and hundreds of dollars in P.E.I. Action is taken one step at a time by demonstrating in evidence exactly what is going to be saved and exactly how this should function. As an example, in British Columbia, when it comes to contraceptives, it already shows that the province is saving more than it costs to run the program. I suspect we will also see that in diabetes. Canadians, rightfully, want to see this in evidence. They want to see these things live out there, demonstrate how they work in each example and then build on that successively. Our health care system was based on an iterative process by making sure that the steps we take are prudent, smart and fiscally responsible, and that is the way that we need to proceed with pharmacare as well.

284 words

Context: House Hansard - 288 - Feb/29/24

Apr/16/24 10:49:08 a.m.
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Re: Bill C-64

moved that Bill C-64, An Act respecting pharmacare, be read the second time and referred to a committee. He said: Mr. Speaker, it is my pleasure to rise. I want to start by extending gratitude to the member for Vancouver Kingsway for his extraordinary work throughout this process. It was a long, hard discussion to find a place of meeting, but it is an example of what is possible when we, in this chamber, focus on getting things done and focus on working together, rather than focusing on what divides us. I think that sometimes we fundamentally misunderstand the purpose of democracy, which is to build consensus, to find points of commonality and to pull people together to find common ground; it is not to find differences or to sow division. I also want to thank so many phenomenal colleagues on our side who have dedicated, in some cases, decades to fight for the moment when people are not forced to make a choice between the medication they need to stay healthy or the essential goods and services they need to stay alive, whether that be their rent or their food. In the 1960s, we launched national medicare, but we forget how challenging that was. It was an incredibly turbulent period to actualize it and to bring it to reality. The dream had long existed, but to bring it to bear was extraordinarily difficult. However, at that moment in time, there were certain things left out, one of which was medicine. That was partially because, at that point in time, the number of medications available were very limited. They were typically prescribed in a hospital setting. They did not have the uses and abilities, and they were not as essential as they are today. Certainly, that dynamic has changed, and this means a new dawn for health. I am going to talk specifically about pharmacare and the legislation therein, but before I do, I will paint a broader picture of the circumstances it faces. Like all countries, everywhere in the world, the vast complexity of our health systems is overwhelming. We are driving down a highway at a 100 kilometres an hour, recognizing that we cannot slow down, and we have to change the engine while we are driving. Due to that difficulty, most health systems had not done the hard work of transformation, of really stepping back and looking upstream at how we deal with prevention and deal with reducing the amount of chronic disease and illness that exists within our system. Then the pandemic hit, and in the pandemic, everywhere in the world, the strains and cracks in our health system were laid bare. Health care workers were asked to carry a burden that was impossibly large, working night and day to try to keep their communities safe, and carrying a load beyond imagining. However, in that moment, here in Canada and in a few places elsewhere in the world, we saw something I think quite remarkable happen, which was that in that chaos, there was one purpose in our system. Doctors, nurses and personal support care workers showed us the possibility of what happens when we move with one purpose, with one direction, and when we focus on people's health and nothing else. We could set aside egos, jurisdiction and turf, and we could make things happen. In an incredibly brief period of time, Canada's pandemic response was indeed one of the best in the world with one of the lowest death rates anywhere in the world. We had unbelievable support for the people working within the system and for one another for that period of time. Then, challenges resumed. The pandemic began to recede. A war erupted in Europe. Global financial turmoil ensued. We forgot the lessons of the fruits of co-operation and of working together, and many of those divisions returned. Within our health system, we saw a workforce who had carried far too much and was dealing with burnout, yet still had the extraordinary weight of a system that needs to change. We saw, for the population, that health was a bit of a hot plate. People's experience of the pandemic was trauma, really, for everybody. It was especially so for health care workers, but nobody was saved from the traumatic experience of going through the pandemic. I would say that it is the responsibility of not just this government, but also every government in this country to remember the incredible heroism of those who were working in the health workforce during those dark hours of the pandemic, and with that same spirit of co-operation and determination, to not focus on what divides us or what makes us different, but to focus on what can be done. That is no more important in any area than it is in health. Canadians do not care much about what political party someone is from. They do not care much about whose jurisdiction it is; they want to see results. That is why the $200 billion that we put forward to invest in health care over the next 10 years was so critical. It required an agreement with every single province and every single territory to develop a plan to deal with the crisis of today, to tackle those issues within our health system around the workforce, the backlogs, the health data and the sharing of patient information, to deal with issues like administrative backlogs, things that are legacies that do not make sense, and to work with every province and territory, regardless of its stripe. Whether it was Adriana LaGrange in Alberta, Adrian Dix in B.C, Michelle Thompson in Nova Scotia or Bruce Fitch in New Brunswick, and so forth, in every instance, that spirit of co-operation pervaded our negotiations. There was a profound understanding in those conversations that we have to be bigger than our partisanship and have to find commonality. As a result, we have had extraordinary agreements signed with all the provinces and territories, in a short period of time, to lay out the next number of years and to see what that health transformation will look like. That spirit of co-operation was also seen in Charlottetown, where we were able to have an agreement on some things that are really essential: health data; looking toward interoperability and how our systems work together with a digital charter; reducing wait times for recognition of foreign credentials, taking it down to a 90-day service standard. We were also able to work later with the College of Physicians and Surgeons to take a process of credential recognition that is normally a couple of years and were able to get it down to a couple of months. The other thing these agreements and conversations did, which I think is critically important for the future of our health system, was to establish common indicators, meaning that every province will have the same indicators for their health system, so that whether someone is a Quebecker in Quebec or a Manitoban in Manitoba, one can see how their health system is faring, not by anecdote but in data, and that can be compared against other provinces. Making sure those indicators are there is essential. It is so important that people feel that positive change, that they experience it in outcomes and that it is also measurable in data. In our federation, as we are making changes and interventions, that ability to have data and to see how we are moving the needle is essential. What one measures, one achieves. For the first time in these health agreements, we have set these essential tools of measurement to be a key component of our health system. We can then turn to dental care. There are some who say that this is just a boutique intervention, something that is a one-off, but it is actually part of a broader vision of health. Imagine that in this country there are nine million people today who do not have access to dental care. I want to thank my predecessor, the former minister of health, now the minister of procurement, the hon. member for Québec, for his extraordinary work to get us to this point in dental care. I want to thank the NDP and the member for Vancouver Kingsway for their work with our caucus in a common purpose to make sure that we pull together over health. Mr. Peter Julian: Hear, hear! Thanks to the NDP. Hon. Mark Holland: Yes, I want to thank parliamentary co-operation. Madam Speaker, I would say to this place that this is what we were intended to do. When we were elected as members of Parliament, we are not here to shout things at each other, to belittle each other or to put each other down. We are here to listen to each other. The purpose of debate is to ensure that we take each other's ideas and that we find common ground. In this bill, Bill C-64, in pharmacare and in dental care, we are embodying exactly what I believe our constituents elected us to do. Right now, we have 1.8 million seniors who, in many cases, have never had access to oral health care in their lives. I talked to a denturist who knew a senior who has not had new dentures for 50 years. They lost their dentures and had no money to replace them. The denturist talked about the dignity and the way that senior felt, knowing that they were going to get new teeth and that they could go out in the world, feeling that somebody cared about them. Let us think of the extraordinary nature of that. When going to seniors homes and when talking to people who work with seniors, they ask if this is really going to happen. They talk about the dignity that comes from it. It is not only about that healthy smile or that they are not going to wind up in an emergency room for an avoidable procedure, but also about the dignity of saying that we care about them, that we see them and that their health matters. We have one of the most extraordinary health care systems in the world, but it cannot be the best health care system in the world unless oral health is part of the equation. When we do not take care of oral health, when we are not there for oral health, then the costs, not just in terms of social justice but also in terms of health outcomes, are entirely unacceptable. I would submit that is not the country we want to live in. I am also extraordinarily proud that, about two weeks ago, the Minister of Families, with many of us there, launched the national food program. When I was at the Heart and Stroke Foundation, I advocated for fiercely for that, knowing when a child goes to school hungry, it is impossible to learn, and when a child is denied nutrition, it has devastating effects on their health. It is so sad to say that the research shows just one healthy meal a day has a dramatic change on health outcomes for children. The other thing it does is to give kids a taste for what nutritious food is. They develop their palates, and for their whole lives, their nutrition and nutritional profile is changed. An essential part of being upstream and avoiding illness and sickness is dental care, a national food program and, yes, action on pharmacare. This is a big task. We know that some 21% of Canadians are struggling to meet the financial burden of being able to afford their medicines. We took essential action on bulk purchasing, reducing the cost of medicine in this country by hundreds of millions of dollars, by working with provinces and territories to do bulk purchasing. We are taking critical action in P.E.I., with a plan for Islanders, on a pilot basis, to improve affordable access to prescription drugs. Since June 1, 2023, we have been able to reduce copays to five dollars for almost 60% of medications regularly used by Islanders. P.E.I. residents have saved more than $2 million in out-of-pocket costs. This was a precursor to show us what could happen. Whether one goes to P.E.I. or other provinces, and I know that the member for Malpeque talks a lot about this, they will hear about the difference it is making in the lives of people, having medication taken off the table as a concern. It is absolutely huge. We also launched, in March 2023, a national strategy for drugs for rare diseases, with an investment of $1.5 billion over three years because we know that drugs for rare diseases can be cripplingly expensive, yet they are absolutely vital to keep people alive. I will give one quick story before I talk about the bill in front of us and about the action we are taking. I had an opportunity a few weekends ago to be in the United States with my partner. We watched someone in front of us collapse. That person was obviously not a person of means. As they came to and I called 911, the thing that person was worried about was not their health, but it was how much money they were going to have to spend. How much money did my call to 911 burden that person with? We do not want to be in a place, with any element of health care, where somebody of limited financial means, through no fault of their own, is in a circumstance that they cannot afford care, or where nurses on the front lines, taking care of patients and investing their entire lives in trying to make things better, are not given the opportunity to get proper health care for themselves. Why these drugs? Why did we start with diabetes medication and with universal contraceptives? Let me start with diabetes medication. I want to thank the member for Brampton South for her fantastic advocacy on diabetes specifically. There are 3.7 million Canadians, and it is a growing number, who have diabetes. When I had a conversation in Ottawa with 12-year-old Raina, she summed it up better than anybody else. She said that as a 12-year-old it is really hard in this world, and that no 12-year-old should have to worry about all the problems of the world and also how they are going to afford their medication. If 12-year-old Raina can get it, then this House can get it. When a person does not have access to their diabetes medication, it means they risk heart attack, stroke, kidney failure, blindness and amputation. I was talking to Sarah in a diabetes clinic, who told me about patients who were reusing syringes because they could not afford them. The risk of blood-borne disease is terrible. That is not the country we should live in, so we all need to rise to this moment to say that for people with a precursor disease like diabetes, which is so indicative of whether they will have future chronic disease and illness, it is essential that we are there with medication for people. On contraceptives, let me just give one example that illustrates the case. Oral contraceptives cost $25 a month and have a 9% failure rate. The IUD costs about $500, lasts five years and has a failure rate of 0.2%. What it means is that a person who does not have money ends up choosing the birth control option that is cheaper, which has a 9% fail rate and means they are more likely to wind up with an unwanted pregnancy or a sexually transmitted disease if they are not able to make the choices that give them autonomy over their own body and their reproductive health and future. Therefore, it is absolutely essential, and not only for health. For example, in British Columbia, it has been demonstrated by UBC that it is saving more money with this initiative than it costs to roll it out. That is similar to what we are going to see in diabetes. This has such a powerful effect in prevention that it actually reduces costs overall. The message it sends to women about their bodies and about their sexual and reproductive rights and autonomy is essential, which is that in this country, no matter where she is, a women will get what she needs to have control over her future and her body. That is a powerful statement, and it goes beyond just contraceptives as a drug. As a very young person, when I was very, very young, I was exposed to sexual violence. That experience, in a family that did not talk about sex and did not have a conversation about what healthy sexual relationships were, had a devastating effect on my life, my self-esteem and my ability to stand up for myself at different moments in my life. It is difficult for somebody who does not have the information about their sexual health, who is not told that sex would never have anything to do with violence, that violence is about control and sex is about connection, that sex should always be consensual, should never be exploitive, should never involve violence and should always involve what a person wants for their body, that it should be pleasurable and it should make them feel like themselves. As a health minister, it should not be in any way controversial for me to say those things to people. Whether a person is in a marriage or intersecting for the first time with somebody else sexually, they need to understand it is okay to be themselves and that as long as it conforms to those things, such as that sex should be pleasurable and that one should be empowered in one's body and have access to the reproductive medicines one needs to make choices about one's life, it is going to save lives, because the second-leading cause of death for young people is suicide. We lose about 500 kids every single year, and way too often it has to do with them not feeling comfortable in their own bodies. We have to end that. In totality, looking at all of these actions, this is a new dawn for health, dealing with the crisis of now and also looking at prevention, so that we can build on what we started in the 1960s and ensure that all Canadians have access to the greatest health care system in the world.

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Context: House Hansard - 288 - Feb/29/24

Feb/29/24 2:49:41 p.m.
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Mr. Speaker, access to medication for diabetes is not just a question of social justice, it is a question of saving lives. It is a question of prevention. It is a question of reducing costs enormously across the country. Specifically with Alberta, I have had very constructive conversations with Adriana LaGrange, who has been willing to work, compromise and find that common ground. Unfortunately, across the aisle, that is not what we see. Today, the leader of the official opposition, the Conservatives, ran away when asked if he would support diabetes medication. He refused to answer whether he would slash contraceptives for women. The Conservatives are already against dental. I would really like to know where they stand on pharmacare.

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Context: House Hansard - 288 - Feb/29/24

Feb/29/24 2:45:55 p.m.
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Mr. Speaker, the representations made by the member are inaccurate, and I would invite people to read the documents, which have been fully redacted. However, this is the contrast with a party that is focused on partisanship and differences. The member opposite talked about working with another party and what that might accomplish. What about dental care? When we focused on co-operation, we were able to get dental care for this country. We were able to make sure that nine million Canadians, including three million seniors, will have access to dental care. They are voting against that. They are against that. Are they against pharmacare? Are they against the other fruits of co-operation that come from— Some hon. members: Oh, oh!

124 words

Context: House Hansard - 286 - Feb/27/24

Feb/29/24 10:16:21 a.m.
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Re: Bill C-64

moved for leave to introduce Bill C-64, An Act respecting pharmacare.

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Context: House Hansard - 286 - Feb/27/24

Feb/27/24 2:55:54 p.m.
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Mr. Speaker, first of all, let me give my thanks to personal care support workers. During the pandemic, which was a time so difficult for all of us, it was enormously difficult for personal care support workers, who did extraordinary work. We did make a commitment to support provinces. It is the provinces that have the principal responsibility for this. We expect them to step up in supports for personal care support workers. We have said we are there to help them, but it is their lead, and they need to make sure that these individuals are compensated and acknowledged in the way that they deserve.

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Context: House Hansard - 286 - Feb/27/24

Feb/27/24 2:31:35 p.m.
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Mr. Speaker, I think it is amazing that the Government of Canada is providing an additional $200 billion over the next 10 years for health care. It takes time to reach a good agreement with each province and territory. It is very clear that by the end of March, there will be an agreement with every province and territory to improve the quality of health care and ensure that our health care system is the best in the world. That is our goal, and it can only be reached with co-operation.

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Context: House Hansard - 275 - Feb/5/24

Feb/27/24 2:30:17 p.m.
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Mr. Speaker, once again, the Bloc Québécois is obviously trying to pick fights. It is always picking fights. Our intention is simply to improve the quality of health care for Canadians across the country. In Quebec, for example, it is absolutely essential that every Quebecker everywhere in the province be able to receive dental care. That is our goal, and we intend to achieve it in a spirit of co-operation, not by squabbling.

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Context: House Hansard - 265 - Dec/11/23

Feb/5/24 2:27:59 p.m.
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Mr. Speaker, of course, we share the member's objective to reduce drug prices for Canadians and to make sure that we have a competitive and fair environment in Canada. We are working together on pharmacare legislation. I look forward to continuing those conversations. Of course, Canada, by engaging in bulk purchasing, has seen a reduction of about $300 million in the cost of drugs for Canadians across the country. With many countries looking at how they can emulate that kind of practice to reduce drug prices in their countries, we are going to continue to do everything we can.

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Context: House Hansard - 238 - Oct/24/23

Dec/11/23 2:30:58 p.m.
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Mr. Speaker, this is a huge leap forward in providing dental care to everyone across the country. I really appreciate the NDP's work. I also like the notion that all parties in the House need to work together to find solutions in these difficult times across the country, not just point out problems and criticize everything. This is a historic day for our health care system.

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Context: House Hansard - 232 - Oct/16/23

Oct/24/23 3:19:34 p.m.
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Mr. Speaker, any time somebody sustains a brain injury, it has a devastating impact upon their life and the lives of those in their families. The member is absolutely right. We have to do everything we can. That is why we are making critical investments across the health system, with $200 billion of additional money being put in. Those dollars are to ensure that we not only can see better health outcomes, but also can have better prevention and better care. We saw a fantastic announcement in British Columbia. There is more to come in the rest of the country. Health transformation is happening.

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