Bill Casey

[Committees of the House, April 18th, 2018]

Mr. Speaker, we acknowledge the comments by the Conservative member. Certainly the report does not have all the answers, but it is a great first step.

I now have the honour to present, in both official languages, the 15th report of the Standing Committee on Health in relation to Bill C-326, an act to amend the Department of Health Act, drinking water guidelines. The committee has studied the bill and has decided to report the bill back to the House with amendments.

I want to thank the member for Lac-Saint-Louis for developing this private member's bill. It calls on the government to conduct a review of drinking water standards and to make recommendations on our national guidelines.

[Committees of the House, April 18th, 2018]

Mr. Speaker, I have the honour to present, in both official languages, the 14th report of the Standing Committee on Health, entitled “Pharmacare Now: Prescription Medicine Coverage for All Canadians”. Pursuant to Standing Order 109, the committee requests that the government table a comprehensive response to this report.

I want to point out that this was a parliamentary initiative. It is the most extensive report we have done. It is really well done. We have spent two years on it. We have had 130 presentations from the best experts around the world. We have engaged the Parliamentary Budget Officer for a year to confirm the financial implications of such a program.

The national pharmacare study answers these questions: Will we save money, and will we have better health care with a national pharmacare program? The answer is yes.

I want to thank all the members from all sides for the work they have done. I also want to thank the analysts, who have produced a wonderful report, and the researchers, the chair, and the clerk of the committee for doing great work on this really important study.

[Committees of the House, March 20th, 2018]

Mr. Speaker, I have the honour to present, in both official languages, the 13th report of the Standing Committee on Health, in relation to Bill S-5, an act to amend the Tobacco Act and the Non-smokers’ Health Act and to make consequential amendments to other acts.

In tabling this, I want to thank all the members of the committee and all the people who made presentations to the committee to help us understand the impacts of smoking and vaping. We learned that every 14 minutes someone in Canada dies of a nicotine-related illness, and that every day 100,000 young people start to smoke. This bill would help to discourage that trend. Again, I want to thank the committee and all those who participated.

The committee amended this bill, and I think we made it better. The report was passed unanimously by all parties. In the end, I am confident that this legislation will have an immediate impact and make Canadians healthier and safer.

[Health, February 12th, 2018]

Mr. Speaker, volunteers and organizations in my riding work tirelessly to help people access home care and palliative care. It is very difficult for them. We made great progress and great advancements in last year's budget in financing home care and palliative care, but there is more to do.

Will the Minister of Health tell us what has been done recently to help organizations that provide palliative care and in-home medical care?

[Aboriginal Cultural Property Repatriation Act, February 1st, 2018]

moved for leave to introduce Bill C-391, an act respecting a national strategy for the repatriation of aboriginal cultural property.

Mr. Speaker, it is truly my honour to introduce to the House an act respecting a national strategy for the repatriation of aboriginal cultural property. This is designed to be an incremental step to encourage governments, institutions, and private collectors to reorient their thinking around the collection, custody, study, and use of indigenous cultural property.

This started for me when I recently visited the Millbrook Cultural and Heritage Centre near Truro. I was admiring a beautiful ceremonial Mi'kmaq robe. The curator came over and told me that this was not the real robe. The real robe is in a museum in Australia, not on display, and it has been there since 1852.

This bill is designed to get us all to think about how artifacts can be returned to their rightful owners, the indigenous people right across the country, and I am very pleased to table it today. It is important that we provide this information to indigenous youth and the communities.

I am pleased that several indigenous members of this House have agreed to second the bill, and I appreciate that the member for Yukon seconded it as well. It represents the country from coast to coast, and I thank members very much.

(Motions deemed adopted, bill read the first time and printed)

[Dick's Jamboree, November 28th, 2017]

Mr. Speaker, about a decade ago, Mr. Dick Bristol, a small businessman in Amherst, Nova Scotia, launched Dick's Jamboree.

The jamboree has been a weekly event in Amherst, featuring artists from all over the area. It has been more than entertainment; it has been truly a social event, where people meet and enjoy each other and local talent.

Dick and Carol have arranged special jamborees for people with disabilities and brought out some incredible talent that nobody knew was there. Dick's Jamboree never charged admission, but it did accept donations. Every single cent was donated to good causes.

For many artists, it was their first chance, and maybe only chance, to perform in front of a live audience. Every year the jamboree had a Christmas party and ensured that everyone who attended had a meal, a gift, and a great memory.

Dick has now retired the jamboree, but to Dick, his wife Carol, and his sister Betty, on behalf of Rosie and I, and all of Cumberland County area, our sincere thanks for the years of incredible generosity and very hard work. We thank Dick and Carol.

[Immigration, Refugees and Citizenship, November 7th, 2017]

Mr. Speaker, I am very pleased to rise today to recognize Aline Nader of Amherst, Nova Scotia. Aunt Aline, as she has become known, has given tirelessly of herself over the past year and a half to help with the successful resettlement of new Canadians in Cumberland County, Nova Scotia. When the refugee families landed here from Syria in 2016, the community welcomed them with open arms. One volunteer, Aline, had a special impact by providing all of these new Canadians with English–Arabic translations, explaining Canadian customs and laws, and helping them adjust to their new lives in their new country, and always with a big smile. It gives me great pleasure to join the Rotary Club of Amherst, the Latif family, and the Alchehade family in thanking Aunt Aline and to welcome the whole family to Ottawa.

[Business of Supply, October 5th, 2017]

Madam Speaker, perhaps it would be better if you did undertake that.

We do not have a time frame, because we do not have the answers to how complicated this is, how the provinces are going to react, and how the different agencies that already have a pharmacare program are going to adapt. There is a lot of private industry involved. Private industry pays, provinces pay, the federal government pays, patients pay, there are a lot of different payers now. We are talking about having one payer in the end.

Our committee report will hopefully develop a model to work with. I do not have a time frame.

[Business of Supply, October 5th, 2017]

Madam Speaker, it is more complicated, because when we brought in the health care there were no health care systems. Now, in this country, we have over 100 pharmacare systems. Each province has a whole whack of them. They have one for seniors, one for people with disabilities, one for indigenous people, one for social service recipients, and so on. Every province, every territory has an array of pharmacare programs. The federal government has one for the military, one for the RCMP, one for indigenous people, and so on and so forth. It is much more complicated.

The hon. member referred to little details that we have not straightened out yet, but here is one little detail. We are talking about someone spending $2 billion a year, and we do not know who or what organization that is going to be. Therefore, I think that before we can go any further on any plan for a pharmacare program, we have to finish our study and then figure out, and agree on, who is going to pay the $2 billion a year for the program. Yes, Canadians are paying $24 billion to $30 billion a year, but under pharmacare there will be one payer. Who is going to pay for it? Where is the money going to come from? We have to figure that out.

[Business of Supply, October 5th, 2017]

Madam Speaker, I will be dividing my time with the hon. member for Brampton South.

First of all, I want to talk about the member for Vancouver Kingsway. We go back quite a ways. He was actually my seatmate one time over here, and we got to know each other quite well. We are both on the health committee. I want to acknowledge the good work he does on the health committee. He is very sincere and diligent about his work. We passed a motion in the health committee. The member agreed with that motion, and he is kind of jumping the gun now. That is all I am saying. The committee accepted the decision of the steering committee, and the hon. member is on the steering committee, "To undertake a study on the development of a national Pharmacare program as an insured service for Canadians under the Canada Health Act and to report the findings to the House”.

We are not there yet. We have not completed that motion that all of us agreed to on the committee. We are partway through the process, but we have a lot yet to know. The parliamentary budget officer's report was really interesting and very encouraging to all of us who are interested in this subject. However, in no way did it propose a model we can use or show a framework we can present to the government, the provincial governments, and all the different agencies involved. There are so many agencies and organizations involved with health care in this country, it is breathtaking.

We have heard 89 witnesses at our committee. We have had 20 meetings on this, and we are still not done. We are well along in the process, but we are not done. We still have a lot of questions. The parliamentary budget officer is scheduled to come to our committee on October 17, and I am sure the member will be asking him lots of questions, because there are lots of unanswered questions.

The report is very encouraging for those who are optimistic about this. I went into this debate on the pharmacare program with no preconceived notion or position. Witness after witness testified that Canada would be better off with a national pharmacare program. I am just speaking on behalf of my own observations and not on behalf of the committee, but there were a significant number of presentations on the strong points of a national pharmacare program. In general, I am really encouraged.

I was amazed to learn how many Canadians do not take their prescriptions because they cannot afford them. I was also amazed to learn that if they could take them, it would save our health care system a lot of time and money. It was amazing to learn about the integrated system in the pharmacare industry in Canada. They have secret deals with each other and all these things. I was amazed to learn how the pharmaceutical system works in Canada. It is very hard to get straight answers on how it works, but a national pharmacare program would eliminate all of that.

There are about 100 or so different pharmacare programs already in Canada. The provinces each have one for seniors. They have one for disabilities. They have one for social services. They have one for their own employees. The RCMP has one on the federal side. The military has a pharmacare program. The government has one for indigenous people. There is a plethora of pharmacare programs. They are all different. They all take management. They all require overhead. One pharmacare program would eliminate all those different agencies. We would have one consistent program across the country. Everyone could have access to pharmacare.

I am leaning toward a pharmacare program myself, but we are not there yet. We still have a lot to learn. Our job as a committee, as the original decision said, is to report the findings to the House when we are done our study. We are not done the study. There are so many questions.

We asked the parliamentary budget officer to do this, and it took him many months to do it. We have been at it for almost two years. Again, we have had 89 witnesses and 20 meetings, and we are still learning a lot as we go. The parliamentary budget officer came back a couple of times and asked for clarification on what he should use for formularies and a structure. We are very grateful to him and his team for doing the work. However, we still have to finish our work. We have not finished our work. Part of that work is to interview him and find the answers to some of the questions we have. I am sure he cannot answer them all yet, because we did not give him a model to use.

We talk about saving billions of dollars, but it is going to cost other organizations and levels of government billions of dollars, so we have to figure out the proper model before we start negotiations. We cannot go into negotiations not knowing what we are talking about or having a model to work with.

The Standing Committee on Health has been almost two years at this now, and we are still hearing from witnesses. We have witnesses coming the week after next. We have heard from patient advocates. We have heard from experts in medicine, social policy, and constitutional law. That is an issue we have not touched on here. The parliamentary budget officer has not touched on it either, because it is not his jurisdiction, but there are constitutional issues in creating a national pharmacare program. What are the responsibilities of the provinces? What are the responsibilities of the federal government? Where do they fit, and how can we work that out? We have to start with a model, and we do not even have an idea of a model yet.

There is a process, and we are only partway through it. The committee, in the end, is going to make a recommendation to the government, and the government will decide. We are not even ready. The member who proposed this is a member of that committee. He has kind of jumped the process to get ahead of us, which is what the motion is asking us to do. It is asking us to not complete the study we all agreed to do. He wants us to go ahead with just part of the information. It is a contradiction. It does not make sense.

I admire the member's work and his intention. Certainly the testimony we have heard has been very compassionate and compelling, but we are not there yet. Our own committee is not ready to make a recommendation, so I do not know how the government could go ahead and start a process to negotiate, without the committee, of which he is a member, coming to conclusions on how we are going to do this and developing a model.

There is no question that we have heard compelling evidence, and all the arguments for it are really good. It is amazing to sit through the testimony we have heard about our health care system.

Again, I go back to the purpose of the study we started. The reason we are debating this motion today is that it came up in our committee meeting. We proposed in our committee to have the parliamentary budget officer do this budget. We proposed it as part of the process, so we now have that. It is valuable. It has given us a lot of information, but there are many questions about who would be responsible for what areas, and we do not have those answers.

Some people say it is not even constitutionally possible. We have to nail that down. We have to get a better idea of who is going to be responsible and what jurisdiction is what. Are we going to bring it in slowly? Are we going to phase it in or bring it in with a big bang? Both have been recommended to us, but we have not come to a conclusion yet, because we have not finished our meetings.

The Canadian Agency for Drugs and Technologies in Health has a role to play. We need to hear from it. The Patented Medicine Prices Review Board will have a say in this, because pricing is everything. Part of the PBO report is based on a significant discount based on volume-buying for the whole nation, one buyer for the whole nation, effectively. We have to confirm that this discount is actually real. Right now the pan-Canadian Pharmaceutical Alliance gets a discount. We have to confirm with the alliance that this could be applied nationally, and so on.

The point I am making is that we have a lot more work to do. What formulary would be used? Everyone has a different formulary. Some approve these drugs and some approve different ones. We do not even have a formulary we have agreed upon.

I admire the member, and I do not blame him for leaning toward a national pharmacare program. Based on the testimony of the 89 witnesses we have heard, one could not come away with any other leaning than that we at least have to look at it as a country. However, we have not finished the report. We have not drawn our conclusions. We have not reported back to the House, as we all agreed to do. Therefore, we are not ready to go ahead with this.