Finance committee  I just want to clarify that the results are valid to the condition, understanding that they include not only the carbon tax but also the output-based pricing systems.

Finance committee  Well, the government made a commitment a few years ago to have a declining debt-to-GDP ratio over time. However, what we have seen is that the ratio increased for a year, then slightly declined. It is still not reaching the starting point, even after the pandemic. What we see is an increase and then a very gentle decline over the next couple of years, based on the government's own estimates.

Finance committee  We estimate, based on the budget document tabled on April 16, that there's a 72% chance that the federal debt-to-GDP ratio in 2029 will be below its 2022-23 level of 41.7%. However, as you pointed out, that's assuming there are no new measures beyond those that were announced in the most recent budget—or at least that, if there are new measures, they are offset by expenditure reductions elsewhere, or by tax increases.

Finance committee  Mr. Chair, members of the committee, thank you for inviting me to appear before you today. First, I'd like to say a few words about the office's work on carbon pricing. In April of this year, in the course of reviewing and updating our computable general equilibrium or CGE model, PBO staff discovered that the original CGE simulations underlying our March 2022 distributional analysis of carbon pricing inadvertently included the economic impact of both the federal equivalent fuel charge and the output-based pricing system.

Health committee  That, unfortunately, I don't know off the top of my head.

Health committee  I'm sorry. Lisa tells me that we have the numbers, so I'll probably let her speak.

Health committee  The numbers that Lisa mentioned are the expenditures that are currently being covered by public, private and out-of-pocket expenditures. For the drugs under Bill C-64— contraceptives and diabetes—it's about $5.7 billion. Assuming that all these expenditures would be covered by the federal government, that's how much it would cost.

Health committee  Everybody needs these expensive drugs, unfortunately, but it's true that while generic drugs tend to be a relatively small portion of all prescriptions, they are a much higher portion of total expenditures. You're right that when new drugs come onto the market, they tend to be much more expensive than generic drugs, as I'm sure Mr.

Health committee  Yes, we took into account inflation, past inflation as well as our projections for future inflation.

Health committee  No, we did not include any provinces potentially reducing coverage for diabetes and contraceptives.

Health committee  It is indeed a risk, as is the case if some employers decide to reduce their coverage, knowing that there is a public plan that would cover their employees.

Health committee  Well, I wouldn't say we have no clue, but there's quite a bit of uncertainty regarding the costing of such a plan, given the potential for public plans and private plans to off-load some of their responsibilities onto the public plan.

Health committee  Sure. You're probably referring to our October 2023 report, where we costed a Canada-wide single-payer universal plan that would cover most drugs. In that case, we assumed that the bargaining power of the federal government would allow the single payer—well, I say “the federal government”, but it could be individual provinces.

Health committee  The short answer to your question is no. The mandate of my office is to provide costing and cost estimates. We rarely do cost-benefit analysis for that very reason, unless we're specifically mandated to do that through a very focused request. Generally, we don't do that.

Health committee  Possibly. Based on our understanding of Bill C‑64 and the technical documents included with the first portion, there's a list of drugs that will be covered. There may be other types of contraceptives or diabetes drugs, but they wouldn't be covered. There may also be a behavioural effect such as substitution.