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

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, we are talking about Bill C-64. I think the provincial government has jurisdiction over health care and the federal government should butt out.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, after the NDP House leader, let us get this back on track and talk about the pharmacare bill, Bill C-64. I am pretty happy to take to my feet. I did have the opportunity to sit in committee for five hours a couple days ago and listen to some of the witnesses and some of the comments and concerns around the pharmacare bill, Bill C-64. I want to put some of my concerns on the record. I see the former health minister and I am looking forward to hearing him talk about it, if he is going to get to his feet.

A year ago, I asked the former health minister how many provincial health ministers at an FPT meeting had asked to bring forward a pharmacare bill. Was it on the top of their priority list? At that time, the minister did not have an answer for me. In committee, a couple of days ago, I had the opportunity to ask the current health minister that exact same question. I do believe that health is a provincial jurisdiction.

My question was whether they were able to name any health ministers who proactively came to the federal government to ask for this bill to be brought forward or whether there were other requests.

I know, in Saskatchewan, that we have a shortage of nurses. We have a shortage of doctors. There are a lot of issues, and I think many provinces do have concerns around doctor and nurse shortages. I think we are short 30,000 doctors right now in Canada. That is a pretty big deal. I think around seven million Canadians do not have access to a family physician.

I think that is something that health ministers probably brought forward at the FPT meetings. I believe that is something that we do need to look at: how we can support our provincial partners and have that conversation.

Once again, the current health minister did not answer my question about whether this was a priority at FPT meetings. Tonight, I was able to ask that question again to the member from Winnipeg North. I asked if he could name a health minister who brought this pharmacare bill forward as a priority for the provinces. I have never seen him play hockey but he was pretty good at skating around that question. He went full circle, but he never really came to the crux of my question as to whether a health minister had asked for this.

This is not partisan rhetoric. This is a legitimate question around public policy and the priorities of provincial governments. I heard from my colleague from Victoria. She talked about a child who needed diabetes care. I listened to her speech and when I asked her if she could tell me the age of full coverage in Saskatchewan, she could not. That is a very real concern of mine, the fact that they are bringing forward this legislation and that people voting for this bill do not know what the different coverages are out there in different provinces.

That is a legitimate problem. We should know where the coverages are across the provinces. In my home province of Saskatchewan, I have been texting with our health minister, I asked him if this was one of the things he brought forward and he said no, that they just came to them and said they were going to do this, take it or leave it. Then they asked for details. The minister said that they never gave them any details because they did not have any yet. It is surprising for a provincial health minister to not have any details on a pharmacare bill. A pamphlet, in my opinion, is not a bill, as it is four pages long. It covers diabetes and contraceptives, but there is little detail given to our provincial partners and that is a legitimate concern that we have to discuss.

They rammed this through. They bring in time allocation and then they just expect everything to be okay. We all know that this is just what the NDP asked for to keep the government in power for a little bit more time. This is part of the supply and confidence deal. They continue to tell falsehoods to Canadians. It is not coverage; two things are being covered.

For NDP members to bring up Tommy Douglas in the House is laughable. He would be embarrassed by the NDP and the situation it is in right now. He would probably be a Conservative right now. He would be completely embarrassed by what the NDP, the rump of the NDP, has become: a bunch of activists. I think it is very funny whenever they bring forward the name of Tommy Douglas, because he probably rolls over in his grave when that happens.

Being from Saskatchewan, I also had a time to be in government, with the Saskatchewan Party and former premier Wall, which takes me to another point. The NDP-Liberal government continues to bring in bills and then it says it is going to do consultation. I think that is a little bit backward. I remember being in Saskatchewan, and I was a member of the all-party traffic safety committee. We travelled around Saskatchewan for a couple weeks, in all corners, and took feedback from all of the stakeholders.

We consulted. We gathered feedback. Then we made legislation. Is that not a novel idea? Talk to people, ask what is going on, ask what works and what does not work, and then put forward legislation, instead of bringing forward legislation and then asking if it can work. Sometimes, I just find that some of the things the government does are quite backwards. The same thing happened with nuclear consultations. We started nuclear consultations in Saskatchewan in the first term of 2007 and continued to talk to people and consult before we even got to the point of even the discussion of small nuclear reactors. That was how long we actually consulted with the people of Saskatchewan. Can members imagine having that approach here in this House, to continue to talk to people, instead of ramming things through based on political ideology and what people think they need to stay in power?

Getting back to my point about diabetes, I have a cousin who plays for Regina Thunder. He was diagnosed with type 1 diabetes when he was two. That is why I am such a champion of diabetes care. His mother and father had to wake him up at night and prick his finger when he was a baby and when he was two or three years old. Then he would get insulin pills. Now he has tracking on his arm. He has a pump that is covered by the province of Saskatchewan. That is progress. That is how to listen to people and get things done. I think that is what we should take forward.

The NDP have talked about compassion. Where is their compassion for the 27 million Canadians who have insurance, but who are scared right now that they are going to have less coverage? I know 1.1 million Canadians are under-insured. We can take care of them.

Just imagine if one of the health ministers of the NDP-Liberal government went to a provincial-territorial meeting and asked how to get people insured under their provincial programs. What is the need out there? The Liberal government of the day wants to take credit for everything. There did not have to be a national program. Imagine if it had worked with its provincial partners and then supplemented their programs? Maybe the provinces would have needed extra money. I guarantee that it would not have cost $1 billion or $2 billion. This program is going to cost $2 billion.

There are several public policy reasons why this bill should not go forward in the form it is in. We should continue to work with our provincial partners. I would love for one of these ministers of health to answer how many provincial health ministers asked for this program to come forward. The same could be said for the dental plan.

Today is a pretty special day in my life. On May 30, 1944, my father, Ron Steinley, was born. I am not able to be home with him, but I want to wish him a very happy 80th birthday. He is in Swift Current, Saskatchewan. I am going to try and rip out there, maybe this week or next week, so we can take him out for supper. Happy birthday to my dad and all the best.

The House resumed consideration of Bill C-64, An Act respecting pharmacare, as reported (with amendments) from the committee, and of the motions in Group No. 1.

Motions in Amendment

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

Mr. Speaker, I always like listening to my colleague.

It seems to me that Bloc Québécois MPs should at least listen to Quebeckers. There are at least two million of them united in the largest coalition in Quebec. They are specifically asking that Bill C‑64 be passed by the federal government. They are very critical of the current pharmacare situation in Quebec. They talk about co-payments. They talk about all the problems that exist in Quebec. All the community and union organizations are asking the federal government not to give in to the provinces and territories that are asking for an unconditional right to opt out with full financial compensation. They are saying that because they want Bill C‑64 to pass.

Why is the Bloc Québécois not listening to Quebeckers?

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Mr. Speaker, we are here to debate Bill C-64 at third reading. It will come as no surprise to anyone when I say that the Bloc Québécois will be voting against this bill. I am the last person from the Bloc Québécois who will be rising today to speak to this bill on pharmacare. We will soon be voting on it and we will see whether it passes.

What we have been saying repeatedly in the House is simple. What the Bloc Québécois wants is for the federal government to stop interfering in provincial jurisdictions. We want the money to be transferred to Quebec with no strings attached and we want full financial compensation. We want health transfers. That is what we want, and that is what we will continue to hammer home. I feel like I have to keep repeating myself in the House and that is not right. All the Bloc Québécois wants is to defend Quebeckers' rights and to simply get the money we send to the federal level back so that we can improve the pharmacare program that we already have in Quebec.

When this bill was being studied in committee, the Bloc Québécois proposed an important amendment. It read as follows:

(4) Despite subsections (1) and (2), a province or territory may elect not to participate in national universal pharmacare, in which case that province or territory remains unconditionally entitled to receive payments in order to maintain the accessibility and affordability of the prescription drugs and related products already covered by its public pharmacare.

I do not think this amendment was unreasonable. Its purpose was simply to uphold respect for jurisdictions. The committee chair rejected the amendment on the grounds that it was out of order. The reason will come as a surprise to many. The chair ruled that our amendment was out of order because, in his opinion, it would have required royal recommendation, which we obviously challenged. In committee, however, we can challenge a decision, but unfortunately, we cannot debate it. The committee therefore voted to uphold the chair's ruling.

I was rather shocked that the committee ruled our amendment inadmissible. The purpose of the amendment was simply to ensure that jurisdictions are respected and that Quebec be given the money that has already been budgeted and set out in the bill. Quebec is simply asking that its share be set aside and that the money be transferred to Quebec so that it can improve the system that already exists in Quebec. It is unbelievable that that was rejected. It makes no sense.

I think the opposite is what should require a royal recommendation. Anything that goes against the Canadian Constitution should require a royal recommendation. That is not the case here. Unfortunately, this bill goes against the very foundations of the Canadian Constitution. Let me explain.

It is rather ironic that it still takes a member of the separatist party to remind the House how the Canadian Constitution works, when the government never misses an opportunity to point out that the Constitution is untouchable and that all the issues related to it are not important to Canadians and Quebeckers or that Quebeckers do not care about jurisdictions. However, as surely as I stand in the House today, based on the polls we are seeing, I can say that Quebeckers want jurisdictions to be respected. Whenever Quebeckers are asked who they would prefer to manage services like education or health care, the vast majority of the time, the answer is the same: Quebec.

It is all the more ironic given that the Constitution I am talking about is the one that was imposed in secret by the father of the current Prime Minister, during the night of the long knives in 1982. That was a little refresher. Since then, the Liberal Party's tendency has grown stronger. Increasingly, English-speaking Canada wants Ottawa to be its real government, the one that manages the bulk of public services. Conversely, Quebec has made a different choice. Quebec wants to manage its own jurisdictions, its own health care system, its own education system, its own day cares and so on. That is the choice that Quebeckers are making and that is the clear choice that the Quebec National Assembly made when its members unanimously reiterated that jurisdictions must be respected.

Of course, pharmacare has a noble objective, that of giving every individual, every person who needs medical services or prescription drugs the ability to get those drugs for little or no cost. It is so noble that Quebec has already done it. Quebec already has its own pharmacare program. Taking care of people affected by the difficult economic conditions we are experiencing is very noble. The problem is that these measures are ill-suited to the different realities of Quebec and Canada's provinces.

Even with all the good faith in the world, this was inevitable. Health and housing are not federal matters. The House of Commons has no business getting involved in those areas. That is because Quebeckers believe that their real government is in Quebec City. As long as that is the case, the concept of fiscal imbalance will exist. My colleague from Mirabel is very familiar with the concept of fiscal imbalance. We will not stop talking about it in the House. By fiscal imbalance, I mean the fact that the provinces have insufficient financial resources in relation to their own powers, while the federal government normally has surpluses. It is hard to understand why it has these deficits given all the money it collects. Yes, it has services it is supposed to deliver, but they are not exactly high-quality services.

The responsibilities that fall under federal or provincial jurisdictions must be respected. More simply, as Bernard Landry used to say, “the needs are in the provinces but the means are in Ottawa”. Even if the federal government tries hard to deny its existence, the fiscal imbalance is a major problem that has been recognized for many years. As the population ages, the cost of Quebec's social programs is rising rapidly. The cost of pharmacare is obviously rising rapidly. It is up to the Quebec government, and the Quebec government alone, to determine where the funds for these programs should go and how to improve the pharmacare program that already exists.

Since Quebec is chronically underfunded, we might wonder, as we often do, if a Quebecker is worth less than a Canadian. The Government of Quebec is shouting itself hoarse asking for health transfers. What does the federal government have to say in response? It responds with even more intrusions into Quebec's jurisdiction. That is what we are seeing again today with pharmacare. Unfortunately, the reason Quebeckers prefer to have pharmacare and every area of Quebec's jurisdiction run by Quebec City, is that everything the federal government touches results in failure. Federal equals failure.

I have talked about ArriveCAN several times in the House. I have a question: How much does Tylenol cost when it is 7,500% higher than its cost, like the ArriveCAN app was? It is going to be expensive. That is what is happening with pharmacare. The pharmacare that the federal government is going to create is going to cost us a lot more because the only thing the federal government does is mismanage its programs, run them completely inefficiently, like it did with ArriveCAN.

Quebec's system may be imperfect, but it does not need interference or duplication of costs. It needs more money. That money is in the hands of the federal government. It is a mixed system, a system that works well between a “forgiver” and company contributions and individual payroll contributions. It is not perfect, but it works. It is based on an existing model in France. The federal government is modelling its plan after it. However, instead of simply saying that Quebec has the expertise and skills to run its own pharmacare, the federal government wants to duplicate it and make it less efficient. It is crazy and that is why the Bloc Québécois is against this type of bill and the pharmacare program proposed by the federal government.

I keep hearing my NDP colleagues remind us that the major unions, including the Fédération des travailleurs et travailleuses du Québec, have come out in favour of moving forward with pharmacare. Of course, they had their reasons, as I will explain today. The reason is noble, the objective is noble. Improving medical coverage and offering pharmacare to people with diabetes or people who use contraception is noble, but it is not a federal jurisdiction. It is up to Quebec to decide how to do that. It would cost Quebec less to improve its own pharmacare program than to have it managed by the federal government. A ton of evidence shows that the federal government has no idea how to manage its own programs. Does anyone need to be reminded about passports or ArriveCAN? No, I will not go there. It is too late, and if the truth be told, I am a little too tired for that.

In conclusion, once we recognize, first of all, the fiscal imbalance problem, which will continue for as long as Canada is governed by the current Canadian Constitution, and secondly, the need to take steps to help our fellow citizens, the House will have to ask itself some hard questions. When the federal system was set up, important needs came under federal jurisdiction, like participating in imperialist wars. Today, the real needs are in the provinces.

Let us be honest. Instead of voting on pharmacare tonight, why not vote to reopen the Canadian Constitution and finally put an end to this farce of separate jurisdictions?

Let us ask Quebeckers to vote again, put an end to jurisdictions, and declare Quebec's independence.

[Joanne Thompson, Liberal, St. John's East, NL]

Mr. Speaker, I am rising in the House today to speak to what our government is doing, and plans to do, to help millions of Canadians who are struggling to pay for their prescription drugs.

Statistics Canada has indicated that one in five Canadians reported not having insurance to cover the cost of prescription medications in the previous 12 months. We have heard, time and time again, that Canadians who do not have drug insurance coverage struggle to afford medications and are left to make extremely difficult decisions to choose between paying for these medications or other basic necessities of life, such as food and housing.

No Canadian should have to make this type of a decision. This is why we introduced Bill C-64, the pharmacare bill, and continue to work with all parliamentarians and colleagues to ensure its speedy adoption.

This bill is needed for so many reasons. It proposes the foundational principles for the first phase of national pharmacare in Canada. These principles of access, affordability and appropriate use and universality have guided, and will continue to guide, our government's efforts in moving towards national, universal pharmacare.

We have seen these principles reflected in the work that is already under way, including launching the national strategy for drugs for rare diseases and improving affordable access to prescription drugs, which is the initiative with Prince Edward Island. I would like to take a moment to highlight the impact that both of these initiatives would have on national pharmacare.

In March last year, the Government of Canada launched the first-ever national strategy for drugs for rare diseases with an investment of up to $1.5 billion over three years. As part of the overall $1.5 billion investment, the federal government will make available up to $1.4 billion over three years to provinces and territories through bilateral agreements.

This funding would help provinces and territories 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 would help ensure patients with rare diseases, including children, would have access to treatments as early as possible for a better quality of life.

With respect to Prince Edward Island, the Government of Canada established an agreement with P.E.I., in August 2021, to improve the affordable access to prescription drugs and inform the advancement of national universal pharmacare. The $35-million investment has allowed for P.E.I. to add new drugs to its provincial formulary and lower out-of-pocket costs for drugs covered under existing public plans for island residents.

As of March of this year, P.E.I. has expanded access to over 100 new medications to treat a variety of conditions, including heart disease, pulmonary artery 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 nine months alone, P.E.I. residents have saved over $2.8 million in out-of-pocket costs on more than 300,000 prescriptions.

These two initiatives highlight how the principles of access, affordability, appropriate use and universality are reflected in our government's work, but they also underscore the importance of working with provinces and territories. Provinces and territories are, and will continue to be, a key partner in ensuring that Canadians get the health care they need. Our government will continue to work with provinces and territories to help ensure that this goal is met.

Finally, I would like to highlight another key component of Bill C-64, and that is the Government of Canada's intent to work with provinces and territories to provide universal, single-payer coverage for a number of contraceptives, as well as diabetes medications and supports. Similar to other initiatives that we have put in place, our work to provide contraception and diabetes medications would be guided by the principles I mentioned earlier and will involve working closely with our provincial and territorial partners. The importance of this provision within the bill cannot be understated.

We have likely heard over the past few weeks, since the introduction of Bill C-64, Canadians sharing their stories of how this bill would help them, how they are currently suffering from diabetes and do not have the insurance coverage, so they have to pay for their insulin, syringes and test strips out of pocket. Similarly, we are hearing stories of young women who do not have the drug coverage needed to pay for contraception or are limited in the choice available to them because more effective contraception is financially out of reach.

We have been receiving, and I certainly have received, numerous letters from Canadians across the country expressing their full support for Bill C-64 and asking the same question of when these drugs would be available to them. There is definitely a need for both of these sets of essential drugs, and I applaud the work of my parliamentary colleagues in getting the bill one step closer to a reality for Canadians.

Bill C-64 would allow for nine million Canadians of reproductive age to have better access to contraception and reproductive autonomy. This will help reduce the risk of unintended pregnancies and improve an individual's ability to plan for the future. As I mentioned, cost is the single most important barrier to access to these medications. Bill C-64 would ensure that Canadians will have access to a comprehensive suite of contraceptive drugs and the devices that they need. Similarly, we know that there is no cure for diabetes, but it can be treated with safe and effective medications.

Due to cost, 25% of Canadians with diabetes have reported not following their treatment plan. Improving access to diabetes medication, as outlined in Bill C-64, will help improve the health of almost four million Canadians living with diabetes and reduce the risk of serious life-changing health complications, which can include amputations or blindness. That is what Bill C-64 would do. It would give Canadians access to medications to maintain their health and give them a choice to determine which medication is best for them. In addition, these efforts will help avoid additional costs to the health care system.

In closing, our government will continue to work toward a national pharmacare plan that focuses on the principles of accessibility, affordability, appropriate use and universality. We will do so in partnership with provinces and territories, and we will do so knowing that Canadians need this immediately to help them access the drugs they need to live a healthy life.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Speaker, I am proud to stand on behalf of the people of Edmonton Manning tonight.

When a bill is brought before Committee, I expect that during the study done there that committee members would be able to make amendments that would improve the legislation. Sadly, that has not happened with Bill C-64, the pharmacare act, which is probably because the legislation is so flawed that nothing can fix it. The only proper fix is to bury it.

I wish that tonight we were debating the merits of a proposed national pharmacare program. Many Canadians would like to see such a thing, although they might not be so enthusiastic once they saw the price tag. The only resemblance the bill before us has to pharmacare is in the name. If we had asked Canadians what they expected to receive from the NDP-Liberal coalition besides ever-increasing taxes, high inflation, sky-high crime rates and housing shortages, they would probably have said, “Well, at least they have promised pharmacare.”

If we had asked what that meant, they would have said, “free prescription drugs for everyone: drugs to treat heart disease or cancer, life-saving drugs and maybe penicillin to treat any number of less serious illnesses”. Instead, what the government is offering is a pledge to consider funding contraceptives and diabetes drugs. It is not a pharmacare plan; it is an empty promise. It is not what anyone was expecting, but it is no surprise. It is not as if the Liberals really want a national pharmacare program. If they did, they would not have needed the NDP to push them into creating the bill before us.

The Liberals' plan is empty and it is pretty simple. They want to delay as much as possible to convince the NDP that a plan is coming and that therefore the incompetent government must be propped up. I have to give the Liberals credit for their political skill in this matter. They have the NDP so completely fooled that the government faces no chance of defeat no matter the scandals and no matter how much Liberal polices are hurting Canadians. The NDP is blindly accepting a Liberal promise, apparently unwilling to admit that they have been fooled.

I think it is safe to predict that when Canadians go to the polls, whether it is in October 2025 or earlier, the NDP will not be able to point to a functioning pharmacare program, not even the limited one that the bill calls for. However, the promise will have accomplished its purpose: keeping an undeserving government in power. It is the Canadian electorate that will hold both the NDP and the Liberals accountable for their actions. It is the Canadian people who will elect a Conservative government that actually cares about serving them and does not just care about political power.

The bill is being shoved through in haste by a government that is so desperate for approval. The Minister of Health is assuring Canadians that the pharmacare plan should not jeopardize the drug coverage that millions of Canadians have through private insurers. I am sure he is well-intentioned when he makes that statement; he may even believe his words, but good intentions are not reality.

The CEO of the Canadian Life and Health Insurance Association says that the bill could indeed cause disruption for those who have existing drug plans. Either he is right or the minister is right; it cannot be both. Given the Liberal track record, I suspect the minister is indulging in some wishful thinking, which is not surprising from a government that thinks budgets magically balance themselves, something that has not happened under the current Prime Minister.

By using time allocation, the government is rushing the bill through the House without opportunity for proper scrutiny, which is no surprise. Despite having had two years to figure out how they were going to implement their deal with the NDP, the Liberals put together the legislation at the last minute.

It is window dressing, designed not to define pharmacare, but to keep the government in office for a few more months to deny Canadians what they want most, which is an end to Liberal overspending and incompetence.

The proposed bill is a promise, and Canadians know what happens when Liberals make promises. They have made promises in the past nine years. The reality is that, when the Liberals make a promise, things always seem to get worse. They promised affordable housing, and housing costs have doubled under their watch. They promised that the carbon tax would not cost us anything, and we find now that 60% of families are paying more than they collect. The Liberals promised that taxes would go down, and taxes have gone up. They promised safe streets, and then delivered crime, chaos, drugs and disorder. It is no wonder Canadians are afraid things will get worse when the Liberals promise pharmacare.

If the government were serious about helping Canadians, it would have gone about things differently. It would have consulted with the insurance industry, found out what the private insurance sector was offering and what the non-profit sector was providing, examined existing provincial coverage, and discovered if there were gaps that needed to be addressed. Instead, the Liberals decided to rush blindly ahead.

Canadians know the government is not worth the cost. That has been proven time and time again over the past nine years. Is this pharmacare program worth the cost? An honest answer is that nobody knows because the minister cannot tell us how much it will cost. Any numbers he tosses around are more wishful thinking than reality.

Canadians are struggling and looking to the federal government for help. Inflation eats away at their paycheques. Every trip to the grocery store, it seems the prices are going up. Liberals' catch-and-release bail policies are turning violent offenders loose to commit yet more crimes. Despite an ever-increasing carbon tax, the government has no plan to balance its books.

The Liberals apparently have no desire to fix the problems created by their wasteful spending. They believe that water runs downhill but never reaches the bottom. They know they will not be in government when the bill for this mismanagement comes due. Food Banks Canada's 2024 poverty report card shows that almost 50% of Canadians feel financially worse off compared to last year, while 25% of Canadians are experiencing food insecurity.

The cost of living has become so high that food banks have seen a 50% increase in visits since 2021. As a direct consequence of the government's inflationary spending and taxes, millions of Canadians are struggling to keep their heads above water, yet the Liberals ask us to take on faith that they know how to set up and run a pharmacare program without turning it into a disaster.

This is the government that spent more than $50 million on an app that was supposed to cost $80,000, and it cannot tell us how or when that cost overrun happened, or who is responsible. Why should Canadians trust it to run anything?

The good news is that this is not a serious piece of legislation. As I said, the Liberals have no idea what they are doing and no real intention to institute a pharmacare program. Bill C-64 is a public relations exercise with which they hope to fool the NDP and Canadians into thinking they are doing something to help people. Given the Liberals track record, I doubt many Canadians will be fooled.

[Yasir Naqvi, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I think throughout the debate on Bill C-64, whether at second reading stage or at committee, we have seen nothing but fearmongering on the part of the Conservatives, for a simple reason: They do not support the bill. They do not want Canadians to have pharmacare. In fact, they support a private health care system. That is why they have chosen every which way to put up blockades against the bill by inventing stuff. We heard the member opposite, the health critic for the official opposition, throughout the committee process make things up while witnesses kept telling him that was not the case. He is still repeating the same mistruths.

I want to ask the member, who gave an excellent speech, this: How does he feel the legislation, if passed by Parliament, would help his constituents get the medications they so deserve and need?

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

The member heckles me and laughs at me right now from down at the far end.

Mr. Speaker, I have a great deal of respect for my colleague from New Westminster—Burnaby, and he is a fellow British Columbian. We have worked collaboratively before.

At every step of the way, we introduced common-sense amendments. If I may, I will read into the record snippets of a few: “universal, in respect of pharmacare, means providing uniform coverage to all residents of all provinces and territories, including Indigenous peoples.” That was one that was voted down by the Liberal-NDP coalition.

Another amendment was this: “payments to the province or territory in order to provide, to Canadians without access to any other prescription drug coverage plan, public pharmacare coverage for or to increase any existing public pharmacare coverage for and to provide universal, single-payer, first-dollar coverage for”. Does that sound like Conservatives are trying to block this piece of legislation? It does not. How about this? This one is very straightforward: “make progress on providing universal coverage of pharmaceutical”.

I offer that to the House because, at every step of the way and throughout the next couple of hours of this debate, we will hear interventions from our Liberal colleagues and our NDP colleagues that will say that Conservatives tried to block this piece of legislation every step of the way.

Those of us who have been tasked, on this side of the House, to work collaboratively with the other side in the health committee worked diligently to try to come up with an actual piece of legislation that was accurate and that provided the necessary tools and meat for such an important topic. We were shut down at every step of the way, primarily by our colleague from New Westminster—Burnaby, who was doing yeoman service for his Liberal coalition on the other side, as most of them sat silent.

I want to remind the House as well that all provinces have their own type of pharmacare and that 97.2% of Canadians have some form of coverage. This is a $2-billion cost, a program cost. Surely, for the one million or 1.1 million Canadians who are without coverage, we could have found a different way of doing this, a better way of doing this, that would not have put in jeopardy the plans that 27 million other Canadians have. We have spoken with insurers. We have spoken with businesses that offer private insurance to their employees, and they have questions: Who is going to pay? What happens to their employees? What happens to those who are insured by them? Insurers have concerns. Canadians have concerns.

Moreover, I will offer this. In last night's committee of the whole debate, a lot was said about this plan being universal pharmacare. We know that we have constituents who are phoning and saying that they are going to the pharmacy today and asking if they can get their medications paid for. The reality is this: No, they cannot.

This was confirmed by the Minister of Health last night when I asked him if Bill C-64 provides any government funding for those struggling or inflicted with cardiac issues. The answer was no. Does Bill C-64 provide any funding for those with ALS? The answer was no. Does Bill C-64 provide any government funding for those who are struggling with asthma? It does not. Does Bill C-64 provide any funding for any medications other than contraception or diabetes? His answer was no, that it does not.

This is not universal pharmacare. It provides the necessary and very important medications for those struggling or living with diabetes and it provides contraception. It does not offer what it is being billed as. That is exactly what we are telling the government.

Tell Canadians exactly what it is. Let us be honest with Canadians. This is not universal pharmacare. That is where we have problems with this bill.

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

Mr. Speaker, it is an honour to stand here and talk about what is being billed as universal pharmacare but what we know is not universal pharmacare.

Before I go down the path of our debate tonight, it is about 5:18 p.m. back home in British Columbia, which would mean that my granddaughter Ren is being picked up from our house. She watches every time I am on, and she always talks to the screen. I am going to say hi to my granddaughter Ren and tell her that papa loves her and will be home soon.

We are talking about Bill C-64 tonight. We are talking about a bill that is literally, for Canadians who are watching, four pages long. That is it. It is being billed as universal pharmacare. We have those who are in the audience to listen to this speech tonight at 8:19 p.m; it is a packed house in the gallery. Canadians at home are watching this important debate.

It is an important debate. There are over 27 million Canadians who are insured and have private plans. There are approximately 1.1 million Canadians who are under-insured or do not have plans. This has been said before by my esteemed colleague from Cumberland—Colchester, a former physician. He and I sit on the health committee. We work together in the best interests of Canadians and the constituents we represent.

When the government forced closure on Bill C-64 and started to ram it through the House, we rolled up our sleeves in good faith and submitted in excess of 43 amendments. These are amendments that the Conservatives and the other opposition parties were asked to submit without the opportunity to hear from the witnesses. Witnesses gave 10 hours of testimony. Surprisingly enough, the two most prominent experts in Canada with respect to pharmacare were not invited. We did not get a chance to hear from them.

There were 43 amendments that we tried to introduce in good faith. The government always says, with its NDP coalition partners, to trust it. We should just get the bill to committee, and we will do great work there. We will work collaboratively with all parties to make reasonable, needed amendments to these watered-down pieces of legislation. It does not work that way.

For five and a half hours, the member for New Westminster—Burnaby filibustered each and every one of the amendments. He says that it was Conservatives who had been blocking the bill the whole way.

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

Madam Speaker, we are talking about pharmacare and the member is talking about cutting the carbon tax.

Let me read a quote from Linda Silas: “Every day, nurses witness the profound impact of poor access to medications on their patients’ health.” She has addressed this to all members of Parliament. Further down she says, “Get it done for the sake of our patients, for the future of our health care system and for the well-being of our country. VOTE “YES” ON BILL C-64.” Linda happens to be the president of the Canadian Federation of Nurses Unions.

Could the member provide his thoughts on why the Conservative Party is going against our professional health care providers, who really want to see this legislation pass because they understand it?

[Jacques Gourde, Conservative, Lévis—Lotbinière, QC]

Mr. Speaker, it is a privilege to speak to Bill C-64, an act respecting pharmacare, which seeks to support the implementation of a national, universal pharmacare program.

I am always ready to champion a federalism that meets the needs of all Canadians, but there are a number of things that bother me about Bill C-64. Apart from the fact that it interferes in provincial jurisdictions, it was born of the Liberals' need to keep a minority government alive. That is why we are debating this bill tonight. Another thing that bothers me about Bill C-64 is that the Liberals are using the NDP like a lapdog, keeping it warm and cozy, only too happy to give in to the NDP's costly demands, while keeping it on a tight leash in a minority government that is on life support until the fall of 2025.

Since this bill does not respect provincial jurisdictions, it is obviously not legitimate. I have a hard time sorting out the reasons for this interference in provincial jurisdictions, which has become chronic over time, since the arrival of this Liberal government. I am even beginning to wonder whether the Bloc Québécois is not starting to rub off on the Liberal-NDP government in the House on other subjects.

One things is certain. Canadians are finding it increasingly difficult to identify with those who have become spokespeople for every issue instead of minding their own business. The Bloc Québécois is another example. On many issues, they are undermining the real well-being of Canadians, and especially Quebeckers, by playing provincial politics in the federal arena. They are confusing everyone.

In its current form, Bill C-64 would replace the private insurance system with a single insurance system. It would be a federal monopoly administered by a centralizing and incompetent Liberal government that has trouble managing its own departments and portfolios. For example, I am thinking about this government's inability to issue passports on time, which we experienced two years ago. I am not even sure what to say about the government's financial management, when it keeps spending borrowed money on the backs of future generations and dragging us towards a chronic and structural deficit. It is distressing to see a Liberal government that is incompetent across the board being supported by the NDP and, unfortunately, all too often by the Bloc Québécois as well.

Canadians are increasingly vulnerable, not because they lack access to medication in the provinces, but because they can no longer make ends meet. They have to make difficult choices between food and housing. Bill C-64 is just another idea where the expense is not worth the cost. Even more of taxpayers' money is being wasted in the expansion of the federal government, which is becoming increasingly intrusive and costly. Bill C-64 was born of noble intentions, but implementing it would create yet another inefficient and costly bureaucracy on top of the one that has been far too intrusive since 2015.

Currently, according to the brief submitted by Innovative Medicines Canada to the Standing Committee on Health, 97.2% of Canada's population benefits from access to prescription drug coverage through a public or private pharmacare plan. However, one in 10 Canadians are not enrolled in a government program that would cover the costs, even though they are entitled to it.

If we want to improve coverage, then we need to better inform Canadians. We do not need to destroy what is already in place to rebuild on a new foundation that has not been proven. The precursor pharmacare system in the province of Quebec, which was implemented 28 years ago, has been proven. The system is already practically universal. Common sense tells us that to improve coverage and access we just need to have targeted policies for the populations that do not have access. It is unnecessary to demolish what is already working, contrary to what the Liberals are currently proposing.

Monopolies of any kind have rarely served the interests of citizens. Replacing all the private drug plans entails major risks, including a reduction in the quality of service. As a result of competition, approximately twice as many new drugs are made available to patients on the private market in half the time.

Canadians appreciate this efficient system. Because it is a high-quality system, hospitals are less crowded, which in turn means lower costs. As I was saying earlier, this is yet another attempt by the Liberal government to interfere in provincial jurisdictions without consultation.

The health minister suggested that it would be absolutely out of the question for Quebec to give Ottawa free rein to create a pharmacare program in the province, unless it gives Quebec the right to opt out with full financial compensation, which the Prime Minister has no intention of doing. The same goes for Alberta.

The real reason behind this bill is that the Liberals have no choice but to bring forward this proposal because it is a condition of the NDP's support for the Liberal government and its survival, which has been at risk since its re-election. They outright ignore all the misgivings about the need for the bill and especially the costs associated with implementing it, as the Parliamentary Budget Officer told us. The survival of the costly coalition is at stake. They are trying once again to establish an even more centralist government, forgetting the country's federative nature and attempting to make it a unitary state.

The government should be more pragmatic and less ideological about this bill, otherwise all its efforts will be counterproductive. Instead of thinking about kickbacks to stay in power, the Liberal government should recognize the following facts. This is not a pharmacare plan. It is an empty promise that will not cover the vast majority of drugs used by Canadians.

After nine years of Liberal governance, the current Prime Minister has made a lot of promises. He promised affordable housing, and then he doubled the cost of housing. He promised that the carbon tax would cost nothing, and now we learn that 60% of families are paying more because of the carbon tax. He promised that taxes would be lowered but they went up. He promised safe streets, but ushered in crime, chaos, drugs and disorder.

This Liberal-NDP government cannot be trusted to deliver anything worthwhile to Canadians. In fact, the people have been betrayed, along with the working class too, to keep the Prime Minister in power while he doubles the cost of housing and quadruples the carbon tax.

Most Canadians already have prescription drug coverage. Many worry about losing the coverage they already have, coverage that works for them. There are also serious concerns about the cost of this proposal. The Parliamentary Budget Officer has said that it could cost tens of billions of dollars. Canadians cannot afford it at a time when they cannot even afford to pay their bills because of this Prime Minister. No Canadian wants a system that performs less well, offers less coverage, costs more and creates a massive new bureaucracy in Ottawa.

In closing, I want to reassure concerned voters who are not buying it. The common-sense Conservatives are going to abolish the carbon tax and bring down the prices of the basic goods that Canadians need. Canadians do not need legislation like this in these difficult times. What they need is an election as soon as possible to axe the tax, build the homes, fix the budget and stop the crime.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, I will actually ask the member a question about the legislation. In Bill C-64, clause 6, “Payments”, it says very specifically that it is supposed “to provide universal, single-payer, first-dollar coverage”.

First-dollar coverage means that if a private insurance company today covers diabetic medication, it will not be able to do so if this legislation comes into force. In fact, it would be a crime. It would be illegal to do that, which means that there is a great potential for Canadians who are currently insured for their diabetes medication with a private insurer to lose it. They are actually the majority in this country.

How many Canadians would lose the coverage that they currently have because of this first-dollar coverage found in clause 6 of Bill C-64?

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

Madam Speaker, it is a pleasure to be able to rise and speak to this legislation today.

There are some aspects of public policy that I have had a great deal of interest in over the years, not only here in Ottawa, but also during the days I spent in the Manitoba legislature. Canadians have a justified expectation that provincial and federal governments will work together on the important issue of health care. It is part of our Canadian identity. In many ways, it is one of the biggest treasures we have as Canadians.

At the end of the day, when I look at this legislation, Bill C-64, I see it as a significant step forward in recognizing just how important it is, when we talk about health care, that medications need to be incorporated in a very real and tangible way into the discussions. I think of the number of people over the years who have ended up going to emergency services, had a premature death or were in situations where there were additional costs for health care. Imagine the number of different pharmacare programs that are scattered throughout the provinces. Even within a province, there are multiple different forms of pharmacare programs being provided. However, even with all of those hundred-plus national or provincial insurance programs that are out there, there are still many Canadians, hundreds of thousands, who have absolutely no insurance for prescribed medicines.

This policy that is sound and makes sense. Therefore, I am bewildered as to why, yet again, we see the official Reform Party across the way saying no to Canadians on what I believe is a significant step forward toward a national pharmacare program. It would start off with two medications, in two areas. I believe Canadians would overwhelmingly be in support of this. Whether it is people in Quebec, Manitoba, B.C. or Atlantic Canada, we will find resounding support for this initiative, and I would like to think that Conservatives, at some point in time, will open their eyes and have a better appreciation for the true benefits of this program.

This is not new for me. I have been talking about it in this House for many years. For the last half-dozen or so years, I have raised the issue. I have presented petitions on the issue. Whenever I had the opportunity to highlight the importance of pharmacare, I would often make reference to the importance of the federal government working with provincial governments across the country to encourage more participation in a truly national program. Interprovincial migration happens all the time. I have family members who live in different provinces. In fact, I have a brother who lives in B.C. and a sister who lives in Newfoundland and Labrador. The types of coverage vary. We all have opinions. Because this includes medication for people with diabetes and contraceptives for women, we would all benefit directly because we all have family members or know people who would benefit from that. I would personally love to see an add-on to it with respect to shingles.

I understand that in some provinces there is better coverage than in other provinces. That is one reason I would argue, as my daughter has in Manitoba, that we need to get provinces to come to the table in such a way that we could recognize the best pharmacare program that we could have, while expanding it to what it ideally could and should be into the future, with a higher sense of co-operation. I believe that is the answer. I think it was back in 2016 or 2017, I recall being on Keewatin Street in the north end of Winnipeg, asking people to sign a petition on the importance of national health care and on a national pharmacare program.

The NDP House leader made reference to a Quebec union and its thoughts about ensuring not only that this program sees the light of the day, but also that all politicians get behind it. There is a saying from the national nurses union that health care workers understand and they appreciate. If one goes into a hospital, one will find, at least in Manitoba, that one's medications are covered. When one leaves the hospital, depending on their situation and what kind of a plan they might have, they will get their medication. Many may not have a plan, so they will not get the medications, and often, the person returns to a hospital situation. I have talked to individuals, particularly seniors, who talk about medications versus food. That is a real discussion that takes place, sadly. From a personal point of view, the pharmacare program has been more important to me than the dental care program, and we have seen the success of the dental care program.

As a government, with the Prime Minister, we have seen how much Liberals value our health care system, our Canadian identity, virtually from the get-go with the buying of prescription medications to be circulated in order to support provinces, until not that long ago when we made a contribution of $198 billion over the next 10 years to support our health care system so that we can enhance programs such as staffing requirements, long-term care and mental health. Those are expectations our constituents have. That is the type of thing that we are delivering because we have seen agreement after agreement with provinces and Ottawa dealing with health care, and we recognize just how important the issue is. We continue to be able to work with the different jurisdictions.

I believe that when we think about issues like mental health, dental services, pharmaceuticals and long-term care, they are all things that I believe, through the Canada Health Act, we have a responsibility to show leadership for. I like to think that whether it is a territory or a province, there is a some semblance of what we could expect and that it would be of a similar nature. That is why we have transfer payments, equalization payments and so much more. That is why we have a government that not only understands it, but it brings in budgetary measures to support it and legislative measures like we are debating today on Bill C-64. The Conservative Party needs to wake up and understand what Canadians want. That is better quality health care, and Bill C-64 delivers just that. Conservatives should be voting in favour of it, not filibustering.

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

Madam Speaker, I am truly surprised that the Bloc Québécois refuses to listen to what Quebeckers are saying.

A large coalition, the largest in Quebec, made up of two million Quebeckers, major unions and community groups, said that Quebeckers applauded the federal government's Bill C‑64.

They said the following:

Never before have we come so close to implementing a real public, universal pharmacare program. The hybrid public-private system in place in Quebec creates a two-tiered system that is unsustainable and needs to be fixed.

While criticizing the system, they also said this:

We are asking the federal government not to give in to the provinces and territories, which are asking for an unconditional right to opt out with full financial compensation.

That is the message that Quebeckers are sending to the Bloc Québécois. It is a bit like dental care, where the largest percentage of people advocating for dental care are Quebeckers.

Why does the Bloc Québécois refuse to listen to Quebeckers?