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

[Mark Holland, Liberal, Minister of Health]

moved that Bill C-64, An Act respecting pharmacare, be read the second time and referred to a committee.

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.

[Peter Julian]

Hear, hear! Thanks to the NDP.

[Mark Holland, Liberal, Ajax, ON]

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.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, those were interesting comments from the Minister of Health. He talked about the incredible results that he thinks he is getting with these new programs. Oddly enough, the backlogs for care in Canada have never been worse: It is 27 and a half weeks from the time of seeing a primary care provider to getting treatment from a specialist, the worst it has been in 30 years.

With regard to the Canada dental care program, he wants to talk about how many people have signed up for it. Although we know he will go on with the fantastical speech he has made here in his incredibly fact-devoid fantasy, the question that would remain for his great dental care program is this: How many dentists have actually signed up for the program?

Very specifically, how many dentists in Atlantic Canada and, specifically, how many in each province of Nova Scotia, New Brunswick, Newfoundland and P.E.I. have signed up for the dental care program?

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, it was true in the 1960s and it is true now, that there are purveyors of doom.

There are those who try to push people to despair. When one does not believe in a public health care system, what does one want people to do? One wants people to despair, because nothing comes from despair. All change comes from looking at what is hard and true and driving for change.

Let us talk very specifically. Every health care system in the world is facing extraordinary backlogs as a result of COVID and stress on their system. It is a question how we meet that. These 13 agreements and these investments of $200 billion are demonstrating that we are meeting that challenge. In these plans, in articulated detail, is exactly how we are going to get to the health system Canadians deserve.

With respect to dental care, we have thousands and thousands of dentists who have signed up across the country.

Secondly, just on Thursday, I met with the dental associations, and I can tell the House that we are down to a couple of minor issues and that I am extraordinarily confident that over the next number of months, we will see virtually every dental office in the country participating in this program.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, the minister spoke about a lot of things. I feel he spoke very little about Bill C-64. However, when we talk to him about Quebec’s interests, he rises in the House and always says that the Bloc Québécois is looking for a fight. Quebec has been administering a mixed drug insurance plan for the past 28 years, but the minister never sat down with Quebec before making his announcement to see how Quebec manages this and how much it might cost.

Does the minister know how many prescription drugs are covered by Quebec’s drug insurance? Has he sat down with the health minister, who says that Quebec does have constitutional rights? When the minister says we are looking for a fight, he should add the word “constitutional”. It is as though we Bloc members have more respect for Canada’s Constitution than he does, despite his party having done all it could to prevent Quebec from signing the Constitution in 1982. Is he aware that the minister wants nothing to do with his pharmacare plan as proposed?

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, there is no denying that Quebeckers’ interests are absolutely the same as those of everyone else in the country. Everyone wants access to a health care system that works properly for all.

As for the questions surrounding drug insurance, I have had some really good conversations with Minister Dubé in Quebec. There is a clear spirit of co-operation.

If one goes looking for a fight or problems, they are easy to find, but the idea is to find solutions and a way to work together to resolve the situation, to improve people’s health across the country. For example, it is absolutely essential that we take into account the indicators for Quebeckers, so that we can compare and contrast how things evolve in their system and how they evolve in the other provinces and territories. This is a very good thing to do, and it is also good to see where the federal money is in the plan. That is why it is more important to co-operate than to pick a fight.

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

Madam Speaker, I would like to congratulate the minister for working attentively with the effective NDP opposition to actually bring about this historic debate today. It is going to make a difference, on average, and I point this out to the Conservatives, to 18,000 constituents in each of the Conservative ridings across the country.

I wanted to reference one of my constituents, a Burnaby, B.C. resident, Amber Malott. She learned she had diabetes when she fell into a coma just before her 21st birthday. With all of the types of insulin and injections that she takes, her monthly bill on insulin because of her diabetes is close to $900. We saw last week the disgraceful exhibit of Conservatives blocking even bringing this bill forward to the House. They blocked it from the kind of debate we need to have on this bill. Conservatives have indicated they would like to destroy this initiative.

What would be the impact on people like Amber if the Conservatives had their way?

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, I want to thank the hon. House leader for the NDP. I am very pleased to work with him again in his role as the critic for health. He is absolutely right. I appreciate that these were not always easy conversations. They were indicative of the conversations we had when we were both House leaders. Finding that common ground, as two different parties, is often difficult.

I think, for people like Amber, we can see what the difference is. The cost consequence for Amber of not being able to have access to the life-changing medication she needs, let us be very direct, could be devastating. It could mean that Amber winds up with a heart attack or stroke. It could mean that she has a limb amputated or that she dies. It certainly means that Amber is less productive, less able to contribute to society and almost definitely going to have an earlier death. The cost of not providing that medication is far superseded by those negative outcomes, not just as a matter of social justice but as a matter of material cost.

Are the Conservatives going to be there for Amber? Are they going to be there for people who need their diabetes medication? Are they going to vote for their constituents who need these medications, or are they going to vote against them?

[Michael Coteau, Liberal, Don Valley East, ON]

Madam Speaker, I am proud to be part of a government that is bringing forward new national programs like child care, student nutrition, a dental plan and pharmacare. It has been decades since a government in this country has moved forward with such massive programs. In fact, we have not seen this type of movement for many decades. I would like to ask the minister about the relationship we have with the provinces and territories as we move forward.

As you move forward, what has been the response by some of the key people, like ministers and stakeholders in other provinces, for this specific plan?

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

I will remind the hon. member to speak through me, please.

The hon. Minister of Health.

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, I thank the member and my friend for an important question. I have been so encouraged by the conversations that I am having with every provincial health minister across the country, regardless of their stripe. Whether I am talking to Everett Hindley in Saskatchewan or Uzoma in Manitoba, the conversations have been incredibly productive and positive. They are focused on how we get people the care they need.

I would challenge the Conservative opposition. They talk about wanting to destroy dental, how they do not want pharmacare and how they are going to block the national food program. They tell people not to dream about it and that they cannot have it. They tell people not to dream that they can get medication. They say not to dream that they can have dental care. The Conservatives are going to make sure it does not work. They are going to call dentists and scare them. They are going to give them false information. They are going to work against people getting care, for political reasons.

I think we should listen very carefully to what the Conservatives say. Are they asking questions about how they can help or how they can ensure that people get dental care? Are they asking questions about the problems that dentists have and how we can help fix them because they want to make sure people get dental care? No, they are saying to give up and have despair, and that they cannot do it. Shame on them for it.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, hopefully today we will move into reality as opposed to the fantasyland that has been painted by the Minister of Health.

When we look at it, the pharmacare program that is being introduced is really about the preservation of the costly coalition. We also know that Canadians are not going to be fooled by the foolishness that has been presented in the House this morning. We know that the other plan its members have is to clearly extend the date of an election so they can access their pensions. The worst state of being a politician one could possibly imagine is to be self-serving, when all of us who come to the House know we should be here for the benefit of Canadians. That is clearly not the case with the costly coalition members. Rather, it is about their preservation, which they have made very clear throughout Canada, which is an essential part of their ability to keep this inept government in power for as long as they have. That is the first part that Canadians, of course, are well aware of.

The other thing that Canadians are well aware of is the state of coverage with respect to pharmacare.

My Bloc Québécois colleagues are well aware that pharmacare falls squarely within provincial jurisdiction.

We know that 97.2% of Canadians are already eligible for some form of prescription drug coverage, which is not some funny Conservative talking point. It comes from Stats Canada, CIHI, CLHIA and the Conference Board of Canada. Therefore, when we look at the numbers, it becomes very simple to understand that there is a gap of about 1.1 million Canadians who struggle without coverage for pharmacare. I think it is important to point that out because we are attempting to have an honest conversation here.

We also know that the numbers of those who are uninsured have decreased precipitously since, for instance, the Ontario government introduced OHIP+. It is also interesting that the minister talked a bit about his historic meetings with all the provincial ministers of health, which I also chose to undertake myself. When I did, what those provincial ministers of health made clear was not the rubbish the federal minister brought forward, but that they in no way, shape or form want another large federal program dropped on their heads to fund, which, as I said in French, is clearly a provincial area of responsibility, the delivery of health care. Oddly enough, the federal Minister of Health himself pointed out that the delivery of health care is a provincial responsibility and not that of the federal government, despite the fact he continues to intervene in moving the responsibility from the provincial authority to the federal government.

I did have an opportunity to mention this bill, and I would like to expand upon that. The bill would create another government agency, which is exactly what Canadians would like to have, more bureaucracy and more gatekeeping. It would create the Canadian drug agency, which would cost about $90 million to create and perhaps another $30 million or $35 million a year to continue to exist as time goes on. However, who worries about monetary policy? It is certainly not the NDP-Liberal coalition.

It is also odd that the government posted on its Canada.ca website a list of drugs, diabetic drugs and contraceptives that may or may not represent what would actually be on the formulary in the future because we know it would be the responsibility of the Canadian drug agency, in consultation with provinces and other stakeholders, to create a formulary to be used.

I think it is also important to point out that, if we are to have any faith whatsoever, which I personally do not, in the formulary that has been put out thus far, much to the chagrin of Canadians, it is rife with older medications, with no fees for pharmacists or the primary care provided by pharmacists to many Canadians because of the sad reduction in the number of family physicians. It is also worth noting, very specifically, that the blockbuster drug in treatment of diabetes in a generation, namely Ozempic, is not included. There is no surprise there.

As I was saying, after the creation of the Canadian drug agency and a formulary, and after holding these consultations, the only consultations that have happened thus far, of course, are with the NDP costly coalition partners, which should not give Canadians any warming in their hearts.

When we look at the other issues that are clearly brewing in Canada at the current time, Canadians know that the state of our beloved health care system has been under siege by the inept management of the NDP-Liberal coalition. We know that wait times have surged beyond what they have ever been in history. For instance, the wait time from seeing a family physician to a specialist to obtaining specialist-based treatment has increased 195% to a 27-week wait time. This is the longest it has been in three decades. Is this a system that Canadians should be proud of?

The other disturbing statistic is that 6.5 million Canadians are without access to primary care. As time will march forward, as it always does, by 2030, in Ontario alone, the 2.3 million Ontarians currently without access will surge to four million Ontarians without access to primary care. It is very clear, even if this were a good pharmacare plan, which it clearly is not, that without access to primary care, there is really no way to get medications. I would suggest that there is a bit of a misguided nature here.

The other difficulty that Canadians are also very aware of is that the newest medications, a class of medications called “biologics”, which account for 2% of claims, are now accounting for 30% of spending. Of course, none of these biologics are included on any of the proposed fantasyland formularies from the NDP-Liberal coalition.

The other problem we have in our health care system is wait times from application to approval of medications to be on the formulary to the actual acceptance on 50% of public formularies, and we have the longest wait times in the world at 25 months for new life-saving therapies. A government should be seized with policy changes to improve the lack of bureaucratic control and the ability to change things that would be cost effective for Canadians, and indeed changes like this to make a government work more efficiently, which would actually not cost the government anything, it would cost Canadians nothing. However, what is the government doing? As I said previously, it is interfering with clear provincial jurisdiction and adding federated programs that in no way, shape or form could possibly reduce the cost for medications.

The other reason, of course, is that the cost of these medications are already in a forum which allows all of the public plans to come together under a program called the “pCPA”, which already allows all public plans to negotiate for low prices for those medications. For the federal Minister of Health to suggest that this new plan would suddenly allow prices to drop precipitously is absolutely and categorically untrue.

The other major issue is related to finances and the cost of living. When Canadians were asked what the major cause of their inability to afford their medications was, and I suspect my colleagues know very well what the answer to that question is, it was inflation. Yes, inflation is cited as the major cause of Canadians' inability to afford their prescription medications.

Why do we have 40-year high inflation? Well, of course, it is because of the costly coalition of the NDP and Liberals. We know that the chance of a young Canadian now owning their own home is almost zero. It is a dream that is almost dead because of the NDP-Liberal coalition's incompetence. We also know that, more than ever, Canadians are turning to food banks to enable themselves to feed their families. Two million Canadians a month, very sadly, are having to go to food banks, and what do we see?

We are seeing more large federal government spending in what David Dodge called last evening “likely to be the worst budget” announcement in the history of this country. We are waiting for more of these terrible budget announcements today, in which we will see another estimated $40 billion of deficit spending.

On top of that, we know that the $1.2-trillion debt that the NDP-Liberal coalition has coffered together, more than all Canadian governments in history combined, is costing more now to service than we are spending on health care. That is an incredibly sad state of affairs. I would suggest that it is one that Canadians are paying very close attention to.

We also know that simply saving for a down payment for a house is now taking 25 years, when the Canadian dream would be that those 25 years would allow us to pay a mortgage, not simply to save for the down payment.

Canadians are suffering more and more with their mental health. We also know that the Liberal government had committed $4.5 billion to the Canada mental health transfer, and not one penny of that has been transferred. That is a very sad state of affairs, when one-quarter to one-third of all Canadians are currently suffering with mental health issues, and it is believed that 50% of those are suffering with inadequate treatment. The $4.5 billion could go a long way to help treat the mental health of Canadians.

This NDP-Liberal coalition has had a multitude of failures, and they are worth pointing out simply because we question why Canadians would believe that another large federal program would ever come to fruition. What we know is that these programs are great announcements. The next prime minister of Canada has spoken about how people cannot eat the papers the announcements are printed on. They are incredible photo ops, when ministers go out to say that they might be capable of doing things, but Canadians know they are absolutely unable to do so.

I had asked a question of the Minister of Health, which he, sadly, once again, failed to provide an answer to, but now I am quite happy to provide that answer on the Canadian dental care program. Last week I had the opportunity to speak to every dental association in this country, save the Yukon, simply because of time. That being said, I have a sample of the number of dentists who have signed up for this widely touted program.

In my home province of Nova Scotia, four, not 400 or 14, but four dentists out of 400 have signed up for this program. It is shameful. In Prince Edward Island, it is even easier. The number is zero. There is no debating zero, it is none, zilch, nada. In New Brunswick, once again, to be clear, four out of 370 dentists have signed up. The most we were able to find was in speaking with the British Columbia Dental Association, and it had 400 out of 4,000, which is still a mere 10% of dentists.

This is a program that has been created without any consultation with respect to dentists. It has been creating an incredible administrative burden on dentists. It has also created a conflict where dentists have to sign a contract with a provider, namely the federal government, as opposed to having a relationship with the patient, which is how health care has historically been delivered in this country.

Dentists will continue to ask questions about this program. Why would they sign up for a program when they have distrust in this NDP-Liberal coalition?

Let us talk a bit about affordable housing, which was another failure. It was promised by the government in 2015. It would have to build 9.6 million homes over the next 10 years. We also know they are now building less than this country was building 50, and not 15, but 50 years ago. Fewer houses are being built now because of the terrible policies of the NDP-Liberal coalition.

We also know that the Prime Minister sat here in the House of Commons and promised 7,500 new doctors, nurses and nurse practitioners, and as I mentioned previously, 6.5 million Canadians now do not have access to primary care. We also know that the government continues to spend money, which could be easily used to generate these spots for Canadians, on its consultants. The government is quite happy to line the pockets of its friends.

The Liberals also said they would reduce Canada's federal debt-to-GDP ratio every year, which sadly has not happened. We know that they can barely even deliver passports, which is actually one thing that is in the purview of the federal government. It is now announcing things that certainly delve into provincial jurisdiction, yet it cannot do things it should be able to do that are the purview of the federal government. As we begin to look at these things, we know that the NDP-Liberal coalition is an abject failure.

People will often say that I have a lot of negative things to say. Why do I not give Canadians hope? Let us focus on that for a few minutes.

The blue seal program we have announced, as Canada's Conservatives, would allow those who have trained internationally to quickly and safely have their credentials recognized here in Canada. That is a program that we would create because, as we go around this country, what we hear from new Canadians who have trained in other countries is that now they are driving taxicabs. I heard a story from one trained physician who is not allowed to work in this country. He was very sad because his young child asked him why, if he was a physician, he went to work dressed as a security guard every day. It does not get any worse for new Canadians than that.

As we look at that, we know that Canada's Conservatives have been working hard to create policies that, when we form the next government, would easily allow new Canadians to have their credentials recognized here in Canada, so they can support Canada's health care system and work in a manner that is attuned to the training they have undertaken in their home countries.

We have, again, a photo op. We have papers. We have announcements. We do not have a plan that has been put forward by the NDP-Liberal coalition, in any way, shape or form. We have more announcements. We have no actions, and we have continued interference in provincial jurisdictional matters. As I said, I have gone around the country speaking to provincial ministers of health. The last thing they want is another federal program dropped in the laps of the provinces, which they have to pay for because of the ineptitude of the NDP-Liberal coalition.

We await the time when the Conservatives will form the next government of this country. We would have a new prime minister and new hope for Canadians, as they would be able to afford their lives, and the inflationary pressures and inflationary spending that continues to be put forth by the NDP-Liberal coalition would end. Canadians could then not be priced out of their lives.

We would axe the tax, build the houses, fix the budget and stop the crime.

I would like to put forward an amendment.

I move:

That the motion be amended by deleting all the words after the word “That” and substituting the following:

“The House decline to give second reading to Bill C-64, An Act respecting pharmacare, since the Bill does nothing to address the health care crisis and will instead offer Canadians an inferior pharmacare plan that covers less, costs more and builds up a massive new bureaucracy that Canadians can't afford.”

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

Madam Speaker, it is really important to look at the contrast between what the Government of Canada, the Liberal Party, and the Conservative Party are espousing. We are the only party that is espousing the national health care system that Canadians have grown to love for generations now. What we are talking about is expanding it and looking at ways we can complement the national health care system by bringing in a pharmacare program or at least taking a good step forward. That is what we are proposing.

The Conservatives, on the other hand, are proposing to kill it. They are proposing that the federal government should not play a role in many aspects of health care. I believe that the Conservative Party is doing a great disservice to Canadians. Can the member give a clear indication as to why the Conservative Party does not believe pharmaceutical care has the role to play in Canadian health care that Canadians want it to play?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, what this member says is categorically untrue. What we have pointed out with the eloquent speech that I just gave is that 6.5 million Canadians do not have access to health care. We know that the wait times are the longest that they have ever been in the history of this country. With the booing and guffawing behind me, they know it is all true that the difficulty that exists inside the current health care program is the inability of Canadians to access the program.

Why would we continue to put lipstick on a pig when the Liberals' inaction has allowed the system to deteriorate to the point where many Canadians say that the system is failing them, as indeed it is? When 17,000 to 30,000 men and women a year in this country are dying on a waiting list, that is a failing system.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, my colleague, the Conservative Party health critic, touched on an important point: access to care and wait times.

Would he tell us about the Conservative Party's plan to reduce wait times? After all, when we were talking about health transfer agreements, I did not hear his leader lobby very hard in favour of doing more than what was on the table, which the provinces know will not be enough to resolve the problem he raised earlier.

How does his party plan to really strengthen health care systems in the provinces and Quebec?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, I believe it is always important to work with all the provinces and encourage necessary changes within the system, but also to respect provincial jurisdiction, which is a fundamental issue. I am sure provincial jurisdiction is important to my colleague as well.

That will be the Conservatives' goal when we form government.

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

Madam Speaker, I had flashbacks when the member was speaking because, of course, we lived through the terrible years of the Harper regime. When the member said the Conservatives would take care of health care, we saw what the Harper regime did, which was to gut health care across the country, leading to the crisis we see today.

The member talked about credential recognition. I heard the same speech from Harper and his minions just before the Conservatives formed government, and the reality was that they did nothing on credential recognition. They doubled the cost of housing. They increased and doubled the lineups at food banks. The Harper regime was absolutely dismal. We lived through it and that is why the Conservatives were thrown out of power. Now, the Conservatives are saying that this time they would be better, but it kind of strikes at credibility.

The member did say very clearly that the Conservatives would destroy pharmacare. This is in Cumberland—Colchester, where 17,000 of his constituents actually need the kinds of supports that come from providing support for diabetes medications, which can run up to $900 a month. I would like the member to say clearly to his constituents in Cumberland—Colchester whether Conservatives would gut pharmacare. Do they refuse the kinds of supports that 17,000 people in Cumberland—Colchester need?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, I am not sure in what fantasyland the member was listening to the fantastic speech I gave. There was no mention of anything that he said in his question, so I am not sure where that came from.

That being said, what we do know is that a new day, a new dawn and a new sense of hope is out there with Canadians because of the hope that we, as the next Conservative government, are able to give Canadians. We know of the damage the policies of the NDP-Liberal coalition have caused for Canadians. As I said, the numbers speak for themselves. There are 6.5 million Canadians who do not have access to primary care.

As far as the great people of Cumberland—Colchester go, Nova Scotia, much like my colleague's riding in the great province of Quebec, has a program for pharmacare that already enables all Nova Scotians to access a pharmacare program, which, indeed, covers even more medications than the one put forward by the inept NDP-Liberal coalition government with the anemic formularies that it has so far put forward.

The great people of Cumberland—Colchester have access to wonderful programs and those are the things that a Conservative government should be supporting in the future.

[Larry Maguire, Conservative, Brandon—Souris, MB]

Madam Speaker, in relation to the question my colleague from Cumberland—Colchester asked the Minister of Health, I have a letter from a local dentist in my area and I am wondering if the member could refer to any similarities between the Canadian dental care plan and what is being rolled out in the pharmacare plan.

This dentist says that it may place our oral dental care system in serious jeopardy. He goes on to say that it is deeply flawed and stands to jeopardize our entire established system and how they deliver care to their patients. He said that only 70% of dentists have said they are likely to participate as a provider in the CDCP program. He went on to say that patients are going to be surprised to learn that dental care will not be free, they may not be able to choose their preferred dentists and nothing has been done to protect access to third party insurance.

I would ask my colleague from Cumberland—Colchester if he can outline more than he did in his speech, which was a great speech, by the way, any similarities he can see between this plan and the pharmacare plan.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, we know that the NDP-Liberal coalition wants to create federated programs that are going to reduce choices for Canadians and push those who do have access to the beloved care they now have into programs that will cover much fewer medications. For instance, we know at the current time that public programs cover about half of the medications that privately funded plans do. That will reduce choice for Canadians.

What incentive will there be for employers to continue to provide plans for their hard-working employees in the future if a federated plan with a few old medications on it is what is being offered “for free” on the backs of all Canadians? Of course, we know that does not account for the bloated bureaucracy that it will take.

As I mentioned, just to create a new Canada drug agency, in and of itself, will cost at least $90 million. Even though my great colleague suggested that perhaps 70% of dentists may support it, we know from the figures now that only less than 10% of the 26,500 dentists in Canada have signed up for this program, which is severely limiting access for Canadians. Indeed, last week, in one day, four great supporters in Cumberland—Colchester showed up at my office and said they have a shiny card for the dental care program, but they cannot find a dentist to provide the care because of the terrible nature of this program, which was created without consultation with the great dentists who provide care to millions of Canadians across this country.

It is a shame. Liberals should be ashamed of their program and should be ashamed of the fact that they want to introduce another bloated federated program on the backs of hard-working Canadians.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

I would remind hon. members that we are debating the amendment.

The hon. member for Montcalm.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, after what I have heard, I would like to begin my speech by commenting briefly on the answer given by the Conservative health critic, with whom I serve on the Standing Committee on Health. In his answer, he spoke strictly about the jurisdictions of Quebec and the provinces and made no mention of what kind of additional funding the Conservatives would provide for health transfers. If I understood him correctly, basically, the only real option Quebeckers have is the Bloc Québécois.

On one hand, we have the Liberal Party, which says that it will give the provinces money but only on its own terms and while infringing on their jurisdictions. The Liberals are duplicating programs and efforts. On the other hand, we have the Conservative Party, which says that it will not bother the provinces and will respect their jurisdictions but it will not give them a single cent more. That is the choice facing Canadian voters, except in Quebec, where they can vote for the Bloc Québécois.

I will begin my speech with a brief comment, and I hope that the Minister of Health will listen carefully to what I am saying. He always talks about the great discussions that he has with the Quebec health minister. I will come back to that a little later.

I want to begin by saying that in June 2019, the Quebec national state, through its National Assembly, with a single voice and across party lines, responded to this desire to implement coast-to-coast pharmacare. The National Assembly and the national state of the people of Quebec have not changed their position on this issue. The motion that was adopted the day after the Hoskins report reads as follows:

THAT it reaffirm the Government of Québec's exclusive jurisdiction over health;

THAT it also reaffirm that Québec has had its own general prescription insurance plan for 20 years;

I should point out that it has now been nearly 28 years.

THAT it indicate to the federal government that Québec refuses to adhere to a pan-Canadian pharmacare plan;

THAT it ask the Government of Québec to maintain its prescription drug insurance plan and that it demand full financial compensation from the federal government if a project for a pan-Canadian pharmacare plan is officially tabled.

That is what is going on right now. This motion was moved in June 2019. The House passed a motion twice on recognizing Quebec as a nation. When we respect a nation as a national state, by allegedly giving it more than mere token recognition, then the least we can do is avoid the kind of heavy-handed approach taken by the current federal Liberal minister of health. We have to sit down respectfully with the people who administer a plan, which is not perfect.

In fact, I imagine that if the federal government was being stingy with the health transfers, it was because it wanted to funnel some of the money into pharmacare and dental insurance. We will talk about that later. In this case, the government should have come and sat down to see who has the expertise, learn how the Quebec system operates and arrange to provide the full compensation that Quebec is calling for, with no strings attached. In that regard, we need to stop all the speculation around what Quebec wants to do with the money.

Quebec’s health minister was very clear when he said, “we have no problem adding this money to the drug insurance program. But it has to be without conditions. It is not up to them to decide what the best drug coverage is for Quebeckers”.

His intention seems pretty clear. There is respect for Quebec symbolically. They call Quebec a nation to avoid looking foolish. When it comes down to it, though, this must not have any legislative consequences, period. The debate could end here if full compensation were offered. The bill provides for a list to be prepared. Earlier I asked the minister if he knew the list of drugs covered in Quebec, but he did not wish to answer my question. Do members know how many drugs are covered by Quebec’s drug insurance plan? The answer is 8,000. I wanted to bring this 792-page list, but I found it a bit heavy.

These sorcerers' apprentices would have us believe they will arrange all this in no time at all. They will create the Canadian drug agency while in Quebec, there is already infrastructure. Ottawa has so much money that they are going to create another structure. There will be a duplication of structures. Is the Institut national d'excellence en santé et en services sociaux, or INESSS, not doing its job properly? It has been 28 years since Quebec has been making decisions, analyzing all the elements at a molecular level and determining whether these elements, many of which are innovative, are to be reimbursed. They are included in the list. Whether we are talking about the public part or the private part of this mixed plan, everyone has access to the same drugs.

This would have been a great opportunity to respect the Quebec nation. The Quebec national state and all its parties are asking for the same thing. The leader of the NDP, that progressive party, is lecturing us. He is completely out to lunch, though, when he says that the health problem in Quebec has to do with the fact that the government has not invested enough in health care. The Government of Quebec increased its budget by 50%. It has enacted reforms to try to do more with less. It implemented a number of reforms and a lot of structural modifications in an effort to achieve greater health efficiencies.

We have a partner that has not been putting enough money on the table. Then, a few years later, this same partner has the nerve to say that Quebec does not know how to manage its own health care system and tries to explain how it should be done. The first thing that partner should do is hand over the money. That would be a good starting point. Quebec's current resistance to all this federal interference should not be that hard to grasp. It is easy for the Prime Minister to say that he does not care about jurisdictions. The Prime Minister does not care about the Constitution. Well, let him reopen the Constitution, then. We will see if he really does not care. The government likes to lecture everyone else, but cannot even take care of its own people. That is the federal government. I will come back to that.

One might think this bill was well-intentioned, but the road to hell is paved with good intentions and the devil is in the details. I asked only one question: How many prescription drugs will be covered by the national public pharmacare program with a single universal payer? Will Quebec's list be used? Will Quebec have to take any prescription drugs off its list? Will INESSS be made redundant, or will it be able to continue doing its good work? Why is a Canadian agency being created to supersede the process we have in Quebec? We are not getting any answers to these questions. However, the minister claims he has maintained a very good dialogue with Quebec. I gave an example. I think the minister is having a dialogue of the deaf, where he listens only to himself and not the other party.

It seems to me that it was quite clear when Quebec's health minister, Christian Dubé, said, “we have no problem adding this money to the drug insurance program. But it has to be without conditions”. He then added the following:

The government is not only refusing to give us the money we asked for in health transfers, but it also wants to interfere in an area under Quebec's jurisdiction. The federal government knows full well that this is a provincial jurisdiction. We have had our own pharmacare program since 1997. That is almost 30 years. We also cover the widest range of prescription drugs of all the Canadian provinces.

The federal health minister just told us that he has very good conversations with him, even though the Premier of Quebec felt it necessary to hold a press conference to tell the federal Liberal government—which is in a coalition with the NDP and was not so centralist before the NDP got involved—to mind its own business. The minister just told us this morning that they have very good conversations, but when we stand up in question period, we are told that we are trying to pick a fight. All we are saying is that the federal government should mind its own business. We are only relaying the message from the National Assembly of Quebec, not from a single party but from all parties, on pharmacare.

The reason Ottawa has money in the first place is because of the fiscal imbalance. Well, we are going to enhance our own program. I challenge anyone here this morning to prove they could do a more competent job managing our program than those who are doing it right now in Quebec City. I challenge anyone willing to make that claim to go make their case to those managing the program and prove that they have the competence. I am talking not only about provincial competence in the jurisdictional sense, but also about incompetence. In that respect, I have a short list I will return to later.

Bill C-64 has put the cart before the horse, as the saying goes. Today, rather than sitting down, holding a summit, talking to people, looking at what was being done and coming up with something of substance, the government announced an intention of putting something in place. However, it did not talk to anyone, it is not open to anything without conditions, and it is saying that Quebec must march to the beat of Ottawa's drum.

This is not well intentioned; this is a political deal to stay in power until October 2025. That is what this bill is really about. That is what is behind it, because no one could be this keen to jump into as sensitive and critical a field as pharmacare.

Drugs in 2024 are not like they used to be in 1996 or 1997. We are not talking about codeine or Tylenol. We are talking about innovative molecules that often give rise to treatments that could potentially allow patients to avoid surgeries and transplants. A case in point is Trikafta for cystic fibrosis. Patients can take two pills and a glass of water a day, instead of being hospitalized for 280 or 320 days a year, instead of having to get a lung transplant. This drug needs to be covered. How will the list be compiled, and how can we trust the federal government, which starts things but then walks away?

After all, this is the government that pilfered from the EI fund and from workers and that never did the right thing by returning the money. This is the government that dumped the federal deficit on the provinces and cut health transfers in the mid-1990s. Jean Chrétien travelled the world, boasting to the G7 countries that all he had to do to balance his budget was cut health transfers and that the best part was that people were protesting in front of the Quebec National Assembly, not in front of the Parliament of Canada. That is what the federal government is like.

It is creating a program now, but how many years will it be before the government disengages because it got the math wrong, it is unable to manage the program properly, and the infrastructure is cumbersome and redundant, when the money should be on the ground, going directly to patients as quickly as possible?

The minister delivered a very nice speech, saying the governments get along really well, the principles are sound, the Quebec government wants to co-operate. In reality, the Quebec government's response was to ask Ottawa to mind its own business.

The federal government is not even capable of handling its own affairs properly. Think about the whole F-35 saga or the lack of investment in defence. Think about Phoenix, the borders, passports, asylum seekers. The national emergency stockpile was empty when the pandemic hit. The Global Public Health Intelligence Network had been dismantled and was ineffective at the start of the pandemic. The federal government should mind its own business and clean up its own house before lecturing us.

It lectures the provinces about health care management, but it is the worst employer for federal health employees. Communities under the federal government's jurisdiction are neglected. The funding Ottawa provides for public health care is insufficient, to be sure, but the federal government treats its employees worse than the provinces do. How it can then lecture anyone, I just do not know.

The bill seeks to put in place principles, and then, based on these principles, a list will be compiled. After this list is compiled, an agency and then a committee will be established. The government is so clueless about where it wants to go with this that it is tabling a bill to create a committee that will make recommendations for rolling out pharmacare. Bravo.

The Bloc Québécois is not opposed to state pharmacare. It already exists in Quebec. It is far from perfect, there are positives and negatives, but it does guarantee minimum coverage. What we are calling for is what the National Assembly has always demanded: the right to opt out with full compensation. Given how long Quebec has been administering pharmacare, if there was a real need elsewhere, I imagine others would have followed suit. However, that was not the case. We are going to ensure that no one is ever allowed to dismantle our system or reduce our coverage.

Medication is currently free for people aged 18 and under. The system is not perfect, of course, and there are certain fees involved. However, if we had the money, we could increase free coverage without compromising on the list of drugs we cover.

Does the federal government really know how much it is going to cost to make everything free from the first dollar invested? I am not sure these sorcerers' apprentices really know what they are doing. Based on the reaction of the National Assembly and the Quebec government, I am certain the federal government has never sat down with them to have a serious conversation about it. Quebec's example and expertise are not going to be on the agenda as the government implements its system.

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

Madam Speaker, many years ago, the Province of Saskatchewan implemented a policy and a program that ultimately led, in good part, to the national government recognizing how important it was to develop a national health care system.

As a direct result, over generations now, we have benefited from Canada's system. However, many people advocated, over the years, for a pharmacare component. What we are seeing today is historic legislation that would lead us to achieving that particular goal.

This is something that is universally shared across the country. People residing in every province understand and have faith in the Canada health system, whether they are in Winnipeg, Toronto, Montreal, Vancouver, Halifax or any municipality in between. There is a great deal of support for the federal government to be involved in health care. That is why we have the Canada Health Act.

Does the member not believe that Canada has more of a role to play than just being an ATM?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, this is our money. What I just heard is very insulting. My colleague talks about an ATM when it is the government that manages our taxes.

All that we are asking for, and what everyone is asking for, is that the Government of Canada make a substantial and recurring investment in health transfers instead of the insignificant amount that has been put on the table.

During the third wave of COVID-19, experts told us that the side effects of the pandemic on non-COVID-19 patients could take from five to eight years before subsiding. Right in the middle of the third wave, what did the government do? It supposedly waited until after the pandemic to give the provinces peanuts to care for their people. That is not only insulting, it is absolutely criminal.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, I would like to thank my colleague for his passionate and factual remarks opposing the costly Liberal-NDP coalition and all its ridiculous programs.

My question is this: When the Bloc Québécois has the opportunity, will it vote against the budget, the government and the costly coalition?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, we will look at the budget. Just yesterday, given Ottawa’s encroachments into areas of Quebec jurisdiction, the Bloc Québécois House leader said that we could not vote for this budget. We will indeed vote against the budget.

However, I will let our critics take a position on this. That is not my job, as I am the health critic. I will not presume to take anyone else's job. In principle, the Bloc Québécois should vote against this budget because it does not respect the Quebec national state or the Quebec nation.

[Niki Ashton, NDP, Churchill—Keewatinook Aski, MB]

Madam Speaker, I would like to thank my colleague for the points he raised in his speech.

As a progressive jurisdiction, Quebec is recognized as having a stronger social safety net than what exists in most of Canada, including its drug insurance plan, child care program, housing and so forth. This is not by chance; it is clearly the result of the battles waged by Quebeckers over decades.

That being said, there are many Canadians who have fought to expand and strengthen the health system in the rest of Canada. I am proud of the work done by the NDP on pharmacare. We have major concerns when it comes to the promises made by the Liberals. We feel we have to make sure to expand the pharmaceutical services that Canadians are entitled to.

Does my colleague agree that Canadians should have these services? As the NDP said, should there be negotiations with the Government of Quebec?

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, I am happy to see that the NDP member appears to know more about Quebec society than her leader, who said that, if things are not going well with health care in Quebec, it is because we are not investing enough. Since 2018, Quebec's health care budget has actually increased from $40 billion to $59 billion. We are investing in health care. The problem is that the federal government is not doing enough.

If other provinces want to adopt a pharmacare plan, they are free to do so, but I would like to hear the NDP and the member explicitly say that Quebec should have the right to opt out unconditionally with full compensation.

[Rhéal Fortin, Bloc, Rivière-du-Nord, QC]

Madam Speaker, my colleague from Montcalm's speech was extremely interesting.

I have been listening to all this and observing the federal government's spending spree in provincial areas of jurisdiction over the past few weeks, which is obviously terrible. I wonder if the real problem we are having with this bill and with the way the NDP-Liberal government is behaving by investing in provincial areas of jurisdiction is not a tax collection problem. Quebec collects taxes from us taxpayers so it can provide services within its jurisdiction; the federal government also collects taxes for services within its jurisdiction, and it always says it has too much and will give some back, but with conditions.

Is the problem we have with the bill not the same problem we have with every bill that encroaches on the provinces' jurisdictions? In the end, is the solution not simply for the federal government to stop taking more money out of Quebeckers' pockets than necessary?

Perhaps Quebeckers should finally make the decision to leave Confederation.

[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.

[Chandra Arya, Liberal, Nepean, ON]

Madam Speaker, I am going to share my time with the member for Kingston and the Islands.

Bill C-64, the pharmacare act, is a transformative shift in our national approach to health care. We are taking a decisive step towards not just improving health care but also fundamentally redefining what it means to be a part of this great nation.

Health care is a cornerstone of Canadian identity, rooted in the belief that access to medical care should be based on need, not ability to pay. However, until now, this promise has been incomplete, because it has not fully covered medications.

Bill C-64 would establish a framework towards national universal pharmacare in Canada for certain prescription drugs and related products, including free coverage for contraception and diabetes medication. This is more than policy; it is a new chapter in our social contract.

This comes after our Canadian dental care program. That program reduced the financial barrier to accessing oral health care services for up to nine million uninsured Canadian residents.

Let us consider the significance of this moment. Many of our citizens, particularly the chronically ill and the economically vulnerable, have had to choose between medication and other essentials of life. This choice, which no one should ever have to make, has led to deteriorating health conditions, increased hospitalizations and, tragically, premature deaths.

Bill C-64 would also mandate that the Canadian Drug Agency works towards the development of a national formulary, develop a national bulk purchasing strategy and support the publication of a pan-Canadian strategy regarding the appropriate use of prescription medications.

Several G7 countries have implemented national pharmacare programs that vary in structure but share the common goal of improving access to medications. In the United Kingdom, the National Health Service covers most prescription medications, with patients paying a fixed prescription charge or obtaining an exemption. It has made medications free for children, the elderly and low-income individuals.

France operates a co-payment system in which patients are reimbursed for a significant portion of their medication costs based on the medication's necessity and effectiveness. Some essential medications are covered at 100%.

Germany features a statutory health insurance system that covers the vast majority of the population. Prescriptions require a nominal co-pay that is capped annually.

Similarly, Italy's national health system provides medications at low or no cost, depending on the medication's classification and the patient's income level.

Japan has a system where patients pay a percentage of the costs for their prescriptions. This is adjusted based on income, age and chronic health status, ensuring that no one is denied access because of financial constraints.

These G7 countries demonstrate a commitment to ensuring that essential medications are affordable. This reduces the financial burden on individuals and promotes better health outcomes across the population.

The United States and Canada have distinct health care systems that reflect differing approaches to health care management and funding. The U.S. health care system is predominantly privatized; health insurance is primarily provided through private entities. It is supplemented by government programs, including Medicare and Medicaid, for specific groups such as the elderly and low-income individuals. This system often results in higher out-of-pocket costs for individuals, depending on their insurance plans.

In contrast, Canada's health care system is publicly funded. Funded through taxation, it provides universal coverage for all Canadian citizens and permanent residents. Health care services in Canada are delivered through a single-payer system, meaning that the government pays for care that is delivered by private entities. This model aims to ensure that access to health care does not depend on one's ability to pay.

While both systems aim to deliver high-quality medical care, the Canadian system is generally more focused on equitable access, whereas the U.S. system offers a wider range of provider choices and faster access to elective procedures, often at a higher cost to the consumer. The U.S. system also features higher health care spending per capita compared with Canada, which has managed to control costs more effectively through its single-payer system.

As a diabetic, I would like to touch on the transformative change that promises to reshape the lives of the more than 3.7 million Canadians living with diabetes.

Diabetes, a chronic and complex disease, poses one of the greatest health challenges in our nation, impacting an enormous swath of our population across every age, socio-economic status and community. The burden of diabetes is not only a personal struggle but also a national concern. The profound physical, emotional and financial strain of diabetes is well-documented. This disease, if not managed properly, can lead to devastating complications, such as blindness, kidney failure, heart disease and even amputations. However, despite the availability of effective treatments, a staggering one in four Canadians with diabetes has reported that, solely because of cost, they have not adhered to their prescribed medical regimen. This is not a failure in health management; it is a failure in our health policy.

The introduction of the pharmacare act is a beacon of hope. This legislation is a crucial step towards eliminating the financial barriers that too many Canadians face in accessing essential diabetes medications. By ensuring that no one is left out because they cannot afford their medicine, we would not only improve individual health outcomes but also enhance our nation's health security. The importance of this act for the diabetes community cannot be overstated. Improved access to necessary medications would mean better disease management and control, which would significantly reduce the risk of severe complications. This is a direct investment in the health of millions of people, and the ripple effects would be seen throughout our health care system. Fewer complications from diabetes mean reduced hospital admissions, fewer medical emergencies and a general decrease in the health care burden on our system. We are not just providing medication; we are restoring opportunities and enhancing the well-being of millions of Canadians.

I would say to all Canadians living with diabetes that this legislation is for them. It is a testament to our belief that, together, as a united nation, we can tackle the challenges of chronic disease with compassion and resolve. Let us move forward with the assurance that our government is committed to their health and well-being. Let us embrace this change, not just for those living with diabetes, but for us all, for a healthier, stronger Canada.

To conclude, Bill C-64 lays out our plan for universal, single-payer coverage for contraception and diabetes medications. Through our bilateral health agreements with the provinces and territories, the Canadian dental care plan and now pharmacare, we are delivering on the promise that every Canadian deserves better health care.

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

Madam Speaker, one of the great failings of the Canadian medical system is that we stopped at the moment we brought in universal health care, which Canadians believe in and want, and did not go further in bringing forth the pharmacare every other G7 country has.

Considering what we are seeing now with right-wing provincial governments, such as Doug Ford leaving community after community in Ontario with ERs closed on the weekends and the fact that they will hire privatized nurses at huge costs while underfunding the public system, is the hon. member concerned that we are going to see the likes of premiers Danielle Smith, Scott Moe and Doug Ford try to kill a really important initiative to help Canadians? How will we prevent them from doing that?

[Chandra Arya, Liberal, Nepean, ON]

Madam Speaker, the hon. member is right that the health care system is not perfect today. A lot of challenges are being faced, and the responsibility lies with the provinces.

The federal government has taken enormous steps to improve the health care of the country as a whole. We have allocated $198 billion, mostly to the provinces and territories, to deliver better health care. My wish is that the provinces step up and shoulder their part of the responsibility to develop quality care for all residents.

[Cathay Wagantall, Conservative, Yorkton—Melville, SK]

Madam Speaker, I will follow up that question with some facts about Saskatchewan. Its provincial government is deeply engaged in assisting, as an example, its seniors get the medications they need if they do not have their own third party plan. My mother is a senior.

This program would not be sufficient and would be far more expensive than the care we have. There is a possibility that third party providers that exist now would throw up their hands, and no longer provide the kind of care that over 90% of Canadians are already receiving, to allow this program to exist in its stead. In challenging the provincial government in an area that is its responsibility and in which it is doing good work, is the member suggesting that maybe Canadians expect and fear this reality?

[Chandra Arya, Liberal, Nepean, ON]

Madam Speaker, health care is important for all Canadians. It is the responsibility of all levels of government to work together collaboratively so Canadians get the quality health care they deserve.

Unfortunately, certain provinces are not in a very collaborative mood when it comes to dealing with the federal government, which has taken enormous steps during the last several years to provide additional funding to the health care system.

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Madam Speaker, I know my hon. colleague suffers from diabetes, so I am certainly interested in hearing his perspective as to why we are focusing on the two areas of diabetes and contraceptives at this point. Why are we seeing the prioritization of diabetes and contraceptives in this bill?

[Chandra Arya, Liberal, Nepean, ON]

Madam Speaker, there was a certain period of time in my life in Canada when I did not have any prescription coverage; therefore, as a diabetic myself, I understand personally how important it is that this sort of support is given to people who do not have coverage available to them.

As I mentioned in my speech, this is the first step towards dealing with that. We have to start somewhere. Diabetes affects a vast number of people. Coverage for contraceptives is available to about nine million Canadians, and diabetes coverage is available to about 3.7 million. This is a step towards a single universal pharmacare system in Canada.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Madam Speaker, I am very pleased to stand today and speak in support of this bill to bring in the first stages of national pharmacare to this country. Pharmacare has figured as a commitment in the Liberal platform. I would go further and say that it is an extension, really, of an arc of social justice that began many decades ago with hospital insurance. Before we had medicare, we had hospital insurance. If someone went to the hospital they did not have to pay, but then they would have to pay if they went to see their physician. Then, of course, we brought in medicare.

On that score, I would like to come back to something that the member for Cumberland—Colchester said that made me think back to 50 or 60 years ago. He said, in reference to dental care, that the plan for dental care would result in the dentist focusing more on the relationship with the payer, the insurance companies, than on the relationship with the patient.

That was one of the main criticisms of medicare in 1970 when the federal and provincial governments were implementing medicare. At the time, many medical professionals, doctors, said it would not be good because it would bureaucratize their profession as they would have to deal with government bureaucracy and that would leave less time to deal with patients. In the final analysis, we saw that it was a more efficient system. Doctors know that they will get paid. They do not have to hire a bill collection agency to collect medical bills and so on. It is funny that we are going back to arguments that were raised 70 years ago when there was opposition, initially, to implementing medicare in this country.

I would like to go back, for a moment, to the pandemic, because I think it is important. The pandemic was a watershed moment in so many ways. I think it will take decades of analysis and doctoral theses, maybe, to really understand how the pandemic changed our world. However, the pandemic did something for public policy that I am not sure we think enough about. It showed us that we can deliver support to citizens in ways that we never thought possible. If one had asked the government before the pandemic to offer support directly to Canadians through the CRA, through payments based on attestation, one would have been shut down right away. The bureaucrats and politicians would have said that it was absolutely impossible.

We proved that it was possible in a crisis to bring financial support to Canadians in a very streamlined way, in a very direct way and in a very timely way. I think that gave confidence to government that it could deliver other services in a very efficient way. Dental care is one example of that. I would bet that if someone had said we could deliver dental care directly through dentists with an insurance company making payments to dental offices and so forth, people would have said we could not do that as lots of bureaucracy would be needed. However, the pandemic showed us that we can do things directly and efficiently.

That brings me to pharmacare and this initial building block of a national pharmacare system. We have heard the Conservatives raise the spectre of a national pharmacare system requiring immense amounts of bureaucracy, but we have learned from the past that these kinds of services with this kind of financial support can be delivered rather effectively.

Now, we know that provincial health care systems across this country are bogged down in bureaucracy. We have seen some of the tragic consequences of that, but when we are talking about the delivery of drugs, each province has a very efficient and effective pharmacy network that already liaises with governments and with private insurance companies, such that when one gets a prescription, the pharmacist already knows that one is covered by a private insurer, or if one is not covered by a private insurer, they know that one is covered by the government system. There is already a very efficient infrastructure in place to deliver national pharmacare with the help of the infrastructure set up within the provinces, so I do not believe this idea that national pharmacare is going to create a heavy burden of bureaucracy.

The member for Cumberland—Colchester talked about the so-called blue seal program that his party is putting forward as a way of recognizing credentials for foreign-trained doctors. Our government is already doing that. Taking away from the fact that it is already provincial jurisdiction to recognize credentials, we do not hear any objections from the other side about invading provincial jurisdiction when we talk about recognizing credentials. The recognition of credentials is, in fact, something that is done by provincial colleges of medical professionals. All of a sudden, the invasion of provincial jurisdiction does not seem to enter into the picture.

However, the point is that, if we want to do that kind of thing, we are still going to need some bureaucracy. We are going to have to have some government employees who are coordinating something. That is just the way it is in modern governments. Sometimes I fear that the Conservatives do not understand the realities of modern governments, but I will not get into all of that right now.

In terms of the role of the federal government when it comes to pharmaceutical products, let me go back to the CERB. It is conventional wisdom that it is the provincial governments that deliver social assistance in this country, yet during the pandemic I did not hear any provincial governments complaining that we were providing CERB to citizens in need. I did not hear it then. All of a sudden, it is back in the picture.

Back to pharmaceuticals, the federal government is deeply involved in the pharmaceutical industry. It does inspections of pharmaceutical companies. The Patented Medicine Prices Review Board has a role in determining the prices of pharmaceuticals. Health Canada is involved in approving drugs for safety and medical devices. This idea that there is this clean-cut distinction between the federal government and the provinces when it comes to those kinds of products is, I think, a bit of a stretch.

That being said, I am not in the government but I think I can speak on behalf of the government. The federal government is not seeking to manage more things. We have lots of responsibilities. If the provinces can do something well, why not? If the provinces can achieve the goals that we have set, based on what Canadians want, then why not? The federal government is not seeking to manage all aspects of pharmacare, but I think that we are responding to the wishes and priorities of Canadians in proposing this plan.

I would like to come back to another argument that was raised by the Conservatives in this debate. Somehow, in a kind of twisted logic, it was suggested that national pharmacare is going to cause inflation. I do not understand that, but I could be wrong. Maybe I have a blind spot and I do not see all of the logic of the argument, but how can providing free drugs to Canadians who need drugs fuel pharmaceutical price inflation?

Pharmacare is an affordability measure. The Conservatives claim to care so much about affordability, but every time we want to do something on affordability, whether child care, pharmacare or dental care, they vote against it. I do not think they care about affordability.

[Earl Dreeshen, Conservative, Red Deer—Mountain View, AB]

Madam Speaker, I have a couple of points on the things I have heard this morning.

Of course, the NDP is talking about cuts that were there during the Harper era. If one were to look at the amount of money from the budgets over the years, when the Liberals first took power, that was the first time that it had ever ducked below the 3% floor that was given. That statement is certainly one that they talk a lot about, but it is incorrect.

The other question I would like to ask the member has to do with the formularies that the provinces already have. In order to get drugs approved, we go through the federal system, but then it goes into the provinces and they make the decisions on how much they can afford to cover. This is different around the country.

I am wondering if the member is at least curious about what the consequences will be when that decision comes from the federal government versus the provinces, whose responsibility it is to deliver health care.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Madam Speaker, the whole issue around pharmacoeconomics is very complex because governments look at the potential benefits of drug use versus the costs, and it becomes a budgetary and political decision. What we are doing with pharmacare is providing more funding so we can surmount these political and budgetary obstacles to providing Canadians with the drugs they need for free.

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

Madam Speaker, I have been listening intently to my Conservative colleagues, who promise something and then oppose it. For example, they really pushed for the suicide hotline and then voted against it. They tried to cut off the funding for it. One wonders why they do these things.

I was noticing the Conservative deputy leader was a lobbyist for AbbVie. This is a pharmaceutical company that jacked up the price of medications for senior citizens by 470%. We know who the Conservatives work for. They are not there for seniors. They are not there for ordinary people. They are freaked out that, if people have access to medication and the Conservatives get into power, they are not going to be able to rip off seniors to benefit the lobbyists, who are pretty much running the national Conservative Party and certainly the deputy leader. This is why we have seen their complete unwillingness to take on grocery price hikes, because the member in Stornoway's boss is a Loblaws lobbyist.

I would like to ask the member what he thinks about a party that would go along with jacking up medication for senior citizens by 470% to benefit its friends.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Madam Speaker, the first thing I would say is that I hope those individuals will not end up working in the health minister's office. That would be a tragedy, of course. However, what is important is that we have a lobbyist registration system and that lobbyist registration system ensures we have the kind of information the hon. member has taken good care to collate and to share with the House and with Canadians.

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

Madam Speaker, I am wondering if the member can expand on his comments regarding the recognition of credentials. The Conservatives are going around misleading Canadians by indicating that they have this grand blue seal program. It is as if they are going to form government and all the individuals who have credentials would get their credentials recognized. It is as if these individuals would just need to write a Conservative exam and miraculously they would be able to work in health care across Canada, across the provinces and so forth.

Would the member not agree that is exceptionally misleading to a very vulnerable component of our communities?

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Madam Speaker, I agree. They are not just doing that with the blue seal program. They are doing it with climate change by suggesting there is some kind of magic bullet that does not cost anybody anything and we can magically get rid of greenhouse gas emissions. Yes, they need to be more forthcoming—

[Ron Liepert, Conservative, Calgary Signal Hill, AB]

You guys can't even be honest with each other.

[Francis Scarpaleggia, Liberal, Lac-Saint-Louis, QC]

Madam Speaker, the opposition needs to be more forthcoming and be a little more direct and frank with Canadians.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I want to remind the hon. member for Calgary Signal Hill that, if he has questions and comments, he should wait for the appropriate time and not try to contribute to the debate until such time.

Resuming debate, the hon. member for Cariboo—Prince George.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, it is an honour to rise today to speak to Bill C-64.

We have heard some doozies over the last day. Of course, today is budget day, so we will hear some more doozies about the billions upon billions that will be spent and heaped on the backs of taxpayers.

One of the reasons it is such a great honour to speak to Bill C-64 is that I get a chance to split my time with the newly minted Conservative member for Durham. Finally, we have a true blue Conservative in Durham, and I cannot wait to hear his speech. I believe it may be his maiden speech today. He is a great member of Parliament. If anybody has not heard his story, it is a true testament that a person can do anything they want if they set their mind to it and do not accept the barriers that life has placed before them. He is a cancer survivor. He was ruled illiterate in grade school and then went to Yale School of Law just seven years later. I am so honoured to share a bench and split my time with my colleague from Durham.

We are speaking about Bill C-64, which is yet another promise or plan of the Prime Minister's to hold onto whatever shreds of power he has. It is essentially a power grab, again. We will be talking a little about some of this announcement, as well some of the other failed announcements that the Prime Minister and his “speNDP” coalition have undertaken in the last four or five years.

From the onset, I will say that I believe that if a Canadian needs medication, we should be doing everything in our power to make sure they have access to the medications they need. However, this bill is not a pharmacare bill. It is a plan or a promise to work towards a bigger pharmacare system. Where did we hear that previously? Oh, that was with the dental care plan that we saw earlier, and now we are hearing that less than 10% of dentists across our country are signing up to it. It is a failed system. I will have more on that as we go further.

The Conference Board of Canada estimates that over 97% of Canadians are already eligible for some form of drug coverage. Over 27 million Canadians rely on privately administered workplace plans. I spoke with insurers who have no idea how this pharmacare plan would work. Are they to scrap their plans altogether? What happens to those 27 million Canadians who already have a plan?

Despite what the health minister said, that he has a great working relationship with Quebec, that was proven wrong time and time again. I believe it was the Quebec health minister who went public to say that there are no talks and that they do not agree with what the federal minister is saying regarding health care. We have seen this time and again with the Liberal government.

Going back to 2015, the member for Papineau campaigned on doing things differently. He campaigned on having the most open and transparent government in the history of our country. Wow. The one thing he has accomplished is having the most scandal-plagued government in the history of our country, and the NDP coalition is complicit in the cover-up of those scandals.

The pharmacare bill is just another in a long list of bills that allowed the Liberals to get in front of the cameras and say they are getting things done for Canadians, when they are really just trying to pull the wool over everyone's eyes.

Now, the Liberals and the NDP will stand up, pound their fists and say how bad Stephen Harper was in the dark years of Stephen Harper. Here is a news flash. The Liberals have been in power for nine years. If it was a priority for them, then they could have gotten it done. They had a majority, and now they have a majority with the NDP, so they could get things done if they really wanted to get things done.

Bill C-64 is nothing more than a photo op; that is it. It does not actually do anything concrete. It talks about, “to consider when working towards the implementation of national universal pharmacare”. In other words, it is just another broken election promise. Why does the government not work with pharmaceutical companies to bring down the cost of all drugs to Canadians? That is a novel idea, but nothing is mentioned in there. All we get are future promises and no plan. Let us really, truly be honest with Canadians. This is a not a pharmacare plan; it is an empty promise that will not even come close to covering every medication that Canadians use.

I spoke about promises. We have heard that Nova Scotia has a bit of plan. We heard that Quebec, obviously, has a plan and was not even consulted on how it has done it. My province of B.C. has the fair pharmacare plan. As a matter of fact, we have 12 plans under that one plan for British Columbians who have trouble accessing medication.

What the Liberals have proven time and again is that, after eight years, they neither trust nor respect Canadians. Apparently, they also think that Canadians are too foolish to see through the truth that is right before their eyes. The truth is that after eight long, miserable years, the NDP-Liberal government is simply not worth the cost. We say that time and time again. With this government, the choice is between costly programs and future promises, or should I say false promises, and Canadians know that NDP-Liberal promises never come true.

After eight long years of this Prime Minister, there have been so many broken promises. In 2015, he promised affordable housing, and then he doubled the mortgage, rent and down payment costs. It now takes 25 years to save for a down payment on the average home. In Vancouver, a person has to earn almost $250,000 just to afford a home. Most young Canadians believe that they will never be able to afford a home. That used to be the dream; now it is just a nightmare. He promised that the carbon tax would not cost us anything, and now we find out that over 60% of Canadians pay more because of that tax. He doubled the tax; actually, he raised it by 23% on April 1, which was an April Fools' Day joke on all of us.

I talked briefly about dental care, and I want to read something from a dental office in Prince George, which wrote that what has been put out to the public as far as the coverage is totally not true. The dental office said that the government has said to the public is that this is free dental, but that it's nowhere close to being free dental, unfortunately. That's why, they said, there's frustration from patients who are signing up and phoning around. Patients are saying that they have free dental now, and they, the dental offices, have to give them the bad news.

She continued by saying that there hasn't been a whole lot of information released to dentists, and the government won't give any more information until you register. It hasn't been totally honest and transparent with the dentists, and the dentists are leery of signing up. She said that it was confusing for them, because they haven't been getting all the facts, and that until the facts are better explained to dental offices, dentists and owners, they're not going to register for something if they don't know what they're getting involved in.

That is par for the course with this government. Its members stand before the public and the cameras, perhaps with a tissue to their eye; they put their hand on their heart and say that they truly care. However, the reality is that they are not doing the work. We have good people across the way who are actually waking up and seeing the failures and the lies of their front bench.

It is about time that this failed NDP-Liberal coalition moved out of the way so that the member for Carleton, Canada's future prime minister, can start righting the wrongs of the last eight years. It is going to be tough, but we have the team and we are ready to do it.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Madam Speaker, I must say that I disagree immensely with almost everything from the start to the end of the comments that my colleague made. Of course, I am not going to add to them. I would like to know what he would be doing, what your government would be doing and what your party would be doing, if it had the opportunity to become the government, which I hope it does not, actually, because I look back on the years of the previous Conservative government, and it was a question of taking away and deteriorating health care.

I think the dental program and the pharmacare program are really important to all my constituents. I am not getting the complaints my colleague was mentioning. My constituents are very grateful to have that program and are already using it. I would expect that my colleague has many people in his constituency who would be very glad to be able to access this program. Is he at a point of eventually supporting this program?

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I want to remind the member that a couple of times she actually was directing comments directly to the member, but she did correct herself at the end.

The hon. member for Cariboo—Prince George has the floor.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, I have great respect for my colleague across the way.

I believe my hon. colleague from Cumberland—Colchester, who is a former physician, mentioned this earlier. We have to, first, eliminate the wait times Canadians face. For example, six million Canadians cannot get a primary care physician. They cannot get their medication if they need that. We would work with the pharmaceutical companies, writ large, to make sure that we were driving down the costs. We would work with the PMPRB. We may even just revamp the PMPRB so that we would be getting those drugs approved faster. Canadians with rare diseases could get the drugs that their friends and families seem to be getting faster in other countries, and they could be looked after sooner. We would develop a rare disease strategy so that those Canadians struggling with rare diseases could get the help they need when they need it.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Madam Speaker, we know that the Conservatives have consistently opposed pharmacare. We heard my colleague from Timmins—James Bay highlight that the Conservative deputy leader was a lobbyist for AbbVie, a large pharma company in North America that jacked up its prices on medications for seniors by over 470%. Who really needs pharmacare lobbyists when we have Conservatives here?

I want clarity, because I heard him say, misleading the House, that people in British Columbia are covered for insulin. That is not true.

I am going to give my colleague another chance to clarify that insulin is not free in British Columbia, and in fact, it is a huge cost to many British Columbians, especially working-class British Columbians. Is he going to oppose, for those British Columbians who require insulin, this legislation that would provide them the support they need on life-saving medication, especially when someone loses their job and their deductible is no longer within their affordability level.

I would like some clarification from my colleague from Cariboo—Prince George.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I just want to remind the hon. member that he might want to retract something. He said the hon. member misled the House. He knows he cannot say indirectly what he cannot say directly.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Madam Speaker, I will withdraw that statement, but I would like clarification, because my colleague was speaking on behalf of British Columbians, saying that they are fully covered. That is not true.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

The hon. member withdrew it. He does not need to elaborate. I just asked him to withdraw.

The hon. member for Cariboo—Prince George has the floor.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, most of that member's minute-and-a-half-long rant was incomprehensible. I could not understand what he was saying. However, on one comment that he did mention is that they like to point fingers at other groups and lobbyists. I will remind the member that his leader's brother is a lobbyist for a big grocer. They may not like the answer. They obviously do not like the answer, so they are shouting over top—

[Some hon. members]

Oh, oh!

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Order.

I want to remind members that they have an opportunity to ask questions, but unless they are being recognized again, they should not be yelling out or trying to ask other questions.

The hon. member for Cariboo—Prince George has the floor.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, it is unfortunate that when we speak the truth here, those members take offence to it, because all they want on the record is their misinformation. They can say everything they want about the Conservatives, but when we fire back at them, they take offence to it.

I hope I did not hurt the member's feelings by not answering, but I am sure we will speak off-line and hug it out afterward. I will end there.

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

Madam Speaker, I rise on a point of order. We have seen a lot in the House, but since the member could not answer the question, he does not need to attack the emotion of my colleague. He does not need to hug him; he needs to tell the truth. It is a simple thing.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

This is a point of debate, not a point of order.

Resuming debate, the hon. member for Durham.

[Jamil Jivani, Conservative, Durham, ON]

Madam Speaker, I rise in the chamber today as Canada's newest member of Parliament elected to represent the riding of Durham. I have a very clear message to deliver on behalf of my community in Durham. We are tired of the Prime Minister's broken promises. We are tired of the Prime Minister promising to fix this and that and, in return, what we receive is a life that is harder and more expensive.

The Conservatives believe that Canadians deserve better and that the topic of debate today, pharmacare, is just the latest example of the Prime Minister promising big things, only to disappoint the people of Canada. I put my name on a ballot and wanted this job as a member of Parliament because, despite the Prime Minister's best efforts, I am optimistic and hopeful about the future of our country. I believe that once we have a new leader in this great land, we will see brighter days ahead.

My optimism does not come from these big deficits or big budget announcements. My optimism comes from my knowledge of the people of Canada and the people of Durham. My optimism comes from people like Kirk Kemp, who runs one of the biggest and most important agricultural businesses in Canada, Algoma Orchards. As he becomes more successful in his business, he only gives back more to our community, supporting initiatives like the Bowmanville Hospital redevelopment.

My optimism comes from people like Dr. Kan Chandra, a dentist in Courtice, Ontario, who has built a tremendous business, provides for his family and gives back to our community as a connector for Durham's growing Tamil community.

My optimism comes from Kim and Leon Morrow over on Taunton Road East in Oshawa, who scrape together every spare dollar they can find and every spare moment to provide guidance and mentorship to young men and women who may otherwise fall into the pitfalls that await struggling youth. However, Kim and Leon have their backs. That is why I am hopeful about the future of the country.

I am very honoured to stand in this beautiful building and I appreciate the chance to dress up in a suit and tie, but my heart was not shaped in places like this. My heart was shaped by people like my grandfather, Robert McFarlane, may he rest in peace. My grandfather worked as a school custodian for decades in the Toronto District School Board, a man who swept and mopped the floors, who kept the classrooms tidy and locked up at the end of the night so that children had a place to learn and teachers had a place to work. I carry his story with me.

I come into this job very much a servant, like my grandpa. I am here to protect what makes the country special, to protect the rights and freedoms of Canadians, to ensure our country continues to be a place where people from all over the world can come and find a better life, people like my grandpa who came here from Scotland, my grandmother who came here from Ireland and my father who came here from Kenya.

I am aware that there is a Liberal playbook that gets used against people who disagree with the Prime Minister, a playbook that likes to marginalize and vilify anyone who has the audacity to stand up and say that what is happening in our country right now is not right. That playbook the Prime Minister likes to use that casts people who disagree with him as racists. I would welcome the Prime Minister to try that with me. Based on our history, I do not think that will go so well for him.

The Prime Minister is completely out of touch with the needs and desires, hopes and dreams of our very diverse country and diverse communities like the one I represent in Durham. He is welcome to take his claims that people who disagree with him are racist to my African father and see how that goes for him.

The Prime Minister also uses the Liberal playbook to marginalize and vilify Canadians who disagree with him by calling those of us who believe in traditional family values bigots. I ask him to come to my diverse riding in Durham and try that on us, where we have Christians, Muslims, Sikhs, Hindus and Jews living together, all people who believe that mothers and fathers matter. He is welcome to try that with us.

I know his Liberal playbook also likes to say that people who disagree with him do not care about the working class or do not care about vulnerable people. That is not going to work on me either. I am not a trust fund baby. Like most people in the country, I have clawed, scraped and worked hard for everything I have. I do not think the Prime Minister can say the same thing.

The reality is this. He is welcome to try that message on people like my mom. She would love to have a conversation with him. She is a woman who raised three children by herself. She is 68 years old and continues to work hard every day, because she cannot afford to retire in the NDP-Liberal economy. The Liberal playbook is not going to work. The Liberals can try their greatest hits. Tune up the guitar, tune up the banjo, the greatest hits are not hitting anymore.

I am here to deliver that message very clearly on behalf of my community in Durham and people everywhere else in our great country who are unhappy with what is happening, who are feeling frustrated because they are unable to say what is happening in their hearts and their minds, do not feel validated and affirmed by the reality they experience not being echoed by many of the institutions across the country that have bought into a narrative that simply does not reflect reality.

With the remainder of my time, I would also like to deliver a message to any young men and women across the country who might hear my words. My presence in this chamber is a glitch in the system. I am not supposed to be here. When I was 15 years old, I failed the Ontario literacy test. I was labelled illiterate by the Ontario education system, but I am here.

At the age of 30, I was diagnosed with stage 4 cancer. I sat in a recliner with an IV in my arm, pumping my body with chemotherapy drugs. I laid on a hospital bed as radiation lasers ran along my spine for months, but I am here. I took on woke censorship from corporate Canada, looked it dead in the eye and I am here. I have been the subject of hit piece after hit piece from Liberal news media. Guess what, I am here.

The reality is that many young men and women are facing a variety of challenges across the country right now, some of whom are facing things I cannot even fathom. As long as I stand in the House of Commons, as long as I am honoured to call myself a member of Parliament, I hope I can be a walking, talking reminder that people should never give up. They should not give up on themselves, their families, their communities and our country. As long as I am here, I will not give up on them either.

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

Madam Speaker, I want to thank the member for sharing his personal stories and congratulate him on his first speech in the chamber.

Could the member give his personal perspective on the principles of a national pharmacare program?

[Jamil Jivani, Conservative, Durham, ON]

Madam Speaker, my concern in being asked about pharmacare is that I have been drawn into a debate that assumes the Liberal-NDP government will do what it says it will do. Over the course of the last eight years, we have seen that is simply not going to happen.

We have a country full of people, tens of millions of people, who have been led to believe over and over again that the Liberal-NDP government and the Prime Minister are going to deliver for the hard-working people of our country, yet that has never happened.

Before I discuss anything like the principles of pharmacare, I would like to be convinced that something substantive actually will happen for the people of Canada. I would love to go back to my riding and say that the Liberals have a plan for us. Unfortunately, everything I have seen since I got here last Monday has indicated otherwise.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Madam Speaker, I would like to join my colleagues in congratulating my colleague on his election and his first speech.

I recall a great quote by Scott Brison, who sat on both the Liberal and Conservative benches. When he sat in the House, he said that although he did not share a lot of the policies of the Conservative Party, regardless of where we sat in the House, we could have a huge impact and difference for Canadians. I hope my colleague will take that to heart and work collectively with members to try to find solutions to support Canadians as we walk forward together.

With respect to the question on insulin, my colleague cited the delays by the Liberal government, and I agree, but does he believe that if insulin were free of charge, it would be of benefit to his constituents and would he be willing to work with us to find a pathway to expedite that?

[Jamil Jivani, Conservative, Durham, ON]

Madam Speaker, when I was a cancer patient at North York General Hospital and Sunnybrook hospital, I saw many people in very dire health circumstances, people facing all sorts of challenges, some of with whom I shared a cancer ward. What was very clear to me was that we needed programs that could help people who did not have the money to purchase the drugs they needed. The cancer ward at North York General Hospital has a provincial program to help people with drugs.

What I continue to be confused about, as I hear this debate on pharmacare, is why there is not a greater recognition of the need to work with the provinces to solve some of these problems. I saw people right beside me, hooked up to the same IVs as I was, getting their body pumped with chemotherapy drugs. They depended on those provincial programs to get the health care they needed. What I worry about, and I think what my fellow cancer patients at North York General Hospital would worry as well, including cancer patients all across the country, is whether this is a matter of creating more bureaucracy in Ottawa or whether we are actually concerned about providing people with what they need at an affordable price.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, my colleague, the member for Durham, has had the opportunity to knock on doors very recently. I wonder if you can enlighten the House on the issues that you—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I would remind the hon. member to address his questions and comments through the Chair and not directly to the member.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

I apologize, Madam Speaker. I was caught up in the moment.

Could the member elaborate on the issues he heard, when he was knocking on doors in his most recent election, so all Canadians can understand what the issues are out there?

[Jamil Jivani, Conservative, Durham, ON]

Madam Speaker, the short answer to my colleague's question is affordability. People from all ages, whether they are seniors who are concerned about their pensions and not being able to afford a good quality of life, or people my own age who are living in their parents' basement, hoping to move out and start a family one day, across generations, across cultures, across languages, are concerned about affordability and whether the NDP-Liberal government can make life easier so we can move forward with our lives. What is uniting Canadians right now is their concern about affordability.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, it is a real pleasure to rise today to speak to a very important piece of legislation, Bill C-64. I will be sharing my time today with the hon. member for Humber River—Black Creek.

This is important legislation because, for decades, we have been talking about the need to bring in pharmacare. I look at this as the first step in bringing in pharmacare, which could cover a whole host of drugs and medicines that are very important for people. I would agree with the member for New Westminster—Burnaby, who was speaking earlier, that this is about preventative health care. This is about helping people before they get to the point when they would need to go to an emergency room. This is about getting people their very important medication.

When we have an issue like this that further builds on our health care system, which is a health care system that has developed over generations through, at times, very difficult partnerships and relationships with provinces, I am disheartened to see that, in the very first speech on this issue, when Conservatives stood, they brought in a motion to amend the bill. The amendment would basically substitute everything after the word “That” with “The House decline to give second reading”. That is all the Conservatives did.

[Some hon. members]

Oh, oh!

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, now they are clapping. Conservatives are clapping as a result of this non-motion. They could have just voted against the bill to say they were not interested. Instead, they introduced a second vote. It will take 10 minutes to vote down their amendment before we vote in favour and pass this very important piece of legislation. I imagine that, much like there was with the piece of legislation on sustainable jobs, which we finally voted on yesterday, there will be obstruction after obstruction with Conservatives playing with the bill at committee and through the various stages of the House.

I ask myself why Conservatives would be so dead set against legislation like this. In my opinion, this is about helping people, particularly the people who really need help. The vast majority of Conservative donors, and the people they look to for fundraising, are individuals who, quite frankly, could probably afford to have private insurance or work in a job that provides insurance. The individuals I see who would really benefit from this legislation are those vulnerable individuals in our society who are not covered by health care or pharmacare plans or who do not have insurance in one way or another.

One of the criticisms we hear from Conservatives is that this is about provincial jurisdiction. The Conservatives have said that this is provincial jurisdiction and ask why we are getting in the way of it. I will then ask them why they voted in favour of the national child care plan. They got up to talk down the plan for hours on end, but ultimately, they ended up voting in favour of it. That was something we needed to work together with the provinces on to make it a reality. The Conservatives saw a benefit in voting in favour of that, so they did. However, they cannot seem to see the same way forward with this particular issue.

This bill would introduce pharmacare by first setting up the system to provide for two drugs: insulin, for individuals with diabetes, and contraceptives. This is extremely important. There are nine million women and gender-diverse Canadians all across the country who would get access to the contraception and reproductive autonomy they deserve. This is really important in the context we are in, and I will explain why.

Right now, when we look south of the border, we are literally watching state legislatures and the Supreme Court of the United States make rulings that are further confining the ability of a woman's right to choose. We are seeing legislation being adopted that is something that we thought would have been dreamt up, that we would have assumed the United States had moved away from decades ago. Canada will stand up to a very aggressive position to say that we will not go down the same road as the United States. Despite the fact that many Conservatives, I am sure, would love to do that, we will not. We will ensure that a woman would have not only the right to choose, but also free access to the necessary medication specifically for contraceptive purposes.

I will certainly be voting in favour of this. I look forward to this bill coming to the House so we can have that vote, if the Conservatives ever let us get there.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Madam Speaker, in my province of British Columbia, we are sending cancer patients for therapy to the United States. Does the member have concerns about provinces sending people to the American system?

The Minister of Health has said that we do not want to go to the United States' system, yet our public health care system in British Columbia is sending patients to the United States. Here we are, talking about expanding more bureaucracy, when we have provinces such as mine that are sending patients there. What does the member have to say about that sad state of affairs?

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, if I understand the member correctly, what he is saying is that his province has to send people to the U.S. for treatment. I do not know about that, but I will take his word for it that he believes it. He is saying his province has to send people to the United States, so we should not try to do anything else to help Canadians.

This legislation is about developing a national framework. I am sorry that there are issues in his province with health care. He should come to Ontario. I would love to have a chat with him about the issues that Doug Ford has created in Ontario.

However, that is beside the point. What we are talking about is developing a national strategy as it relates to pharmacare. This member can find all the excuses in the book that he wants to vote against this. At the end of the day, what he is going to do is vote against helping vulnerable Canadians, in particular, getting access to the medications they need.

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Madam Speaker, I listened to the speech of my colleague with great interest, and I know he is a great advocate for health care for Canadians.

I would like to ask him about the situation in Quebec. Maybe he is not that familiar with it, but we did hear how many unions are in favour of our health care plan, even if their members have employer drug insurance.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, that is an excellent question because we have different levels of coverage throughout our country. Those levels of coverage, directly or indirectly, are going to correlate to whether individuals are more wealthy or not. Therefore, somebody who works in a corporation, for example an executive high up in the corporation, probably has really good coverage. As well, within the unions, there are going to be different levels of coverage.

This is about accepting, realizing and coming to the conclusion that we all deserve the exact same level of coverage, regardless of who we are, where we work or what our income is.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, in responding to the member from Quebec's question, the member just proved that he knows absolutely nothing about Quebec's pharmacare program. Everyone gets the same coverage and has access to the same molecules. The example he gave makes it absolutely clear that this government does not know what it is talking about when it talks about pharmacare. They are sorcerers' apprentices.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, the member is referring to the question that was previously asked and not to my answer. I would say that maybe the member did not hear what the question was.

The question the member asked me was specifically about union support for this bill and unions in Quebec that support it. I would encourage my Bloc colleague, who stands up quite often for the workers of Quebec, to consider what the union folks in Quebec are saying about this legislation. From what I hear, they are saying that they are supportive of it, so maybe the Bloc members should really give some consideration to that when it comes time to vote for this.

The House resumed consideration of the motion that Bill C-64, An Act respecting pharmacare, be read the second time and referred to a committee, and of the amendment.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Mr. Speaker, I was not sure I would get the opportunity to speak this afternoon, so I am glad to be able to join in debate on a very important bill, Bill C-64, an act respecting pharmacare.

Bill C-64 represents the next phase of our government's commitment to establishing a national universal pharmacare program. It proposes the foundational principles of the first phase of national universal pharmacare and our intent to work with provinces and territories to provide universal, single-payer coverage for a number of contraception and diabetes medications. This is an important step forward in improving health equity, affordability and outcomes, and it has the potential to provide long-term savings in our very endangered health care system.

Public health care in Canada was built on the promise that, no matter where one lives or what one earns, one will always be able to get the medical care one needs. Despite this promise, Canada is the only country in the world with universal health care that does not provide universal coverage for prescription drugs. In the bill, we talk specifically about contraception and the things needed for diabetes. They are very important aspects of this program.

When medicare was first introduced, prescription drugs outside of hospitals cost less and played a smaller role in health care. Today, prescription drugs are an essential part of our health, helping to control chronic conditions, treat temporary ones, and aid in overall health and well-being. We need to work harder to get those costs reduced.

One area that has seen significant change is diabetes treatment, as mentioned earlier by the minister and by other colleagues. Over 100 years ago, thanks to a Canadian team of researchers, Frederick Banting, Charles Herbert Best, John J.R. Macleod and James Bertram Collip, insulin was discovered. Since this monumental scientific discovery, there have been several advancements in diabetes treatment, from the introduction of fully synthetic human insulin to glucose monitors and insulin pumps.

These breakthroughs have improved quality of life immensely for people living with diabetes, whether it is by enhancing their self-esteem, increasing social participation, or improving overall health and well-being. Through hard work, one colleague in the House brought forward a program for a national diabetes strategy. These breakthroughs have come with higher costs, creating new affordability challenges for Canadians.

Outside of hospital, prescription drug coverage comes from a mix of private insurance, out-of-pocket cash payments and various provincial programs. While the majority of Canadians have access to some form of public or private insurance, about 2.8%, or 1.1 million Canadians, do not. We constantly hear just how expensive everything is in and around the diabetes forum on a monthly basis for an individual.

Although most Canadians have some form of drug coverage, as I mentioned, this does not mean that those with insurance have equal access to the prescription drugs they need. The existing patchwork system of private and public drug plans leaves millions of Canadians under-insured. That is, their out-of-pocket prescription drug costs create a financial burden that leaves them struggling to afford an essential part of health care.

In 2021, Statistics Canada found that more than one in every five adults in Canada reported not having the insurance they needed to cover their prescription costs. They had to decide whether they were going to fill their prescription or buy dinner.

Under-insurance can take many forms. For example, Canadians may have high deductibles, resulting in significant out-of-pocket costs before their insurance coverage even kicks in; they may reach the maximum annual or lifetime coverage limits for their insurance and have to pay out-of-pocket; or they may have high co-payments, which are often more than 20% of the drug's cost on private plans and sometimes more on public plans.

All provinces have drug coverage to protect Canadians from catastrophic drug costs, but deductibles under these plans can range from 0% to 20% of net family income. In many cases, Canadians will never reach the deductible, leaving them without any support for their drug costs. This variability across the country creates a postal code lottery.

We can again consider the advancements in diabetes treatments. For a working-age Canadian with no private insurance, out-of-pocket costs vary widely. In some parts of the country, out-of-pocket costs for people living with type 1 diabetes can be higher than $18,000 per year out-of-pocket; for type 2 diabetes, they can be higher than $10,000 per year in out-of-pocket expenses. Even those with private insurance can face high co-pays or exceed annual plan maximums, resulting in high out-of-pocket costs.

Even for cases in which an individual is not accessing devices that cost thousands of dollars, they can face significant out-of-pocket costs. For example, we can consider a woman in her mid-twenties who is working a minimum wage job. An IUD, one of the most effective forms of birth control, can cost up to $500 with no insurance. Even with private insurance, a co-pay of 20% would be $100. While IUDs can last from three to 12 years and save money over the long term, the high upfront cost can make them inaccessible.

Under-insurance can be a particular concern for young adults, who age out of their parents' private insurance but do not have their own form of private coverage. Lower-income Canadians also make up a disproportionate share of the under-insured. While most provinces have put drug coverage in place for those accessing social assistance benefits, a gap clearly persists. Many lower-income households that do not qualify for social assistance continue to struggle with out-of-pocket prescription drug costs.

Employment factors contribute to differences in insurance coverage. People with low-paying jobs, such as entry-level, contract and part-time positions, often report less adequate drug insurance coverage. This may even discourage people who are accessing social assistance benefits from applying for jobs: Once hired, they may lose their public drug coverage, but many entry-level and part-time jobs do not offer drug benefits. One study found that only 27% of part-time employees reported receiving medical benefit coverage.

Under-insurance can have serious consequences. Many Canadians with high out-of-pocket costs report forgoing essential needs, such as food and heat, or not adhering to their prescriptions because of the costs they have to pay. Statistics Canada also found that, in 2021, close to one in five Canadians spent $500 or more out-of-pocket for their prescription medication; almost one in 10 reported not adhering to their prescription medication because of costs. This includes delaying filling prescriptions or skipping doses in order to save money.

When people do not take their prescription drugs the way they are supposed to, their health can suffer, and this results in serious consequences for the individual and their household. It also results in unnecessary costs to the health care system, as patients are more likely to visit an emergency room and be admitted to hospital. For example, the full cost of diabetes to the health care system in 2018 was estimated to be around $27 billion, and it could exceed $39 billion by 2028.

I think we can all agree that no Canadian should be put in a position where they must choose between the prescription drugs they need for their health and well-being and putting food on the table. This is unacceptable, and it is why we are continuing our work to improve accessibility, affordability and appropriate use of prescription drugs as we move forward with national universal pharmacare.

I am thankful for the opportunity to speak to a very important bill, as we start the debate and move towards to the legislation passing in this House.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Mr. Speaker, it was an interesting speech. Once again, it would appear that the Liberals are suffering from counting problems today.

That being said, we have often heard today about the number of insulins covered on this fantasy pharmacare program proposed by the NDP-Liberal costly coalition. We know, clearly, that in British Columbia, on their formulary, there are 17 insulins covered, and on this program there are only nine. Again, we come back to the magical number of eight, which is how many insulins are not covered by this program. I thought I would give the answer to the member before there is difficulty answering the question, as there has been all day.

I would also like to ask a question. For a cash-paying customer paying for birth control pills, how much would that be a month? Certainly the numbers are not adding up once again.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Mr. Speaker, this is a new program that is being introduced. I cannot tell the House how pleased I am that it is here.

I have heard from my constituents, whether they are interested in the issue of diabetes support or in talking about contraception opportunities. At the end of the day, this would save lives and a lot of money. It would also make our country far more understanding and appreciative of what people are suffering. When we talk about affordability, we need to start by helping people with their drug costs.

[Simon-Pierre Savard-Tremblay, Bloc, Saint-Hyacinthe—Bagot, QC]

Mr. Speaker, I would like to thank my colleague for her speech. She is the chair of the committee I sit on. We have often worked together in the past four and a half years, almost five. I have sat on the same committee since I first came to the House, so I have had the opportunity to work with the chair.

I will digress briefly, if I may. I urge her to table the motion we adopted last Tuesday as soon as possible. It has been a week now, and it would be nice to see it tabled in the House as soon as possible.

Now that I have said that, here is my question.

Quebec is certainly not against pharmacare, seeing as we have our own plan and are very good at public programs. Why would it be so difficult to include a right to opt out with full financial compensation that would allow us to receive our share of the money and improve our existing programs? That would make everyone happy.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Mr. Speaker, the member's first question was regarding a report. The member can rest assured that I will report the motion to the House at the first opportunity I have to do so.

On to the issue of Bill C-64, this is the beginning. It is a new program. We expect that there will be times for alterations as to how we do things. We will continue to work with the provinces on how we do the rollout of this plan. I think the best thing the member could do would be to work with all of us, and all of the parties in the House, to see that this legislation, Bill C-64, gets passed as soon as it can.

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

Mr. Speaker, certainly New Democrats support investments in pharmacare. We support the national dental care plan, which is bitterly opposed by the lobbyists in the Conservative ranks.

We have to look at larger issues of health care. I want to speak about indigenous health care, particularly children's health care. The government has spent millions of dollars fighting against the implementation of Jordan's principle at the Human Rights Tribunal, yet we still see, time after time, the government refusing to pay in a timely manner for children who need treatment in all manner of areas. We have therapists who simply cannot keep the lights on because the federal government refuses to pay.

Does the member not understand that these are obligations that were ordered by the Human Rights Tribunal, and that if we are going to provide health care, it has to be done in a timely manner for the vulnerable indigenous children covered under Jordan's principle?

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Mr. Speaker, I want to thank the hon. member for his commitment to his community and the indigenous community, in particular.

Bill C-64 is one more way for us to talk about health care in Canada. We are certainly talking about the indigenous community, but we are also talking about all Canadians. The more opportunity we have to look at where we could improve the system, the better it is for all of us.

[The Deputy Speaker, Conservative, Chris d'Entremont]

Before I call the next speaker, I would remind members that we will probably have to stop right around four o'clock. The member might get her whole speech in, but maybe not.

The hon. member for Fort McMurray—Cold Lake.

[Laila Goodridge, Conservative, Fort McMurray—Cold Lake, AB]

Mr. Speaker, it is an absolute honour to be able to rise in this place and bring forward a perspective on this bill and to speak in support of the amendment that has been brought forward by my colleague and friend, the member for Cumberland—Colchester.

It is very terrifying to me, because this is effectively another fairy tale promise that the government is pushing forward, along with a long line of fairy tale promises when it comes to the things it is claiming it is doing on behalf of Canadians.

This bill is not a pharmacare plan. Government members might state that it is a pharmacare plan and they can repeat it over and over again, but that does not necessarily make it true. Just because one says something over and over again does not make it so. This is something I will repeat over and over again, because if they think that it somehow works, then maybe we need to bring this forward as well.

This is a legislative framework to look at possibly one day, maybe, kind of, sort of, creating a pharmacare scheme of sorts, but it is not a true pharmacare scheme because it would only cover a couple of different drug types for a couple of different spaces, and it flies directly in the face of many provinces. In fact, in my home province of Alberta, the health minister, who is a former colleague of mine, Adriana LaGrange, very early on was exceptionally clear that Alberta would pull out of a federal pharmacare plan, citing subsidy program concerns and a lack of consultation from the federal government.

Whether the government and its NDP partners in its coalition want to admit it or not, provinces and territories in this country are the ones constitutionally responsible for the delivery of health care in this country. Therefore, not doing adequate consultation with provinces and territories before bringing forward a bill that would directly impact the delivery of health care is exceptionally concerning and should concern every single person in this chamber, whether they care about what the Constitution says or not.

Inevitably, we will see something similar to what we have seen with so many of the bills brought forward by the government. It will end up resulting in a whole bunch of lawyers getting rich from court cases when it gets found out five years, six years or seven years from now that, unfortunately, it did not fall within the government's jurisdiction and it overstepped.

The government has an opportunity right now. We are giving it an out. We are giving it a pass. It can accept the amendment from my colleague and vote against this and allow us to have a bit more consultation and to have some real conversations about this. However, government members are not concerned about that. They want to bully through. They think that Ottawa knows best, and frankly, in Fort McMurray—Cold Lake and right across Canada, the people in those communities know better for their communities. The provinces know better about how to deliver health care than Ottawa will ever know, but the Liberals will not pull the cotton out of their ears long enough to listen, and that is very unfortunate.

Like I said, this is just a promise. This is a promise along the lines of so many broken promises over the last eight years from the government. The government promised affordable health care. The reality is that it doubled housing costs. It promised that the carbon tax would not cost us anything, yet the reality is that we found 60% of families are paying more because of these carbon taxes. It promised taxes would go down, yet the reality is that taxes have gone up. It also promised safe streets, yet the reality is that we see crime, chaos, drugs and disorder.

I point out these broken promises because Canadians deserve to understand that, after eight years, the Liberal-NDP coalition government is just not worth the cost. It bears repeating that it is yet again trying to buy votes with a fairy tale scheme of sorts to possibly one day look at something that should be looked at, but it should actually consult with provinces and territories, which is something the government has decided to completely abdicate its role in.

I want to highlight the fact that I would be splitting my time with the member for Souris—Moose Mountain, who is one of my colleagues on the health committee and someone who is very passionate when it comes to provincial jurisdiction, as well as making sure that people are getting adequate care.

Going back to the broken promises we hear time and time again, it is indicative of a pattern. If we do not look at the patterns and take the government at its word because it claims this is new and shiny and that we should trust it, that would terrify the people I have talked to in Fort McMurray—Cold Lake. It is something people do not want to hear. They know full well that Ottawa breaks the things that it touches. I hear that day in and day out. People are saying something might be an okay idea and that we should talk about it, but they do not trust that the government is going to get it done.

Housing is a perfect example of this. We have seen, under the last eight years of the Liberal-NDP government, that housing prices have doubled. People in my generation do not think they will ever be able to afford a home. It now takes longer to afford a down payment on a home than it took most Canadians in the previous generation to pay off their mortgages. If that does not terrify everyone in this room, there are some serious problems at play.

We will continue to fight for Canadians because they deserve to have someone to fight for them right now.

We understand that the NDP did this in a quest to grab on to some form of power and to prop up a government that it complains about on every occasion yet votes with time and time again. New Democrats will get up in question period and have a big fight, but when push comes to shove, they co-sign everything the Liberal-NDP government puts forward.

Canadians have had enough. I hear from them every single day, as do all of my Conservative colleagues. We hear from people who are struggling to put groceries in their fridges and feed their kids a nutritious meal. We hear from families who are struggling with whether to turn the heat up in the dead of winter or put food on the table. These are real, true, honest concerns, but the government seems to be completely negligent when it comes to standing up for Canadians.

The news is positive. Conservatives have been very clear. We want to see a few things from this government, especially in this upcoming budget. We want to see it axe the tax. We want to see it build the homes. We want to see it stop the crime, and we want to see it bring forward a dollar-for-dollar law so that Canadians do not have to pay for its extravagant promises and costs.

Frankly, the Liberals would do well if they took my advice, voted for this amendment and allowed us to axe this bill.

[The Speaker, Liberal, Greg Fergus]

It being 4 p.m., the House will now proceed to the consideration of Ways and Means Proceedings No. 20 concerning the budget presentation.

Bill C‑64—Time Allocation Motion

[Steven MacKinnon, Liberal, Leader of the Government in the House of Commons]

moved:

That in relation to Bill C-64, An Act respecting pharmacare, not more than five further hours shall be allotted to the consideration at the second reading stage of the bill; and

That, at the expiry of the five hours provided for consideration at second reading stage of the said bill, any proceedings before the House shall be interrupted, if required for the purpose of this order, and, in turn, every question necessary for the disposal of the said stage of the bill shall be put forthwith and successively, without further debate or amendment.

[The Deputy Speaker, Conservative, Chris d'Entremont]

Pursuant to Standing Order 67.1 there will now be a 30-minute question period. I will ask hon. members who wish to ask questions to rise or use the “raise hand” function so that the Chair can have some idea of the number of members who wish to participate in the question period.

On a point of order, the hon. member for Mégantic—L'Érable.

[Luc Berthold, Conservative, Mégantic—L'Érable, QC]

Mr. Speaker, while you were reading the motion, I was unfortunately distracted by the Liberal government House leader when you were specifying the number of hours allotted for debate on this issue.

Could you please remind the House of the number of hours specified in this time allocation motion to discuss the bill? This will illustrate the lengths to which the government is going to prevent us from talking about it any longer and debating it as much we would have liked.

[The Deputy Speaker, Conservative, Chris d'Entremont]

The time allotted is five hours.

The hon. member for New Westminster.

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

Mr. Speaker, the member for Burnaby South, the leader of the NDP, was the leader in actually bringing the bill to bear, with pharmacare being so vitally important for so many Canadians. He basically said, last week, that the Conservatives had up until noon today to remove their blocking amendment.

The Conservatives put an amendment forward that would block pharmacare. What that means for each and every Conservative MP is that 17,000 people, on average, who depend on vital diabetes medication would still have to pay for it out of pocket, in many cases $1,000 a month. That is an unbelievable charge on their ability to put food on the table or keep a roof over their head, and the Conservatives did not care. The reality is that 25,000 women who are looking to take care of their reproductive health in terms of birth control or contraception are also being denied by the Conservatives' blocking this important legislation.

My question very simply—

[The Deputy Speaker, Conservative, Chris d'Entremont]

The hon. member for Mégantic—L'Érable is rising on a point of order.

[Luc Berthold, Conservative, Mégantic—L'Érable, QC]

Mr. Speaker, has the question and answer period on the time allocation motion started yet?

[The Deputy Speaker, Conservative, Chris d'Entremont]

Yes, the hon. member for New Westminster—Burnaby has started asking his question.

The hon. member for New Westminster—Burnaby may continue.

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

Mr. Speaker, the Conservatives should have stood up and should have the guts to actually defend the unbelievably negative things that they have tried to do around pharmacare.

My question to my colleague is very simple. When 17,000 of their constituents need access to diabetes medication and 25,000 need access to their reproductive health prescriptions, which are part of this bill, why are Conservatives blocking the ability of Canadians to access these medications?

[Mark Holland, Liberal, Minister of Health]

Mr. Speaker, I thank the member for his work on this legislation. Specifically, I want to take an opportunity to thank the member for Vancouver Kingsway for his work as well.

Canadians expect parliamentarians to work together to get results, to get the services and the care that they need. It is fine that the Conservatives are going to vote against dental care or vote against pharmacare, which means they are voting against medication for diabetes and against women getting access to the contraceptives they need. It is bad enough that they would vote against it, but to block it actively, to block the elected will of the House to be able to get care to people, is extremely disturbing.

I will talk about dental care. It was really revealing to talk to dentists across the country who had been filled with misinformation, and who were shocked by how easy it is to use the dental care plan. The reason that confusion, in many cases, exists is because of the confusion deliberately being pumped into it.

Again, I would say this to the Conservatives: It is fine that they do not want people to get diabetes medication, they do not want seniors to get dental care and they do not want people to be able to get access to the contraceptives that they need. That is one thing, but they should allow the House to do its work, allow us to move the legislation forward and allow us to make sure that those people who need care get care.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Mr. Speaker, I was listening to the minister when he said to allow this House to do its work. Allowing the House do its work also means not limiting debate. I know the minister to be a reasonable man. Is he not embarrassed to be limiting debate?

Bill C‑64 includes some extremely important powers. There is a danger. No one will be surprised to learn that the Bloc Québécois is against encroachment, against jurisdictional overlap, against what will likely be a waste of public funds on administrative redundancy. I think it is important to take the time to debate this properly.

Is the minister not embarrassed to be limiting the time for debate?

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, there will be time for the committee to conduct a study. After committee, there is still going to be time for the report stage and third reading. After that, there will be time in the Senate. It is important to keep the debate going, one step at a time. We need to make sure we can have a conversation with the Quebec government.

I had a good conversation with Minister Dubé. Quebec is ready to move forward. If the House takes too long, it affects people who really need medication, whether it is diabetes medication or contraceptives.

Yes, it is important to debate. However, there is plenty of time for debate in committee and during the rest of the House process. It is time to get on with it and move forward.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, my question is about pharmacare, in particular, the contraceptive angle of this and the supports it is going to provide.

At the heart of this is really a woman's right to choose. I found it very alarming that, on Friday, the member for Leeds—Grenville—Thousand Islands and Rideau Lakes stood up in the House and said, “A common-sense Conservative government would use the notwithstanding clause only on matters of criminal justice.”

It was in the nineties when it was actually made a crime to perform an abortion. What we have seen is that the Supreme Court, using those charters rights, overturned that law. We now have Conservative members saying that, in terms of criminal justice, which that law was, Conservatives would consider using the notwithstanding clause. In theory, Conservatives could bring back a similar law to that which was in the nineties, using the notwithstanding clause to make sure that it stuck, something that the Supreme Court would not be able to overturn.

I find it alarming that, only a year after the United States reintroduced legislation regarding a woman's right to choose and preventing it, Conservatives are now toying with and basically laying out the framework for how they would restrict those rights in the future. I am wondering if the Minister of Health would like to comment on that.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, I think it really is reprehensible to see the backward movement we are seeing over women's reproductive health and rights, where their autonomy over their own bodies is being called into question.

Let me make it very clear, as Minister of Health, that we will do everything in our power to make sure that women have full power and autonomy over their bodies. That is a fundamental freedom. That includes their reproductive futures.

In many of these instances is an inability to have real conversations about sex and about whether a woman should have the autonomy to make a choice about the way in which she makes decisions with her body. It is absolutely unacceptable in this country. When we take something like contraceptives, such as a condom, that have a failure rate of about 9%, and an IUD, which has a failure rate of 0.2%, how could people, first of all, have the position that they are going to tell a woman what she does with her body and then, secondly, try to block her ability to get reproductive technologies so that she does not wind up with an unwanted pregnancy?

Those things, to me, seem to be diametrically opposed. If one was opposed to abortion, if one was opposed to a woman being able to make that choice over her body, it would seem to me that one would at least stand up and support her ability to get reproductive medicine.

For me, it is extremely disturbing that this is any kind of debate in this country. Everywhere in this country, every woman should be told that she has autonomy over her body and that she has access to the medication she needs. That is fundamentally what this bill is about, in part. I am sure we will get an opportunity to talk about diabetes as well.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, the debate right now is on time allocation on Bill C-64, and I would put it to the Minister of Health that I would love for us to be having a debate on an actual proposal for pharmacare.

It has been since June 2019 that the former Ontario health minister, Dr. Eric Hoskins, gave the government and this country clear direction that we need a national pharmacare program. We are the only country in the world with a national health care program that does not automatically include the provision of needed prescription drugs. We know from the Hoskins report that, properly implemented, a full national pharmacare program will save this country $5 billion a year at least.

However, the bill is picking out only two things, which is what is so strange about this bill and why I object to the debate being closed before we can actually discuss it. Why are we only talking about reproductive health care and diabetes medication? What that may end up doing is giving those opposed to pharmacare evidence that it costs more than it is worth, when we need to prove to everyone concerned that national pharmacare will save our health care system money and ensure Canadians get the health care they need.

[Mark Holland, Liberal, Ajax, ON]

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.

[Branden Leslie, Conservative, Portage—Lisgar, MB]

Mr. Speaker, I view this legislation not as a pharmacare plan but a spending plan and what will be another empty broken promise, just like the carbon tax was going to be revenue-neutral and just like housing was going to become more affordable under the current government. Frankly, I do not see enough trust from Canadians to see another project fail to be delivered properly.

I have been getting a lot of questions from constituents regarding the proposed plan. People are asking me if they should cancel their existing insurance plans because, like many others, the majority of Canadians are already covered. They are worried there is going to be a reduction in availability of coverage under the single-payer system that is being partially promised, partially proposed and, ultimately, I expect, poorly delivered.

Perhaps the minister could clarify, for the hundreds and thousands and millions of people across Canada who are wondering if they are in limbo, if they are going to lose the quality of the coverage they have through their private insurance and whether they should cancel it now and await further clarification from the government, what eventually may be covered under the pharmacare plan.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, the answer, of course, is no, and that point is not grounded in any kind of reality. There is no plan. I used to be the head of Heart and Stroke, and we would negotiate benefit agreements. They cannot say, “Oh, there are two drugs and now people are going to cancel the rest of their medical coverage.” That is a preposterous notion that is not rooted in anything resembling reality. What really would happen is that people would have choice. What does that mean? Let me be very clear, and put the question back to the member.

For somebody in the member's riding who does not have the money for contraception, why should they be limited to the choice they can afford, which has a 9% failure rate, when there is something available to them that has a 0.2% failure rate? Why should somebody who has less money not have access to the contraceptive medicine they need to have choice and autonomy over their own body? I can tell the member that I have had direct conversations with Minister Asagwara. We are ready to work together to deliver this in the same way that we are working together to create dental care.

It is fine if the Conservatives want to vote against it. If they do not think those people should have access to contraceptive drugs, then that is fair. They are allowed to have that position and to go and defend it. However, they should not try, with misinformation and blocking in the House, to sabotage the ability of somebody to get dental care or contraceptives. Let us have a debate rooted in reality. The reality is that there is an enormous need. This bill would make sure that everybody would get exactly what they need and would not be left in a position without the critical medication that they require.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, I find it really funny that the Conservatives are talking about health care plans. Clearly, their lives have been marred with privilege, especially because every member in the House has a pharmacare plan that is paid for by taxpayer dollars, including the member for Carleton, who has had this for over 20 years.

In saying that, I have a feeling about why the Conservatives are stalling this, and it is because something is going to freeze over before they support the reproductive rights of women and, certainly, trans folks. The opinion held by the Conservative Party on the bodily autonomy of trans folk and women has been demonstrated through things such as voting for Bill C-311, which was a piece of backdoor anti-abortion legislation. It was called out by anti-violence groups, and it was supported by the Conservatives.

Let us not be too cozy with the Liberals either. Out east in New Brunswick, people cannot access an abortion. I have spoken to the minister about it, and the fact is that access to safe trauma-informed abortion care out east is not a reality. Although the Liberals wipe their hands of it as being provincial jurisdiction, I would like to remind the them that they do provide federal transfer payments, and they are obliged to uphold the Canada Health Act. That is not happening in parts of the country.

I am concerned about the Conservatives here. I know there was a whole revolution around women getting menstrual hygiene products. Now, there is a whole revolution around women or folks who use contraception getting contraception because not everybody has a health care plan and not everybody has access to safe trauma-informed abortion care. I wonder if my hon. colleague would speak to what his government is planning to do to make sure that folks who need a safe trauma-informed abortion can have it and what he is willing to do to make sure that this pharmacare plan gets passed.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, I recognize and appreciate the work of the New Democratic Party in this bill. It was a good example of members coming across party lines to find a way to work toward solutions.

In the first order, every member should be very clear about where they stand with respect to reproductive medicine for women. It is a pretty basic question, and I hope every member would answer it in the affirmative. Should women be able to access the reproductive medicine that they need to have control and autonomy over their own bodies? I hope every member would say yes. I am concerned that some might not agree with that statement.

In the second order, in this country, people can have an opinion on whether a woman should have an abortion or not, but they do not have the right to tell a woman what to do with her body. It is that simple. The member is quite right that the ability of every woman everywhere in the country to have clear, definitive and unquestionable choice over who she is as a person and her sexual and reproductive health is essential. Anywhere that a woman is blocked from that, then we have a collective demand for action. Yes, there are provincial and territorial considerations in that, but I absolutely and firmly agree with that, as a matter of principle. I look forward to working with the member to make sure that we live in the type of country that she and I both want to have, where every woman has full control over her body and over her sexual and reproductive choices.

[Claude DeBellefeuille, Bloc, Salaberry—Suroît, QC]

Mr. Speaker, I agree with the minister when he says that everyone who needs it should have drug coverage. The Bloc Québécois wholeheartedly agrees with him.

That being said, what is the best authority, the best government to manage a pharmacare program? The Bloc Québécois is convinced that it is the Government of Quebec and the provincial governments that should fulfill that responsibility for their citizens.

I know that the minister wants to impose a gag order because he is worried that the Conservatives will delay the debate to prevent the bill from being passed. On the other hand, the Bloc Québécois still needs to debate this bill, because it creates an agency that will manage a Canadian pharmacare program.

It is complicated. I am wondering how things will be done in Quebec because we already have a hybrid public-private program managed by the Régie de l'assurance-maladie du Québec.

That means that we have a lot of questions and we need to hear from witnesses. I understand that the minister wants to move fast on this and that he is concerned that the Conservatives will filibuster, but we still need to debate this matter and study it further. We need to hear from witnesses to determine whether this bill will work for Quebec and the provinces. Is it the best solution to provide good coverage for all Quebeckers and all Canadians? I have to wonder.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, for the bilateral agreements with every province and territory, there is truly a spirit of collaboration. The focus is not on jurisdictions, but on the best way to work together, to ensure that there are nationwide indicators for tracking progress in the data for every province and territory.

As we did for oral health care, we are once again going to work closely with the Province of Quebec, Minister Dubé and the entire Government of Quebec to ensure that the program works properly. There are going to be debates in committee and at third reading stage. After that, it will go to the Senate, and then to the provinces and Quebec. I am very open to the idea of working with the members across the way because we have a common objective: to ensure that everyone receives services and ensure that the jurisdictions are respected. The goal is to work collaboratively to find a solution together.

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

Mr. Speaker, health care is such a critical issue. It always has been in my 30-plus years as a parliamentarian. We talk a lot about health care. We have achieved health care accords or agreements with different provinces and territories. We made a $198-billion commitment toward health care. That is talking about future generations.

For many years, I have been a very strong advocate for a pharmacare program, and my question to the minister is this: As I see it, a pharmacare program is a huge step forward toward the type of health care system Canadians want to see here in Canada, and I am wondering if he could provide his thoughts on how the pharmacare legislation we are proposing today would complement our health care system into the future.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, each of these actions does not stand on its own. They are part of an overall plan to make sure that we have the best health care system in the world. We cannot have the best health care system in the world, just as a point of fact, if one-third of Canadians do not have access to dental care. We cannot have the best health care system in the world if women do not have access to the contraception they need or if we have diabetes patients who do not have access to their medication. As an example, Sarah, in an Ottawa clinic, was talking about people having to reuse syringes because they do not have the money to get new devices.

Also, we think of the school food program, about kids getting the healthy food and nutrition they need. We think about what we are doing for the safe long-term care act and, as the member mentioned, the 26 agreements signed across the country, whether they are on aging with dignity, working together, primary care, nurses or doctors. What we are seeing with the provinces and territories is that, by working together, we are able to make huge change everywhere in our health system to improve it.

What we all need to be doing in the space of health is to be focused on data, evidence and moving forward because, I will say, and I know the member feels the same way as I do, that what Canadians expect of us is to not talk about our differences. This is not to try to find problems and spend all of our energy criticizing things, but to find solutions and answers, to drive that forward and to make things better. That is squarely where our mind is focused, and I know that it is squarely where the health ministers across the country of every political stripe are as well. I look forward to the meeting we are going to be having later this week with all health ministers.

[Brad Redekopp, Conservative, Saskatoon West, SK]

Mr. Speaker, the Conservatives have no problem with Canadians getting the drugs they need.

I am doing something the government does not often do, and that is to think ahead. This is the first bit of the pharmacare legislation it is talking about, with a couple of drugs. There are plans to do more.

Many Canadians already have drug care coverage. I am curious as to why the program is being developed in the way it is because there is a large percentage of Canadians who have coverage. One of the big questions I often get is whether Canadians are going to have to opt out and lose the coverage they have to go with this.

The costs are the big concern. The PBO has said there would potentially be tens of billions of dollars being spent on the pharmacare program once it is implemented. Why are we spending money on something that Canadians already have? This is a question I have.

On top of that, we know that Liberals cannot be trusted. We look at the cost of taxes, which have gone up. The cost of housing has gone up. The cost of groceries and food has gone up. I just do not see how Canadians can trust the Liberal government to implement something such as a pharmacare program at any kind of a cost that would not cause taxes to go up.

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, the member opposite would know that we are dealing with an inflationary crisis that exists across the world. That makes it incredibly difficult for Canadians.

It does not matter that Canada has one of the lowest rates of inflation in the industrialized world. In fact, we have the second-lowest rate of food inflation in the OECD. It is ridiculous to pretend that that exists in some kind of domestic bubble that only Canada is facing. It ignores the complete reality across the world.

The question is what we do when people are facing hard times in the world. Do we pretend that it only exists domestically and tell people that cuts to government services and programs is somehow going to magically make things better, or do we lean in and help people?

I would say the member for Saskatoon West has an opportunity. He says that people have access to the drugs that they need. That is not the case. That is absolutely not the case. People who have an existing drug plan are going to continue to enjoy the access that they have to their drugs.

The question here is about, for example, a woman who is an abusive relationship and whose insurance overage is through her partner. She would not have the ability to get that medication on her own. That is what this bill is about. If a young woman, whose health coverage is through somebody else, is making a decision about their reproductive future, it is about making sure that that person has access. There are absolutely millions of people who do not have any coverage at all, for whom dollars and cents mean they do not have access to life-saving medicine.

If the member opposite does indeed support the people who do not have access to these medications getting them, there is great news. There is something he could do, and that is vote for this bill.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Mr. Speaker, I would be interested to hear from the minister about the timing of this blockade by the Conservatives.

We know that every year, unfortunately, quite a lot of very young people are brought up onto the Hill as part of a very anti-choice movement. They are susceptible to the forces at will that would bring them up for various reasons. That is happening this week on the Hill. Considering the Conservatives' focus on their own fundraising abilities, would the minister say that this has anything to do with their timing in the blockage of the bill?

[Mark Holland, Liberal, Ajax, ON]

Mr. Speaker, I thank the member for her work and for her advocacy in this space. I recognize that she has worked long and hard to try to make sure that women have access to what they need, to make sure that they have autonomy over their own bodies and their sexual and reproductive health.

I cannot guess as to why the Conservatives would block something as important as this. Underlying it is a conversation that we do need to have as a country about sexual health. We have to be able to have open conversations about sex. When we do not have open conversations about sex, it means that people are more likely to be mistreated, manipulated and subject to abuse. Consent can only come from knowledge. Sexual shame does radical and destructive damage everywhere in the country.

For me, women having access to the contraception that they need is not, just in and of itself, enough. We also need to be able to say to women, to men, to those who are non-binary and to those who are trans that who they are is just fine and anybody who tries to make them feel less than or to attack their identity is creating an act of sabotage that is totally and utterly unacceptable. The real villain is the shame that we push upon others for being who they are, and the damage that does is unspeakable and must be stopped.

[The Deputy Speaker, Conservative, Chris d'Entremont]

It is my duty to interrupt the proceedings at this time and put forthwith the question on the motion now before the House.

The question is on the motion.

If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

[John Brassard, Conservative, Barrie—Innisfil, ON]

I request a recorded division.

[The Deputy Speaker, Conservative, Chris d'Entremont]

Call in the members.

(The House divided on the motion, which was agreed to on the following division:)

Vote #751

Pharmacare Act

[The Deputy Speaker, Conservative, Chris d'Entremont]

I declare the motion carried.

It is my duty, pursuant to Standing Order 38, to inform the House that the questions to be raised tonight at the time of adjournment are as follows: the hon. member for Abitibi—Témiscamingue, Sport; the hon. member for Kitchener Centre, Foreign Affairs; the hon. member for Calgary Nose Hill, Carbon Pricing.

The House resumed from April 16 consideration of the motion that Bill C‑64, An Act respecting pharmacare, be read the second time and referred to a committee, and of the amendment.

Second reading

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Mr. Speaker, I rise to speak to Bill C-64, an act respecting pharmacare, to highlight two major concerns. The first is the federal government's intrusion into matters of provincial jurisdiction, and the second is budgetary concerns.

This neo-liberal initiative, which came from the Liberal-NDP coalition, raises serious concerns because of its impact on provincial jurisdictions. During its nine years in power, this Liberal government has not even been able to properly and competently manage its own files. How, then, do the Liberals think they can get away with interfering in provincial health care by imposing Bill C‑64 on the provinces, including Quebec, which has been offering Quebeckers its own pharmacare program since 1997, so for nearly 30 years?

Instead of continuing to overstep its boundaries by interfering in provincial affairs, the government should focus on matters within its jurisdiction, such as managing passports, fighting crime, fixing the immigration system, which it broke, and cutting inflationary taxes. These are just a few examples of areas where it needs to direct its attention and energy, instead of investing time and money in provincial matters.

A pharmacare program is not a program that should be set up at the federal level. That is a provincial responsibility. This arrogant, pretentious government wants to impose its science when it totally lacks the authority to manage this type of file.

Was this pharmacare program designed in close co-operation with all provinces, territories and indigenous peoples? Was it developed following a thorough review of what already exists in each of these areas of responsibility? Is it the result of thoughtful consultation with experts and stakeholders? We know the answer: Of course not.

We have here a shameful attempt by the Liberal government to stay in power thanks to the support of the NDP. The Journal de Montréal's Yasmine Abdelfadel writes, and I quote:

Make no mistake: Justin Trudeau has sold his soul to the NDP. The New Democrats are the ones who are really in power, the same New Democrats that did not have the support of the public in the last election.

This initiative seems well intentioned, but it is not. Because the Liberals only hold a minority, they found a dance partner, the NDP, which is keeping them in power in exchange for the implementation of various measures that the New Democrats care about, like dental care and pharmacare, the issue that is before us today.

Canadians did not vote for that or for the NDP. Only 17.7% of Canadians supported this far-left party in the last election.

Also, Radio-Canada notes that neither dental care nor pharmacare were part of the Liberals' election platforms.

Despite what they want us to believe, this pharmacare bill is therefore no reflection of the NDP-Liberal coalition's benevolence toward Canadians. It is mere political and electoral theatre. To suggest otherwise is to lie to Canadians.

Now, getting down to dollars and cents, this pharmacare plan, as proposed, would generate massive costs, a concern that seems to have been glossed over, if not completely ignored. In a report published on October 12, 2023, the Parliamentary Budget Officer wrote the following:

...we estimate the incremental cost to the public sector (that is federal and provincial governments combined) to be $11.2 billion in 2024-25, increasing to $13.4 billion in 2027-28.

I would remind the House that the Parliamentary Budget Officer thinks the total is going to reach $40 billion.

I find it hard to trust in the current government's ability not only to implement an effective pharmacare program, but also, and more importantly, to maintain it over the long term. A government that has proven repeatedly since 2015 that it cannot maintain a balanced budget and is fiscally incompetent does not exactly inspire confidence.

I think it is worth reminding the people watching at home that the national debt has doubled since the Liberals came to power in 2015. It now stands at $1.255 trillion. I also want to remind everyone that since we have to borrow money to pay for the Liberals' reckless spending—because they are spending money they do not have—we are also paying interest. The interest on this unbelievable debt is $54 billion. That is more than the total amount of health transfers to the provinces, and it is the equivalent of all the GST paid by Canadians. This money is being thrown away to pay for the creation of programs that already exist.

Access to medication is a major concern for Canadians, which is why it is imperative that we carefully examine the viability of such a program, so as to be absolutely certain that it will last over the the very long term. More than anything else, it is hard to justify creating such programs, which would require additional bureaucracy and uncontrolled spending, when the vast majority of Canadians, four out of five, or 80% according to Statistics Canada, already have drug coverage in their respective provinces, coverage that is even broader than what is proposed in Bill C‑64.

Here is what Quebec's health minister, Christian Dubé, had to say to La Presse:

Not only is the government refusing to give us the money we asked for in federal health transfers, but it wants to interfere in an area of Quebec jurisdiction. The federal government knows full well that this is an area of provincial jurisdiction. We've had our own drug insurance program since 1997. It's been nearly 30 years. We also probably have the broadest drug coverage of any Canadian province.

By the way, he also pointed out that 45% of Quebeckers are entitled to drug insurance coverage through the public plan and that 55% of Quebeckers have private insurance. Guess what? Fifty-five per cent plus 45% equals 100%.

The federal government has caused countless crises in Canada since coming to power. Canadians continue to be both witnesses and victims of this incompetence every day in things like immigration, passports—we are starting to see lineups again—the correctional system, the use of food banks or the lack of affordable housing across Canada. Do my colleagues know that since the Liberals came to power in 2015, the public service has grown by 40% and hired 100,000 public servants?

I am going to quote a sharp mind on the subject of bureaucracy. I would not bet that he is a Conservative. Listen to this:

Like a black hole, it can also absorb astronomical budgets without leading to an improvement to public services.

Look at the Phoenix pay system, the chaos in immigration management, the ArriveCAN saga, the passports saga, the airports saga, etc. Despite the huge amounts of money squandered on new programs administered by an armada of public servants and the gigantic debt it has run up, the [Liberal] government's incompetence at delivering effective services to the public continues to defy expectations.

That is a quote from Boucar Diouf.

I want to close by quoting Gérald Filion, an economics journalist who is very well respected in Quebec. In his opinion, the government is creating a lot of programs and economists are concerned about the impact that will have on Canada's credit rating. The creation of many expensive programs that must be maintained in the future means additional spending.

All of the provinces offer coverage, particularly Quebec. We therefore recommend that we not go forward with this bill because we cannot afford it right now with this government's reckless spending.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Mr. Speaker, on September 21, 2010, when my colleague was a minister in the Charest government, Le Soleil published an article that said, “the Charest government was hoping that Ottawa would recognize Quebec's right ‘to opt in or opt out of federal financial initiatives’ and that, if it decides to opt out, it would receive ‘full compensation’”.

The member voted against the Bloc Québécois's subamendment, which called for exactly the same thing that she was calling for when she was a minister in the Charest government. I listened to her speech and it seems as though she has changed her mind again.

What is her final position on Quebec's right to opt out with full compensation?

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Mr. Speaker, what is clear to us is that the economic situation in Canada right now is very precarious, even worrisome. We have a government that spends money hand over fist. Canada's debt has doubled since 2015 and public debt charges are up to $54 billion. That is money that is being thrown onto the fire. It is not being used to help Canadians. That money is being given to bankers because we are spending too much here in Canada. It is therefore a very bad idea to implement a pharmacare program when the vast majority of Canadians and all Quebeckers already have drug coverage.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, there are three million people across our country living with diabetes, and they pay about $18,000 a year out-of-pocket. This is going to make a big difference for those folks, especially knowing that they are going to have the devices as well.

This is the first step in a model that I really believe in, which would result in collective purchasing. Any Canadian would know that, when we buy collectively, prices usually go down. Of course, that is why Canada pays the second- or third-highest medication rates on the planet.

Does the member have any thoughts on the hopefulness of the people who will finally get medication they can afford?

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Mr. Speaker, this is just wishful thinking. I read the bill carefully. There is nothing specific in it and everything remains to be done. No agreements have been reached with the provinces and a list of drugs has not yet been compiled. All the bill says is that a strategy will be developed and a committee of experts will be set up.

This is just pure politics, completely partisan politics. As I demonstrated in my speech, the only reason this minority Liberal government proposed the pharmacare and dental care programs was to stay in power. It is supported by the NDP, which said that the Liberals had to bring in a pharmacare program to stay in power. Let us not kid ourselves this afternoon. That is the Liberal government's real motivation, and it is a national disgrace.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, we are offering it under a Westminster parliamentary system that is multiple centuries old. The member is talking about a minority government as though she has never even come close to understanding what happens in a minority. I am sorry if the NDP figured out how to actually get things done on behalf of Canadians while Conservatives would rather just yell and scream all day long about what they wish would happen; clearly, they do not use any kind of ability to act like adults in this room to get things done on behalf of their constituents.

Very simply, if Conservatives are going to be voting against this, is it safe to then say that they would remove this program if elected into government?

[Dominique Vien, Conservative, Bellechasse—Les Etchemins—Lévis, QC]

Mr. Speaker, the Liberals put on quite the spectacle. Pharmacare was not even part of their election platform. As a minority, they rely on their NDP friends to keep their hold on power, sometimes with help from their Bloc Québécois friends too—we must not forget that. Then they turn around and criticize us for supporting or not supporting measures that they never raised with Canadians themselves. They cozy up to the NDP, which received only 7.7% of the vote in the last election, and have the nerve to lecture us. We are not going to take that.

[Darrell Samson, Liberal, Parliamentary Secretary to the Minister of Rural Economic Development and Minister responsible for the Atlantic Canada Opportunities Agency]

Mr. Speaker, I am thankful for the opportunity to speak to Bill C-64, an act respecting pharmacare. I am extremely excited to talk about this, because this is a very important program, another transformative initiative for Canadians. We are again supporting Canadians. We can think back to 1968, when we brought in medicare. We knew the Conservatives were against it then, and the Liberals brought it in; today, no one wants to get rid of medicare, because of its importance.

In this speech, I will be talking about the framework on pharmacare and also talking about diabetes and the three million people with diabetes, and how difficult it is for them. Also I will share some information about the pilot project we have been running in P.E.I., which has given us some information, as well as where we sit in the G20 when it comes to health care and drug care. Finally, I will talk about all those initiatives the Liberals have brought in, which are helping Canadians today and in the many years forward. It was the Liberal Party that brought those.

Let me start off by saying that this act is focused on certain drugs that we would bring forward, and related products.

Of course, my colleague will be joining me afterwards. I will be sharing my time with the member for Dorval—Lachine—LaSalle.

To continue, we are talking about certain drugs, such as contraceptives and diabetes medication. Again, as I said, there are over three million people with diabetes in Canada. Back in December 2023, we created the Canadian drug agency, and its focus is on three major areas. One is a formulary, which is putting up a list of all the drugs that would be included in this pharmacare program. Another is bulk purchasing. As some have mentioned already, we have already saved millions of dollars, and there are billions to be saved through that process, which will continue. Third, we will be publishing, of course, appropriate use of medication in Canada.

I also want to say that once this legislation is passed and receives royal assent, within 30 days the minister will appoint a committee of experts to make recommendations within a year, so that we can move on this as quickly as possible.

When I go to get some medication at the drug store, my pharmacist often tells me, “You have to do something for people with diabetes. The cost is unbelievable. Many Canadians are facing a cost they cannot afford to pay. You need to come forward with some type of initiative.” I am so pleased to be here today to talk about that.

In the last decade, we have seen a doubling of the number of people facing challenges with diabetes, which is extremely important. Today, 3.7 million people are living with this. If we do not do something to help them, 25% of those people have indicated that they cannot afford to pay for that medication. If we do not treat that disease, we know what some of the end products would be, and they are not very good. We are talking about blindness. We are talking about amputation. There are all kinds of challenges that come with that.

Just for insulin, for type 1 or type 2 diabetes, the cost can range anywhere between $900 and $3,000 or $4,000 a year, which is extremely high. The good news is that we are going to work with the provinces and territories and have a deal, so that they can have frontline services for these individuals.

Diabetes Canada said, “We are very pleased with the government's commitment to prioritize improved access to diabetes medications and devices. This monumental step demonstrates a genuine dedication from our political leaders to enhance the well-being of the over four million individuals living with diabetes in Canada.”

For example, last year in June we started a pilot project in P.E.I., and from that pilot project we have seen the medication costs drop by over 60%, helping the residents of P.E.I. In a very small province, they have already saved up to $2 million, out of pocket. That is extremely important, and when we talk about affordability, this is another step forward that our government is bringing to the table.

Where do we sit in the G20? Well, it is important. People ask why we are bringing this in. We are bringing this in because we probably should have brought it in before, but the time is now. We are the only country in the G20 that has health care insurance but yet does not include drugs. The U.K. has included some prescription drugs. Australia has a mixed formula of private and public. France has, of course, a health care system and is now paying significant portions toward drugs. There are other countries in the G20 that have some type of pharmacare, including Germany, Italy, Japan, South Korea, Argentina, Brazil, etc.

According to a CBC article, “the federal Advisory Council on the Implementation of National Pharmacare, led by Dr. Eric Hoskins, stressed how people's lives can suffer if they skip needed prescription drugs, and noted a Canada-wide program could eventually lead to system-wide savings of nearly $5 billion annually.” When they talk about how much it would cost, we could actually save up to $5 billion. I think that is also a very easy answer as to why we should move forward.

When I talk about our government, the values and ideology of the Liberal Party have always been to tighten up the gap, help the most vulnerable and make sure that all Canadians have opportunities to be successful. Let us look at some of the things that we brought forward: 1968, medicare; 1969, the Official Languages Act, making both languages the official languages of Canada; 1982, the Charter of Rights and Freedoms, which all Canadians should be very proud of. Some of the opposition members are hesitant today on some pieces of the charter and we will see where they go with that piece.

There is the new and improved universal child benefit. When the Conservatives had it, it was 30% to 40% less and it was taxable; now it is not. There is the new and improved CPP, in 2019, which went from $11,400 a year to almost $20,000 a year. Those are programs that are helping every Canadian. These are opportunities. This is what makes Canada great. This is why people want to move to Canada.

Let me speak about some more initiatives that we are bringing to the table. The national school food program would help over 400,000 young people. The new disability program would help over 600,000 people with disabilities, who we know comprise most of the individuals living in poverty. Those are major initiatives to help. We are also building the dental care program. Nine million Canadians would have access to the dental care program. These are big numbers. There are many Canadians who have challenges, and our government has been focused on how to support the individuals facing those challenges.

I am going to end with something that Canadians must listen carefully to. If the Conservatives ever came to power, what would they cut? They do not want to tell us. They say “a dollar for a dollar”, so if there is a deficit of $40 billion today, we know they are going to cut $40 billion tomorrow. That we already know; we just do not know which programs. Therefore, I am going to ask the Conservatives. Would they cut pharmacare? Would they cut dental? Would they cut the disability benefit for people with disabilities? Would they cut the school food program that we have been talking about for 20 years? Would they cut the CCB, which is helping young families? Would they cut the early learning and child care program? I do not know. I am sure the Conservatives do, and I would love for them to share that with Canadians.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Mr. Speaker, it is always a pleasure to rise on behalf of the people of Kamloops—Thompson—Cariboo. Before I begin my intervention, I want to recognize the life of Albert “Bert” Malfair. He was a father to a young woman I went to school with. He bravely served the RCMP to the point where he was chasing robbery suspects and was ultimately disabled from that in 1984. We are grateful for him. He recently passed away, and I pass my condolences to his family. May perpetual light shine upon him.

When my colleague gave his speech, he just so casually threw around the number of a $40-billion deficit. It has gotten that bad. That was a government that said it would have modest deficits and the budget would balance itself, and what has it done? It has spent, spent, spent. What do Canadians have to show for it? They have nothing. They are now struggling even more with heating and eating.

How does the member say these numbers so casually, $40 billion, $50 billion, $60 billion? We are spending more now on servicing the debt than we are on health care.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Mr. Speaker, the difference between my colleague's party and our party is that they spend and we invest. We have invested in Canadians since 2015. Do members know why we can afford to invest? We can afford to invest because we have an AAA rating, one of only a few countries in the G7—

[Some hon. members]

Oh, oh!

[The Deputy Speaker, Conservative, Chris d'Entremont]

Order. I cannot hear the hon. member, so let us try to keep the ruckus down a bit.

The hon. member for Sackville—Preston—Chezzetcook.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Mr. Speaker, inflation has been brought safely down to 3% by the Bank of Canada, our prime rate is among the lowest ever in the history of Canada, and we have the lowest debt-to-GDP ratio in the G7. What else do they want? We are in a good, solid position to invest, and we are going to continue to invest for Canadians.

[Simon-Pierre Savard-Tremblay, Bloc, Saint-Hyacinthe—Bagot, QC]

Mr. Speaker, there is one thing I do not understand: Why is it difficult to provide for the right to opt out with full financial compensation? Everyone would be happy. Those who want in, stay in. Those who want out, take the money and do their own thing.

It is not going to lessen our desire to be independent, but it may make us less angry with the Liberals when we do get our independence. That is all there is to it. It is not complicated.

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Mr. Speaker, a Canadian is a Canadian. We have a program that is there for Canadians, and we are going to make sure that Canadians are respected in every province and territory, including Quebec. We are very proud to work closely with our colleagues, and we will continue to do so.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Mr. Speaker, the hon. member talked a lot about the cost savings in terms of this program. Of course, this goes right back into medicare and our health system.

The direct cost associated with unintended pregnancies here in Canada is an estimated $320 million, so the benefits of universal contraception do not just end unwanted pregnancies with prevention and cost savings, but can actually help in terms of prescription contraceptives for other health conditions like abnormal uterine bleeding and endometriosis, precancer of the uterus, polycystic ovary syndrome and the prevention of ovarian and uterine cancer.

Can the member talk about the importance of seeing those benefits and the cost savings to our system as well, in addition to the health of people who need that support?

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Mr. Speaker, often, it is not about throwing more money. There are ways of changing how we do things so that the end result of the investment is to supply and support more Canadians by investing less.

There are cost savings. We already talked about the cost savings with bulk purchase, which are in the billions of dollars, and there are more cost savings to be had in other areas that the member mentioned as well, such as contraception, etc.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, I find it funny that the Conservatives were laughing when the member said that we are investing while they are spending. They laugh as though it is some kind of joke. Let us not forget that Tony Clement had money to spend on the G8 and used it to build gazebos in his backyard. Conservatives' memory is so short-term.

The reality is that the member is absolutely correct. We are investing in Canadians. We are investing in the future. We are asking those who make the most to pay a little bit more in order to keep those investments going. Would the member agree with me on that?

[Darrell Samson, Liberal, Sackville—Preston—Chezzetcook, NS]

Mr. Speaker, my colleague is 100% correct. We are not investing in gazebos. We are investing in pharmacare, dental care, a disability benefit, a school food program, CCB and early learning.

We continue to support Canadians. That is why people want to move to Canada. They are proud of our great—

[The Deputy Speaker, Conservative, Chris d'Entremont]

Resuming debate, the hon. member for Dorval—Lachine—LaSalle.

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

Mr. Speaker, I am grateful for the opportunity today to speak to Bill C‑64, an act respecting pharmacare.

This bill represents the next phase of our government's commitment to a national universal pharmacare program. It proposes the foundational principles of national universal pharmacare and our intent to work with provinces and territories to provide universal single-payer coverage for many contraceptives as well as diabetes medications.

This is an important step forward in improving health equity, affordability and outcomes, and it could save the health care system money in the long term.

Public health care in Canada was built on the promise that no matter where one lives or what one earns, one will always be able to get the medical care one needs. Despite this promise, Canada is the only country in the world with universal health care that does not provide universal coverage for prescription drugs.

When medicare was first introduced, prescription drugs outside of hospitals cost less and played a smaller role in health care. Today, prescription drugs are an essential part of our health, helping to control chronic conditions, treat temporary ones, and aid in overall health and well-being.

One area that has seen significant changes is diabetes treatment. Over 100 years ago, thanks to a Canadian team of researchers, Frederick Banting, Charles Herbert Best, John J. R. Macleod and James Bertram Collip, insulin was discovered.

Since this monumental scientific discovery, there have been several advancements in diabetes treatment, from the introduction of fully synthetic human insulin to glucose monitors and insulin pumps. These breakthroughs have immensely improved the quality of life for people who have to live with diabetes, enhancing self-esteem, increasing social participation and improving the overall health and well-being of these individuals.

They have also come with higher costs, creating affordability challenges for Canadians affected by diabetes.

Outside of hospital, prescription drug coverage comes from a mix of private insurance, out-of-pocket cash payments and various provincial programs. While the majority of Canadians have access to some form of public or private insurance, about 2.8%, or 1.1 million Canadians, do not have access to private or public drug coverage.

Although most Canadians have some form of drug coverage, this does not mean that those with insurance have equal access to the prescription drugs they need. The existing patchwork system of private and public drug plans leaves millions of Canadians under-insured, and that means their out-of-pocket prescription drug costs create a financial burden that leaves them struggling to afford an essential part of health care.

In 2021, Statistics Canada found that more than one in five adults in Canada reported not having the insurance they needed to cover their prescription drug costs. Being under-insured can take many forms, for example, Canadians may have high deductibles, resulting in significant out-of-pocket costs before their insurance coverage even kicks in. They may reach the maximum annual or lifetime coverage limits for their insurance and have to pay out-of-pocket, or they may have to make co-payments, which are often 20% of the drug's cost on private plans and sometimes more on public plans.

All provinces have drug coverage to protect Canadians from catastrophic drug costs, but deductibles under these plans can range from 0% to 20% of net family income. In many cases, Canadians will never reach the deductible, leaving them without any support for their drug costs. This variability across the country creates a postal code lottery.

Let us consider the advancements in diabetes treatments. For a working-age Canadian with no private insurance, out-of-pocket costs vary widely. In some parts of the country, out-of-pocket costs for people living with type 1 diabetes can be higher than $18,000 per year out-of-pocket; for type 2 diabetes, they can be higher than $10,000 per year in out-of-pocket expenses. Even those with private insurance can face high co-pays or exceed annual plan maximums, resulting in high out-of-pocket costs.

Even for cases in which an individual is not accessing devices that cost thousands of dollars, they can face significant out-of-pocket costs. For example, we can consider a woman in her mid-twenties who is working a minimum wage job. An IUD, one of the most effective forms of birth control, can cost up to $500 with no insurance. Even with private insurance, a co-pay of 20% would be $100. While IUDs can last from three to 12 years and save money over the long term, the high upfront cost can make them inaccessible.

Under-insurance can be a particular concern for young adults who age out of their parents' private insurance but who do not have their own form of private coverage. Lower-income Canadians also make up a disproportionate share of the under-insured. While most provinces have put in place drug coverage for those accessing social assistance benefits, a gap still exists. Many lower-income households that do not qualify for social assistance continue to struggle with out-of-pocket prescription drug costs.

Employment factors contribute to differences in insurance coverage. People with low-paying jobs, such as entry-level, contract and part-time positions, often report less adequate drug insurance coverage. This may even discourage people from accessing social assistance benefits or from applying for jobs, because once hired, they may lose their public drug insurance coverage. However, many entry-level and part-time jobs do not offer drug benefits. One study found that only 27% of part-time employees reported receiving medical benefit coverage.

Under-insurance can have serious consequences. Many Canadians with high out-of-pocket costs report foregoing essential needs, such as food and heat, or not adhering to their prescription due to drug costs. Statistics Canada found that, in 2021, close to one in five Canadians spent $500 or more out-of-pocket for their prescription medication, and almost one in 10 reported not adhering to their prescription medication because of costs. This includes delaying filling prescriptions or skipping doses to contain costs.

When people do not take their prescription drugs the way they are supposed to, their health can suffer. This results in serious consequences for the individual and their household, and unnecessary costs to the health care system in the long run, as patients are more likely to visit an emergency room or to be admitted to hospital when they do not receive consistent treatment. For example, the full cost of diabetes to the health care system in 2018 was estimated to be around $27 billion and could exceed $39 billion by 2028.

I think we can all agree that no Canadian should be put in a position where they must choose between the prescription drugs they need for their health and well-being and putting food on the table. This is unacceptable, and it is why we are continuing our work to improve accessibility, affordability and appropriate use of prescription drugs as we move forward with national universal pharmacare.

[Simon-Pierre Savard-Tremblay, Bloc, Saint-Hyacinthe—Bagot, QC]

Madam Speaker, I know that my colleague is a member from Quebec. The members of the National Assembly of Quebec unanimously requested a right to opt out of the pharmacare program with compensation. This means that we are not opposed to Canada having its own program. They say that as Quebeckers, we have the expertise and experience in social programs, we definitely do not want this program to be managed like the borders or the passports. We want the federal government to give money to Quebec and let Quebec manage its own affairs. If the others want to keep this program, we have no problem with that. We respect that.

Does my colleague, as a Quebecker, agree with the position of her national assembly?

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

Madam Speaker, indeed, I am a proud Quebecker.

Our program is going to help millions of women, people from various backgrounds and people with diabetes. It is going to help everyone, all Canadians and all Quebeckers.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Madam Speaker, members have spoken a lot today about the money saved by individuals and the money saved by the system, which we could reinvest into health care. By providing free contraception, an individual is said to have a lifetime savings of up to $10,000, which is huge.

I would like to hear more about the larger issue. How can this piece of legislation itself, through contraception, empower women and those who menstruate?

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

Madam Speaker, we have been talking a lot throughout our speeches, as have all our colleagues, about how we are investing in Canadians, and this is an investment. There is a saying that it is better to prevent than to cure. This is one of those times when we could prevent, for example, botched procedures or when women have to go out of their way to do things to protect themselves and to make sure there are not unwanted pregnancies. This national pharmacare program would help women and those who are gender diverse to be able not just to cure but also to prevent. It would make sure that they have optimal health and that their well-being and mental health are being taken care of at the same time.

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Madam Speaker, I listened to my colleague's remarks with great interest, particularly around the risk of people being uninsured. I am not sure everyone always realizes what that is and what it means until they get into trouble. I would like to hear her speak more on the different vulnerable population groups who could be working but who could be under-insured.

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

Madam Speaker, it would be surprising to most Canadians to learn that there is a huge under-insurance problem in this country. Many people, we could say, slip through the cracks. As I mentioned in my speech, for those who are part-time workers, who end up getting phased out of their parents' health insurance plans and for those who are taking social assistance, there is always a gap between the two insurances. We need to make sure that everybody is covered and that every Canadian is treated equally. It is all about equality and equity. This is how those gaps can be prevented.

As my hon. colleague from London—Fanshawementioned, it is important for women to be able to take care of themselves. It should not matter what one's income bracket is. One should be able to access contraceptives and these services in order to create a more equal society.

[Blaine Calkins, Conservative, Red Deer—Lacombe, AB]

Madam Speaker, it is a pleasure for me today to speak to Bill C-64.

Before I go any further, I would like to let the Speaker know I will be splitting my time with my good friend and colleague from Souris—Moose Mountain.

The debate today is about Bill C-64, an act regarding pharmacare. At least everybody is being told that is what it is about. I would rather call it, I guess, the so-called pharmacare bill because I think that “the cost of keeping the Parliament going bill” is probably a name that has already been used.

This bill is very tepid. It is not a national pharmacare program. This is actually just a piece of legislation that is meant to check a box to keep a supply and confidence agreement in place.

To the NDP members, I cannot believe they actually think this is the pharmacare bill they envisioned. I have not met a program the NDP members would not want to nationalize, but they say it is a very sad day when one—

[Some hon. members]

Oh, oh!

[The Assistant Deputy Speaker, NDP, Carol Hughes]

There seems to be some cross discussion from one end of the chamber to the other. I see it is in front, so I apologize for that.

I just want to say that it is disruptive when someone is trying to speak. It disturbs them, so I want to ask members to please be respectful.

The hon. member for Red Deer—Lacombe has the floor.

[Blaine Calkins, Conservative, Red Deer—Lacombe, AB]

Madam Speaker, there is a joke going around that says, “It's not knowing that a politician can be bought; it's knowing how little they'll let themselves go for.” For a member of the NDP caucus right now thinking that this is the misery they are suffering in the polls, the misery they are suffering nationwide, which is the same misery Canadians are suffering, this is all they managed to get out of the supply and confidence arrangement with the government today.

It is not a pharmacare program. Health care is actually a provincial jurisdiction. It should be delivered by the provinces. The bill would simply be adding contraceptives and some diabetes measures into it. I guess, on the surface of it, that is a good thing, but to the tune of $1.5 billion. If viewers watching at home actually believe this is all it is going to cost them, I will remind them that the government bought a $7 billion pipeline and built it for about $40 billion. Therefore, if history is any predictor of the future when it comes to what things cost under a Liberal-NDP coalition, then they should be looking at least to that example if not more.

To us, as Conservatives, the issue is one of provincial jurisdiction. I come from Alberta, and this is a very important issue to our province and to our premier. This is just another intrusion into provincial jurisdiction. We think that, during these financial times, when Canadians are struggling to make ends meet, pouring more fuel on the inflationary fire is certainly not going to help. It is another financial albatross in the making, which Canadians cannot afford and are not willing to pay for.

It is not just me saying this, and it is not just Conservatives saying this. John Ivison eloquently stated in a piece that he published back on February 29, when the bill or this notion first came out, that this is “the woebegone child of a loveless Liberal-NDP marriage.” This is basically what we are dealing with.

It has become clear to me that the bill before us is basically the cost of keeping the NDP support for this Parliament under supply and confidence, and the coalition partners can take this until October 2025. It was supposed to be October 20, but it is going to be extended by another week to make sure that certain people here get the financial benefits they think they are entitled to. However, it just goes to show that there is only one serious opposition in the House, and that is the Conservative Party.

The NDP is not an opposition party but a willing accomplice to everything that the Liberal government has in its agenda. Its members have been witting partners in creating a massive inflationary deficit; setting restrictive policies towards, for example, lawful gun owners and natural health products, which they signed up for two years ago without even knowing they were going to vote in favour of that in Bill C-47 last year; impeding upon provincial jurisdiction time and time again, which is, of course, front and centre with this piece of legislation; continuing to cover up for the government's scandals, covering for it at committee and also here in the House of Commons; introducing soft-on-crime legislation or supporting that soft-on-crime legislation, which has turned our justice system into a revolving door; sending Canadians to food banks en masse, at a couple of million visitors, which is up over 300%; allowing housing prices to skyrocket; and neglecting our military to the point where our soldiers are basically relying on food donations while they are in Ottawa for training. I could continue, but I think members get the gist of what I am trying to say.

It is bad enough that NDP members backed budget after budget and shut down our work to hold the government to account at committee, but they are telling Canadians that they are doing their actual work as an opposition party. Well, they cannot have it both ways. They cannot be in opposition while they support everything that the government does. I do not buy it, and neither do Canadians.

A December 2023 Leger poll indicated that only 18% of Canadians listed the establishment of a national pharmacare program as a health care priority, and the promise was not included in the 2021 Liberal platform. Canadians did not vote for a party promising pharmacare, yet here we are, thanks to an NDP party that is keeping this weak and basically lame-duck government in office. It is no wonder that some provinces are already saying publicly that they are choosing to opt out.

Let it be known that the absence of the NDP as an opposition is also keenly felt in other areas. Just last year, as I was mentioning, the NDP-Liberal coalition passed Bill C-47.

I do not suppose anybody in the NDP was told, when they signed on to this supply and confidence agreement back in March 2022, that they would be asked to regulate natural health products in the same way as therapeutics, but they did it anyway. As a matter of fact, they made that commitment a year before the bill was passed, and it is going to basically shut down our supplements and natural health product industry when they are classified and rebranded as pharmaceutical drugs.

What did the New Democrats do when this came up for debate? They backed the budget instead of forcing the government to remove those four little clauses from Bill C-47, the budget implementation act. They had a chance. They could have flexed their muscles and said they were not going to support the budget implementation act unless the government removed them, but no such request was forthcoming, and the bill passed. It has caused unforeseen chaos in the natural health products and supplements industry across this country; consumers, of course, are rightly worried. In response, I had to table my own private member's bill, Bill C-368, to reverse these changes. This is just part and parcel.

New Democrats say one thing to Canadians but actually do another. Could anyone imagine such a thing as being the House leader of the NDP, for example, standing up and saying time and time again how much one does not like omnibus legislation, and yet gleefully passing Bill C-47. The NDP House leader has said this for the 18 years that he and I have been in the House together. However, he told the government that New Democrats would continue to pass every budget and every budget implementation act henceforth after March 2022. He cannot have it both ways. He cannot stand up and say New Democrats are going to hold the government to account while continuing to give it the keys to the house to do whatever it wants.

In the case of natural health product governance and regulations, New Democrats tell Canadians they are against omnibus legislation and that they are keeping the government accountable. However, as I said, they voted for Bill C-47, threw that industry into turmoil and then criticized me for giving them an off-ramp on the Bill C-368 debate last week. I was giving them a pathway to redemption, and all they could do was basically blame Stephen Harper for the mess that the country is in. I cannot even make this stuff up.

The most common questions I get from Canadians are these: When are we going to have an election? Who believes anything anybody in the NDP has to say anymore, when their actions are completely 180° opposite from what they say with their words?

It should also be highlighted that the bill was introduced with no public consultations whatsoever, which comes as no surprise to Conservatives. This piece of legislation has been pushed from a government with a terrible record on transparency. It is a government that regularly rushes massive changes with little regard for those people the changes may impact. It talks about the intended consequences, but it never fully understands the unintended consequences of the things it does, which is why we are in the mess we are in today.

The Conservative position on Bill C-64 is that the Liberals know this project is an expensive boondoggle. That is why they abandoned it in their 2019 election promise. Even former finance minister Bill Morneau noted in his book that a single-user system would cost an additional $15 billion a year. We cannot believe the $1.5 billion number, and that is why my colleagues here on the Conservative side and I will respect provincial jurisdiction and vote against this piece of legislation. We encourage New Democrats to change their ways before their party actually fades into oblivion forever.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, I have heard a number of Conservatives use the same line, that only 18% of Canadians, or one out of every five, think this should be a priority. I guess the fact that one out of every five Canadians needs something is not enough for the Conservatives. What is their number? When does it warrant a program? If it is not one out of every five Canadians, is it two out of every five, is it three, is it four, or is it when everybody demands this program?

If one out of five Canadians needing this is not good enough for him, could the member tell me what number Conservatives will accept where, yes, it is good enough for Canadians?

[Blaine Calkins, Conservative, Red Deer—Lacombe, AB]

Madam Speaker, health care delivery is provincial jurisdiction. The private insurance companies out there are already talking about how their systems and programs, which deliver tremendous results for Canadians, are going to be undercut. This is going to lead to a public system that does not offer the same value and benefits that the private system already does. Conservatives are going to respect provincial jurisdiction.

It is too bad that the government has squandered $600 billion in debt and the debt servicing that goes along with it, so we are actually spending more on servicing our debt than we are on health care transfers. If only we had prudent fiscal management, we could transfer the money to the provinces so that each province could make a decision for itself about what coverage it wants to have for its citizens. That is the way Conservatives would have handled this.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, we will repeat the same question, because that is the most important aspect for us.

My colleague ended his speech by talking about what Ottawa should do instead of mismanaging the public purse. I am with him to that point. According to my colleague, the government should give the provinces money so that they can decide what to do and what to cover and not cover in their own jurisdictions. We know what Quebec wants. Quebec wants generous coverage. We already have a better system in place than the other provinces.

In this context, how is it that my colleague got up last week to vote against the Bloc Québécois's subamendment to the budget, an amendment that called for the right to opt out with full compensation when the federal government spends money on programs that fall under provincial jurisdiction? Is he prepared to change his position and support a right to opt out with full compensation, as all elected officials in the Quebec National Assembly are calling for?

[Blaine Calkins, Conservative, Red Deer—Lacombe, AB]

Madam Speaker, we oppose this particular plan simply because we know it is nothing more than the cost of the agreement between the NDP and the current federal government. It is not a serious agreement in the sense that we are actually getting a national pharmacare program; as I said in my previous comments, which would have already answered my colleague's question, this is much better delivered through provincial jurisdiction.

I am an Albertan, and as the member is a Quebecker, he ought to know that there is one thing Albertans and Quebeckers often have in common: We know how to look after our own people best, and we do not need these federal intrusions into provincial jurisdiction.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Madam Speaker, I am curious. We have seen that the Conservative Party of Canada is riddled with corporate lobbyists in its governing body: big oil, real estate, anti-union companies, insurance companies and big pharma. In fact, its members are using the talking points from those corporate entities in their conversations today against the bill. Ultimately, is the member actually defending his constituents or the corporate interests of big lobbyists?

[Blaine Calkins, Conservative, Red Deer—Lacombe, AB]

Madam Speaker, the individual who just asked me the question had her answer in the question itself: support for big pharma. Who is supporting big pharma with this piece of legislation? The NDP and the Liberals are. A national pharmacare program will do more to help the pharmaceutical industry. Let us examine that for a second.

Everything New Democrats say they are for, they are also against. This speaks to the same hypocrisy they have on everything they do. They want more pharmaceuticals and are supporting big pharma with this piece of legislation with more government money, so more costs going to the pharmaceutical company, while accusing Conservatives of being in the pockets of big pharma. It is ridiculous.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Speaker, I thank the House for the opportunity to speak on behalf of the people of Souris—Moose Mountain, and I appreciate the opportunity to speak to today's debate as we discuss Bill C-64, an act respecting pharmacare, and its amendment.

I think it is important to ensure that Canadians truly understand what the piece of legislation before us is and how it might affect them in the future. In fact if we read the amendment that has been put forward, we see that it states:

The House decline to give second reading to Bill C-64, An Act respecting pharmacare, since the Bill does nothing to address the health care crisis and will instead offer Canadians an inferior pharmacare plan that covers less, costs more and builds up a massive new bureaucracy that Canadians can't afford.

Unfortunately, much of what I am about to talk about in dealing with what the government has put forward is that we need to determine that it is going to be to the detriment of most Canadians, thanks to the NDP-Liberal government, which only continues to make life harder for those who are just trying to get by in difficult times like these. Bill C-64 is yet another example of an empty promise put forth by the Liberals in an attempt to please the NDP and maintain power in this country. There is virtually nothing for the vast majority of Canadians.

The document is a measly six pages long, much of which is preamble and definitions. I can almost guarantee that when Canadians were told that a pharmacare plan was coming, they were expecting a whole lot more than six pages that lack any of the necessary details like costs, timelines, formulary, which drugs are in and which drugs are out, and other relevant information. The reality is that the majority of Canadians, 79% of them, already have private health care insurance to cover their medications. Many of them are afraid of losing their plan.

The legislation, however, has become typical of the Liberal-NDP coalition government. Let us have a quote: “Bragging is not doing.” I wonder who said that. I will get back to it. After eight years of empty promises, brags, Canadians have lost trust in the so-called leadership of the Prime Minister. He promised affordable housing, yet housing costs has doubled across the country. Bragging is not doing; let us remember that.

The Prime Minister promised that the carbon tax would put more money in the pockets of taxpayers, yet 60% of Canadians are paying more because of that very tax. Bragging is not doing. In fact in 2019, his then environment minister promised Canadians that the carbon tax would not exceed $50 per tonne, stating that the price would not go up and that there is no secret agenda. However, after the election, the Liberals' hidden secret agenda came out, and the current carbon tax is at $80 per tonne and will be going up to a whopping $170 per tonne by 2030.

How are Canadians supposed to believe anything the government says when it breaks promise after promise, to the detriment of its own people? It does not take much to see that the sad little bill before us is simply a Liberal attempt to cater to the NDP, which has been propping the Liberals up and keeping them in power since the last election.

Since the pharmacare bill contains almost no details about how the program would actually work, I would like to touch on a similar plan that is about to be launched across Canada, more bragging, I hear. It is the Canadian dental care plan, which is set to start providing coverage. It is a great example of the Liberals' providing blatant misinformation to Canadians by omitting context.

They will tell us that the plan is a huge success because 1.6 million seniors have already signed up to participate. What they do not tell us is that Canada has only about 26,500 dentists practising in total, and fewer than 10% of them have enrolled in the new dental care plan, which also includes dental hygienists. There are eight dentists enrolled in New Brunswick. Ontario has 65 and Nova Scotia has six. P.E.I. has zero and Manitoba has seven. This is just to name a few of the provinces. Why is that? There is too much paperwork and signing of contracts, to name just some of their concerns.

Considering that Canada is already dealing with a massive shortage of doctors, the last thing taxpayers want to know and see, and have talked about many times, is the need to find yet another health care practitioner. That struggle is immense.

Another hugely alarming issue with the Canadian dental care plan that is also a major concern with pharmacare is the lack of consultation the government held with the important industry players. When it comes to the dental issue, the provincial associations stated that the federal Liberals started consulting them only in late November, just one month before the program was announced. One dentist stated that dentists were brought in at the eleventh hour. They asked why we started so late and whether we were rushing into a program that maybe we should be putting the brakes on.

Again, the lack of consultation has now become a hallmark of the NDP-Liberal government's agenda, as the Liberals also failed to consult with insurance industry stakeholders during the formulation of the pharmacare bill. If this is the Liberal track record on industry consultations that have the potential to greatly impact a key piece of legislation that would affect millions, then of course we need to be concerned that the same thing could happen with pharmacare.

Misinformation is also something that needs to be top of mind when dealing with the NDP-Liberal government. Initially, the government's dental care plan was pitched as being free, and yet now we know that is not so. The program covers only some types of dental care, and it does not adequately pay providers in line with the fees that are recommended by the provincial and territorial guidelines.

Will it be the same for pharmacare? One wonders. Canadians are going to be told not to worry, and then all of a sudden be required to pay for their medications despite the promises made by the government. Since the Liberals are completely inept at creating and implementing programs that actually work, this is unfortunately what Canadians have come to expect.

Since the pharmacare plan was first announced in February, physicians across the country have been vocal about the concerns they have with how the plan would actually work. Since the bill itself contains almost no information, there is worry that instead of filling the gaps left by public and private health care coverage, the bill could actually create more gaps, with more Canadians falling through the cracks.

There is also a lot of uncertainty over which drugs would make it onto the formulary. If there are extra steps involved in this, it would place an additional administrative burden on physicians, which is frankly the last thing Canada's health care system needs right now.

Furthermore, as we are all aware, wait times for health care in this country are longer than they ever have been. Currently, there is a median wait time of 27.7 weeks between getting a referral from a general practitioner and the receipt of treatment. This is an almost 200% increase in wait times since 1993.

We all know there are over six million Canadians without a family doctor, and we have overwhelmed emergency departments throughout Canada. Through ill-thought-out bills like the pharmacare one, the federal government would be burdening our physicians with even more paperwork and administration, instead of allowing them to provide the care that Canadians need. By increasing the administrative burden, there is also a concern that doctors, nurses and other health care providers would face greater instances of burnout, causing them to leave their professions altogether.

A very important part that the government continues to ignore is that the provision and administration of health care falls under provincial and territorial jurisdiction. It is not the job of the federal government to make decisions on issues like drug coverage, which the bill could certainly allow for. We need to respect the authority of the provinces and the territories to do what is best for their populations, as this is not a situation where Ottawa knows best.

One part of the bill that I personally take issue with is the fact that it would establish a committee of experts to make recommendations on pharmacare. The reason this concerns me is, yet again, the Liberals' track record when it comes to creating committees to create committees to create committees, ultimately doing nothing to address the issues they were created to address.

Ultimately, given that the pharmacare bill is so short on any details, we still do not know how big the committee would be and what the qualifications of the members would be. If the Liberals failed so drastically with something like just transition, which affected a small portion of Canada's population, how is anyone supposed to believe that they would handle this?

As an example, one year ago the Liberals pledged $1.4 billion for drugs for rare diseases, yet there is still no deal with the provinces. Therefore, once again, to quote the Prime Minister, “Bragging is not doing.” The NDP-Liberal coalition is all about brag and no action. Unfortunately, until the Liberals are out of office, Canadians will continue to pay the price of the Prime Minister's lack of leadership and his broken promises. It is time to end the bragging. It is time for a change, time to assist hard-working Canadians and time for a common-sense Conservative government.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, the member talked about a lack of consultation around the dental care program. How much consultation did he do?

Do members know what I did when the program was released? I wanted to make sure dentists in my riding knew about it. I wrote all of them a letter. My team followed up with them. We encouraged them to get involved. I visited a number of dentists. As a result, 41 dentists in my riding, which is more than half of them, are on the dental care program.

How much consultation on the dental care program did the member do in his riding, or did he not care enough about his constituents to bother making sure that they knew they had access to the new service, regardless of which political party brought it?

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Speaker, the member said he had 40 dentists sign up. Based on the numbers that I provided, 65 dentists in all of Ontario have signed up. It sounds like, in the Kingston area, most of the dentists have signed up for it. They are the only ones; it is interesting. The member should look at the number of dentists in Ontario. It is significantly more than 65.

To answer his question, I did consult with my colleagues in my riding, because I do happen to be their colleague. I spent many years as a professional dealing with dentists. They are all asking whether the government is stepping forward to make socialized dental care in Canada so that all dentists would have to be mandated to apply and get paid what the government says.

[Simon-Pierre Savard-Tremblay, Bloc, Saint-Hyacinthe—Bagot, QC]

Madam Speaker, I listened carefully to our colleague's speech. I liked the “Ottawa knows best” criticism. It is true that Ottawa, usually after crises like the one we are currently in, always tends to centralize, to leverage its authority in order to achieve greater uniformity, to deploy its powers in a tentacle-like manner, spreading everywhere, and to impose its priorities, values and rules on the the provinces.

That is also why I am not resisting the urge to rake my colleague over the coals for not supporting the Bloc Québécois's subamendment last week on opting out with full compensation.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Speaker, I apologize if I missed something in the translation, but I did not recognize an actual question in the statement by the member.

I think, ultimately, as the member has indicated, that we need to remember the fact that health care is a provincial issue. Dental care is health care, and it is a provincial responsibility to deal with it. The provinces determine who the professionals will be and how they will be regulated. That is up to the professional bodies, whether it is for the dentists, the chiropractors, the physical therapists, the doctors or the dental hygienists. The plans are determined by the provinces, as Quebec has done. We need to recognize that and continue to focus on the fact that it is the provinces' responsibility to make those decisions; it is not for the federal government to invade and intrude in that area.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Madam Speaker, I find it hilarious that the Conservatives are protecting big insurance companies. I find it particularly entertaining that the member and his party, which would not be affected by this, including with contraception, fight so diligently against the reproductive rights of people. I find it funny.

Does the member support access to trauma-informed abortion care and access to reproductive rights, which would include free contraception care for those who do not have insurance and those who fall outside the programs, or does he think the Conservatives should just keep violating reproductive rights in real time as we are seeing in the House?

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Madam Speaker, I will say to the member, as I have said from day one when I first was running to get nominated, that I will never, ever, tell a woman what she can or cannot do with her body. As a doctor, I will provide advice and I will provide what I know, and it is up to the woman to make the decision.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Madam Speaker, I will be splitting my time with the wonderful member for Port Moody—Coquitlam.

In this debate this evening, we can lose a bit of the context, and that context is the historic nature of the legislation before us. I am so proud to rise on behalf of the people of Skeena—Bulkley Valley and speak to Bill C-64, an act that will lay the groundwork for Canada's first national single-payer universal pharmacare system, a system that is going to help millions of Canadians, including many people in northwest British Columbia. The case for this bill is—

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, I rise on a point of order. I believe, if you seek it, you will find unanimous consent to table this document showing the total number of dentists in Toronto alone, which is well over 500, who are under the current program, despite what the member for Souris—Moose Mountain said.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Is there consent?

[Some hon. members]

No.

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

Madam Speaker, on a point of order, we generally do not interrupt speeches, so I would hope that the member for Skeena—Bulkley Valley could start from the top.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

This is not the first time that an individual has been stopped during a speech. The hon. member still has nine minutes and 16 seconds to continue.

The hon. member for Skeena—Bulkley Valley.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Madam Speaker, I thank my colleague for his timely intervention.

This is a proud and historic moment because Canada stands alone in the world as the only country with universal health care that does not have some form of universal coverage for prescription medication, and the case for this bill and the case for pharmacare are exceedingly strong.

One in five people in this country have zero or poor medication coverage. Nearly a million people cut their spending on things like groceries and heat so that they can afford medication, and one in five households have a member who did not take the medication they were prescribed because of the cost of that medication. This is something that profoundly affects the lives of the people we represent, and I am surprised, to be frank, that there is not unanimity in the House to try to expand our health care system in this way and to get people the help they so desperately need.

I will tell a really brief story. I held a meeting on pharmacare, which had attendance by nurses and health care folks in northwest B.C. and concerned citizens. One of the nurses told this story about patients she sees come into the hospital for a very routine procedure, a colonoscopy, which is something that many of us will be getting in order to detect what can be really life-threatening illnesses. I have not had one of these procedures yet, but I very much look forward to it.

In preparation for this procedure, people have to take a medication in advance that allows this procedure to take place. That medication, at the time, cost about $40. For many of us, the cost of a $40 prescription to get ready for an important procedure is something that is affordable. However, the nurse said she was surprised by the number of patients who came in for this scheduled procedure, went home with the prescription and never came back for the actual colonoscopy because they could not afford the $40 for the medication.

That is what we are talking about. What happens to those people? They are not getting a diagnostic procedure that could save their lives, and some of them, a percentage of them, are getting sick and ending up back in our hospitals and in our emergency rooms. They are having to have surgery and some of them are losing their lives all because they could not afford medication that was not covered under our health care system. That is shameful and it is something that we in the House can change. We can change it today by voting for Bill C-64.

Why would anyone oppose the bill before us? We have heard some of the arguments and, frankly, it is somewhat surprising. I was listening to the member for Red Deer—Lacombe extolling what he sees as all of the various problems with it. Then he got to the fact that it would cover diabetes medication and devices, and he said something like, “on the surface of it, that is a good thing”.

This bill would be incredibly positive for a lot of people, yet we see opposition. We also see a cynical critique of the legislation, and that critique goes like this: The Conservatives say that the NDP and the Liberals call this a pharmacare bill, but it is nothing of the sort. They say that it does not go nearly far enough, and Canadians who are expecting this wonderful vision of pharmacare are going to be disappointed.

When Canadians hear that, they are going to think that the Conservatives want something even better, that they want coverage that goes even further and that would help more people, but no. What the Conservatives are proposing is to get rid of this legislation altogether and not to improve it one iota. The Conservatives have brought forward an amendment to kill it outright. That is not contributing to the conversation. It is not going to make people's lives better in this country. With all due respect, it is a cynical critique of the bill before us.

It is also incredible that in the Conservatives' opposition to pharmacare, they are parroting many of the same lines coming from big pharma. We have heard that most people will be worse off under the pharmacare program. We heard from the Conservative leader that most people already have coverage through their employer, and we heard that this law is somehow going to prevent people from getting their own private insurance. It is incredible that Conservatives and big pharma are sort of harmonizing in the same beautiful key of total nonsense. It is incredibly frustrating because none of this, of course, is true. This is a program that is going to help millions of Canadians.

We hear that health care is a provincial jurisdiction, yet nothing could be further from the truth because it is shared jurisdiction. If we look at the Canada Health Act on the federal government's own website, it clearly lays out that, while the provinces are responsible for health care delivery, the federal government is responsible for setting national standards and, of course, for funding health care, in part, through federal transfers. Therefore, this is very much in the federal government's wheelhouse and something I believe the federal government has a moral and a practical responsibility to fulfill.

However, despite all of this opposition from Conservatives to pharmacare, we are here on this historic day to move this bill through the legislative process and make it a reality. This is a bill that, among other things, enshrines the step-by-step implementation of single-payer universal pharmacare in our country, for the very first time, in accordance with the principles of the Canada Health Act. It is a bill that forces the government to develop a list of essential medications within a year of this bill's passing into law. It is a bill that establishes an expert committee that is going to guide the implementation and the financing of pharmacare right across the country.

I am very pleased that not only will this bill lay the groundwork, the foundation, for universal pharmacare that covers a wide range of prescription medications, but it is starting in its first phase with two major classes of medications that are going to help a lot of folks who are struggling with the costs. People in the House know what those two classes of medications are.

First is contraception, which can cost people upwards of $200 a month, and disproportionately that cost is borne by women in our country. When it is not affordable for people, they are forced to make other choices, but sometimes they do not have choices. Ensuring that people have affordable contraception is going to improve the lives of so many people.

The other class of medications is diabetes medications and devices. Anyone who knows someone who lives with diabetes knows the incredible out-of-pocket costs that can come with managing the condition. Diabetes Canada approximates that the cost of type 1 diabetes is upwards of $18,000 a year, out of pocket, and for type 2 diabetes it is upwards of $10,000 per year, out of pocket. These are the out-of-pocket expenses that our constituents are paying. With the bill before us, as soon as agreements are struck with the provinces, this program is going to cover those costs for Canadians, and I could not be prouder for having been part of the process of making that a reality here in Canada.

I am going to leave it at that. I know that the constituents I represent want this bill. I know the health care professionals who work in our health care system recognize the importance and significance of this bill. I hope everyone in the House of Commons votes for this bill and passes it unanimously into law as quickly as possible.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, one of the things I find most perplexing about this entire debate is that not only are Conservatives against this bill, but it is as though they are actively rooting for its policy failure. It is like they are downplaying how many dentists have signed up. They are downplaying the impact this would have on Canadians. They keep saying that only one out of every five Canadians wants this, as though it is not a good thing to do something when one out of five Canadians wants it.

I wonder if the member can make sense of all this, the fact that Conservatives are not just against the bill but are actively rooting for the failure of this program.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Madam Speaker, in many ways they are rooting for big pharma, whose incredible profits are threatened by the idea of the bulk purchasing that would be enabled under a universal pharmacare plan. The hon. member across the way's question made me think about what it would be like to be debating the Canada Health Act in the House of Commons in 2024, and what arguments Conservatives would bring forward against the idea of every Canadian having the dignity of basic access to health care. I think we are very fortunate that the act got passed all those years ago, in the late 1960s, before I was born, maybe before he was born—

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Yes.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Yes, we are the same age, Mark.

Now we have a chance to expand it to include pharmacare, and I think this is a wonderful opportunity.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I want to remind the hon. member that he is not to call a member by his first name or his last name; however, “hon. member” is fine.

Questions and comments, the hon. member for Port Moody—Coquitlam.

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Madam Speaker, I was struck by the member's comments about someone needing to go for a colonoscopy and not being able to afford the prep. I have heard this in my riding as well. I have heard it in regards to dental care also, that they are not being able to pay the $5 or $10 to go to dental care.

I would just ask the member if he could share how important it is that people have basic access to medication to stay proactively healthy.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Madam Speaker, this is something I did not have time in my speech to get to, but the reality is that when people are able to take the medication that their doctors prescribe, they are often able to get better. When they get better, that means they are not showing up at the doors of the emergency room. They are not ending up in hospital beds for long hospital stays. We know that it costs $1,000 a day to have someone in our hospitals, and these are all costs that are borne by our system.

The bill before us is about making people's lives better, first and foremost, but also, when we look down the road at public pharmacare, universal pharmacare, we see that it is going to save our society, as a whole, billions of dollars through bulk purchasing and through allowing people to lead healthier lives. I think that is a huge, positive move in the right direction.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Madam Speaker, those at home watching this may be wondering who does not want this. This is child care 2.0. However, the reality, as we know, is that, like this morning, there was a British Columbia mother who was saying that she was going to be homeless because she cannot find child care.

I just had a text from a dentist. I asked them what they thought of the dental program. The reply was that it is an absolutely amazing election slogan. That is exactly what has happened here.

My question to the member opposite, who props up the Liberals continuously, is this: Why does he think the Liberals will actually deliver this? It is almost abusive to watch what they do to the NDP because they will not deliver what they said they would. My question is this: Is he okay with that?

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Madam Speaker, as I mentioned in my speech, pointing out the shortcomings of health care programs is an argument to make them stronger, not to gut them and to get rid of them altogether.

However, I will ask my colleague this question: Looking forward a year from now, when her constituents in Kawartha are looking west to British Columbia and are seeing that their fellow Canadians are getting their diabetes medication, their diabetes devices and their contraception provided for free under universal pharmacare, how is she going to explain to her constituents that they are not part of that program because her province did not get on board because she did not support it?

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Madam Speaker, I really appreciated the speech by my colleague from Skeena—Bulkley Valley. He shared such amazing points today about the importance of looking after Canadians.

I am standing today, as a woman in Parliament, discussing one of the most important aspects of women's health and daily life: access to contraceptives. This health care measure is currently restricted by whether one can afford to access it or not. It should not be that way. Every time I enter this place, I am aware of how different my experiences are from the men who have not had to deal with regular menstrual cycles, painful periods, ovarian cysts, PMS and PMDD, endometriosis, menstrual migraines and unintended pregnancy. These are part of daily life when one has ovaries, starting in one's teens. Having ovaries requires management and affects everyday choices for school, work, recreation and more.

With that in mind, I am going to take a moment to read a poem by my daughter Coral. She is a writer and a poet. I wanted to share it because it shows how periods affect women, girls and non-binary people, from their very early teens. It is called Late Bloomer.

In the seventh grade, all my friends started menstruating,
but not me.
We would travel in a gossiping group to the school
washroom and I would listen as my
friends ripped tape inside stalls.
In high school, we had swimming in gym. I had a hard
time with a box of “easy applicators”.
I cried, one foot propped up on the toilet.
I lied on the ground, tried to raise my hips and contort my
body to be comfortable.
The garbage filled with failure. I surrendered to pads.
Diapers, my friends called them.
I would hide panic as girls exchanged tampons in cute
pink wrappers. Once a pad fell out of my bag, I snatched
it up, cheeks shame red.
I concealed pads far up sleeves and deep down in
pockets. On days I forgot a pad I settled for folded tissues
and tied my jacket around my waist.
Today, I borrowed a pad from a stranger.
Her cheeks weren't red and neither were mine. bloom,
bloom, bloom

“Bloom, bloom, bloom” is how I see this bill. It is time to blossom. It is a bill that sets in place a framework to consider the needs of women, girls and transgender people who menstruate.

My message to the men in power across the globe, including in Canada, who have spent their legislative time trying to control women and their bodies, while ignoring the enhancements that are there in basic health care, is to stop it, and let this bill bloom.

At a time when the possibility of gender equity remains elusive, what gives me hope is that in this bill, and currently in the tabled budget, the needs of women are starting to make their way onto the main stage, after 150 years. Affordable child care, free contraceptives, the red dress alert from my colleague, the member for Winnipeg Centre, a caregiving strategy and a sectoral table on care economy are all women's issues that the Conservatives and the Liberals have ignored for decades.

With that in mind, that is what causes me worry. The Conservatives in the House are rejecting these important advancements for women and, at the same time, are working against us by espousing that they would override women's charter rights on a whim. Conservatives are dangerous to women. If they ever had the power, they would immediately go after a woman's right to choose, just like what has happened in the United States. I never want to see that happen.

Not only would Bill C-64 help women as a framework for historic expansion of health care to single-payer pharmacare, but also the first rollout would give access to life-saving medication and devices for diabetics.

Linda, a resident in my riding, recently told me she estimates that, since she was diagnosed with diabetes over 40 years ago, she has spent over $120,000 on medication and devices to manage it. This is unfair. She has had to spend thousands of dollars a month just to stay alive. While I am on the topic of gender equity, Linda shared that she was 26 when she was diagnosed. She went to the doctor. She was single at the time, and the doctor said to just go find herself a husband, and she would be fine. This is what happens when someone cannot afford their medication or when society decides that women should not have economic empowerment and that they would not be able to afford their medication on their own.

Even with the loss of the life of a diabetic, if they do not get their medication, the Conservatives have decided to block the pharmacare bill. While they enjoy their MP taxpayer-funded health care and dental benefits, they deny them to others who need them. With the new pharmacare bill, New Democrats know that Canadians would have the access to medication that they need, not with a credit card, but with a health care card.

This would mean that close to 10 million Canadians would not have to suffer in pain and discomfort, would not have to put their health at risk and would not have to let their conditions get worse. This would no longer have to happen. The reason the Conservatives and the Liberals have let it happen in the past is profits from big pharma, as my colleague from Skeena—Bulkley Valley mentioned.

It is about trying to keep big pharma happy, not about trying to keep Canadians healthy. We need to do the work to keep Canadians healthy, to make sure we do preventative medicine and to release the burden of the expenses of contraceptives, diabetic medication and other medications as they come out. This is why we must pass the bill as quickly as possible. People are waiting on us, and the provinces are ready to come together and make life better for people.

The NDP has gotten this victory for Linda, for all women, and for people who use contraceptives and have not been able to get access to contraceptives. All those people will be able to get access very soon, and it would roll out to be even more. They would be able to keep the money in their pockets rather than in the pocket of some rich CEO.

I want to close and to double down on the fact that this is not the time to let our guard down as Canadians and as the NDP. This is not the time to let our guard down. Ideologies south of the border are coming up into Canada. There is a conversation in the House, and the Conservatives are trying to open a conversation about removing a woman's right to choose. They are using bills like this pharmacare bill around contraceptives to have that conversation. We cannot let it happen.

Also, for all Canadians, who are paying some of the highest drug prices in the world, this is not fair, and this is legislation. This is because of the Conservatives and the Liberals before, who have let big pharma take advantage of Canadians, gouge Canadians and made Canadians sicker because of their lack of compassion and their desire to control a woman's body.

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Madam Speaker, I thank my colleague for sharing the poem by her daughter. I think it is very special.

We have come a long way, because there was a time, I can certainly remember, when talking about menstruation cycles and so on was very taboo. Here we are in the House of Commons, and we can talk about it. We need to talk about it because contraceptives are a very important priority for the pharmacare act that we are discussing tonight. I would like to hear from my colleague because she alluded to this. For people who are not insured or who may be working but are under-insured and still cannot afford the care they need, could she tell us about the stigma that can surround vulnerable groups when they are seeking proper medical care?

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Madam Speaker, I think about those who have episodic health conditions where they might go to work on a regular basis but have episodes. One I think about is debilitating menstrual migraines. A lot of teenagers go through this, and they do not necessarily have access to medication for that. Lots of teenagers who go to university are no longer on their parents' plans, or they do not have a plan and cannot get access to this. I know a number of young women who have come through my home, as I have three daughters. They have suffered because they could not afford access to any kind of medication for their menstrual headaches. It is unbelievable. They cannot work, and they cannot go to school. It takes them out of the workforce, and it takes them out of their school time. It is really not fair, and that is just because of the price of medication.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Madam Speaker, I want to put on the record that the best thing we can do for women is to give them financial autonomy and make life affordable so that they can make the choice to leave an abusive relationship. Under the Liberal-NDP government, domestic violence is up 72%.

The Canadian Life and Health Insurance Association has stated that the bill “will spend billions of dollars unnecessarily on drugs for people who already have coverage.” With a cost-of-living crisis, and an inflationary deficit where people cannot afford to live, is the hon. member okay with this wasteful spending?

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Madam Speaker, I think that just magnifies my point. It made me think about the fact that the member here wants to control what women can have. Women can have this, but they cannot have that. We want them to go out there and work. There is a saying that says everyone should live like that, but then the Conservatives say that nobody should live like that. What I am saying is that there should not be a choice between women only having a little bit of this, but are not being given that.

In Canada, every Canadian deserves to be able to fulfill their life in work, in school and with family. Whatever their choices are, they should be able to fulfill them. Pharmacare is a fundamental piece of that, not just on contraceptive and diabetic medication, although we are starting with those two, but with all kinds of medications that keep people alive in this country.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Madam Speaker, I would like to thank my colleague for his speech, and I want to share a secret: I find it difficult to sit with the NDP members. I should start by saying that, for the most part, they are very nice and I get along well with them. Our values are very similar. The problem is that they are not sitting in the right Parliament. The notion of areas of jurisdiction seems abstract to them. They cannot seem to grasp that concept.

Perhaps it is because they are not from Quebec and they do not understand that, in Quebec, the Quebec government plays a greater role in people's lives than other provincial governments. I find it difficult because we often find ourselves voting differently, even though we share the same values and agree on the fundamentals.

The question I would like to ask my colleague is this. Considering that, through the pan-Canadian Pharmaceutical Alliance, the matter of group purchasing to reduce drug costs has already been settled and therefore that argument does not hold water, would my colleague still be able to sleep at night if the government were to say that Quebec has the right to opt out with full financial compensation, that everyone has pharmacare and that everyone is happy?

[Bonita Zarrillo, NDP, Port Moody—Coquitlam, BC]

Madam Speaker, I have stood many times in the House to say how wonderful it was and is to raise children in Quebec. There is access to many programs that are not available across the rest of the country. I have spoken before about the access to swimming lessons, diving lessons and sports, which are all affordable and accessible in Quebec. Everyone should have access to those types of life-changing and family-changing opportunities. I think there is always a way for the Bloc to come and want that for everyone in Canada.

[Mario Simard, Bloc, Jonquière, QC]

Madam Speaker, I will be sharing my time with my colleague, the member for Berthier—Maskinongé, for whom I have a great deal of respect. I hope I do not embarrass him over the next ten minutes.

I am not sure if my colleagues heard the Prime Minister when he said that people, and I am quoting him because I do not speak this way, could not care less about jurisdictional bickering. That is what the Prime Minister said when asked about pharmacare and dental insurance. A recent Leger poll shows the opposite, that 82% of Quebeckers hope that the federal government will respect provincial jurisdictions. What is more, 74% of Quebeckers believe that Ottawa should get approval from the Government of Quebec before implementing programs like pharmacare and dental insurance.

Let us settle this right now: People do care about jurisdictions. They care because they know full well that the federal government falls short when it comes to supporting social programs that fall outside its jurisdiction. Let us set that aside. I would like to come back to something that seems rather important: Does Quebec society need the federal government to implement social programs? Is Quebec society lagging behind the NDP and the Liberal Party in social democratic matters? I have to say no, it is not.

The best family policy in North America is in Quebec. The most generous family policy is in Quebec, with parental leave and child care, which the federal government tried to copy 20 years later. Quebec is the least expensive place in North America to get a post-secondary education. Quebec is the most generous in terms of loans and grants for post-secondary education. Quebec also has the most progressive tax system. Quebec's inequality index is 0.31, as measured by the Gini coefficient. This compares favourably with Sweden's index of 0.29. If we look at Canada, we see that Canada has an index of 0.37. This is pretty close to the United States, at 0.42, which is one of the worst in the G7.

Quebec no longer needs to demonstrate that it is a very generous society when it comes to social programs. I am going to say it again, although I am certain my colleagues have been saying it all day: We already have pharmacare in Quebec, and while it is not perfect, it does exist. Furthermore, Quebec is in the process of trying to make the program meet Quebeckers' needs more efficiently. Why are we studying a federal bill to introduce pharmacare? Is it so the Liberals can maintain their coalition with the NDP? Of course it is. My colleague from Mirabel, who is a bit of a rascal, frequently says that dental insurance was put in place because the NDP is kissing the Liberals' feet—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I am sorry to interrupt the member, but there seems to be a telephone near his microphone. It is bothering the interpreters. We must ensure their health and well-being.

The hon. member for Jonquière.

[Mario Simard, Bloc, Jonquière, QC]

Madam Speaker, I apologize.

I was saying that the member for Mirabel, who is a bit of a rascal will go so far as to say that the NDP wanted to bring in dental insurance because they are spending so much time kissing the Liberals' feet that they are going to get a fungal disease. I would not say something so asinine. I think it is disrespectful, but it is one way to see who might be interesting.

When it comes to pharmacare, Quebec has been well ahead of the rest of Canada since 1996. No other province has really expressed a desire to have such a program. By all accounts, with the exception of Quebec, the rest of the Canadian provinces are ambivalent about having pharmacare.

The thing that upsets me most about this is that it is a prime example. The Liberal-NDP coalition is a prime example of “Ottawa knows best”.

Take the leader of the NDP, for example. A while ago, he drafted a letter to Quebec's minister of health. While he was writing his letter to Quebec's minister of health, he decided he would also contact Québec solidaire, the NDP's sister party in Quebec City. He therefore sent the same letter to Vincent Marissal, a Québec Solidaire MNA.

In his letter, the NDP leader told them that he was writing to explain why pharmacare was necessary. Talk about blatant paternalism. As I was saying, he wanted to explain why pharmacare was necessary. In Quebec, however, we have pharmacare already, of course, and we have made more progress on social issues than they have. Unfortunately for the NDP leader, he seemed to have forgotten at the time that Quebec already had pharmacare. Had he been a little more on the ball, the NDP leader could have asked his member for Rosemont—La Petite-Patrie to contact the Québec solidaire MNA for the provincial riding of Gouin. Both of them are in the same office and in the same building. The member for Gouin could have explained to the member for Rosemont—La Petite-Patrie the finer details of this issue and the fact that Quebec already has pharmacare.

This is a prime example of centralizing federalism, or even what I call predatory federalism, which indiscriminately interferes in provincial jurisdictions.

As Quebeckers, we know that entrusting the development of our social programs to a neighbouring nation that does not have comparable coverage is out of the question. That would make no sense. Why would we entrust the development of our social programs to a government that cannot even manage its own jurisdictions? The French word for area of jurisdiction, “champ de compétence”, includes the word “competence”. When I think of the federal government, what immediately comes to mind is Phoenix, the passport crisis, its chaotic management of the border, immigration management without any real indication of acceptable integration thresholds, and ArriveCAN. The federal government is not doing a competent job of managing its own jurisdictions.

Despite that, the feds want to tell us how to manage our social assistance coverage in Quebec. Quite frankly, it is a bit insulting. Asking Quebeckers to let Canadians manage their social programs is like asking Canadians to let Americans manage their drug coverage. It would make absolutely no sense.

I want to point out something else that is rather important: Historically, the federal government has been unreliable when it comes to social intervention. A case in point is the occasion that members know I love to talk about, when Jean Chrétien, in a moment of clarity, admitted at the G7 that he could balance his budget by cutting transfer payments without ever having to pay a political price. The provinces are the ones who paid the price at that time. Let us all remember the drastic cuts that the Liberals made to health care after 1996-97, namely, $2.5 billion ongoing in 1996 and $2.5 billion in 1997.

Thus was born and introduced the fiscal imbalance. Who paid the price? Lucien Bouchard. Everyone said that the birth of neo-liberalism in Quebec began with Lucien Bouchard and the shift to ambulatory care, but that was certainly not the case.

I will conclude by reading the motion that was passed unanimously by the National Assembly. It was tabled in 2019, when pharmacare was first being proposed.

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.

All parties agreed to sign the motion, including the Quebec Liberals for the Liberal Party. For our NDP colleagues, the Québec solidaire people also signed.

That explains why we will be voting against this bill.

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

Madam Speaker, the Bloc party's position on the legislation does not surprise me. For separatist reasons, the Bloc does not believe in national programs. My issue is more with the Conservative Party's opposition to the legislation.

When listening to the speeches, Conservatives seem to acknowledge that the federal government has no role to play in health care. I would like to remind my Conservative friends across the way, as well as members of the Bloc, that there is a thing called the Canada Health Act. Canada does have a responsibility. A vast majority of Canadians, in all regions of the country, recognize that the federal government has a role to play in health care, and that goes beyond just handing money over to provinces.

We have the health care system we have today because the province of Saskatchewan kind of started it, but the federal government made sure all Canadians would be able to receive it. Would the member not acknowledge that, at the very least? Is that not a good thing?

[Mario Simard, Bloc, Jonquière, QC]

Madam Speaker, it is rather remarkable when you think of it. When the parliamentary secretary was asked whether he acknowledged that the federal government had a role to play in health, he said yes. In the same sentence, he said that its role was not limited to transfers of funds. However, the federal government does not manage any hospitals or any doctors. It wants to have a role in health but has no health-related expertise.

In the beginning, the health system was a 50-50 proposition. For every dollar invested in health, 50¢ was provided by the federal government and 50¢ by the provincial government. Today, the federal government provides barely 22¢. If the federal government was serious, it would invest more in health care than it offered, and it would address the criticisms of the Parliamentary Budget Officer and the Conference Board, who have stated that provincial finances will eventually become unsustainable because of skyrocketing health costs.

That is your role. It is not your role to meddle in jurisdictions that are not yours.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I would remind the member to address his comments through the Chair.

Questions and comments, the hon. member for North Island—Powell River.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Madam Speaker, this is a place of debate. We are looking at complex issues and trying to find solutions that would better the reality of Canadians across the country. I believe and understand that bulk buying would allow the cost of medications to go down a lot.

Is there a way the member could envision a respectful process that really looks at us buying collectively, as a country, to see those costs go down, while also honouring the provincial distinctions?

[Mario Simard, Bloc, Jonquière, QC]

Madam Speaker, if we want a robust system, then the simplest thing to do would be for the federal government to stay out of what is happening in Quebec, which is in negotiations with the large pharmaceutical companies.

What the federal government managed to do was to negotiate prices that are worse than what Quebec already had. That is one sign that the federal government does more harm than good when it interferes in areas that are not under its jurisdiction and puts together a poorly thought-out piecemeal program to score election points. That is what is happening here.

If the federal government wants to implement this program, then it needs to come to an agreement with the provinces first. That will help the government to avoid many pitfalls, to avoid wasting public money for absolutely nothing and to respect provincial jurisdictions, which is what we are asking it to do.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, in his arrogant comments that I must say were also ignorant, the member for Winnipeg North said that Ottawa supposedly has powers over health care. He cited the Canada Health Act, which is a manifestation of the federal government's spending power, which Ottawa, which has more revenue than it needs for its own responsibilities, is using to give itself the right to impose conditions on Quebec in Quebec's own jurisdictions.

I would like my colleague to explain whether this is a manifestation of the fact that Ottawa takes in more revenue than it needs to deal with its own responsibilities. I would also like him to tell me, once and for all, why this justifies Quebec having a right to opt out with full financial compensation for programs under Quebec's jurisdiction.

[Mario Simard, Bloc, Jonquière, QC]

Madam Speaker, what a valid and interesting question. My colleague is absolutely right. The Séguin report demonstrated that best. Mr. Séguin, who was Quebec's finance minister, was not a sovereignist, but a federalist. In his report, he clearly demonstrated that the federal government's revenues are much higher and that its expenses are smaller, which means it is constantly putting pressure on the provinces. In the next few years, when there is a Conservative government, we are going to see transfer payments reduced, and it is the provinces that are going to be blamed. Such is the Canadian federation.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Madam Speaker, I commend my hard-working colleague from Jonquière on his brilliant speech. My friend is always a hard act to follow.

I wanted to begin my speech by talking about the Quebec National Assembly motion, but my colleague just read it, so I will not repeat it. I will simply add a little to the speech by my colleague from Jonquière, who rightly mentioned that a unanimous motion in the Quebec National Assembly means that all the political parties adopted it. It was not just the separatists, as the parliamentary secretary opposite claims. It was adopted by all the MNAs from across Quebec, including the members of the Liberal Party—the sister party to the federal Liberals—the members of Québec Solidaire, who have a lot in common with the NDP, and of course the members of the Parti Québécois, who have more in common with us. There are no Conservatives in Quebec, because Quebeckers do not vote Conservative, which is not bad news in and of itself. It is important to understand that all the political parties in the Quebec National Assembly asked for the right to opt out with full compensation. Based on that, it seems to me that the next step is simple.

I am somewhat disappointed with the answer that my NDP colleague gave earlier. I admitted quite candidly that I find it difficult to work with the New Democrats. On the substance, our values often closely align in that we want to take care of people and we are progressive-minded. It is on the form, the “who needs to do what”, that they differ quite significantly. The New Democrats want to trample on the jurisdictions of the provinces and Quebec and tell them what to do. When I talk about that, I am told that members of the Bloc Québécois should want Canadians to have pharmacare. Of course we want Canadians to have pharmacare. I want to make an important clarification. The Bloc Québécois is not here to hurt the rest of Canada. We are here to defend the interests of Quebec. If we can help the rest of Canada, then all the better.

We are not opposed to that. All we are saying is that, in the fine system the government wants to put in place, we want our fair share of the money. We are glad this is happening. It is long overdue. Once again, in terms of social programs, Ottawa is way behind Quebec. Quebec has had a similar program for 18 years. We are glad the rest of Canada wants pharmacare. Go ahead. All we are asking is that Quebec be given the money it is entitled to, because we already have a plan that works well. It is not perfect, but it works well. There is not a Quebecker today who does not have pharmacare. It is important to point that out. Quebec is ahead of the curve in this area, as it is in day care and plenty of other areas. I will make a list for my colleagues a little later. The point is that we do not need the federal government for those things.

That highlights, in big fluorescent letters, the Canadian problem with the fiscal imbalance. It highlights how toxic federalism is for the Quebec nation. The federation claimed that we should form an alliance and work together for the common good by establishing jurisdictions for the provinces and Quebec in order to respect the regional disparities and priorities of each province and territory, since priorities cannot be the same in Alberta and Quebec. The people of Alberta might make different choices when it comes to pharmacare and health care. That might happen and that is fine. They can do what they want. As long as they are getting the money from the taxes that they paid, then they are entitled to their own services. They can make their own choices.

Quebeckers have already made that choice. The government seems to be acting out of contempt, ignorance or snobbery. I am not sure which term to use. I think contempt is the most appropriate. We know that Quebeckers have been doing that for a long time, but since the government is under no obligation this time, it is going to go over our heads. It is going to steamroll over us. It will absorb our system and replace it with the great big Canadian system. An exception was allowed for child care, however. I would like the parliamentary secretary to talk to me about child care. How are things going with day cares? Are Canada's day cares in trouble because Quebec got the right to opt out with full compensation? I do not think so. Things are just better in Quebec's day care centres because we have a little more money now than before. That is all we want. We are not out to hurt anyone.

That being said, the legislation sets out some fine principles. It says it will respect the principles of the Canada Health Act. This program will be publicly administered. We like that it will be publicly administered because it is different from the dental care plan, which is being entrusted to a private insurance company. When things are subcontracted to private companies, we know what happens. We recently saw what happened with ArriveCAN, and we do not want to see that again. This waste of public money was atrocious. However, even if the program is publicly administered, if a federal system is imposed on top of Quebec's system, there will inevitably be friction and inefficiency. The government says it is going to come up with a list of drugs. Quebec already does that. Are the feds going to check our list? How will this work? If the federal Minister of Health or the committee comes up with a different list, what will happen then? That is what we do not want. We do not need it.

I will address the Liberals through the Chair, since the Speaker has specified that we cannot address other members directly. We do not need the Liberals to administer pharmacare for us. We have our own system, period.

The bill states that the federal government will have to provide financial support to the provinces through agreements. Could an agreement consist of the right to opt out with full compensation? Could Ottawa simply respect the fact that Quebec already has something in place, that we do not want to change it, that our system is working fine and that we would improve it if we had more money? Would that ever be possible? Unfortunately, that does not seem possible.

As for the federal government's role in health care, it comes from spending power. My colleague from Mirabel did a good job explaining this issue. The parliamentary secretary may find me too boring, but as I see it and as Quebeckers see it, the federal government's role in health care is to transfer money. Its role is to transfer money because the federal government gets roughly half the taxes but does not have half the responsibilities. We have repeated this so many times in the House, but it does not seem like many people are listening or else people simply do not understand. When I said earlier that we should be given the right to opt out with full compensation, it was taken as me saying that I did not want Canadians in other provinces to have pharmacare. We have never said that.

The bill also indicates that a committee of experts must be established within 30 days to look into the operation and financing of national, universal, single-payer pharmacare and to figure out how it could work. This will be done for the rest of Canada, because Quebec wants the right to opt out with full compensation.

I will warn my colleagues that my speech today will be repetitive. We want the right to opt out with full compensation because the federal government has no business interfering in this area. The bill does not in any way recognize what is being done in Quebec right now. It is barely mentioned. There is no recognition of Quebec's expertise, yet in their speeches, the government members are saying that Quebeckers were forward-thinking, that they are going to take inspiration from Quebeckers and that they are going to implement a similar system everywhere. Why would they do away with our system to implement their own? That is the logic.

I am a separatist; it is in my blood. I always end up talking about the fact that the federalist parties are unable to live up to the contract they shoved down our throats in 1982. It does not seem that hard to me. We are demonstrating our good faith. Not only did we disagree and not sign, but we are working within those confines because we have had no choice since 1982. When members of the Bloc Québécois sit in the House, we rigorously respect the institutions.

Despite that, when we asked for compromises on MAID, when we moved a minor amendment that would have put Quebec another 20 or 40 years ahead of the rest of Canada, socially speaking, we were told no. When we ask for the right to opt out with full compensation, we are told no, even by people who have been telling us all day that Quebec's jurisdictions must be respected. Those people voted against this proposal. The way they vote should reflect what they say during the day.

As for the proposal about the oath to the King, it would not have cost anyone anything. We were saying that we would respect a Constitution that we did not even sign. They said that even that was far too much, and on top of that, they sang God Save The King at us.

So be it. Let them keep attacking Quebec institutions.

We are going to get ready. In a few years, we will have a good debate, and when the federal government comes to us with its red flags, the decision will be already have been made and we will be independent.

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

Madam Speaker, I am looking for clarification from the Bloc members. They seem to give the impression that prescription drugs are free in the province of Quebec. I would ask the member if he could, for clarity purposes, give an indication of whether people are charged any sort of deductible or fees.

Different provinces have different mechanisms. Some have private and some have public. I am wondering if he could expand on exactly what type of plan there is in the province of Quebec and how it applies, in particular for contraceptives.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Madam Speaker, it is true that contraceptives are not yet covered. That is why we need money. We are going to improve our system.

Since my colleague is asking questions about how it works, I will quickly explain. We have a mixed system in Quebec. People who are not covered by private group insurance pay, if I remember correctly, between $0 and $731 in premiums per year, depending on their income. That is how it works for people in the public system. For everyone else, the employer deducts an insurance premium from the employee's earnings.

I should also point out that ours is the most progressive taxation system in North America. The tax rate is income-based. There is no better place in North America for that.

The Quebec system is certainly not perfect, as I said in my speech. However, we are going to improve it. All we have to say to the government is let us manage it on our own.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Madam Speaker, I studied the pharmacare system when I served on the Standing Committee on Health. The Liberals did not do anything until they introduced this bill.

The Quebec system has a list of drugs, a formulary, and I think it is the best system in the country. What does the member think about the fact that this bill targets only two drugs for this pharmacare system?

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Madam Speaker, I thank my colleague for her intelligent question and for recognizing that Quebec's list is working well.

We have a good system, but it could be improved, as I mentioned earlier. That is why we want the money. We are often told by government members that we, the Bloc, see the feds as an ATM and that all we want is our money. Well, it actually is “our” money, since it is our citizens who paid the taxes, so, yes, we want our money in order to provide services to Quebeckers in our areas of jurisdiction.

To finish answering my colleague's question, the list could certainly be improved. We sincerely hope so. My biggest fear, however, is that the federal government will come up with a list that will likely be much worse than Quebec's, because when it comes to social issues, I am sorry, but Quebec is ahead of the curve.

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

Madam Speaker, I like my colleague a lot, but I find it hard to accept that the Bloc Québécois is refusing to listen to the people in Quebec who are in favour of this bill.

The Centrale des syndicats démocratiques, the Confédération des syndicats nationaux, or CSN, the Centrale des syndicats du Québec, or CSQ, and the Fédération des travailleurs et des travailleuses du Québec welcome the introduction of this bill.

Luc Beauregard of the CSQ said:

Quebec's hybrid system, with a public plan and private plans, has not lived up to its promises. We think it should absolutely not be used as a model for the rest of Canada. It is a costly, ineffective and unfair plan.

Quebec's unions say that we must pass this bill. Why is the Bloc Québécois not listening to these voices in Quebec?

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Madam Speaker, we can quote unions, too. The CSN is on the side of Quebec independence. I do not know if my colleague agrees with them on that point. I am guessing he does not agree with them on everything.

The unions know we are part of Canada for now, and they want more money so their members will be able to pay less for their medication.

When we meet with them and explain that if the federal government gets involved, there will be redundancy, it will cost more, it will be less efficient, and that it would be much better if we had our own money, I think that, at the end of the day, they agree with us.

We obviously place great trust in the members of Quebec's National Assembly, who have sent out a clear message.

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

Madam Speaker, it has been interesting to listen to what members have to say about Bill C-64. In some areas, I am not surprised. In other areas, I am surprised. Let me provide a bit of an overview before I get into more detail.

When I think of pharmacare and the potential that pharmacare has for all Canadians, I think that we undervalue and underestimate the degree to which Canadians as a whole would support not only the concept, but also the implementation, of a true pharmacare program. This is not new for me. I have been talking about pharmacare for many years. I have been an advocate for it because I understand and believe in the benefits of a national program.

There is no province or territory in Canada that has absolutely free prescribed medications for its population. Everything depends on the province that one is in. It could be based on age or affordability, but there are all sorts of different variations. There is public sector participation and private sector participation. There is a wide spectrum, a smorg, of different ways that pharmaceuticals are being delivered in Canada. That is the reason I asked the Bloc member to provide more detail of the plan in Quebec. Someone will stand up to says it is free in Quebec, but this bill clearly demonstrates that it is not free.

Many would say that, if we have to pay a deductible or an annual premium, and if things are not in it that should be incorporated, it is not free. I am glad the member said that there is room for improvement. No matter what program we are talking about, there is always room for improvement. I suggest that the way we should be looking at the whole issue of pharmacare is to take a holistic approach to the expectations people have for health care in general.

I have said many times in the past how important health care is to all people in Canada, in all regions of our nation. That has not been lost on the government. The Bloc will say it does not want Ottawa to be involved, other than to hand out money. That particular attitude does not surprise me, and I will add further comments on that in a bit.

What really surprises me is the Conservative Party's approach to health care. It is demonstrated with Bill C-64. People need to be aware of this. At the end of the day, we value and treasure health care here in Canada. The Canada Health Act protects the integrity of the system in all regions. It is one of the reasons the federal government allocates the billions of dollars it does for federal transfer payments.

We have seen a national government and, in particular, a prime minister, our Prime Minister, who has taken a health care initiative, recognizing how important it is to Canadians. We are looking at ways to enhance it, to build a stronger health care system. Nationalized health care or the Canada Health Act are established, and many other countries today that have that form of legislation or that sort of delivery of health care have already incorporated a national pharmacare program.

One does not have to be a Liberal or a New Democrat to see the benefits of it. I used to be the health critic in the province of Manitoba, and I understand just how critical medicine actually is to our health care system.

We can think about it in the sense that, if a person gets sick and goes into a hospital, they receive medications in that emergency setting. I do not believe any province is actually charging for that. This is virtually universal now across Canada. It might be because of an ulcer issue, some sort of a bleed or any other need that might be there. If a person has to stay in a hospital facility for however long a time, the hospital staff does not say, “Well, here's a bandage. By the way, you're going to have to pay for that.” Or for medication, maybe a painkiller, they do not put out their hand, saying, “We want money before we inject the painkiller.”

However, the moment that person leaves the hospital, then it changes. This may not happen in every province, as some provinces might cover prescribed medications more than others, some might not charge as much, some will have a deductible and, as I said, some will have those annual premiums. What happens, generally speaking, is that the individual leaves the hospital and finds that now they are going to have to start paying for the medications.

I cannot tell members how many 55-plus facilities, personal care facilities or independent living facilities I have been to where they talk about the cost of medications, with diabetes being one of them. They will tell us, “Look, we cannot afford the medication.” As a result, I would suggest that there are many people who end up going back to hospitals because they are not getting the medications they require. This is because of decisions they have actually had to make in terms of buying and purchasing the medication versus food or possibly rent, or the amount of medications that are required and the bill that is associated with that. Those are the types of things that end up costing communities, society and the taxpayer a whole lot more when that individual ends up returning to the hospital because they were not taking the medications that were necessary in order to keep them out of the hospital facility.

The problem with the debate on the pharmacare issue is that I would have liked to hear more about, collectively as a House, seeing the value of this and that we want to move forward. This is what Bill 64 is doing; it is moving us forward on a very important issue. I would rather have seen everyone coming to an agreement that, yes, this is good stuff, we should be supporting it, and then adding value to that.

I think of Cardine, whom I met at a local restaurant on a Saturday. She was talking about the issue of the shingles vaccination and how this is something people should not necessarily have to pay for. I raised that with some of my colleagues.

[An hon. member]

Oh, oh!

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I know it is not on the list. At the end of the day, some provinces, from what I understand, provide coverage for shingles vaccination for those 55 and over, or maybe 60 and over, whereas some provinces do not. However, I was suggesting, by bringing it up, that this is the type of discussion I would like to hear more about, but not in terms of how we keep Ottawa away from the issue of pharmacare or developing a national program. I do not think that is what our constituents want to hear. I believe they want to see consistency, where they can, in the different regions of our country.

I have presented many petitions in the House on the issue of pharmacare. I have consulted and talked about pharmacare at the door for years. I understand who has what kind of responsibility in health. As I said, I was a health care critic in the province of Manitoba.

However, I do not understand denying the opportunity for a federal government to participate in providing contraceptives or diabetes medications. I do not understand how opposition parties could oppose that, no matter what province they are from. Tell me a province, and I say that to all members, that provides any form of support for contraceptives today. I am not aware of any, but I could be wrong on that.

How could anyone say that the legislation would not be of benefit for all Canadians? It is a major part of the legislation. When we think of diabetes, we are not talking about a few hundred or a few thousand Canadians; we are talking about hundreds of thousands of Canadians who would be affected by Bill C-64.

What are opposition members afraid of? If they were truly listening to what people are saying in their communities, I would suggest that they should talk more about the issue of health care. I talk a great deal about health care in my riding. I understand why it is so important.

[An hon. member]

It's provincial.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, a Conservative heckles across the way, and she is consistent with other Conservative members who say it is a provincial responsibility. That is the attitude. We can remember, at the beginning, I said that the Bloc does not surprise me. I understand why Bloc members do not support it. It is a separatist party. It would just as soon Ottawa hand over the money, then Quebec would take the money and develop the programming.

In contrast, the Conservative Party thinks it is a provincial responsibility. People need to be aware, because it is the same as the member's off-the-cuff heckle. I would suggest that it is not just a provincial responsibility. If the member truly understood the Canada Health Act and, more importantly, her constituents, she would quickly realize that it is not just a provincial responsibility.

Even when I was in the Manitoba legislature, I argued and articulated that health care is not solely the responsibility of the Province of Manitoba. I like to think that, at the end of the day, all provinces have a responsibility to follow the Canada Health Act. When I talk to people about the pharmacare program and Bill C-64, it is a positive discussion. I have yet to hear anyone, outside the Conservative Party, tell me that Ottawa moving forward with respect to a national pharmacare program is a bad thing. I cannot recall anyone saying that we should not be doing this.

That might precipitate a few emails to me, but at the end of the day, I believe it is because people truly appreciate and understand the value.

That is why I said before the interruptions that one has to take a holistic approach to health care. Let us look at what has happened since 2015, when a new Prime Minister was elected and the agenda of health care started to change in a very positive way. It was not that long ago, and I referred to this earlier, that we actually had the Prime Minister in Winnipeg at a press conference at the Grace Hospital. My colleague would be very familiar with the Grace Hospital. At the end of the day, we had the premier of the province, the provincial minister of health, the Prime Minister and the federal Minister of Health. We talked about the future of health care and how the $198 billion over 10 years would have a positive impact not only for today but for tomorrow, thinking of generations ahead. We talked about how it would impact the province of Manitoba.

Let us think about the number of agreements that have been achieved by the government with the different provinces and territories and indigenous community leaders, all dealing directly or indirectly with the well-being and health of people. Something that was missing previously was the type of financial commitment, along with the sense of co-operation. Then we look at the type of national programs that we would bring in, which would make a difference.

People talk about the dental program as an example. Having a dental program ultimately helped literally thousands of children over the last year, including children who would not have been able to see a dentist or get some of the dental work that they received as a direct result of a national program. There are actually children in the province of Manitoba who end up going to emergency departments because their dental work has been neglected. Moving forward with a dental program is a good thing.

We just came out with the national food program, where we are delivering more nutritious food for children throughout the country. Hundreds of thousands of children will actually benefit from the program.

That is why I said that health care is a lot more than just a hospital facility. People need to look at everything from independent living and community living to what takes place in our schools. They need to think in terms of the medications; the bill is about getting people talking about medications and the important role they play in health care. Along with that, I would suggest that there is a general attitude that says we are committed to the Canada Health Act and to making sure that we continue to provide the type of progressive programs that would complement the health and well-being of Canadians. That is the way I see Bill C-64. It complements the Canada Health Act, and people should not fear it. They should accept it and look at ways in which we can improve upon it.

We often hear about the issue of bulk buying, as an example, and the hundreds of millions of dollars that have been saved in that area. I would suggest that we could do even more. I look forward to seeing the ongoing debate on this very important issue. I would hope that my Conservative friends, in particular, would revisit their positioning with the idea of getting behind the legislation and voting in favour of it.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Madam Speaker, not too long ago, at the beginning of this year, there was a shortage of Ozempic, which is a medication diabetics take. For some diabetics, this was the only type of medication that would help them with their particular condition. There was a shortage and there was not enough to go around. With the government in charge of deciding who will get this life-saving medication in the event of another shortage, because there will be one, how will the government decide who lives and who dies?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, look at the options of the Conservative Party and what the Conservatives would be saying. They would be saying not to go to them because they do not care. They would tell people to go to the provinces or anywhere else but not to Ottawa, because the Conservative Party does not believe that Ottawa plays a role when it comes to the health and well-being of Canadians. If this debate we are having today was on the Canada Health Act, the Conservative members of Parliament would be instructed by their leader to vote against it. They do not believe in—

[An hon. member]

That is not right.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Yes, it is true. That is what we are—

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Order. It is not about having debate back and forth unless someone is recognized. I would ask the hon. parliamentary secretary to ignore the comments that are being made on the other side.

I would also ask members on the other side to wait until they are recognized to make comments as opposed to heckling or trying to ask other questions.

The hon. parliamentary secretary.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, think about it. Many Conservatives have stood in the chamber and said that health care is a provincial responsibility. I for one believe what they are saying is what they believe. If that is what they believe, Canadians need to be concerned that the Conservative Party of Canada today has dropped the issue of being progressive and will cut health care. That is the bottom line coming from the Conservative Party.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Madam Speaker, let us take things down a notch by asking a fundamental question. I have a two-pronged question for the parliamentary secretary.

First, does my colleague think that the child care program is a good program? Does he think that it works well across Canada?

Second, does he not think that the pharmacare program could work just as well, if the federal government would respect Quebec and its jurisdictions for once and give the Government of Quebec the money that belongs to Quebeckers? That would not cost the rest of Canada anything. This is just a matter of respecting the systems that are already in place and those who blazed the trail.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I think the Province of Saskatchewan led the way, which encouraged Ottawa to ultimately come up with the Canada Health Act, and today Canadians have a fantastic health care system. Sure, there are some imperfections there, but at least we have a quality national health care program.

The Province of Quebec had a wonderful child care program. Ottawa was able to look at the Quebec example and establish a national child care program that all provinces have signed on board with, thereby ensuring that we have a strong, healthy national health care program. I think Ottawa is in a good position to be able to deliver for Canadians in all regions of the country and I would hope we would get participation. I would encourage the provinces to look at ways we can continue to work together in certain areas to ensure that we have healthier communities.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, I know that it was the NDP who pushed for the beginning stages of this pharmacare plan. I am very proud that the NDP government in Manitoba already has free contraception in place. I am glad that the Liberals are finally coming on board, after a lot of coaxing.

However, despite the Liberals saying they support the right to choose, they have not done their due diligence in ensuring access to safe, trauma-informed abortion care, including out east where women cannot even access abortion. Does my hon. colleague agree that the government is responsible to ensure that women can access safe, trauma-informed abortion out east and that the government needs to do more to uphold that right?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, whether it be the Prime Minister, members of cabinet or members of Parliament within the Liberal ranks, I think that we all have been very strong advocates on that particular point. I would suggest to the member that there is potential. As I cited, Saskatchewan played a very important role in regard to health care. Quebec played a very important role in regard to child care. I would love to see Manitoba play an important role on the further development of a pharmacare program that would be something that we could share with different provinces. I believe the best way we can deliver the best type of pharmacare program would be to have different levels of government working together for the betterment of Canadians.

I am an optimist. I am going to hold out and believe that the Province of Manitoba and others will seriously look at ways to make the program more successful.

[Bardish Chagger, Liberal, Waterloo, ON]

Mr. Speaker, it has been quite a fruitful debate today. It has been interesting to hear the diversity of perspectives and experiences as to what different provinces are doing.

I know that here, in the province of Ontario, it has been really challenging to have the provincial government step up at the level that it should, so the federal government has been doing more than its fair share. To have a partner, as the member referred to, would be quite interesting. To hear what other provinces are doing, it really does make me think that, if other provinces can do it, would it not be great to see my province able to do that? Perhaps there is something that Ontario is doing that other provinces could do.

What I would like to hear from the member is really on the matter of pharmacare. I know he has stood up in the House numerous times in regard to petitions and his constituents. Within the riding of Waterloo, constituents who have access to pharmacare have been saying, great. Constituents who do not have access say they want to have that access to pharmacare and they want access to medication.

Is the advancement of this legislation something we can take for granted? I know today there have been comments hoping everyone is unanimously supporting it. Can the member just reiterate and share what he has been hearing within this chamber as to the voices of all parties? Are all parties in support of this to ensure that every Canadian has access to pharmacare?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, what has become very clear is that Canadians should be concerned if they support the concept of a national pharmacare program. They need to know that the Conservative Party of Canada will not support pharmacare and a national pharmacare program. Member after member has stood up who will clearly be voting against this legislation. There is no doubt that it will be on the axing block if the Conservative leader ever forms government. People should not take this for granted.

I think that Conservatives need to be clear with Canadians on this very important issue. Pharmacare would complement our health care system, and this is something that we should all be voting in favour of. I am very much concerned that the Conservative Party appears to be voting against this legislation.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, when I studied pharmacare at the health committee, we heard from the Parliamentary Budget Officer and multiple stakeholders that 95% of Canadians already have prescription medication coverage, and most of them are covered for 15,000 drugs, not two, like this lame bill that we have before us. Not only that, but the Liberals want to have the critical medications for Canadians delivered to them by the same fantastic bunch that cannot get a passport out the door in seven months and that have a 30% error rate in CRA. Is that who we want to manage the critical medications of Canadians? What could possibly go wrong?

Would the member just admit that this bill is a pacifier for the NDP, to keep them from pulling their support and calling an election?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, I have been advocating for this type of legislation for a number of years. This is something that has been brought into Liberal platform positions in the past.

This is something about which the government is very serious. Again, the member just reinforced that the Conservative Party does not support national pharmacare. I think Canadians need to be fully aware of that.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, it is an honour, as always, to stand in the House of Commons to represent the incredible people of Peterborough—Kawartha.

Tonight on the docket, what do we have here in Ottawa, in the House of Commons? We have a bill that was put forward by the Liberal—NDP coalition and it is called pharmacare.

I just want to give some context for folks at home of the summary. This is the official summary:

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.

One can tell, with the word salad here, which we often see put forward by the government, that it just leaves a lot of loopholes to say that they are not going to over-commit and that they are not going to do anything, so they can then skirt out of it when it fails.

What is the bill? It is really the crux of the supply and demand agreement. It is simply a bill to keep the Prime Minister in power. The leader of the NDP sold his soul for this bill, and it is sad because he has also sold out Canadians. It is frustrating. It is infuriating. It is exhausting for everyone at home.

After nine years of the Prime Minister, here is what we have. I actually have to read it off of paper because there is so much that has happened.

There has been doubled housing costs, the highest food bank usage in history and a steady decline in the Canadian economy, meaning that Canadians are now poorer by $4,200 per person. This is Canada's worst decade for real economic growth since the 1930s. There are Facebook groups called “dumpster divers” because people cannot afford food.

Crime and chaos are at all-time highs. There are criminals running free and terrorizing neighbourhoods because of the Prime Minister's soft-on-crime policies. Domestic violence has increased. Compared to 2014, intimate partner sexual assault is 163% higher. Online child predators are up 300%.

Recruitment and retention in the armed forces is the lowest in history. Young people believe that they will never own a home. People have no motivation to go to work because 46% of their paycheque goes to taxes.

I had one gentleman message me. He said, “You know, Michelle, we work so hard. I'm almost embarrassed to say this because I make $100,000 a year. That sounds like so much money, but our interest rates have increased. Our mortgage costs have doubled. ” He said, “I decided I'll go take some overtime because we really can't make ends meet. We really have no money left at the end of the month. We can't afford to feed the kids. We're having to cut their sports. It's taking a toll on my marriage. It's taking a toll on our life.”

He goes and works 30,000 dollars' worth of overtime and he was taxed $22,000 out of that $30,000. That was time away from his family, time away from his kids, time away from everything, to go to work, to do the right thing. Work does not pay.

Why are people going to work? Why would one go to work? What a devastation to the soul, because people love to work. It is purpose. It is structure. We work for two things: because we have a purpose in this world and to collect a paycheque to provide for our families. The Liberal government has taken away both of those things.

Our birth rate is the lowest in history. Has anyone noticed a trend here? These are historic numbers that have never been seen before. People cannot afford to have a baby. They are saying they cannot afford a home and cannot afford to have kids. They are terrified. There are headlines like that of a Global News article, which says, “B.C. mother says lack of child care could leave her homeless”. Guess what? The Liberal-NDP government promised that it would make affordable, accessible child care, that it would save everybody, and that everything would be great. What has been delivered? Absolute chaos.

Women entrepreneurs have given their life; they have sacrificed everything to care for kids in their home, and they are losing their businesses because the Liberal-NDP government is so ideological that it does not offer flexibility and choice. It has to be the government's way always. It wants control, and that is what has happened.

I visited a child care facility in Manitoba this past weekend. It was absolutely incredible. It was able to build 22 child care spots in 18 months. It is remarkable what it has been able to do. A woman who spoke to me said that the CWELCC program, or the $10-a-day child care program, is actually a risk to children because moms and parents are having to choose between feeding their kids and putting their kids in safe child care. That is the reality of what has happened under the Liberal government.

Every day there are viral videos of Canadians who say they are moving because Canada is broken and no longer recognizable. We have a Liberal Prime Minister with historic records of corruption and scandals. Every single day is another scandal or another corruption. There is zero trust with the Canadian people. A guy came up to me on the street and said he just wanted me to know that people are exhausted. He is a restaurant owner and he said he was exhausted. He said that he cannot believe we have a Prime Minister who has destroyed our country in the way that he has, and that people are so tired. The NDP leader keeps him there with the bill before us that would deliver nothing, again.

There are 22 people a day dying from overdoses. Drugs have flooded our streets, and addiction has taken thousands of families hostage. I want to tell members a story because I think it is critical. Right now, the Conservatives are the only party saying “enough with the wacko drug policy, safe supply”. How does it work? I want to explain it because I think it is really important. Safe supply is, ultimately, the idea that somebody dealing with or battling with addiction walks in and is given a supply of Dilaudid. On the street, they are called “dillies”. It is a highly addictive opioid. Someone is given 30 of them, Dilaudid or dillies, then they go out, maybe want to do the right thing, and take them and try to level out.

However, it does not work, and they need something stronger, so they sell the Dilaudid. This is called diversion. They sell them on the street, and it brings down the value of the drug. Then they seek something stronger. Then there are all of these “safe” drugs; that is how the drug dealers sell it to high school kids. They go around and say, “Hey, this is safe. It is only a buck. Your parents can take it.” The kids buy it and now get addicted to opioids. There is a whole new generation addicted to opioids.

What happens is that the addict progresses, takes fentanyl, a street drug, and dies of a fentanyl overdose. That is why we have people, especially in the NDP, who say that people are not dying of safe supply and of diversion. However, they are dying as a direct result of the failed experiment of safe supply. That is a true story. The number one cause of death for children in British Columbia between the ages 10 and 18 is opioids. It is unbelievable. There is an outreach worker in Ottawa who tells the story of what is happening on the streets of Ottawa, outside pharmacies, of dillies being diverted to teenagers.

There was an arrest just outside my community, of a 14-year-old with safe-supply fentanyl. This is the reality of what has happened after nine years of the current Prime Minister. There are record applications for MAID, including from those who simply cannot afford to live so they are applying for medical assistance in dying.

What a time to be Canadian. I have just read historic stats to members. Never before in my lifetime have I ever seen Canada like this. Certainly why many of us chose to run for politics was to correct the course we are on. It is not a fluke, and it is not random, why we are here. It is all a lack of leadership. That is the reality of what we are dealing with in this country. When we have a leader whose sole mission is power and control, we can guess who loses; it is Canadians.

There are consequences to actions and consequences to policies, and Canadians are feeling the misery and suffering after nine years of the Prime Minister. How does this impact pharmacare? The Prime Minister knew he was tanking in the polls. He had to think up a plan, and he had to think it up quick, just like the good old Grinch. He said, “I know who I can exploit. I am going to go to the leader of the NDP. He will never be in power, so I will make him an offer, make him think he has power, and that is what I will have to keep myself in power. In case an election is called, this is how I will do it.”

Every single day, I get calls asking why there is not an election. We are done. Every single thing has an expiration date. The Prime Minister is long overdue his, but he is in power, and the pharmacare bill is a big piece of it. The leader of the NDP signed a coalition agreement, and maybe he had good intentions. Maybe he thought he was actually going to help Canadians, and maybe he thinks he is going to get something out of this.

I thought at the beginning of my term, and now I know, that power and control are what the Liberals want. That is the driving force for the leaders of the NDP and the Liberals in the House. The pharmacare bill is yet another marketing slogan. It sounds wonderful, but as with everything the Liberals announce, they promise us one thing and deliver another. In so many instances, they actually deliver nothing.

I want to tell a story that is really sad. The Liberals often hurt the most vulnerable because they set an expectation, saying, “We are going to promise the moon, the stars, the sun and $10-a-day day care for everyone, except that one person does not get it, and another and another do not get it. One does get it, that guy right there, but everybody else is a loser. There is one winner.” There are winners and losers. That is what the Liberal-NDP government does.

The government set out the Canada disability benefit. The minister of, at the time, disabilities and inclusion came to testify at the human resources committee in October of last year. We were waiting. We had witnesses. We were studying the bill, and we asked what the benefit would do. The minister said that the benefit “will lift...people out of poverty, big time.”

Along came budget 2024. The Liberals were so proud. They came out and said, “Here is our disability benefit: six dollars a day.” Rachel and Jason came to my office. They are with the Council for Persons with Disabilities in Peterborough. I said, “Tell me how you feel about the disability benefit.” They said, “Well, you know, we are grateful”, because this is what the Prime Minister does. He shames people. They cannot speak out, because they just have to be grateful for the scraps the government gives them. It takes everything away from people, and then it gives them little scraps. It belittles them and make them feel small and worthless.

Rachel and Jason said that it is basically like this: Members know that old game of trust, the trust and fall exercise we used to play as kids. We would close ours eyes and fall backwards, and the person behind was supposed to catch us. Jason and Rachel said to me that it is as if the person who catches is the Liberals, but not only do they not catch someone but they got out of the way and did not tell them.

That is the reality of the bill before us, and the Liberals make it seem like the Conservatives do not care about this. No, it is that we do not believe them. We do not trust them and we do not believe them, because they have not delivered anything they said they would. We are the only ones standing in here fighting for the Canadians who are genuinely struggling to survive. That is the problem with the bill. Not once have Liberals proven to us that they will deliver what they said they will.

There are historic highs of food bank usage in this country. Housing costs have doubled, and young people believe they will never own a home. However, the Liberals get up and say, “We have done a great job. We are such good people and Canadians should be grateful. We are really good. We are great.” Guess what? Canadians have caught on. They know so much; they see right through it. The bill is just another distraction of “We will give you this.”

Let us break down the facts. Currently we are spending more on serving the Prime Minister's out-of-control debt than we are on health care transfers. This is a true story. It is going to get worse and worse because he keeps spending and spending like a maniac. It is basic economics. Anybody who has ever had to balance a household budget knows this.

If someone makes $100 a month but spends $150, what happens? The person has to borrow the money. Then the next month, if that person makes $100 and again spends $150, they need to borrow more and are now at $200. They had to use their credit card to do that and are now paying credit card interest, so they are just putting money toward the interest and not even paying down their debt. Their credit score goes down and they go further and further into debt. They cannot spend time with their family and are stressed out of their mind.

This is Mental Health Week. The number one thing a good leader would do is make life affordable. That is the greatest gift we can give our kids. They do not need money and things; they need us. They need connection and they need time. Parents cannot give that because they are too busy working trying to pay for food and housing they cannot afford because of the Liberal Prime Minister.

There are six million Canadians without a family doctor, and wait times have never been longer. Where is the bill on that? I do not see it. The wait time from seeing a family doctor to getting specialist treatment is crazy. Listen to this. Something is wrong with a person, and they need to see the family doctor. The wait time has increased incredibly. The person does not have a family doctor, so there is problem number one. Number two is that the family doctor then has to recommend the person to the specialist.

The wait time to get to the specialist has increased 195%. This is the longest it has been in three decades. People are literally dying while waiting to see specialists and to get surgery. We have the longest wait times in the world, at 25 months, for new life-saving therapies. I do not see any money in the budget for that.

Who writes prescriptions? Doctors do, so if someone does not have a doctor, how are they going to get the prescription from the magical pharmacare bill? The Canadian Life & Health Insurance Association has stated that the bill would spend billions of dollars unnecessarily on drugs for people who already have coverage. Who cares about monetary policy, right? What possible consequences could come from not wanting to balance a budget? There are 27 million Canadians who rely on workplace plans and who would be placed at risk by the legislation. It would create the Canadian—

[An hon. member]

Monetary policy is not fiscal policy.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

I love how the Liberals across the way are defending the Prime Minister, who said to the reporter, “Glen, we took on debt so you don't have to”.

[An hon. member]

No, you just don't know the difference between monetary policy and fiscal policy. They are two different things—

[The Deputy Speaker, Conservative, Chris d'Entremont]

Order, please.

There are going to be questions and comments after this, and I am sure if members put their hand up they can get to ask questions on this.

The hon. member for Peterborough—Kawartha has the floor.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, 27 million Canadians who rely on workplace plans would be placed at risk by the legislation. It would create the Canadian drug agency, which would cost about $90 million to create, and perhaps another $35 million a year to continue. The Parliamentary Budget Officer says it would cost tens of billions of dollars. However, when asked, the Liberals do not have an answer. They are not sure. It is kind of like the carbon tax, which was supposed to be revenue-neutral but made a billion dollars, but we are not really sure where that money went. Nobody seems to know.

The major cause of people's inability to afford their medications is the cost of living. The number one reason people say they cannot afford their medications is inflation and the cost of living.

This one is my favourite. Who remembers the $4.5-billion promise from the Liberals of a mental health transfer? I cannot find it. I have not seen it. However, what I do know is that we have ranked 35th out of 38 in the world for teen suicide. That is where we are at in Canada, but the Liberals are going to come save us. They do not deliver. They are the guy who promises—

[The Deputy Speaker, Conservative, Chris d'Entremont]

The member is out of time, almost 30 seconds past her time.

Questions and comments, the hon. member for Châteauguay—Lacolle.

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Mr. Speaker, I am glad I do not live in the world the member lives in. It is another dystopia. The last time I listened to the member go on in a speech in that vein was on Bill C-35, the child care bill. She went on and on arguing against it and then, at the end of the night, she voted for it. In fact, every single member on that side voted for the bill.

I am wondering if it is going to be the same story with the pharmacare bill.

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, I am so glad the member brought up child care, because what chaos has been delivered by the Liberal-NDP government. I would strongly encourage her to reach out. There is a call right now by child care operators and families across this country. They are in dire straits from coast to coast to coast. They cannot access child care. Women cannot go to work because they cannot access child care. Children have nowhere to go. Operators who have built their entire lives on this are losing their business. There are 77% of high-income people accessing this program. That is on the Liberals' watch.

It is another failure, and it is exactly what this pharmacare bill will be.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Mr. Speaker, the member for Châteauguay—Lacolle just asked my colleague who just spoke a question saying that they do not live in the same world. The member for Châteauguay—Lacolle also lives in a world where the National Assembly unanimously voted for a first resolution, then a second, and then a third.

For years, we have been calling for Quebec to have the right to opt out with full financial compensation when Ottawa institutes new spending programs in the jurisdictions of the provinces and Quebec. She supposedly lives in that world, but it does not seem like it because across the way, in their alternative world, the federal government is supposed to be able to manage a hospital, which it has never been able to do properly.

I have the following question for my Conservative colleague. Perhaps the Conservatives will form the government some day; it is hard to say. When that happens, will they agree with the concept and principle of a right to opt out with full financial compensation for Quebec when the federal government institutes programs in the jurisdictions of the provinces and Quebec?

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, again, child care is a great example. The Liberal government loves to weasel its way into provincial jurisdiction, and that is what it did with child care, too. Things were fine and everything was in its own little jurisdiction, but no, the Liberals had to meddle, disrupt it and cause chaos. Then, when it fails, they are going to blame the Conservatives. That is the way they operate.

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

Mr. Speaker, I am both shocked and saddened by the member's speech. I am shocked because she mentioned the Conservative government. I lived through, as Canadians did, the shockingly bad years of the Harper regime, with the record deficits each and every year, the bad financial management, the scandals, one after another, and the fact that they gave $30 billion a year in the infamous Harper tax-saving treaties to the wealthy, $300 billion over the course of a dismal decade. There were cuts to health care funding and slashing of veterans' benefits. It was one of the worst periods in Canadian history, and it was certainly the worst government in Canadian history.

I am saddened because the member has seen the benefits of dental care already in her own riding, dozens of people. There were 15,000 seniors in the first three days who got dental treatment. There were dozens in Peterborough—Kawartha. The reality is that 17,000 people would benefit from pharmacare in her riding.

Why does she not listen to the 17,000 constituents who would benefit from pharmacare?

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, what is sad for me is a New Democratic Party that props up the Prime Minister so he can stay in power. If the member listened to anything I said and if he really cared about the most vulnerable and the disability benefit, he should know that the record-high use of food banks in history is because New Democrats are keeping the Prime Minister in power.

Who is really standing up for people? That is what I would like to know.

[John Barlow, Conservative, Foothills, AB]

Mr. Speaker, I want to thank my colleague for holding the Liberal-NDP government to account on its promises, which in many cases are just marketing projects that are never followed up on with the actual hard work of governing.

Now, my colleague mentioned a couple of times that the pharmacare bill is nothing more than window dressing and that there is nothing in this bill that actually is a pharmacare plan. This is merely a bill to maybe talk about a plan to maybe talk about a pharmacare plan maybe later down the road.

The NDP is championing this legislation as such a big win for them, just to keep the Prime Minister in power. Is there anything actually in this legislation that promises Canadians any change or additional access to health care or health care products?

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, I love that question, and the answer is no.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, this is what I am worried about. This bill talks about contraceptive medication. In particular, when we talk about a woman's right to choose, what I am worried about is that the Conservative Party of Canada—

[Some hon. members]

Oh, oh!

[The Deputy Speaker, Conservative, Chris d'Entremont]

Order. Let us just make sure we get the questions and comments, and we can continue on.

The hon. member for Kingston and the Islands has the floor.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, the Leader of the Opposition has been suggesting recently that he will use the notwithstanding clause where he sees fit.

On Friday, the member for Lanark—Frontenac—Kingston specifically said, “A common-sense Conservative government would use the notwithstanding clause only on matters of criminal justice.” Well, performing an abortion back in the nineties was considered a crime.

The member could very easily put my concern to rest by answering this question. Can the member categorically say that a future Conservative government would absolutely protect a woman's right to choose and not use the notwithstanding clause on a matter such as that, yes or no?

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, what a question coming from a man. I would love him to tell me what to do with my uterus. That is great. That member will never tell me what to do with my body. We know the Liberals are losing really bad when they bring up abortion. We will never bring this up. If the member opposite wants to talk about my reproductive rights, he had better put a woman up and stop mansplaining to me.

[Some hon. members]

Oh, oh!

[The Deputy Speaker, Conservative, Chris d'Entremont]

Order.

The hon. member for Abitibi—Témiscamingue.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Mr. Speaker, in her speech, my colleague quite pointedly criticized various aspects of this bill. She explained why it should not be passed.

In my opinion, she left out one thing, and that was jurisdictions. It is not the federal government's place to become involved in health issues or, by extension, in drug management.

Does my colleague have anything to add about the federal government's jurisdiction over pharmacare?

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, absolutely, we believe in provincial jurisdiction. Again, we have just seen a federal government and a Prime Minister that want more control weighted into an area that has nothing to do with the Liberal government.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, this is such an important bill, because it would help individuals who need it most, whether it is women who may need medicines for their reproductive health or people who suffer from diabetes. These are two areas of pharmaceutical care that are desperately needed throughout Canada, in the territories and in all the provinces.

Could the member better explain how this bill is not supporting those people, specifically women who may need access to abortion because of an unplanned pregnancy that they may have experienced?

[Michelle Ferreri, Conservative, Peterborough—Kawartha, ON]

Mr. Speaker, I want to tell the member that I was actually with a constituent of hers on the weekend. His name was Josh, an incredible young boy who was accessing the services at Toba child advocacy centre. What that young man has been through and what his family endured up north is absolutely incredible. He said to me, “I'd like to see the Conservative government win so that we can deal with drugs and drug addiction and help people who are most vulnerable”, which is what I would like to focus on.

I think we can help all of the folks the member is referring to, in particular women, to be out of poverty, have access to housing and have access to all the things they need. There are truly people struggling in this country, and it is just not in the bill; that is the reality.

This is a failed Prime Minister who will not deliver anything he says he will. It is time for a competent government that delivers what it says it will and restores confidence in the people, restores trust and makes life affordable again.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Mr. Speaker, it is always a pleasure and an honour to rise in this most honourable of houses. This evening, I will be sharing my time with the hon. member for Milton.

Before beginning my formal remarks, I would say that, when I think of Bill C-64, an act respecting pharmacare, and the implementation of a piece of legislation that would obviously strengthen our health care system and the delivery of it, I would not be remiss to say that this is not only an excellent piece of legislation that would help Canadians, specifically those in need of contraceptives and the nearly 4 million Canadians dealing with diabetes, but also another sign of our government's strengthening of our social fabric and social system. It would build on other programs that we have implemented, including the Canada child benefit, which we know has lifted hundreds of thousands of children out of poverty and helps families every month. In my riding, nearly $80 million or $90 million a year arrives, tax-free and monthly. We know that the Canada workers benefit, which helps our working poor and those trying to make ends meet and get ahead, helps literally millions of Canadians. We introduced middle-income class tax cuts in 2015, raised the basic personal exemption amount and accelerated the pace. We know those are delivering $10 billion annually in tax relief to Canadians, as we speak.

More recently, the Canadian dental care program, which thousands of dentists have signed on for, is benefiting individuals in my riding of Vaughan—Woodbridge. In fact, in the heart of my riding at Weston Road and Rutherford Road, there is a big billboard, put up by one of the dentists in the community, stating that they welcome patients who are eligible and approved for the Canadian dental care program. This program is already helping thousands of residents in the riding of Vaughan—Woodbridge and in the city of Vaughan. The work that we are doing on Bill C-64 would continue to build on that work of helping Canadians to receive the services they need, which, in this case, is to improve health care.

With respect to health care, I was at the announcement with the Prime Minister and the Premier of Ontario, Doug Ford, when we announced a $3.1-billion bilateral agreement of health care funding for more nurses, more doctors and more health teams across the province of Ontario, a part of the $200 billion the federal government is committing to health care across this beautiful country.

I appreciate the opportunity to speak to the important work under way through Bill C-64 with regard to the Canadian drug agency, or CDA. The CDA is one of the key features contained in Bill C-64. On December 18, 2023, the Government of Canada announced the establishment of the CDA, which is to be built from the existing Canadian Agency for Drugs and Technologies in Health, in partnership with provinces and territories. The government committed $89.5 million over five years to establish the CDA, providing dedicated leadership and coordination to make Canada's drug system more sustainable and better prepared for the future. This investment would be in addition to the existing funding of $34 million per year to support CADTH's current work.

The CDA would build on CADTH's existing mandate and work, expanding to include new functions such as appropriate prescribing and use, data and analytics, and system coordination. Developing the CDA recognizes the organization's reputation of excellence, performance and results. It also ensures that we would be adding value to the system by building on what is already working with the CADTH.

Let me say a bit about how we got to this important milestone. Canada's pharmaceutical system evolves slowly over time, often responding to address new challenges as they developed. When medicare was first introduced in Canada in 1966, drugs used outside hospitals were primarily inexpensive medicines for common conditions. A growing number of specialized drugs are now helping to cure or manage a range of conditions, and rising rates of chronic disease have made prescription drugs a central part of our current health care system.

New pharmaceutical system organizations and functions have been created to manage the access and use of prescription drugs, but this has happened in an ad hoc and fragmented manner. Canada currently has over 100 public drug plans and 100,000 private drug plans, creating a patchwork of access and coverage for Canadians. Despite improvements in recent years, high prices and the patchwork of drug coverage leave many people in Canada facing barriers to access the prescription drugs they need when they need them.

Stakeholders in landmark reports have underscored the need for federal leadership in addressing these gaps. In recognition of concerns about the sustainability of the Canadian pharmaceutical system, budget 2019 provided $35 million over four years to establish the Canadian Drug Agency Transition Office, or CDATO, to provide dedicated capacity and leadership to work with provinces, territories and key partners on a vision, mandate and plan to establish the CDA. Since its establishment in 2021, the CDATO has conducted extensive engagement and analysis, holding over 400 meetings and round tables with a diverse range of stakeholders to understand the gaps and challenges in the pharmaceutical system and obtain advice on how to make improvements.

Extensive engagement has taken place with provinces, territories, patients, pan-Canadian health care organizations, health care professionals, industry insurers and international partners. Based on this engagement analysis, the CDA will build on CADTH's existing mandate and functions, expanding to include new work streams that better support patients and system sustainability, namely improving the appropriate prescribing and use of medications, increasing pan-Canadian data collection, expanding access to drug and treatment information, and reducing drug system duplication and lack of coordination.

Through our engagement, we learned that the appropriate prescribing and use of medications is a clear priority for many stakeholders. This is about ensuring that patients are prescribed the safest and most effective treatment for their outcomes and conditions. Each year, $419 million is spent on potentially harmful medications for seniors, and $1.4 billion is spent to treat harmful effects. However, there is no unified approach to guide and inform prescribers or patients on appropriate prescribing and use.

To date, we have launched an appropriate use of advisory committee involving patients, clinicians, experts and leading organizations in the field. The committee is advising on the development of a pan-Canadian appropriate prescribing and use strategy. Later this spring, the committee will issue its final report that will inform the work of the CDA to create and implement an appropriate prescribing and use program in collaboration with partners.

Stakeholders have also pointed to the need to improve pharmaceutical data and analytics to better understand the impact of drug treatments. However, there is limited ability to access, link or share drug data, which is siloed in different sources, such as hospitals, private drug plans, physicians' offices and jurisdictions. This fragmentation limits our ability to understand a drug or treatment's use pattern and effectiveness, including how it performs once it is being used by patients in the real world and how it compares to other available treatments.

We are working with several organizations in the health data field, such as CADTH, the Canadian Institute for Health Information, Canada Health Infoway, Health Data Research Network Canada and the pan-Canadian Pharmaceutical Alliance, to improve access to and use pharmaceutical data. Stakeholders also consistently emphasize the importance of incorporating patient equity and lived experience in the CDA's developments and operations. They noted that patient engagement in the pharmaceutical system is limited. Incorporating patient perspectives through engagement and governance were key recommendations for an organization that is transparent, accountable and meaningfully involves those who need it most, the patients.

We have also heard of significant challenges regarding system coordination. During the course of our engagements, most stakeholders highlighted at least one coordination-related issue that they face. Challenges include a lack of information sharing, confusion about roles or responsibilities or limitations to meaningful engagement. Our pharmaceutical ecosystem is managed by multiple organizations that have different purposes, priorities and areas of jurisdiction.

There is one organization mandated to convene players, focus the agenda, ensure efficiency and enhance collaboration. Because of this, there are both gaps and duplication in the system. Building from CADTH is a significant step in promoting system alignment. CADTH is a highly reputable organization with strong leadership and a shared federal, provincial, territorial governance model that works.

Through CDATO and CADTH's extensive partnerships and building on the work to date, we will build a CDA that is well positioned to convene key players and focus on promoting better outcomes for patients. We will develop an organization that has the capacity to adapt to the ever-changing pharmaceutical landscape. Our work to date reflects the significant input provided by stakeholders over the last three years. It also highlights a strong interest across the system to make meaningful improvements.

The CDA will support pharmaceutical system modernization in Canada and lay a strong foundation for future growth, including by providing the capacity to support the commitments outlined in Bill C-64, which is now before the House. The CDA will assume a leading role in the pharmaceutical system to ensure Canadians have better health outcomes and are well informed about the medications that they need now and into the future.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, by now, Canadians are used to broken promises from the Liberals. In 2015, members will remember that they were going to make housing affordable, and now housing prices, mortgages and rents have doubled. They also promised the last election under first-past-the-post, but maybe not.

However, on pharmacare, I think maybe Canadians need a history lesson because the Liberals have been promising to do pharmacare since 1992, and they have never done it. The bill before us is also not pharmacare. It is a plan to get a plan to maybe do pharmacare. It is not going to be national. Quebec has already said that it is not going to participate.

Could the member just admit that this is an attempt to pacify the NDP to make sure that it does not pull its support and trigger an election?

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Mr. Speaker, since 2015, when I was first elected to this most honourable House, my focus has been on helping and ensuring the success of the residents of my riding of Vaughan—Woodbridge and of all Canadians, and that is what we continue to do. We continue to implement policies that strengthen our social system, including what is contained in Bill C-64, specifically for folks with diabetes and individuals in need of contraceptives.

Obviously, the rare disease strategy is something near and dear to my heart as I have a nephew who suffers from a rare genetic disease. I understand the issues that my brother and sister-in-law go through in taking care of my nephew. The issue of expanding pharmacare, expanding our national system and strengthening our social safety net is very near and dear to my heart.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Mr. Speaker, we heard several times this evening from Conservatives talking about child care. If we look at how that legislation came about, which is something the NDP pushed for for years, it was eventually written into legislation and passed in a very similar format to pharmacare, and it required the participation of provinces. We heard all sorts of opposition from the Conservatives, but what we saw is that provinces, one by one, came on board. Now, we see the same thing with pharmacare.

I am just wondering if the member can project on whether we are going to see, over the coming months and the coming year, as agreements are signed with British Columbia and Manitoba, that other provinces are going to have a hard time explaining to their people why they do not get free contraception and free diabetes medication, and slowly they are all going to sign on to a national universal pharmacare plan. Is that how it is going to roll out?

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Mr. Speaker, leadership is about having the confidence to invest in Canadians and invest in Canada. We continue to work with all the provinces. We have signed all the agreements for the national early learning and child care agreements across the country with all the provinces, Conservative, New Democrats or Liberal. We have done the same on health care.

As I said in my speech, I was there with the Prime Minister and the Premier of Ontario, Doug Ford, the morning we signed the bilateral health care agreement of injecting $3.1 billion as part of the agreement with the Province of Ontario. That is real leadership. That is not hot air. That is real leadership, which is providing real solutions to individuals in the province of Ontario and across this country that we call home.

We will continue to introduce measures that I know make a real difference in the lives of everyday Canadians, including the ones who live in my riding of Vaughan—Woodbridge.

[Anju Dhillon, Liberal, Dorval—Lachine—LaSalle, QC]

Mr. Speaker, I listened with great interest to my colleague's speech.

I would like to ask the member about how something as simple as monitoring diabetes and testing sugar levels, which can prevent hospitalization and the additional costs that can occur due to hospitalization when people do not have this equipment to be able to take care of themselves at home. I would also like to ask, if he has a few moments, if he could talk about oral contraceptives for women.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Mr. Speaker, we know that almost four million Canadians have a form of diabetes, and we want to prevent their condition from deteriorating and their ending up in the hospital, which costs our hospital system even more. We want to prevent that, which is a big piece in Bill C-64.

Obviously, with contraceptives, we know that there are women out there who may not be able to afford the cost. We would be there to assist those individuals, especially the most vulnerable, in our country.

[Adam van Koeverden, Liberal, Parliamentary Secretary to the Minister of Environment and Climate Change and to the Minister of Sport and Physical Activity]

Mr. Speaker, reproductive and sexual rights are human rights. Our government recognizes that, and we stand by it as a matter of principle. Members of the Conservative Party caucus can stand in the House and say they are not interested in pursuing anti-abortion legislation that would infringe upon women's reproductive rights; however, sadly, that conviction is far from a universally held one in the caucus. In fact, the entire caucus has been designated as anti-choice by the Abortion Rights Coalition of Canada.

I am proud to say that, on this side, we are walking the walk. We are leading by example and putting forward Bill C-64, an act representing pharmacare, which would provide universal access to prescribed contraceptives to Canadians. In collaboration with provinces and territories, we will support universal coverage of contraceptive medications and devices so that nine million Canadians of reproductive age will have access to the contraception that they need and deserve. This will ensure that Canadian women can choose whether they are going to have children. It will give them greater control over their bodies and their futures.

Currently, Canada is one of the only countries in the world where access to health care is universal but access to contraceptives is not. Women therefore have a more limited range of options, and are more likely to experience unwanted pregnancies, which can impact their lives.

Access to safe, reliable birth control is essential. It gives women the freedom to plan their families and pursue their long-term goals and dreams. Unintended pregnancies, on the other hand, can cause a great number of negative health and economic impacts on families. At present, coverage for contraceptives varies across the country. Most Canadians rely on private drug insurance through their employer for their medication needs, and 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, and only a fraction of Canadians are eligible for prescription birth control at low or no cost through a public drug plan. When a person pays out-of-pocket for their contraceptive needs, regardless of whether they have coverage, cost has been identified as the single most important barrier to accessing contraceptive medications or devices that they require.

One study showed that women from low-income households are more likely to use less effective contraceptives, or no contraceptives at all. Cost is a significant obstacle to gaining access to more effective forms of contraception.

For example, oral contraceptives cost approximately $25 per unit, or $300 per year. In comparison, intrauterine devices, or IUDs, are often more effective and last up to five years, but they have an upfront cost of approximately $500 per unit. IUDs are a much more effective method of contraception, since they have a low failure rate of 0.2%, compared with that of oral contraceptive pills, which is 9%. Furthermore, they do not require daily doses to remain effective, which is a long-standing challenge with the pill.

At this time, I would also point out that women can have the choice, but sometimes, it is not so much a matter of choice; it is a matter of how a woman's body reacts to these various interventions. It really should be a matter of choosing not based on cost, but based on what works best for them. If someone is a young woman in their twenties, working at a part-time job that does not offer private coverage, accessing an IUD or other contraceptive method can be a big cost when trying to manage other basic life expenses, such as rent or grocery bills.

As colleagues can see, this is the reality that many Canadians are currently facing and trying to manage. We have decided to intervene and help. Bill C-64 would address the lack of access by working with provinces and territories to provide universal coverage of contraceptive medications and devices, so Canadians can access the contraceptives they need. Furthermore, some provinces are already paving the way; this is similar to how Saskatchewan led the way by implementing universal health care in the 1960s. Last year, British Columbia became the first province to provide universal access to contraceptives to their residents. Recently, Manitoba also announced a commitment to implementing universal contraceptive coverage in their province. I would join my colleague in clapping.

There is a certain trend I see, with certain provinces offering these services to Canadians. What is that common trend? I think we can leave it to our imagination, but it tends to be parties that are left of centre, that are more progressive and that are willing to step in and help where people need it most. Studies from the United Kingdom show that universal access to contraceptives provided a return on investment in health and social services of nine to one for every investment in universal contraceptive access.

In the Canadian context, evidence from the University of British Columbia estimated that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year.

We commit to working with those provinces and the others in Canada to ensure that everyone in Canada has universal access to contraceptives.

This new coverage, to be delivered by provinces and territories that enter into a bilateral agreement with the Government of Canada, means that Canadians would be able to receive the contraceptives they choose, no matter where they live or how much they earn. In turn, Canadians will be healthier; they will be empowered to make important life decisions, and they will not have to opt for less-effective or less-desirable methods of contraception because of the cost of this essential medicine.

We will work with provinces and territories to provide Canadians with universal coverage for contraception. This is just the first phase of a national pharmacare plan, which can show how much of an impact universal coverage for contraception and, indeed, more than just contraception, will have on the lives of Canadians and further enshrine reproductive choice in Canada.

In closing, we look forward to working with all parliamentarians to pass the pharmacare act so that all Canadians can have reproductive choice and rights and get the contraception they need and deserve.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, the member opposite opened his speech by talking about the morning-after pill. Does he know that, in his province of Ontario, that is already covered? With respect to all the money that is going into protecting women from going full term in pregnancy, would the government instead, or in addition, at some point choose to direct the funding towards in vitro fertilization?

Our birth rate in Canada is lamentably low. Rather than focusing on wiping out or tapering off the population, would they consider helping women to have babies?

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Speaker, that is a shameful display of the type of anti-choice rhetoric that happens in the House far too often with Conservatives. The facts remain: Women want the right to choose. They want the right to choose how to have their bodies, and—

[Some hon. members]

Oh, oh!

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Speaker, as I am being heckled by a Conservative—

[The Deputy Speaker, Conservative, Chris d'Entremont]

Order. Ask questions, get answers and comments.

The hon. parliamentary secretary has the floor.

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Speaker, the Conservatives can find all the excuses that they want to deny women access to free contraceptives, whether it has—

[An hon. member]

Oh, oh!

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Speaker, I continue to be heckled by a caucus that has a perfect score with the Abortion Rights Coalition of Canada as being completely anti-choice. They can deal with that on their own time. We will stand with Canadians. We will stand with women, and we will stand for women's rights and reproductive rights.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Mr. Speaker, let us bring a little bit of cheer to all this by asking questions about the content.

I would like the member to tell me whether he thinks that the child care program is working well in Quebec and the rest of Canada. We know that the federal government recognized Quebec's jurisdiction and its right to opt out of that program with full compensation.

Does my colleague not believe that the pharmacare program could also work just as well if the federal government were to respect Quebec's expertise and jurisdiction by simply transferring the money?

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Speaker, I thank my colleague for his question. It is true that Quebec is a leader in Canada in many areas, including women's rights and reproduction.

It is important to recognize when a province or territory is a leader or ahead of its time when it comes to important, progressive issues. The federal government must consider all of its options to create a level playing field.

To level the playing field, it is important that we find ways to ensure that great ideas in provinces such as Quebec, Manitoba or British Columbia are shared by all Canadians.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, as I have heard in the House tonight, I know the Conservatives think providing free contraception is communist, but I would like to say this to the hon. member across the way: They talk about reproductive rights, but in New Brunswick, one cannot even access a trauma-informed abortion at care. We have a Canada Health Act that they have to uphold, and I am glad that the member supports that, but his government actually does not support action. It is one thing to say that we support the right to a safe, trauma-informed abortion, but it is another thing to provide access to that right.

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Speaker, I am grateful to the member opposite for her intervention tonight, because it underscores the importance of electing good provincial government and the necessity to look at provinces' leadership, read their platforms very carefully and consider who they are. They demonstrate exactly who they are, whether it is their approach in New Brunswick or, frankly, in Alberta, to how they support LGBTQS+ kids. The position on abortion in New Brunswick has been demonstrated very clearly. Canadians know what they get when they elect Conservative governments in Canada: a questioning of the enshrined rights of women.

[An hon. member]

Oh, oh!

[Adam van Koeverden, Liberal, Milton, ON]

Mr. Speaker, as I continue to be heckled by members of a caucus that has a perfect score with the Abortion Rights Coalition for being anti-choice, I think they are demonstrating exactly who they are.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, I am proud to rise today to support what the NDP has fought for. It is the beginning of a pharmacare plan that will start with one of the things the NDP has championed for years: the reproductive rights of women and people who menstruate. It is a significant step forward to promote reproductive rights for women and gender-diverse people in Canada; we know, for far too long, leaders have neglected calls to improve reproductive health services. In this room today, I have heard Conservatives saying such things as that we already pay for abortion; they know very well that even the Liberal government still does not provide access to safe, trauma-informed abortion care. We are talking about the gamut of reproductive rights; that includes the ability, if one so chooses, to access contraception.

I used to be a high school sex ed teacher. One thing we would talk to the kids about was choice and how to protect themselves and their reproductive rights should they want to avoid pregnancy. I know there are Conservatives smiling because the discussion around sex, abortion and contraception is a difficult one, but these are important open discussions that we have to have, especially as we change into a society that is becoming much more inclusive in our gender diversity. I support that. The bill would allow nine million people of reproductive age in Canada to access contraception, providing them with reproductive autonomy and reducing the risk of unintended pregnancies.

However, we know that bodily autonomy is currently under attack. We have heard in the House, in fact, petitions that have been put on the floor by the Conservative Party that attack the trans community. The March for Life is happening on Thursday, and I wonder which Conservative faces we will see again this year at the campaign. Just as the colleague across the way said, the Campaign Life Coalition has labelled the Conservatives anti-choice. This is not surprising, because in this very session of Parliament, Bill C-311 was named a backdoor anti-abortion legislation in the name of so-called violence, even though it was not supported by any women's groups working with women and gender-diverse people who are experiencing violence.

The bill is also a major win for promoting the rights of economic empowerment for women and gender-diverse people in Canada. We have a right to choose what we want to do with our own bodies. I find it disturbing that, in 2024, most of the people opposing the bill in the House on the Conservative side are not even impacted by it. I do not know many men in the House who have to run to the drugstore to get birth control pills or have to use diaphragms or IUDs. This is a gender-specific issue for women and gender-diverse people. It is really appalling, because the very Conservative opposition that is talking about freedom, with a leader who talks about freedom, does not believe in freedom when it comes to bodily autonomy. The member for Carleton does not believe in freedom of religion, with the kind of Islamophobic, visceral garbage I have to hear on that side. Now they are directly attacking women's right to choose.

[The Deputy Speaker, Conservative, Chris d'Entremont]

We have a point of order.

The hon. member for Sarnia—Lambton.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Mr. Speaker, you certainly have given lots of advice on people not impugning other members with motives. I think the member has gone quite far enough, and I would ask if you could return her to the theme of today.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, on the same point of order, the member has not impugned anything. The member is just simply stating what she knows to be true. I do not think there is any motive being impugned here. I just think the Conservatives are slightly offended by what they are hearing.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, I rise on the same point of order. I was eating my dinner in the lobby and was horrified to hear the member throw out these accusations of Islamophobia, which are very serious accusations against members, with no basis. I think that is unparliamentary. The member is providing no support because she is talking utter nonsense. If I were to casually say that a member is anti-Semitic, Islamophobic or anti-Christian, I think you would find that unparliamentary. I hope you will call that member to order.

[Mike Morrice, Green, Kitchener Centre, ON]

Mr. Speaker, on the same point of order, these are obviously not points of order. I think the member should continue her speech.

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

Mr. Speaker, on the same point of order, I completely agree with my colleague from Kitchener Centre. Let the member for Winnipeg Centre speak, and hopefully the Conservatives will not provoke any more interruptions.

[The Deputy Speaker, Conservative, Chris d'Entremont]

I will just remind everyone to be careful in what they say about one another and to make sure that we stay within the parliamentary rules of this institution.

The hon. member for Winnipeg Centre.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, I will give some examples. We are talking about facts, so I am going to give some examples.

This is from rabble.ca. It is entitled, “The inconvenient anti-choice record of 'pro-choice' Pierre Poilievre”. The Abortion Rights Coalition—

[The Deputy Speaker, Conservative, Chris d'Entremont]

Order. It is against the rules to use someone's name in the chamber. Just make sure we do not use the names of members, and let us not use props.

The hon. member for Winnipeg Centre.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, my apologies, but I am actually reading, and my understanding in the House is that we are allowed to read from notes.

The article states, “The Abortion Rights Coalition of Canada (ARCC) keeps a list of anti-choice members of Parliament and has always rated Pierre Poilievre as anti-choice and continues to do—

[The Deputy Speaker, Conservative, Chris d'Entremont]

Order. Let us all take a big, deep breath.

The hon. member for Winnipeg Centre, let us back that up one more time.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, the member for Carleton. I am so sorry. That is totally my fault, and I take responsibility. My apologies, but I am reading verbatim.

The article reads that the coalition has always rated the member as “anti-choice and continues to do so.” It continues to say, “he has consistently voted in favour of anti-choice private member bills and motions, with just one exception”.

Here are some examples: “There's just too many other reasons to doubt [the member for Carleton's] pro-choice claims”. “Like Erin O’Toole, [the member for Carleton] would allow private member bills against abortion to be introduced and would allow a free vote.”

On Bill C-311, which is likened to an anti-abortion bill, the entire Conservative Party, including the member for Carleton, voted in favour.

That is in this Parliament, so it is not surprising to me, when we are talking about an opportunity to lift up the rights of women and gender diverse people, to lift up equality, to support a person's right to choose and to have access to safe, trauma-informed abortion care, that the Conservatives are violently opposing this legislation. Why? It is because they do not care about reproductive rights. In fact, they have actively voted against reproductive rights.

The fact is that Conservatives are going against the pharmacare bill and are talking about insurance plans. There are a lot of people in this country who do not have insurance plans, which tells me how out of touch the Conservatives are with people who are struggling. These are the people who are struggling and who they talk about all the time. They are working, not for a living wage, and have no benefits and no pension plans. They not only have fought against this benefit, should they have diabetes or should they choose to not want to get pregnant, but also have actively fought against a living wage, often in marginalized jobs, often taken up by women in marginalized communities.

Do members want to talk about freedom? It is freedom only if it suits the Conservatives' narrow, and what has been likened by some, certainly in the media, extremist rhetoric. These are things like the member for Carleton endorsing Jordan Peterson, who is anti-trans, anti-choice and anti-women.

Therefore, it is not surprising that in a bill that focuses on specifically lifting up equality in Canada, the Conservatives are conveniently fighting against it in the name of so-called “choice”. By them denying individuals' access to contraception or to the morning after pill, they are denying freedom to make a choice over one's body. This includes banning medications from young people who are transitioning, young trans kids. We need to protect trans kids. We need to protect women's rights, and we need to protect the right to choose.

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, I, of course, come from the province of British Columbia, where contraceptives are already provided by the provincial government. To ensure equality for women, how much money would the Province of British Columbia receive from this NDP bill because we already have contraceptives? For equality's sake, what is the number B.C. would get?

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, I would also like to apologize for my misreading when I was reading the article. I do apologize. I was not trying to be cheeky, but I was reading directly from an article.

We know that certain provinces, provinces his colleague called “communist”, are providing free contraception care—

[The Deputy Speaker, Conservative, Chris d'Entremont]

There is a point of order from the hon. member for Mission—Matsqui—Fraser Canyon.

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, I would just like the record to state I never said “communist.” I only came into the debate—

[An hon. member]

No, you did not.

[The Deputy Speaker, Conservative, Chris d'Entremont]

We are getting into debate.

The hon. member for Winnipeg Centre has the floor.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, I certainly was not saying that he called provinces communist. I said that some of his colleagues have called them communist.

Certainly, provinces do not act alone in health care. The federal government works with provinces to provide services. We have pushed the federal government to ensure provinces have what they need to provide, as a starting point, free diabetes medication and also contraception.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Mr. Speaker, one issue seems fundamental to me in this context. The Government of Canada and the rest of Canada want pharmacare. That is fine for them, but it goes against the spirit of the Constitution.

I would be curious to hear my colleague's thoughts. Quebec already has a pharmacare system. Would she agree that Quebec should have the right to opt out with full compensation?

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, the federal government is responsible and obliged to uphold national standards. We know that Quebec is ahead of the game on a number of issues. I will give the hon. member a couple of examples. On child care, Quebec is decades ahead, as well as on social programs, certainly.

Absolutely, when we are talking about provinces, the federal government is obliged to provide provinces with what they need to be able to offer these services.

I would, however, give a caveat to New Brunswick. In New Brunswick, currently, women cannot access an abortion. There need to be guidelines, in terms of public health transfers, if provinces are not upholding what the Liberal government has called the human right to access safe, trauma-informed abortion care.

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Mr. Speaker, I have greatly appreciated the comments of my colleague from the NDP. It has been a very spirited debate here. We are talking about the provinces, the jurisdictions, and also about equality of care across the country. I think that is where the federal government comes in. That is where legislation like Bill C-64 comes in to ensure that there is equality of access to pharmacare, specifically in the areas of contraceptive care and diabetes.

I would like to hear my colleague's comments on that issue.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, that is exactly it. If one looks at access to reproductive rights, they vary throughout the country. We need to change that to ensure that if this country is actually doing what it says, which is protecting the reproductive rights of those people who can get pregnant, then they need to start doing that. That means access to safe, trauma-informed abortion care or access to contraception.

[Yasir Naqvi, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I am thankful for the opportunity to speak about Bill C-64 and about how this represents a historic milestone in the evolution of the Canadian health care system.

This bill and other investments made by our government will help millions of Canadians who are struggling to pay for their medication.

I was very thrilled when the Minister of Health, and many other incredible Canadians who have been advocating for a pharmacare program in Canada, joined in my community of Ottawa Centre, at the Centretown Community Health Centre, where, toward the end of February, we made the announcement on Bill C-64, on covering diabetes and contraception medication. One could see the excitement among people when that announcement was made in my community.

In fact, I have been working on this issue for over a decade now, during my time as a member of provincial Parliament in Ontario. I was part of a Liberal government that brought something that we called OHIP+. That “plus” covered medications for young people, and then, we were moving on to cover medications for seniors. It was really unfortunate that the Conservative government under Doug Ford cancelled that incredible program because it allowed for care for so many Ontarians.

However, I am thrilled that we are taking this important step here at the federal level.

In 2021, Statistics Canada found that one in five adults in Canada did not have the insurance they needed to cover their medication costs. This means that over 20% of adults in Canada face out-of-pocket drug costs that create a financial burden. This can lead to people sacrificing their basic needs, such as buying groceries or heating one's home, in order to afford their medications. It can also lead people to ration their medications, causing them worse health outcomes. This is not acceptable and I do not think that this is the kind of country any of us want to have.

Choices like whether to fill a prescription have serious consequences. Whether skipping meals or skipping doses, the decision to go without can create a cascade of negative impacts on a person's health and can increase the burden on our health and our social safety nets.

We can and we must do better. That is why we introduced Bill C‑64 and proposed this first step toward universal pharmacare.

Our commitment to address the accessibility and affordability of medication can be seen with the various initiatives we have implemented with respect to national pharmacare. In addition to the introduction of the pharmacare act, which includes a commitment to work with provinces and territories to ensure universal access to contraception and diabetes medications, we also established a partnership with P.E.I. to improve the affordability of prescription medications, implemented the first-ever national strategy for drugs for rare diseases and established a Canadian drug agency.

Let me start with the pharmacare act, which outlines a way forward toward national universal pharmacare in Canada. Bill C-64 recognizes the critical importance of working with the provinces and territories, which are responsible for the administration of health care. It also outlines our intent to work with these partners to provide universal, single-payer coverage for a number of contraception and diabetes medications.

This bill is an important step toward improving health equity, affordability and outcomes, and could help reduce health care system costs over the long term.

Coverage for contraceptives would mean that nine million Canadians of reproductive age would have better access to contraception, reducing the risk of unintended pregnancies and improving their ability to plan for the future. We are a government that has always and will always recognize that autonomy over one's body and the ability to control one's own sexual health is a matter of fundamental justice.

Contraception is a key component of individual autonomy. It is an essential component of reproductive health and contributes to advancing gender equality.

Cost has consistently been identified as the single most important barrier to accessing contraception and the cost is unevenly borne by women, people with low incomes and young people, all of whom are more likely to work in part-time or contract positions and often lack access to private coverage. Studies have demonstrated that publicly funded, no-cost universal access to contraception can lead to public cost savings. The University of British Columbia estimates that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. Having safe, reliable birth control represents freedom and safety. However, these costs continue to be a barrier. With Bill C-64, we are taking action to remove the barrier.

The same cost reduction principle applies to diabetes medication. Diabetes is a complex disease that can be treated and managed with safe, effective medication.

However, one in four Canadians with diabetes have reported not following their treatment plan due to cost. Improving access to diabetes medications will help improve the health of 3.7 million Canadians living with diabetes and reduce the risk of serious, life-changing health complications, such as blindness or amputations.

Beyond helping people with managing their diabetes and living healthier lives, if left untreated or poorly managed, diabetes can lead to high and unnecessary costs to the health care system due to diabetes and its complications, including heart attack, stroke and kidney failure. The full cost of diabetes to the health care system could exceed almost $40 billion by 2028.

Independent of the legislation, we have announced that we will work with provinces and territories on a diabetes devices fund. This fund would ensure that people with diabetes have access to the medical devices and supplies they need, such as syringes, test strips, glucose monitoring devices and insulin pumps. This, combined with the framework outlined in Bill C-64 for universal single-payer coverage for first-line diabetes medications, will help ensure that no person with diabetes in Canada is forced to ration their medication or compromise their treatment.

I previously mentioned our excellent work with P.E.I. and how this $35-million investment is focused on improving affordable access to prescription drugs while at the same time informing the advancement of a national universal pharmacare. The work accomplished by Prince Edward Island has been outstanding. Since last year, P.E.I. has expanded access to over 100 medications to treat a variety of conditions, including heart disease, pulmonary arterial hypertension, multiple sclerosis and cancer, and is saving millions of dollars in out-of-pocket costs for P.E.I. residents.

On a national level, we launched the first-ever national strategy for drugs for rare diseases in March 2023, with an investment of up to $1.5 billion over three years.

As part of the overall investment of $1.5 billion, we are making up to $1.4 billion available to the provinces and territories over three years through bilateral agreements.

This funding will help to improve access to new and emerging drugs for Canadians with rare diseases as well as support enhanced access to existing drugs, early diagnosis and screening for rare diseases. This will help ensure patients with rare diseases have access to treatment as early as possible for a better quality of life.

I want to quickly mention that, in December of last year, we announced the creation of the Canadian drug agency, which will provide the dedicated leadership and coordination needed to help make Canada's drug system more sustainable and better prepared for the future.

This is an incredible opportunity for Canadians coast to coast to coast, working alongside provinces and territories, to allow for pharmacare, especially when it comes to contraception and diabetes. This is the beginning of building a more robust health care system that will work for all Canadians. I am excited to support this bill, and I encourage all my colleagues to do the same.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

Mr. Speaker, I want to ask a question about incompetent Trudeau government overspending. Of course, it raises the ire of members on the other side sometimes when I talk about the Trudeau government of the 1970s and 1980s and the devastating cuts that resulted in the mid-1990s of 32% over two years from 1995 to 1997 for spending on health care, social services and education.

I am wondering if the hon. member shares the same concern about the incompetent Trudeau government overspending of the 1970s and 1980s and also of his own Liberal government as it relates to our ability to fund important social programs in the future.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Mr. Speaker, I would suggest to the member that it would be incompetent for any government not to invest in health care for Canadians.

I would ask the member, if he thinks that this is wasteful spending, if he would cut the spending. Would he not provide pharmacare for Canadians? What else would he cut? Would he cut the Canadian dental care plan, which is now helping millions of seniors, just starting a few days ago, and has the incredible potential of improving people's lives? Is he going to cut $10-a-day child care, which is helping so many families? I would suggest to the member that it would be incompetent for any government not to invest in the important needs of Canadians by making their lives more affordable.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Mr. Speaker, my question is simple. Does my colleague think that the pharmacare system they want to put in place will be ineffective if the government gives Quebec the right to opt out with full compensation?

What is that going to change given group purchasing is already happening? The group purchasing argument no longer holds water. There is no other argument.

Why not respect Quebec's will? The member does not live that far away. He must have some understanding of Quebeckers. I would like to have a nice honest answer to that.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Mr. Speaker, I will suggest to the member that this is an incredible opportunity for us, as a federal government, to work closely with provinces and territories. We have much to learn from Quebec. The member for Winnipeg Centre mentioned a few things earlier in her debate. Quebec has been a pioneer and a leader, whether it is pharmacare or child care. We have an opportunity to work with each other, to learn from each other and to replicate the models that work best for all Canadians.

Our federation works best when all orders of government, in this case, federal and provincial governments like that of Quebec, are working together to find solutions for all Canadians, whether they live in Quebec or elsewhere.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, I would like to ask my colleague about Canada's placement in the world regarding subsidized or free contraception. More than 25 countries worldwide, including the United Kingdom, New Zealand and Australia, have offered subsidized or free contraception since as far back as 1967.

I wonder if the member can respond by giving us his views on why it is so important for Canada to join other countries regarding this important legislation so that we can ensure better protection for women.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Mr. Speaker, I want to first thank the member for Nunavut, along with the member for Bruce—Grey—Owen Sound, for joining me on Sunday in support of Christie Lake Camp, which is a worthy organization in Ottawa, in my community, raising $20,000 to support kids from priority neighbourhoods. I must say the member for Nunavut is an excellent basketball player, so it was a great afternoon.

I agree with the member that we need to catch up with many countries that allow for free contraception. It is about the autonomy of women. It is making sure that women are able to make decisions about their own lives. By passing Bill C-64, we will take the very important step of making sure that Canada really values women and gives them the autonomy they deserve as equal citizens.

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, before I begin, I would just like to give a shout-out to the Abbotsford Rugby Football Club, which won the provincial championships over the weekend. The division 1 side has faced a lot of adversity. Our fields were flooded during the big flood in Abbotsford a few years ago. This team has really built back. Big congratulations go to Coach Chambers and all members of the squad on the game-winning kick by Mr. Rowell. Congratulations to all the boys for their accomplishments.

Now, I turn to Bill C-64, an act respecting pharmacare. As my colleague, the hon. member for Cumberland—Colchester, said in the House in April, the half-baked pharmacare plan being debated is truly about preserving the costly NDP-Liberal coalition.

In order to ensure that the coalition survives the next fixed election date, so many members can lock in their pensions, the NDP has agreed to a pharmacare plan that covers only two categories of drugs, while costing a billion and a half dollars and adding even more bureaucracy and gatekeepers to the already extremely bloated federal government.

There are 97.2% of Canadians who already qualify for some form of prescription drug coverage. It is important that we work to ensure that the 1.1 million Canadians without coverage can access pharmacare, but the proposed system would leave them woefully under-insured and no better off. In the context of British Columbia, we already have coverage for contraceptives through our provincial government.

What we have in front of us today is not a universal pharmacare system, as the NDP-Liberal government has been campaigning. It is a diabetes medication and contraceptive coverage system.

The member for Ottawa Centre just said in his speech that in 2028, diabetes alone will cost the medical system in Canada over $40 billion. Even the money put forward in this bill is only a drop in the bucket, and I wish the members of the NDP-Liberal government would come clean about misleading Canadians about what they are doing, because all of us have had constituents come to our offices and ask when the universal drug coverage will kick in. I am sorry to say that it will not; this is a PR exercise by this government, and it is shameful.

Canadians know how much a promise from the Prime Minister means, and it is not very much. This is the same Prime Minister who promised to balance the budget, or rather, that it would balance itself. This is the same Prime Minister who promised a $4.5-billion Canada mental health transfer that is yet to be delivered. This is the Prime Minister who promised British Columbians a universal day care system at $10 a day. Good luck trying to find that in our lifetime.

This is the same Prime Minister who promised that interest rates would stay low for a very long time, right before spending more money than any government in Canadian history and driving interest rates higher than they have been in decades. This is the same Prime Minister who has led to all of our GST payments, on every purchase we make in Canada, solely servicing the federal debt. Let that sink in. Every time we buy something, the taxes that we pay are only paying for the mistakes of the member for Papineau.

The only goal of this bill, as we all know, is to appease the NDP and avoid an election the government knows it would lose.

Speaking of the New Democrats, they really ought to be ashamed of themselves for even agreeing to this plan. For decades, they have campaigned on a single-payer pharmacare system, and now that they finally have a sliver of power in this Parliament, they fold and accept a half-baked plan that would cost taxpayers billions while failing to provide coverage for the vast majority of medications Canadians rely on, which the NDP promised to deliver. Shame on them.

The leader of the NDP loves to say that he will win the next election and often starts phrases with “when I am Prime Minister”. If he truly believed what he was saying, why does he continue to prop up that failed government, and why did he agree to this plan, which fails to cover the vast majority of drugs and treatments? If they are going to do it, they should go all in and take a risk. They are not willing to take a risk, because it is just about covering their own butts and getting their pensions.

The bill could have negative—

[The Deputy Speaker, Conservative, Chris d'Entremont]

The hon. member for Winnipeg Centre is rising on a point of order.

[Leah Gazan, NDP, Winnipeg Centre, MB]

I fully acknowledge that I said the leader's name, but I also know that we cannot say things like saving “butts”. That is my understanding, and I am just pointing that out. If he could take that out—

[The Deputy Speaker, Conservative, Chris d'Entremont]

We just need to be careful in the words we are using.

The hon. member for Mission—Matsqui—Fraser Canyon is rising on a point of order.

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, sometimes I find the members' words very violent, but I will—

[The Deputy Speaker, Conservative, Chris d'Entremont]

The hon. member for Sherwood Park—Fort Saskatchewan is rising on a point of order.

[Garnett Genuis, Conservative, Sherwood Park—Fort Saskatchewan, AB]

Mr. Speaker, the point of order from the hon. member seems quite prudish. I thought we heard earlier that we should be willing to more openly talk about certain things, but the member gets called out for saying the word “butt”, which I have never heard called unparliamentary before. I wonder whether there is a new standard of prudishness that the NDP is trying to set—

[The Deputy Speaker, Conservative, Chris d'Entremont]

I do not want this to descend completely into debate.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, on a point of order, the member of Parliament probably could have finished eating his taxpayer-paid supper before coming in here. However, I would appreciate—

[The Deputy Speaker, Conservative, Chris d'Entremont]

This has descended completely into debate. I am standing up and I have the microphone. I am done on this point of order. I will just give a reminder to be judicious in the words we are using.

The hon. member for Mission—Matsqui—Fraser Canyon.

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, I take that comment, and I take the comment from the member for Winnipeg Centre. I will say “to save their epidermis”. There we go.

The bill could have negative consequences for the 27 million Canadians who rely on private insurance. The non-profit insurance sector has serious concerns about its future should Canada pursue a single-payer pharmacare system. Providers like Blue Cross could be wiped out entirely. As usual, the government tabled the bill without consulting a single stakeholder in the private and not-for-profit insurance industry. Killing private and not-for-profit insurance would be devastating for millions of Canadians.

Across the country, private coverage is, on average, 51% more extensive than provincial public counterparts. When a new drug is approved by Health Canada, it takes an average of 226 days for private insurers, including Blue Cross, to approve its coverage. Public plans take an average of 732 days after Health Canada approval to add the drug to the list of covered treatments. Canadians with serious health conditions that require drugs and treatments that are only just going through the approval process in Canada cannot afford to wait another two-plus years after Health Canada approves them.

Today, more than six million Canadians are without a family doctor. A half-baked public pharmacare system would do nothing to change that and to address their needs. Rather than spending another $1.5 billion setting up a system that would not cover the vast majority of medications, the government should be focusing on ways to support provinces in the recruitment of new doctors and nurses.

That is why Conservatives have proposed a national blue seal program. This program would ensure that when a foreign-trained doctor or nurse arrives in Canada, they could quickly apply to have their credentials recognized and would be given an answer within 60 days as to whether they could practice in Canada. Once approved, they would be able to work in any province that signs on to the federal plan. Right now, a doctor licensed in Ontario cannot practice in Nova Scotia. A nurse licensed in B.C. cannot practice in Manitoba. It is time to change this anachronistic system.

In closing, the program would not be a universal pharmacare program, and it would not do anything to help the 1.1 million Canadians without access to pharmacare coverage nor the 6.5 million Canadians who cannot even see a doctor. It would be yet another expensive bloating of the federal government, adding more gatekeepers and more debt for Canadians to pay for while delivering next to nothing. I would add that, in a riding like mine with a large indigenous population, it would not be accessible to indigenous Canadians or rural areas either, because the amount of money is simply not enough to do even what the government says it is going to do.

After nine years, the only drugs the government has been able to deliver are hard drugs, like fentanyl, heroin and meth, which are flooding our streets and killing thousands every year. Conservatives will bring home the doctors and nurses our health care system so desperately needs. We will axe the tax. We are going to build the homes, fix the budget and stop the crime to lower the cost of living for all Canadians. That is what they want us focused on.

I encourage all members to support the amended motion put forward by the member for Cumberland—Colchester, dispose of the bill before us and start working to actually address the serious problems in health care across Canada.

[Lisa Hepfner, Liberal, Parliamentary Secretary to the Minister for Women and Gender Equality and Youth]

Mr. Speaker, I think I heard the member opposite say that the people in his riding do not want this pharmacare plan. They do not want their diabetes medication or pharmacare for reproductive health to be covered.

It sounds to me as though he is more concerned about the insurance companies and how well they are going to make out after the legislation goes through. Is that the case?

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, I believe Hansard will show that I did not say that my constituents do not want the legislation. However, what my constituents do want is access to drugs in a timely way. If we were to adopt universal drug coverage in Canada, it would lower the standard and accessibility of drugs for private insurance programs. This includes the program that all public servants are on right now; it would lower their ability to get the drugs they need to keep them healthy.

I do not know why the member for Hamilton Mountain is against public servants having access to the very drugs that keep them healthy.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Mr. Speaker, we are supposed to be studying a bill on pharmacare, yet we have addressed every issue under the sun since the evening began. We even debated abortion, in terms of who is for it or against it.

I keep asking the same question over and over, but I get no answer from the Conservatives. If it ever comes to power some day, will the Conservative Party support Quebec's right to opt out with full financial compensation when Ottawa creates programs in areas under Quebec's jurisdiction, yes or no?

Yes or no, do the Conservatives support the right to opt out with full financial compensation?

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, I thank my colleague from the Standing Committee on Industry and Technology for his question.

If a Conservative government is elected, I would like Quebec to keep its jurisdictions, just as I would like British Columbia to keep its jurisdictions. The Conservative Party wants open federalism that respects the jurisdictions of Quebec and British Columbia.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Mr. Speaker, I found one part of the member's speech particularly interesting, and that was the blue seal program. The way I understand it, if he explained it correctly, is that it is a federal program in an area that is currently provincial jurisdiction. Doctors who obtained this blue seal would be able to practise their craft in any province that signs up for this federal program. It sounds an awful lot like other federal programs in areas of provincial jurisdiction, where we have a federal program with federal funding and provinces can sign up for it.

Why is there this double standard when it comes to interfering in areas of provincial jurisdiction?

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, I would disagree with respect to the blue seal program being a double standard. In Canada, immigration is a shared jurisdiction. Right now, many of the doctors who come to Canada, through our federal points system, do not have access to the professions that allowed them to enter Canada in the first place.

The basis behind our plan is to make sure that, when we accept someone into Canada through our immigration system, we are actually doing what we said we were going to do, which is to allow them to contribute in the profession of their choice to make Canada a stronger and more vibrant nation.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Mr. Speaker, the member for Mission—Matsqui—Fraser Canyon began his speech by outlining how widely covered medical care is for both diabetes and the pill. They are already widely covered in that they cover so many voters.

Would the bill not be more aptly called “farm a vote”?

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, farm a vote; I agree. I would like to thank the member from the Ottawa Valley for her question. The bill is solely to ensure that the NDP and Liberal government can maintain their working relationship.

Unfortunately, the NDP members did not stand up for what they believe in and what they promised their voters in the last general election, which was universal pharmacare. They are selling themselves short with the legislation, because they are not afraid to face the electorate.

[Lisa Hepfner, Liberal, Parliamentary Secretary to the Minister for Women and Gender Equality and Youth]

Mr. Speaker, I really appreciate this opportunity and all opportunities to speak in the House on behalf of the residents of Hamilton Mountain, particularly with respect to this very important piece of legislation, which is necessary to help millions of Canadians who are struggling to pay for their prescription medications.

We have heard lots about access to and the affordability of prescription drugs in Canada. Statistics Canada data from 2021 indicates that one in five Canadians reported not having insurance to cover the cost of prescription medication in the previous 12 months. The same Statistics Canada data also found that a higher proportion of new Canadians reported not having prescription drug insurance coverage. Having no prescription insurance coverage was associated with higher out-of-pocket spending and higher non-adherence to prescriptions because of cost. This results in some Canadians' having to choose between paying for these medications and paying for other basic necessities such as food and housing. We likely all know someone who is struggling with this issue. Members may know someone, or maybe have heard stories about a person with diabetes who does not have insurance coverage through work and has to pay for their insulin, syringes and test strips out of pocket; a student who had insurance coverage up to a certain age through their parents and then lost that coverage; or a cancer patient who does have insurance but is still not covered under their plan for the type of medication they need to treat their cancer.

That is why we have introduced legislation based on the principles of accessibility, affordability, appropriateness and universality. These principles will help guide ongoing efforts to advance the implementation of national pharmacare. We need pharmacare that helps make prescription drugs more accessible. This includes improving the consistency of access to drug coverage and needed medications across the country. We also need pharmacare that helps make prescription drugs affordable. This includes reducing financial barriers for Canadians, such as deductibles and copays. Additionally, we need pharmacare that helps ensure that the prescription drugs that people are taking are appropriate. This includes getting the right drug to the right patient at the right time to support their physical and mental well-being. Finally, we need pharmacare that is universal. This means we need to work to ensure that the principles of accessibility, affordability, and the appropriate use of prescription drugs are applicable to all Canadians, regardless of where they live.

These pharmacare principles align with the work that is already being done on national pharmacare. This work includes our partnership with Prince Edward Island with respect to the improving affordable access to prescription drugs initiative, our implementation of the first-ever national strategy for drugs for rare diseases and the recent announcement of the creation of a Canadian drug agency. Going forward, these principles would be reflected in the upcoming bilateral agreements for universal coverage of contraception and diabetes medications.

Let me spend a moment to explain how those principles are already being put into action. On August 11, 2021, the Government of Canada announced it would work with the Government of P.E.I. to improve affordable access to prescription drugs and inform the advancement of national universal pharmacare by providing $35 million over four years to add new drugs to its list of covered drugs and lower out-of-pocket expenses for drugs covered under existing public plans for island residents.

As of December 2023, P.E.I. has expanded access to over 100 new medications to treat a variety of conditions, including heart disease, pulmonary arterial hypertension, multiple sclerosis, psoriasis and cancer. In addition, effective June 1, 2023, P.E.I. reduced copays to $5 for almost 60% of medications regularly used by island residents. I am pleased to share that, through this initiative, within the first three months, P.E.I. residents have saved over $2 million in out-of-pocket costs on more than 200,000 prescriptions.

As of July 1, 2023, P.E.I. also made adjustments to the catastrophic drug program, lowering the cap on the amount of money a household needs to spend out of pocket on eligible medications. As a result, no eligible P.E.I. household will have to spend more than 6.5% of their household income on eligible medications. Once that 6.5% cap has been reached, eligible medication costs for the remainder of the year will be paid by the program. As members can see, this collaboration is already creating more affordable access to needed medications for island residents.

On a national level, we have launched the first-ever national strategy for drugs for rare diseases in March 2023, with an investment of up to $1.5 billion over three years. Most of this investment will be going to provinces and territories through bilateral agreements to improve access to new and emerging drugs for Canadians with rare diseases, as well as support enhanced access to existing drugs, early diagnosis and screening for rare diseases.

Similarly, we are providing $33 million over three years to support first nations and Inuit patients with rare diseases, and $68 million is being invested in various initiatives to support collaborative governance, data infrastructure and research for drugs for rare diseases.

Through this, the government will help increase access to and affordability of effective drugs for rare diseases to improve the health of patients across Canada. These principles will be further demonstrated and reflected in the next step of national pharmacare outlined in this bill, which describes our intent to work with provinces and territories to provide universal, single-payer coverage for a number of contraception and diabetes medications.

In addition, and separately from the bill, we will also create a fund for diabetes devices and supplies. This fund will be rolled out to support access to diabetes devices such as continuous glucose monitors, insulin pumps, syringes and test strips. This new coverage, to be delivered by provinces and territories that enter into a bilateral agreement, provides an excellent opportunity to see the principles of affordability, accessibility, appropriateness and universality at work. Canadians, no matter where they live or how much they earn, will be able to receive the contraception and diabetes medications they need. In turn, Canadians will be healthier, empowered to make important life decisions and will not have to skip doses due to the cost of these two types of essential medications.

In closing, we will continue to work on national pharmacare initiatives that include the principles of accessibility, affordability, appropriateness and universality laid out in this bill, because Canadians need national pharmacare that embodies these principles. We look forward to working with all parliamentarians to pass the pharmacare act so that these principles will continue to guide our ongoing efforts to advance the implementation of national pharmacare.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Madam Speaker, my colleagues and I have been saying the same thing from day one: We are in favour of pharmacare for all Canadians. We think it is a good idea and it is high time for Canada to consider it. However, we have said and keep saying that this is a provincial jurisdiction.

If the other provinces want to have a federal program, then they can fill their boots. We know that the Constitution says that this is a jurisdiction of Quebec. Quebec already has its system. Why not leave us with our system? Let the government give us our share. We will keep making group purchases and everything will be fantastic in the best of all possible worlds.

Where is the problem?

[Lisa Hepfner, Liberal, Hamilton Mountain, ON]

Madam Speaker, I agree with the fact that everything we do as a federal government has to be done in collaboration with the provinces and territories. We must communicate with Quebec, we must learn from Quebec and will continue to collaborate. It is not something we are going to do alone. We cannot. The provinces cannot do it alone either. We need to work together.

I thank the Bloc for everything they contribute to the House.

[Frank Caputo, Conservative, Kamloops—Thompson—Cariboo, BC]

Madam Speaker, it is always a pleasure to rise on behalf of the people of Kamloops—Thompson—Cariboo.

Before I begin, I would like to recognize two very wonderful young men from my riding, both of whom received the Chief Scout's Award, one being Shawn Hodgkiss, who managed to collect over 1,000 pounds of food for the food bank, and another named Jared Roberts, who volunteered with The Loop and Our Street Church. I congratulate them. They are now in Hansard to reflect their incredible achievement.

At the end of the day, the Liberals have spoken so much about doing so many things, yet they have executed everything so poorly. We have had deficit after deficit. We could not even get a passport. The dental program has been a disaster as so few dentists have signed up in the Maritimes, for instance.

How can we have any confidence that the government will get this right?

[Lisa Hepfner, Liberal, Hamilton Mountain, ON]

Madam Speaker, I congratulate the member opposite for getting his constituents' names into Hansard today. That was well done.

I note that one of the constituents he mentioned is involved in a food program. I would remind the member that one of the things the government has accomplished and that, hopefully, everyone will support is a national school food program, because we absolutely agree that we need to make sure children are well fed in school so they can learn and have good lives.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Madam Speaker, it is a pleasure to work with my hon. colleague across the way at the Standing Committee on the Status of Women. There are other folks on the committee and I really enjoy working with all of them, even across party lines, believe it or not.

The Conservatives are talking about voting against free contraception in this plan. There is no question that they are anti-choice. All the members have been listed as anti-choice, but they also voted against the school food program and pushed against the national child care program. The Conservative Party does not seem to be supportive of equity in this country.

Supporting this bill is so important. I am wondering if they are really serious about advancing the rights of women, or if maybe they just want women and gender-diverse people to stay in the dark ages.

[Lisa Hepfner, Liberal, Hamilton Mountain, ON]

Madam Speaker, I appreciate my NDP colleague's work on the status of women committee. She is a true champion for women.

I have appreciated in the debate this evening how she keeps bringing up the word “abortion”, because in this country, we have to worry about the rights of women in terms of their bodies, their right to choose, being taken away. We constantly see legislation proposed by the Conservatives that would restrict a woman's right to choose.

I stand with the member for Winnipeg Centre across the aisle on the right of women to choose for their own bodies.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Madam Speaker, Bill C-64 is a classic example of the legislation the Liberal government has brought before this Parliament. Once again, it has over-promised and under-delivered.

When the leader of the NDP sold his party's soul and coincidentally guaranteed that he would receive a pension for his efforts, many people thought he got too little for it. New Democrats did not even get 30 pieces of silver, as they betrayed their ideal and the Canadian people.

What has this betrayal cost Canadians? Inflation continues at record levels, fuelled by the carbon tax. Housing costs have doubled. Health care has vanished. Food bank use is at record levels. The immigration system is broken. Our military suffers from neglect, and foreign governments try to influence our elections. The Liberal response is to shrug. Canada has become a joke on the world stage.

What does the NDP receive for this blind support of the Prime Minister and his disastrous policies? It receives a promise to look at what it would take to establish a national pharmacare program. It is not even that, really.

Canadians thought a pharmacare plan would cover their drug costs. For the majority of the country, this was not a pressing issue. According to The Conference Board of Canada, 97% of Canadians are already eligible for some form of drug coverage, although the final report of the advisory council on the implementation of national pharmacare indicated that 20% of Canadians receive what could be termed inadequate coverage. In December of last year, a Leger poll indicated that only 18% of Canadians thought the establishment of a national pharmacare program was a health care priority.

It may come as a surprise to the Liberals and the NDP, but Canadians are worried about rising prices on everything, due in large part to the carbon tax. When people are worried about being able to feed their family, pay the rent or mortgage and put gas in their car so they can get to work, they do not spend much time thinking about a drug plan that does not cover the medications they need.

Canadians were hoping the Liberals could get it right. That turns out to have been a false hope. On this issue, as on many others, the Liberals are proving once again to have no idea what they are doing. The Liberal idea of pharmacare is restricted to just two types of medication. If one suffers from heart disease, one is out of luck. Heart disease is the second-leading cause of death in Canada, but medication for it would not be covered.

The Liberals' approach to pharmacare reminds me of their approach to Canadian liquid natural gas, or LNG. When the chancellor of Germany came to Canada looking to buy Canadian LNG, the Prime Minister told him there was no business case for such exports. That was a huge surprise to those companies looking to expand their markets.

Not only is there a business case for Canadian LNG, but there is a moral one as well. In the aftermath of the Russian invasion of Ukraine, countries are looking to replace Russian LNG and have turned to Canada, only to be told by the Canadian government that it does not want to sell Canadian LNG. The Prime Minister needs to learn that when there is a customer willing to buy the product, there is indeed a business case to support it. If Germany and Japan and Greece want to buy Canadian LNG, why would we not want to sell it to them?

A previous prime minister asked farmers, “Why should I sell your wheat?” This tells buyers there is not a business case to sell them the product they are asking for, while at the same time offering Canadians a pharmacare program they did not ask for, a plan so flawed it is unlikely to work.

This is the government that promised a firearms buyback program four years ago. So far, it has not managed to launch it, yet it wants Canadians to believe it has the skills necessary to design and implement a pharmacare program. Put simply, what is being offered is not pharmacare.

It is just another Liberal election gimmick, a promise they will campaign on in 2025, hoping that voters will not look at how many promises they have already broken. Anyone who has looked at the current state of drug coverage in Canada is concerned by this attempt to create additional bureaucracy. We already have some public drug plans; they do not seem to be as good as the private ones. Private drug insurance plans cover many more different medications than public plans do. The difference varies by province, but, on average, private coverage is 51% more extensive than its public counterpart is. In Quebec, the figure is 59.6%. Then there are the delays. Once a drug is approved by Health Canada, it takes an average of 226 days for a private insurer to approve the coverage. By contrast, it takes 732 days for approval by Health Canada, or a little over three times as long, for a public plan to add a drug to its list of covered treatments. These figures do not paint a rosy picture of the ability of public insurance to meet the Canadians' needs.

The marriage contract between the Liberals and the NDP required that the bill come before us last year. It did not. It took the Liberals two years to come up with the legislation, a bill that seems to have been put together without much thought, just to meet a deadline. Given how weak the bill is, I can only imagine what the first draft looked like. Maybe it was just one line, such as “We promise to look at establishing a pharmacare program in the hopes people will vote for us before we have to deliver.” Wait, is that not what Bill C-64 is?

After almost nine years of misgovernment, incompetence and mismanagement from the Liberal-NDP coalition, Canadians have lost all faith in the government's ability to discharge its responsibilities. What is the cost of this national pharmacare program? With two years to look into it, the Liberals either did not think to ask or are afraid to tell Canadians just how much more they want to raise taxes to pay for a plan that would benefit almost no one.

The bill is a public relations exercise by an utterly desperate government that is disliked by more and more Canadians every day. The inability of the Liberals to deliver on their promises is well known. Already, two provinces have opted out of this program. There is no indication that other provinces are interested. One would have thought that, in attempting to create a national program in an area of provincial jurisdiction, the Liberals would have consulted with the provinces. One might have expected that they would have hearings and consultations with stakeholders to see what exists now, what needs to be improved and the best way to do that. As far as I can tell, all they did was ask the NDP the minimum they could promise to keep the NDP's support.

Can the Minister of Health tell us what impact the bill will have on the 27 million Canadians who rely on privately administered workplace plans? If he is an honest man, he cannot, because he does not know. There was no consultation with the insurance industries when the bill was being drafted. Maybe he felt there was no need to check the facts. A promise had been made by the NDP, and the Liberals had to deliver. The needs and wishes for the Canadian people were not worthy of consideration. What is not worthy of consideration is this sad attempt at legislation; Canadians deserve much better than that.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, I have heard a number of Conservatives say the same thing today. They keep saying that only one out of five Canadians wants the legislation; only one out of five Canadians wants pharmacare.

If one out of five Canadians is not good enough for Conservatives—

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Madam Speaker, I want to call to the attention of the House that I do not think we have quorum.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

We are on autopilot. We do not need quorum.

[Arnold Viersen, Conservative, Peace River—Westlock, AB]

Madam Speaker, debate on second reading of Bill C-64 took place tonight without quorum, which means that Bill C-64 will have been considered without the constitutional requirement of quorum. In the event that Bill C-64 receives royal assent, I trust that the fact—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Before the member goes any further with his point of order, I will remind him that, on February 28, 2024, the House duly adopted an order prescribing that the Chair not receive any quorum calls after 6.30 p.m. today. Back in May 2022, the Speaker delivered a ruling as to the admissibility of the same provision from a similar motion, including the section dealing with quorum calls during extended seatings of the House. That ruling can be found in the debates of May 2, 2022, at pages 4577 and 4578. I would invite the member to read the ruling of the Speaker to find that this matter has already been settled.

It being 9.49 p.m., pursuant to an order made earlier today, it is my duty to interrupt the proceedings and put forthwith every question necessary to dispose of the second reading stage of the bill now before the House.

The question is on the amendment.

If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, I would request a recorded division.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Pursuant to Standing Order 45, the division stands deferred until Tuesday, May 7, at the expiry of time provided for Oral Questions.

The hon. deputy House leader is rising.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, I understand that you have received proper notice from all recognized parties, and if you seek it, you will find unanimous consent to see the clock at midnight.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

I have received notice from all the recognized parties that they are in agreement with this request.

Is it agreed?

[members]

Agreed.

The House resumed from May 6 consideration of the motion that Bill C-64, An Act respecting pharmacare, be read the second time and referred to a committee, and of the amendment.

Pharmacare Act

[The Speaker, Liberal, Greg Fergus]

It being 3:17 p.m., the House will now proceed to the taking of the deferred recorded division on the amendment of the hon. member for Cumberland—Colchester to the motion for second reading of Bill C‑64.

Call in the members.

(The House divided on the amendment, which was negatived on the following division:)

Vote #752

[The Speaker, Liberal, Greg Fergus]

I declare the amendment defeated.

The next question is on the main motion.

If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

I request a recorded vote, please.

(The House divided on the motion, which was agreed to on the following division:)

Vote #753

[The Speaker, Liberal, Greg Fergus]

I declare the motion carried.

(Bill read the second time and referred to a committee)

The hon. member for Joliette is rising on a point of order.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Mr. Speaker, I ask for the consent of the House to have my vote on the amendment be counted as a yes.

[The Speaker, Liberal, Greg Fergus]

Is it agreed?

[members]

Agreed.

[The Speaker, Liberal, Greg Fergus]

I wish to inform the House that because of the deferred recorded divisions, Government Orders will be extended by 24 minutes.