Debates of May 6th, 2024

Bill C‑64—Time Allocation Motion

[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?