Bill C-64

Pharmacare Act

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 obliges the Minister 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.

Pharmacare Act

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, no one will be surprised to hear me say that, by continually oppressing us, by not recognizing that we are a national government, by making sure that any recognition is merely symbolic and has no legislative impact at all, the federal government is making sure that, one day, Quebeckers will decide to take control of their own affairs and make Quebec its own country.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Madam Speaker, with respect to our monetary policy and how it relates to health care policy, I did some quick math: $1.2 trillion of national debt at a 4% interest rate would be $48 billion for annual servicing costs.

What does the member for Montcalm think the likelihood is that the Liberal promises about health care, dental care and now pharmacare would actually be successful in this environment of high debt servicing costs?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, there is not much time left until the election. The Liberals are incapable of hearing Quebec's demands, among other things. Quebec will not prevent the federal government from doing what it wants everywhere else, but it is warning the federal government to be careful, because Quebec requires the right to opt out unconditionally with full compensation. I think that, if the federal government denies this, it will not have time to do anything.

If the next government is Conservative, as today's polls suggest, I think that there will not be much for health care. If I understood the Conservative Party's health critic correctly earlier, the Conservatives will not interfere or tell us what to do, but we will not get a penny.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, to begin, I will respond to my colleagues from the Bloc Québécois, because they do not seem to have read or listened to the Quebeckers who support this bill.

I will start by reading the statements issued by the Centrale des syndicats démocratiques, or CSD, the Confédération des syndicats nationaux, or CSN, the Centrale des syndicats du Québec, or CSQ, and the Fédération des travailleurs et travailleuses du Québec, or FTQ. These labour federations represent one million Quebeckers. When we factor in the families of these workers, these federations represent more than one-third of Quebec's population.

The labour federations said that they:

...welcome the introduction of a pharmacare bill by the federal government to lay the foundation for a future universal public pharmacare program. Several aspects of this bill are encouraging, including the fact that it takes into account the principles of the Canada Health Act (public administration, comprehensiveness, universality, portability and accessibility), maintains long-term federal funding, covers birth control and diabetes medication, and includes first dollar coverage.

I also want to quote the leaders of the labour federations. First, Luc Beauregard, secretary-treasurer of the CSQ, had this to say:

Quebeckers deserve better. They need a universal public pharmacare plan as soon as possible.

Next, Magali Picard, president of the FTQ, said this:

With the rising cost of living, many Quebeckers are struggling to make ends meet. Every year, more than one person in 10 goes without prescription drugs because they cannot afford them. That sort of situation should not be tolerated. Medication should be free, because no one chooses to be sick and to need medication.

I would like to mention that “[t]he labour federations believe that Quebec is misguided in calling for an unconditional right to opt out.”

Caroline Senneville, president of the CSN, had this to say:

We feel it would be unacceptable for Quebec to receive federal funds unconditionally in order to maintain a dysfunctional and unfair system...

Finally, Luc Vachon, president of the CSD, had this to say:

It is unacceptable for a person's health to depend on their income or to be up for negotiation. Quebec has its own system, but it discriminates against those with lower incomes. A real universal public system must guarantee everyone the right to easily access medication. There is a strong consensus in both Quebec and Canada on the implementation of a universal public pharmacare program, and the time has come to move beyond constitutional squabbling so that everyone has real access to affordable medication.

Again, the leaders of Quebec's largest labour federations have been clear. They represent more than one-third of Quebec's population.

We just heard the Bloc Québécois's arguments against this bill. I am asking them very nicely to listen to Quebeckers rather than assuming that they know what Quebeckers think. The Bloc Québécois does not like to hear that this bill represents what Quebeckers really want. The reality is that these are the voices in Quebec that the Bloc Québécois should be listening to.

It is no secret that Quebec's current system is not working. People are falling through the cracks. This bill, which the NDP pushed for and which is before the House because of the NDP, will make a difference in the lives of Quebeckers and Canadians across the country.

That is my message to my Bloc Québécois colleagues. It is difficult to be against Bill C-64 after hearing all those people who have looked at it and want us to move forward with it. They want us to help those who have trouble paying for their diabetes medication, as well as the low-income people who are falling through the cracks. It is something worth thinking about. I hope that my Bloc Québécois colleagues will hear these voices and act accordingly by voting in favour of the bill. They cannot just be reactionary like the Conservatives.

First, I want to about the impact of pharmacare. A little over three years ago, I brought forward, on behalf of the NDP caucus, the Canada pharmacare act. This would have made a difference in the lives of Canadians from coast to coast to coast. There were 120,000 Canadians who wrote to their members of Parliament, hundreds of them wrote to each Conservative MP and systematically the Conservatives and Liberals voted against that bill, which would have established, on the basis of the Canada Health Act and its five principles of universal health care, pharmacare in Canada.

For me, this is poetic justice. Three years later now, because of the NPD's pressure, the work of the leader of the NDP, my colleague from Burnaby South, our health critic at the time, the member of Parliament for Vancouver Kingsway, and the entire NDP caucus, using our weight and our pressure in a minority Parliament, we have actually achieved something that will make a significant difference in the lives of people.

The Conservatives have said that diabetes and contraception is only a start, which is very true, but the reality is that when we talk about diabetes medication, the cost of having diabetes, which is a profound health challenge, can be up to $900 a month. I cited a little earlier that a resident of Burnaby, B.C., Amber Malott, pays $900 a month.

Each and every Conservative MP has in their riding 17,000 people to 18,000 people who would be impacted by this significant move forward in Canadian health care. They would benefit from that. The ones who are paying anywhere from $100 a month to even $900 a month finally have that burden taken off them.

The Conservatives have signalled they want to gut it. They blocked the bill last week and refused to even have it brought to the floor of the House of Commons. They have indicated that they will try to block and destroy this legislation at every step. We have to ask the question, why? Is it just weird ideology, is it just their extremist leader or is it the fact that they have not even read the legislation and have not consulted their constituents? If they talked to 17,000 people or 18,000 people in each of their ridings, they would find those constituents saying that we need to adopt legislation, that they cannot continue to pay $200 a month, or $500 a month or $900 a month for medication, that they simply cannot afford to put food on the table or keep a roof over their heads and pay for this medication at the same time.

If the Conservatives consulted their constituents, they would hear overwhelmingly from those 17,000 people or 18,000 people that this would make a difference in their lives. I certainly will be going out to Conservative ridings and consulting their constituents, because they seem unwilling to do so. For them to block the bill and to say that they do not even want it discussed on the floor of the House of Commons indicates their extremism within—

[Some hon. members]

Oh, oh!

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I want to remind members there will be an opportunity for 10 minutes of questions and comments. If hon. members have questions and comments, they know they should wait until the appropriate time to ask them.

The hon. member for New Westminster—Burnaby.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, from the reaction of the Conservatives, it is obvious they are a little worried about this. They know that they have not consulted their constituents. They have not talked to them.

The Conservatives love to say that they are concerned about affordability. We recall that under the dismal, terrible Harper regime, food line-ups and the price of housing doubled. They say that Liberals did the same thing, but the reality is that the Conservatives, at no point, have ever taken responsibility for what they imposed on Canadians. At least the Liberals are willing to accept NDP leadership to bring forward things that will benefit people, such as dental care, affordable housing and, now, pharmacare.

If the Conservatives are sensitive about this, if they are saying that do not want people talking to their constituents, the 17,000 to 18,000 people who would benefit from having their diabetes medication and devices taken care of, we have to wonder about their motivation. They do not want to consult their constituents themselves and they do not want anybody else to consult their constituents. They just want to, in a disconnected way, make their speeches in the House of Commons, without actually talking to the people who would benefit from the bill.

We have to wonder about the kind of responsibility the Conservatives take as elected representatives, particularly given how deplorable their record was when in government. Under the Harper regime, it was the worst government in Canadian history. I could easily spend hours speaking to that, and in fact I did.

As members will recall, I spoke for 14 hours about the 2012 budget and the appalling impacts of that budget on Canadians, on Canadian seniors and on environmental policy. I could literally speak for hours about the scandals, the dishonesty, the lack of transparency and the brutality of the Harper regime; about what it did to seniors, forcing them to work longer; what it did to veterans by shutting off all their services. However, I am going to leave that for today. Hopefully, at some future time, we can really remind Canadians how dismal and terrible the Harper regime was. The Conservatives who were there should be ready to apologize, but they have never apologized for everything they did.

Here is an opportunity for the Conservatives to address the wrongs when they were in government, when housing prices doubled, when they slashed affordable housing and when they ensured that services were gutted. They have an opportunity to address some of those things, and they are saying no. They are refusing to provide pharmacare or have any kinds of supports for the people in their ridings, the 17,000 or 18,000 people in each of their ridings who would benefit from having their diabetes medication covered. They are saying that they do not want to help their constituents at all. That is a sad thing.

The reality is that this bill on pharmacare would make a big difference, on average, for every member of Parliament, not just the Conservatives. Every member of Parliament in the House of Commons would see 17,000 to 18,000 of their constituents benefit. The people who are struggling to pay for their diabetes medication, to put food on the table and to keep a roof over their head would benefit. Imagine the cost of up to $900 a month, and we are talking about a $10,000 benefit, yet the Conservatives say that they are not interested.

There is more. This is where we get back to three years ago when this was brought forward in the House of Commons. The Conservatives and Liberals, with alacrity, voted down the Canada pharmacare bill. Thankfully, the Liberals are now apologizing for that by bringing forward and supporting the pharmacare bill.

As we know, with pharmacare writ large, and the Parliament Budgetary Office has indicated this so many times, the overall savings to Canadians would be about $4 billion. The savings to our health care system are enormous. Many of the people who end up in our emergency wards across the country are there because they cannot afford to pay for their medication that keeps them in good health.

Canada is the only country that has universal health care, thanks to Tommy Douglas and the NDP fighting hard for it in the 1960s, but does not have universal pharmacare.

Why is it that every other country has coupled universal health care with universal pharmacare? It is that having access to medication beyond the hospital makes good sense for the health care system as a whole. If someone can take the medication their doctor prescribes for them to keep them in good health, they are not going to spend their time in the acute care ward or the emergency ward at the hospital. We know what those costs are. An acute care bed over the course of a week is $30,000.

Why would we not put pharmacare in place in a way that allows someone to stay in good health and to stay out of the hospital? That is why the Parliamentary Budget Officer stressed not only the savings to the health care system, but also the savings that come from bulk purchasing negotiations that have led other countries like New Zealand to reduce the cost of some of its medications by up to 90%.

It is no longer a multitude of hundreds of different negotiations taking place where the pharmaceutical companies can play one against the other. With a universal pharmacare system, we can tell the pharmaceutical companies what prices we are going to pay. When New Zealand reduced the cost of some of its medications by 90%, that was due to bulk purchasing being the best practice.

Conservatives will not talk about this at all because, quite frankly, I find most Conservatives are mathematically challenged. When it comes to budgets, they simply do not do it well. We saw it under the Harper regime and its record deficits. They are terrible when it comes to managing money and to paying down debt.

According to a stellar source, the Ministry of Finance, in its fiscal period returns, actually compared NDP governments with Conservative and Liberal governments at the provincial and the federal levels. NDP governments, over the last 40 years, have been the best at managing money and at ensuring money goes into the health care system for things like that.

Rather than paying money to the pharmaceutical companies, we need to be negotiating cheaper prices and making sure it is accessible to everybody, which then saves money in the health care system. It means fewer stays in acute care beds and fewer visits to emergency wards. It makes sense, which is why other countries have universal health care and universal pharmacare.

This is the first important step to universal pharmacare. It is to ensure that people who are forced to take diabetes medication and who need access to diabetes devices actually have them paid for and no longer have to question whether they can pay for them. If they cannot pay for them, they end up in the hospital and it costs our health care system far more than having pharmacare in place. It just makes good sense.

It is not just that people who cannot afford to pay for their medication end up in acute care beds and in emergency wards, but Canadian nurses have been telling us for years that, tragically, hundreds of Canadians die every year because they cannot afford to pay for the medication that would keep them alive. That is hundreds of Canadians.

This has been a crisis in our health care system. People cannot afford to pay for their medication, so they go to the hospital and cost the health care system more with an acute care bed, but worse, they also pass away. That creates even more mourning in the health care system. We simply should not be willing to tolerate that.

Conservatives and Liberals, for decades, have said that it is not their problem. They were not going to take charge of it. Thankfully, the Liberals, and I do compliment the Minister of Health for stepping up on this, are finally moving forward with the first step of pharmacare in Canada. This is vitally important.

Professionals in the health care system say that this is the smart thing to do. Financially, we know it costs $4 billion less to have a pharmacare program in place than it would to continue with the patchwork we have now. If we could save hundreds of lives, then all these things make sense. It should not even be a matter of controversy. This should be adopted at all stages and adopted by all members of Parliament.

As I mentioned, 17,000 to 18,000 Canadians, in every riding in the country, would benefit from just having access to the diabetes medication that is prescribed in the bill. The NDP is happy to see this first step taken. We are not going to give up. We are going to keep pushing. I have constituents who are paying $1,000 a month for heart medication, and that is going to be the next push for us. However, we believe strongly that the House should be adopting the bill. We should move it to committee, and we should get going with putting in place the first steps of pharmacare in Canada.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I have often witnessed a sad thing in Manitoba, where individuals who go into hospital situations require medications after they leave the hospital. While they are in the hospital, the medication is free, but when they leave, they have to cover their own costs for medications. That puts many people, especially those on fixed incomes, in positions where they have to decide on food versus medicine. Ultimately, they end up going back to the hospital because they are not taking the medications that they should be taking.

When I think of the long term and how we evolve and develop a pharmacare program, we should be reflecting on what it initially meant when we brought in a national health care system, and there was always the thought of having a pharmacare component to it. I wonder if my colleague could provide his thoughts on how important it is that we recognize this as is a stepping stone moving forward into a stronger and healthier health care system.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, I often disagree with the member for Winnipeg North, as he disagrees with me, but on this issue, we are in solidarity because he is absolutely right. We are wasting tax dollars on a health care system that has been dysfunctional. When a person goes to a hospital due to a medical emergency, medication is paid for. Then, the moment they leave, it is up to them, and they are on their own. If they have to scrimp on food or have to move out of their apartment to pay for that medication, it is up to them. The reality for so many Canadians, for hundreds who die every year, is that they simply cannot afford to do all those things. It is time that we put in place pharmacare, and it is time that we start extending it to other types of medications.

[Marc Dalton, Conservative, Pitt Meadows—Maple Ridge, BC]

Madam Speaker, this is not a pharmacare plan; this is a PR exercise by an NDP-Liberal coalition that is floundering in the polls. There is a reason that almost a quarter of the NDP MPs are not seeking re-election.

The member is from British Columbia, as am I also. As he was speaking, I was looking up what the plan is for pharmacare in B.C. It says, specifically, that pharmacare covers approved diabetes management supplies and most insulin. It is already covered. The plan being proposed does not even compare.

I wonder if the member will also mention that, due to inflationary spending, we have to pay $50 billion in interest and that it is actually undermining health care across Canada.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, I think the member has just made my point.

Yes, B.C. is already moving. It is the leader in the country in terms of affordable housing, with more housing built in British Columbia than in the rest of the country combined. It is a leader in the country in environmental legislation, in health care investments and in post-secondary education. Therefore, the member is absolutely right to point out that the B.C. NDP government is doing the best job in the country of any government, and we appreciate that he is acknowledging that. The point is that we want to bring these best practices from B.C. and put them in place right across the country.

The member also mentioned deficits. I find it rich that any Conservative would talk about deficits after their deplorable record of $30 billion a year given to overseas tax havens. Under the Harper tax haven treaties, it was $30 billion. Over their watch, it was $300 billion. They have been absolutely deplorable in financial management, and we are still paying the cost today.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

Madam Speaker, I would like to start by pointing out what the NDP member did, that is, highlight the exemplary work of Quebec's labour federations, which fought for years for Quebec to implement universal pharmacare. We succeeded. For 20 years, I took part in the fight that led to the implementation of the pharmacare plan Quebec has today. The plan is not perfect, but it is false to claim that Canada is going to create a pharmacare plan without taking the reality of Quebec and the provinces into account.

If my colleague were honest, he could also have said that the labour federations called for the right to opt out with full compensation. It says so in their statements. However, the NDP does not care about that because it wants social programs that extend from coast to coast to coast. We know that New Zealand has a population of five million. Canada has a population of 34 million, and this number will continue to grow.

If the federal government does not respect the provinces' jurisdictions, in particular when it comes to administering social programs and programs like health care, that goes totally against what Canada stands for.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, the Bloc Québécois should apologize for trying to distort what I just said. Caroline Senneville, president of the Confédération des syndicats nationaux, said the following: “The labour federations believe that Quebec is misguided in calling for an unconditional right to opt out.”

Luc Vachon, president of the Centrale des syndicats démocratiques, said that “the time has come to move beyond constitutional squabbling”.

The reality is that all of these labour federations, which represent one million workers in Quebec, which amounts to almost one-third of Quebec's population, said that they welcomed the introduction of a pharmacare bill. Consequently, the Bloc Québécois should take responsibility by supporting the bill and sending it to committee so that we can move forward with the bill, which the labour federations welcome.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Madam Speaker, it was fascinating to watch the Conservatives put up their doctor who just trashed the notion of medical treatment, not with any facts, but with those kinds of bumper-sticker slogans: four legs good, two legs bad. I was trying to understand how a doctor could be so dismissive of basic health care. Then, of course, it dawned on me that the Conservatives' deputy leader was a lobbyist for AbbVie. That was a company that jacked up its medical prices for seniors by over 470%, so we know what the Conservatives would do with seniors and medical treatment. They do not want seniors to get pharmacare. Then, we also find out that the Conservative Party's governing body is full of lobbyists for big pharma.

I'd like to ask my hon. colleague why the Conservative MPs and their one doctor are so concerned about protecting the interests of companies that they worked for that have jacked up medical costs on basic pharmacare for seniors.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Madam Speaker, that is an excellent question from my colleague from Timmins—James Bay. The corporate Conservatives are all over; there are lobbyists in their ranks and lobbyists influencing the Conservative Party. They see Canadians as plunder, and they can just jack up oil and gas prices. It was jacked up 30¢ in British Columbia as gas price gouging, and not a single Conservative MP from British Columbia said one word. With grocery price gouging and food price gouging, we find out that the director of the next Conservative campaign is a Loblaws lobbyist. There is not a word about food price gouging. The Conservatives simply allow the corporate sector to plunder Canadians. We saw this under the Harper regime. As my colleague from Timmins—James Bay points out, it was the worst government in Canadian history.

We saw big corporations basically ravaging this country. The Conservatives' massive giveaway of $30 billion each and every year did not go to seniors, to students or to health care. It does not go to support any building at all in the country. It went to the Harper tax haven treaties. Basically, they signed a whole bunch of tax haven treaties so that the wealthy and the big corporations could take their money overseas and not pay a dime of tax. Conservatives should be ashamed of themselves.