Canada Pharmacare Act

An Act to enact the Canada Pharmacare Act

This bill was last introduced in the 43rd Parliament, 2nd Session, which ended in August 2021.

This bill was previously introduced in the 43rd Parliament, 1st Session.

Sponsor

Peter Julian  NDP

Introduced as a private member’s bill. (These don’t often become law.)

Status

Second reading (House), as of Feb. 27, 2020
(This bill did not become law.)

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

This enactment enacts the Canada Pharmacare Act, which establishes criteria and conditions in respect of drug insurance plans established under the law of a province that must be met before a cash contribution may be made.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.

Votes

Feb. 24, 2021 Failed 2nd reading of Bill C-213, An Act to enact the Canada Pharmacare Act

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:05 p.m.
See context

NDP

Peter Julian NDP New Westminster—Burnaby, BC

moved that Bill C-213, an act to enact the Canada pharmacare act, be read the second time and referred to a committee.

Mr. Speaker, I am very pleased to kick off this historic debate in the House of Commons on a very important measure that would help millions of Canadians.

I want to start by thanking the seconder of the bill, our national leader, the member for Burnaby South, who is a strong advocate for national pharmacare. I also want to thank my seconder tonight, the member for Rosemont—La Petite-Patrie, our deputy leader, who is also a very strong advocate. I want to thank the member for Vancouver Kingsway, who is our health critic and knows more about pharmacare than any other member of Parliament, and our deputy health critic, the member for Vancouver East.

In other words, this is not an initiative of one member, though it is presented under Private Members' Business. This is an initiative of the entire NDP caucus. The entire NDP team is stepping forward to meet a need that, we know, is urgent across this country.

I want to preface this important debate by talking about another historic debate that took place in the House of Commons, in the old chamber in Centre Block, 100 metres from here, about half a century ago. Members will recall from the history books that at that time there was no medicare in our country. Anyone who has read the stories of life before medicare will know what hardship and desperate choices took place in Canada at that time.

People were having to choose between whether they could pay for the food on the table and keep making their payments for their home or for their farm, and having to cope with sudden and unexpected injury or severe disease or disability. What resulted was that often Canadians had to sell the farm or the home. They had to go bankrupt. They had to make desperate choices.

As members know, a man stepped forward, represented in this House as he was the national leader of the NDP, Tommy Douglas. At that time in Saskatchewan, he saw the necessity for universal health care, and what Tommy Douglas did as premier of Saskatchewan was put in place universal health care. He transformed Canada in a very real sense.

When he arrived here in the House of Commons, in the series of minority parliaments that we had in the 1960s, he, his House leader Stanley Knowles and the entire NDP caucus reached across the aisle to the prime minister at the time, Lester B. Pearson. They came together to put in place our universal health care.

As members are well aware, that has transformed Canada. When we ask Canadians what institution they are proudest of, often Canadians will say it is having universal health care in place. It is no longer having to pay for health care and making those desperate choices that happened in life before medicare. This remains an institution that Canadians are proudest of. Tommy Douglas went on to become judged by Canadians, from coast to coast to coast, as the greatest Canadian in our history for his endeavour and the work he did to put in place the universal health care system.

When we look at the Debates of the House from that time, we read that Tommy Douglas talked about how important it was to put in place medication as part of universal health care. It was very much a practical, realistic and necessary dream that he had, to extend universal health care to include pharmacare. Half a century later, Canadians are still waiting, but with Bill C-213, our Parliament and parliamentarians, members of Parliament from all parties, can come together. We can complete that vision by passing this important legislation.

The backbone of Bill C-213 is to put in place, in the same way we have with the Canada Health Act, the principles around pharmacare. Those principles are exactly the same as in the Canada Health Act for our universal health care. Those principles are for public administration and not for profit, for reasons that I will get into in a moment. As well, they are for sharing the comprehensiveness and universality of our pharmacare program, and making sure that the principles of portability and accessibility are also maintained.

What it does is set the legal framework that allows the government to negotiate the financial arrangements with the provinces that will bring into being pharmacare in our country. That is why it is so important to pass Bill C-213. We have waited half a century and now is the time to complete the vision Tommy Douglas had and ensure pharmacare becomes a reality.

Why? The reasons are very compelling. We know that eight million Canadians have no coverage for medications. UBC tells us, in consortium with other academic institutions from across the country, that a million Canadians have to make those desperate choices of putting food on the table, paying for their medications or heating their homes. Canada is one of the coldest countries in the world in December, January and February.

Those are compelling choices, but when we add to it the fact, as the CFNU tells us, that hundreds of Canadians die each year because they cannot afford to pay for their medications, we know we absolutely have to make the right choice and adopt this bill.

People in Quebec have also been saying that we need a pharmacare program. The major unions have all said that, because Quebec's current system is so flawed, we need a publicly managed universal pharmacare program. People all across the country agree that such a program is needed.

As the Parliamentary Budget Officer has told us, this a very cost-effective thing to do. The PBO tells us that Canadians as a whole will save about $4 billion by putting in place universal pharmacare. Why? With its universal discount, which the PBO estimates that at 25%, we reduce the costs of medication overall. The reality is that with this proliferation and patchwork of private and public plans right now, one in five Canadians have no coverage at all. At the same time, it increases the overall costs, not just administrative costs but also the costs of acquiring the medication, which is so important to the health and welfare of so many Canadians. The PBO put it at 25%, but we have seen other countries, like New Zealand, reduce the costs of certain medications by up to 90%. Therefore, that universal discount is a very real reality.

As well, the PBO tells us that Canadians as a whole pay about $5 billion out of pocket, but small and medium-sized businesses across the country pay about $6 billion in drug plans for their employees. This is another reason why the bill is so important. As members know, our universal health care is a major competitive advantage. In general, it is about $3,000 per employee for a Canadian company compared to its American competitor.

In Canada, with universal health care, we do not have those additional expenses that those companies have to pay in the United States. Pharmacare is about a $600 cost advantage, so it is competitive and an advantage for our business community. We spend about $13 billion through a variety of this patchwork of provincial plans, so putting into place universal pharmacare makes sense financially.

I have spoken in the House before about the $750 billion in liquidity supports that were provided to Canada's big banks within days of the pandemic hitting. If anything, this pandemic has taught us the importance of bringing in universal pharmacare. That $750 billion in liquidity supports equates to more than 35 years of universal pharmacare. It is the right decision to make.

We speak in this House, but we also need to listen, and I want to talk about three friends and how their lives would be advantaged by putting into place universal pharmacare. There is Jennifer, a friend of mine from New Westminster. She has Crohn's disease and is recovering from ovarian cancer. Her medication is a considerable cost. She is a campaigner for pharmacare because she understands, not just for herself but so many others, that universal pharmacare would make such a difference in her life.

There is Jim, who, up until a few months ago when the pandemic started, was begging in front of the Château Laurier because his medication costs about $500 a month and he lives on a fixed income. The only way he can afford to pay for the medication that keeps him healthy is to beg outside the Château Laurier.

No Canadian should be forced to do that. That is why we need universal pharmacare. Because of the pandemic, Jim has been unable to beg and is now facing huge debts. He has had to make that desperate choice between making sure he takes his medication to maintain his health and going into debt because there is no pharmacare.

Then there is Cole, a friend of mine from Burnaby, British Columbia. His family spends about $1,000 a month on his father's heart medication and is struggling to keep a roof over their heads. These are three voices saying to all of us in this House that it is time to put universal pharmacare into place.

This strikes back to the heart of the point I am making, and I hope other speakers will make it too. We have an initial hour tonight. We will have a second hour of debate in about 90 days, and then, subsequent to that, as we know, a vote in principle on the Canada pharmacare act. Over the next 90 days, every member of Parliament should be listening to the people in their ridings, their constituents, their bosses, our bosses, to make sure they have an understanding of how pharmacare would change their lives for the better.

There are a million Canadians tonight having to make desperate choices. They are deciding if they can afford their medications. They are scrimping on them and trying to get by with taking half as much, even though their doctors know that is dangerous for them, so they can put food on the table or keep their homes heated in the dead of winter. These are choices that Canadians should never have to make.

For members of Parliament to hear Canadians, Canadians' voices need to be heard. I am urging all of the people listening tonight who care about, as we do, putting into place universal pharmacare, to phone, email, do whatever it takes to contact their local member of Parliament and tell them to vote yes on Bill C-213. I urge them to share their stories. I have shared three tonight, but there are so many compelling stories of Canadians who are forced to make desperate choices because we have no universal pharmacare.

Canadians can speak up over the next 90 days. Canadians, I believe, will have an impact on each member of Parliament's vote and Canadians, in that way, can influence the result. If we vote yes on Bill C-213 in 90 days' time and move it through committee, we could have pharmacare within a short time frame. People having to beg and borrow could get the money to pay for their medications. All of the people cutting back on their food or heat right now, as a million Canadians do, to pay for their medications will see this Parliament acting in their interest.

I said earlier that this is a date with destiny for each member of Parliament. Each member of Parliament will have to make that crucial decision in the interests of their constituents and all Canadians. I ask all members of Parliament to please vote yes on Bill C-213, the Canada pharmacare act.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:20 p.m.
See context

Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Mr. Speaker, I thank my hon. colleague for his intervention today and his passionate plea. I think he did an extremely good job of pointing out a lot of the challenges that exist, unfortunately, for so many Canadians. He is absolutely right. No person should have to decide between taking their medication and putting food on the table. No senior should have to make the decision of reducing their prescription in order to make it last longer.

If he canvassed the House, I think he would find that a majority of its members support the concept of universal pharmacare. This government has been committed to that and put together an agency to review it in the last session of Parliament, which came back with suggestions, as my colleague knows.

The one thing I did not hear the hon. member talk about was the fact that creating a program like this relies so much on the relationship with the provincial government and developing it in partnership with the provincial government. How would he see that rolling out and how do we do that, practically, to make sure that we have buy-in from the provinces?

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:20 p.m.
See context

NDP

Peter Julian NDP New Westminster—Burnaby, BC

Mr. Speaker, the hon. member's question is important. I mentioned earlier the $13 billion that provinces are paying right now for a patchwork of public plans that leave so many Canadians behind. We saw all of the provincial governments come together for universal health care. The same thing can take place with universal pharmacare.

What the bill would do is provide the legal framework for the government to have negotiations and discussions with the provinces, so that pharmacare can become a reality. We can move very quickly on this, if we choose to.

We saw $750 billion going to banks in a heartbeat. Now is the time to provide the same level of support to regular Canadians. We can do that through universal pharmacare.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:25 p.m.
See context

Conservative

Michelle Rempel Conservative Calgary Nose Hill, AB

Mr. Speaker, I also share my colleague's objective of ensuring that vulnerable Canadians have access to pharmaceuticals. We can do that.

I am just concerned about examples of nationalization of pharmaceutical care having unintended consequences, as we saw with the OHIP+ program in Ontario, where 2.1 million Ontarians ended up, with the elimination of their privately funded system, having worse levels of care than they did before. They did not have access to drugs that they needed.

Has the member given any thought to that potentially unintended consequence of the bill and how he would mitigate that?

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:25 p.m.
See context

NDP

Peter Julian NDP New Westminster—Burnaby, BC

Mr. Speaker, I think the principles are very clear. They are the principles Canadians already accept in our universal health care system. There is not a single party in this country that would want us to go back to the days before our universal health care. The same principles would apply to universal pharmacare. It means making sure that we put this into place and that we follow those five principles that I mentioned earlier: public administration, comprehensiveness, universality, portability and accessibility.

Those are the guiding principles that will lead us to the same level of public buy-in around universal pharmacare that we already see with our universal health care.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:25 p.m.
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Bloc

Yves Perron Bloc Berthier—Maskinongé, QC

Mr. Speaker, I thank my colleague for his speech. The Government of Quebec has decided that it does not want to be part of a Canada-wide pharmacare system.

Does my colleague acknowledge that Quebec society is more advanced than any other North American society when it comes to family policies, access to post-secondary education, taxation and pharmacare? Yes, Quebec already has a system, albeit one that is not perfect and could certainly be improved.

Can he tell me if he thinks Quebec should have the right to opt out unconditionally with full compensation, which would in no way preclude Quebec's collaborating to purchase drugs for less?

I would like him to comment on that.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:25 p.m.
See context

NDP

Peter Julian NDP New Westminster—Burnaby, BC

Mr. Speaker, I thank my colleague for his question.

I think he should talk to major unions in Quebec, such as the Fédération des travailleurs et travailleuses du Québec, the FTQ, the Confédération des syndicats nationaux, the CSN, and the Centrale des syndicats démocratiques, the CSD.

The four major unions have said it is important to set up this universal pharmacare program. They know perfectly well that Quebec's existing system has a lot of problems and that many Quebeckers slip through the cracks.

We have to set up the system we are proposing. That is what Quebec's major unions are saying, and it is important to listen to them.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:25 p.m.
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Liberal

Judy Sgro Liberal Humber River—Black Creek, ON

Mr. Speaker, I am very happy to join the debate tonight, even if it is virtually, to address Bill C-213.

I must say to my colleague that it is great that he took the initiative to bring the bill forward. I think that any time we have a chance to move the discussion on things that we know clearly Canadians would like us to discuss, we should take it. The work that is required to make that all happen, of course, is way ahead of us. Every time we have a debate, I think it is terrific.

I never thought that I, as a member of Parliament, would deliver a speech from the comfort of my home office, but this is a new normal that we are all experiencing in order to stay safe and flatten the curve of COVID-19. It is my hope that I will soon join my colleagues in the House to continue the great work that this government is providing for Canadians.

We know Canadians should not have to choose between buying groceries and paying for medication. That is just unacceptable, and I believe every one of us in the House believes that.

When constituents from my riding of Humber River—Black Creek visit the Yorkgate Mall or Jane Finch Mall, they should be able to reach into their pockets and purchase the food and medication they need. That is why the government is committed to implementing a national pharmacare program that would ensure all Canadians have access to the prescription drugs they need, and why I also welcome this discussion tonight.

It is a goal we have been working toward since we first formed the government in 2015, and it remains our goal. No matter how difficult COVID has been, it is still our goal to see national pharmacare, as we clearly stated in the most recent 2020 Speech from the Throne to remind everyone that we intend for this to happen.

The COVID-19 pandemic has reminded us how important it is that Canadians have access to the medicines that keep them healthy. We need to implement a national pharmacare plan that gets Canadians the drug coverage they need as soon as possible. People are struggling: we know that. I get calls at my constituency office every day from seniors and others looking for help, who want to visit loved ones, play cards at their local community centres and simply want to get their lives back to normal.

I tell them we are doing everything we can to fight the pandemic. National pharmacare would make a significant difference in the lives of many people in my riding. It would be a relief to many of these individuals if we could assure them that in their lifetimes they would have the dream of seeing national pharmacare happen.

People today need a break, and while we are now more committed than ever, it is important we get this plan right. To modernize the whole issue of drug regulations, we need to address the rising cost of drugs in this country. As the price of drugs continues to go up, trying to find sustainable drug costs has to be a solution.

Canada's approach to patented drug price regulations was outdated. Our previous pricing regime was established a very long time ago, and it needs to change to be brought up to date with current issues. We have more than 100 different public drug plans and thousands of private drug plans. All this means is we have many drug plans. It does not necessarily mean they are doing what they are supposed to be doing, other than being a patchwork.

It is well past time to bring these regulations into the 21st century. In order to make drugs more affordable, Canada needed a modernized approach to regulating patented drug prices that would protect Canadians from excessive prices. That is why last summer the government modernized the Patented Medicines Regulations, which provide the Patented Medicine Prices Review Board with the tools and the information it needs to protect Canadians from excessive prices.

Secondly, we want to consider the value a drug offers and its overall affordability. Most other countries with national pharmacare programs already do this, so we are behind the eight ball on this. When setting a price, one needs to have many discussions on things such as value for money, if the drug offers a therapeutic benefit that justifies its cost, the size of the market, how many people will benefit, Canada's GDP and GDP per capita, and if we can afford to pay for it. These things are not easy.

These changes would provide the Patented Medicines Price Review Board with the tools it needs to protect Canadians from excessive drug prices, and would bring us in line with the policies and practices of most other developed countries.

These regulatory changes were critical steps toward improving the affordability and accessibility of prescription drugs. Along with other consumer protection initiatives at the Patented Medicine Prices Review Board, we anticipate that these changes will save roughly $13 billion over the next 10 years. These are significant savings for Canadians. From the savings, public and private drug plans will have greater capacity to improve benefits for plan members or to consider new therapies not currently covered. All Canadians, including those with drug plans and those paying out of pocket, will benefit from lower prices for prescription drugs.

Modernizing pricing regulations complements the work already under way at Health Canada to streamline the regulatory review process for drugs by enabling priority drugs to reach the market more quickly. This supports the work already taking place under the pan-Canadian pharmaceutical alliance to negotiate lower prices for prescription drugs. As a member of this alliance, the Government of Canada is able to combine its buying power with that of the public plans in the provinces and territories. It is estimated that the alliance will save public drug plans more than $3 billion over the next five years. Successful negotiations will result in more affordable prescription drug prices for public drug plans and will lower generic drug prices for all payers.

These steps that we have taken to increase the affordability of drugs will improve the viability of a national pharmacare program. A national pharmacare program would be another step that could help us further control drug prices and make drugs more affordable for Canadians, especially drugs for patients of ALS and some of the other very serious rare disorders.

The government has also made some significant investments to ensure that we continue to take important steps in the right direction as we build this national pharmacare program we all want.

Budget 2019 earmarked $1 billion over two years beginning in 2022-23, with up to $500 million ongoing, to help Canadians with the rare diseases that I alluded to earlier access the drugs they need. Budget 2019 also proposed $35 million over four years to support the implementation of a Canadian drug agency, including the development of a national formulary, an important step toward a national pharmacare program.

A national formulary and increased capacity to coordinate across drug plans would bolster Canada's negotiating power to achieve better prescription drug prices on behalf of all Canadians. Negotiating better prices could help lower the cost of prescription drugs for Canadians. However, as we develop this formulary, we must work with the provinces and territories to determine which medicines represent the best value for money for Canadians from coast to coast to coast.

The people of Humber River—Black Creek and across Canada want a national pharmacare plan. I am confident that the government will be successful in implementing the initiatives that I have outlined today, and I congratulate my colleague for bringing this issue forward in a private member's bill so that we can continue to keep everybody's feet to the fire. That includes all of the provinces and territories, which have to be partners with us on this issue.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:35 p.m.
See context

Conservative

Michelle Rempel Conservative Calgary Nose Hill, AB

Mr. Speaker, all Canadians should have affordable access to prescription drugs. It is a key component of health care. Income and ability to pay should not stop people from having access to life-saving treatments.

I do want to thank my colleague from New Westminster—Burnaby for bringing forward a suggestion on how we can help people like his friends Jennifer and Jim. For us to evaluate whether his potential approach is the best one or would actually work, we must begin with a review of the current state. There are three points to consider.

First, how many Canadians have drug coverage at present and how many do not? At present, most recent estimates suggest that between 90% and 98% of Canadians have some form of prescription drug coverage, whether through private insurance or a public plan. While a smaller percentage of Canadians do not have coverage, many Canadians already do. We should be targeting our intervention to Canadians without adequate coverage and clearly defining what that means.

Second, the gaps in coverage are not just for those who cannot afford to pay for prescription drugs. There are also gaps in coverage when drugs are available elsewhere in the world, but not in Canada. One example is the life-saving drug for cystic fibrosis patients called Trikafta.

Third, health care delivery has a large jurisdictional responsibility within the provinces. While I believe federal and provincial governments should work together to address issues like this, we also need to ensure that any potential solution respects jurisdiction and the unique regional challenges of our Confederation.

In the context of these three points, I will evaluate whether the proposal of this bill is the best option to address this issue.

First, let us start with what this bill does. To re-emphasize, many Canadians already have some form of drug coverage, but the coverage these plans do provide is provided by employers and insurers, not taxpayers. This bill proposes that the best way to provide coverage to the smaller percentage of Canadians who do not have adequate coverage is to eliminate access to private plans for those who currently have them and replace them with plans provided by a government agency and the taxpayer with varying degrees of coverage that might be less than their current level of coverage and likely with a tax increase to cover the significant associated cost. This is what is commonly referred to as pharmacare in Canadian politics.

Many people do not understand that what proponents of pharmacare mean to do is eliminate the coverage many Canadians already have, replace everything with state-run coverage that might not be as good as their current coverage and likely significantly increase taxes to do so. I believe that instead of this approach, it would be better to focus on targeting support to those who do not have it, rather than entirely scrapping a system that works for a majority of others.

Second, this bill does not address the potentially unintended negative impact it might have on patient care. We do not know the level of coverage this proposal would provide and whether it would be a lower standard than what many Canadians already have in their current plans. This needs to be clarified.

A good example of this is what happened with the OHIP+ program under the Ontario Liberals. OHIP+ was supposed to fix access to drug coverage for people under 25 by providing public coverage. However, Ontarian Jackie Bain had to start paying out of pocket for her son's ADHD medication because her private insurance was no longer recognized. Many Ontarians face similar issues with access to other prescription drugs for epilepsy and rheumatoid arthritis.

OHIP+ transferred 2.1 million Ontarians who already had private plans to a public plan that provided worse coverage than what they had before and at a higher cost. In other words, the government's attempt to increase drug coverage by fully eliminating private plans removed more people from drug coverage than it added. The vagueness of this bill gives rise to this possibility, but on a national scale.

Third, this bill needs to clarify the potential impact of nationalizing access to pharmaceuticals on workers in pharmacies across this country. Would their jobs and businesses and ability to provide expert advice to Canadians be affected? This impact needs to be addressed.

Fourth, there is no consensus on whether this bill's approach would actually provide savings. For example, the Neighbourhood Pharmacy Association of Canada estimate a single-payer, pharmacare plan would cost between $10 billion and $14 billion, which is different from what this bill's sponsor has suggested. That cost estimate is on top of other issues it would produce in terms of dismantling existing private coverage and replacing it with government bureaucracy, for which detailed publicly available costing is not available.

On the issue of bulk purchasing, nationalization is not needed for provinces and territories to buy drugs in bulk.

Fifth, this bill does not address the issue of lack of access to life-saving drugs in Canada. There is no doubt that we need a strong drug and therapeutic safety review process, but as we have seen with the Liberals' slow and backward approach to reviewing COVID rapid tests, this system could use improvement.

Drug access for Canadians has arguably been threatened by the government's changes to what are called the PMPRB regulations. We have seen how this regulatory uncertainty has deterred some life-saving drugs from entering the Canadian market. These changes could dramatically alter pharmacists' abilities to run patient-support programs. While the new guidelines may lower some drug prices, they might also harm our ability to get access to certain new therapeutics, and this needs to be addressed.

Sixth, the bill does not adequately address other issues related to drug supply. Our drug supply has been in jeopardy since the start of the COVID pandemic because of disruptions to supply chains. Canadian pharmacists have been ringing alarm bells for months, but the government has not done anything. Given that government usually does not do anything particularly well, in this regard I worry about what would happen if the government took total control of access to prescription drugs, as the bill may propose.

Seventh, I am worried that the member has not addressed jurisdictional issues raised by members during debate today.

In short, I believe the bill will not provide access to pharmaceuticals to vulnerable Canadians who need them the most and could have significant negative unintended consequences that could actually make drug access worse for some Canadians and add another tax burden to already heavily taxed working Canadians. However, I do agree with the bill's sponsor that we need to help vulnerable Canadians who do not have access to prescription drug coverage, like his friends Jennifer and Jim.

This is what I suggest.

We should encourage the government to finally come up with a fully costed plan in coordination with the provinces to provide support for those without prescription drug coverage within the system that already provides significant coverage to millions of Canadians. That plan should be compassionate and first aimed to help those who are in critical need of access to life-saving drugs.

It should reduce bureaucracy rather than create it, as the bill proposes; sustain access to coverage for those who already have it; and protect jobs and businesses rather than looking to replace them with unnecessary government bureaucracy.

It should respect provincial jurisdiction while taking a leadership role to help those in need. It should also work with the provinces on creative ways to enable bulk purchases within existing regulatory structures.

It should look at innovative ways to reduce costs for these products within the existing system, such as looking at policy options like classifying common drugs that are classified as over the counter in allied countries like the U.S. and the U.K. as over the counter here. Some estimates suggest that if we did that for just three drugs, we could ensure Canadians save $1 billion a year on spending on drugs.

This plan should also bolster Canada's capacity to domestically manufacture critical drugs. It should ensure strong safety reviews for therapeutics and devices, while eliminating the pedantic, slow and innovation-killing systems that prevented Canadians from getting COVID rapid tests and Trikafta. It should correct policies that prevent Canadian medical innovations from being commercialized in Canada, as many of our innovations are currently licensed out of the country instead of being retained here.

I strongly believe that we have a duty to provide support to people who do not have access to pharmaceuticals in Canada. I think it is long overdue, and it is something federal Liberal governments have been talking about since the 1970s. However, I do not think the bill gets it right. I think we should be looking at a hybrid system that takes into consideration the points I have made and allows Canadians to have adequate coverage. We should then build on that rather than just seeking to nationalize it. I think we should also be questioning what the role of government is in this regard, and we should be targeting our plan to the people the member for New Westminster—Burnaby talked about in his speech, rather than trying to eliminate coverage for people who already have it.

I certainly want to emphasise that the Conservatives will continue to support government action that makes prescription drugs more accessible and affordable for Canadians. We will hold governments to account, especially the current Liberal government, which has not addressed issues like access to novel therapeutics like Trikafta. However, we do not think we need to nationalize the entire system to do this, and we are concerned about examples like OHIP+, which really failed a large portion of people who enrolled in it.

I look forward to working with my colleague in a non-partisan way on this approach, but I think his bill needs a lot of improvement.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:45 p.m.
See context

Bloc

Gabriel Ste-Marie Bloc Joliette, QC

Mr. Speaker, it has been nearly 25 years since Quebec adopted its pharmacare program.

The program was far from perfect and implemented with limited resources since, at the time, Ottawa was cutting transfers for health, education and social services and imposing austerity. The Quebec program helped reduce poverty. In 25 years, no other province has adopted such a program.

If Ottawa ever goes forward with a universal public pharmacare program, which seems unlikely to me, then Quebec must have the right to opt out with full compensation so it can, for example, increase the coverage provided by its own program.

Quebec's labour unions have been sounding the alarm for several years now. The downside to Quebec's program is that pharmaceutical companies are generating revenue at the expense of union health care plans. They said, and I quote:

Rising premiums are eating into salary increases and threatening other collective insurance coverage...Funding through premiums is not fair because it places a heavier burden on low-income earners and even leads some part-time workers to resign.

It is costing them a fortune and the situation is becoming untenable. We need to take appropriate action. Ottawa's role with respect to health is to provide as much funding as possible, which it has not been doing for the past 25 years.

The Fédération interprofessionnelle de la santé du Québec, the Fédération des travailleurs et travailleuses du Québec, the Alliance du personnel professionnel et technique de la santé et des services sociaux, the Union des consommateurs, the Centrale des syndicats du Québec, the Confédération des syndicats nationaux and the Table des regroupements provinciaux d'organismes communautaires et bénévoles all want a universal public system.

In their request, they stress that such a system must respect provincial jurisdiction and that the federal government must allow provinces to opt out with full compensation as long as they create an equivalent or better system of their own. All members of Quebec's National Assembly agree with that condition.

On June 14, the National Assembly unanimously stated that, “Quebec refuses to adhere to a pan-Canadian pharmacare plan”. In its motion, the National Assembly called for “full and unconditional financial compensation if a proposal for a pan-Canadian pharmacare plan is officially introduced.” Members of all four parties represented in Quebec's National Assembly agreed to that motion.

The NDP in 2005 adopted the Sherbrooke declaration, in which it said it recognized asymmetrical federalism and intended to give Quebec the systematic right to opt out, but it seems to have written off Quebec ever since. That is what the drafting of this bill suggests.

Why did it not take into account the specification requested by the major unions or the unanimous motion of the National Assembly in the drafting of this bill? Why did it not use the demands of the Fédération des travailleurs et travailleuses du Québec, the FTQ, as inspiration?

For the FTQ, the terms and conditions of a public, universal pharmacare program must first and foremost be discussed in Quebec and established according to the needs of its people. That is why Quebec must be able to opt out with full compensation from any pharmacare plan. Furthermore, the federal government cannot discuss pharmacare without addressing the problems in health care funding. To ensure the sustainability of Quebec's health care system, the federal share of funding must be increased.

Ottawa has to increase health funding. Just before the Speech from the Throne, the provinces came together to call on Ottawa to increase its share of health care spending from 22% to 35% with no strings attached, a request that 75% of the population supports. Despite all that, the government chose to dig in its heels against the provinces.

The NDP's and the Liberals' obsession with wanting to interfere and decide for Quebec where it should spend its own money is toxic. The NDP and the Liberals should instead agree to the provinces' requests and increase federal health transfers permanently.

When it comes to access to drugs, there are things the federal government can do starting with regulating prices. According to the federal government's own data, drug prices in Canada are among the highest in the world, costing 19% more than the average country in the Organisation for Economic Co-operation and Development.

This situation did not come out of nowhere. It is the result of a government decision. The patented medicine regulations, which regulate the price of drugs, harmonize prices in Canada with the pricing used in countries with the highest prices. The Bloc has been after the government for years to change the list of countries it bases its pricing on and to exclude the United States and Switzerland, where prices are prohibitive.

We thought that we had prevailed. Members will recall that in 2017, draft regulations that met our demands were released. However, under pressure from the pharmaceutical industry, the government withdrew the regulations before their scheduled entry into force, set for January 2019. The regulations were then supposed to come into force in July 2020, but that was pushed to January 1, 2021. We shall see if, four years on, the date will be pushed back once again. I had to laugh when I heard my Liberal colleague talking about big accomplishments, when this matter has been delayed for four years for no reason.

Under these new regulations, whenever they come into force, the Patented Medicine Prices Review Board will be in a better position to do its job of ensuring that pharmaceutical companies do not overcharge for their patented drugs in Canada.

Once these regulations come into force, taxpayers could save $220 million in the first year, and up to $13 billion over 10 years. That is a huge difference. All the government has to do is implement the regulations it has been delaying for nearly four years.

During the election campaign, the Liberals also said that they wanted to take action to bring down the cost of drugs used to treat rare diseases. We have heard nothing for more than a year. They reiterated this intention in the Speech from the Throne, but we are still waiting for their strategy. The federal government must provide more information about what it plans to do. Above all, it must decide if it will co-ordinate with the rare disease strategy that Quebec intends to establish.

I hope that Quebec will have a universal pharmacare program. I really hope it will. Given that Ottawa underfunds health care, Quebec cannot afford to implement it. Quebec innovated with its system almost 25 years ago. It made a difference, and in the context of the austerity imposed by Ottawa, it was a remarkable policy. Twenty-five years later, we see the problematic consequences, especially for unions' group insurance plans.

That is why I would be very surprised if a universal plan were adopted here. If it ever does happen, Quebec should have the right to opt out with full compensation so it can enhance its own plan, in accordance with the areas of jurisdiction, the will of the National Assembly and the demands of unions.

I am gobsmacked that this was not included in the bill. It would have led to change, for once.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 6:55 p.m.
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NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Speaker, it is with great pride that I speak to Bill C-213, the Canada pharmacare act.

I would like to recognize my colleague for New Westminster—Burnaby for his tireless advocacy in support of universal public drug coverage and thank him for introducing this historic legislation.

We introduce this bill in a unique moment in time. One hundred years ago next year, Sir Frederick Banting, a Canadian orthopaedic surgeon, along with his colleagues, Charles Best and J.J. Macleod, discovered insulin at the University of Toronto. However, Dr. Banting did something exceptional with his life-saving medicine: He sold the patent rights to the university for one dollar, claiming that the discovery belonged to the world, not to him. This allowed insulin to be mass produced, making it widely available to all who needed it no matter their financial means. The bill before the House reflects this noble principle.

The Canada pharmacare act would establish a framework for the implementation of universal public pharmacare in Canada. This legislation is modelled on our cherished Canada Health Act. It mirrors the 2018 majority support of the House of Commons Standing Committee on Health, which studied the issue of pharmacare for two solid years. It also is based squarely on the recommendations of the Hoskins Advisory Council on the Implementation of National Pharmacare.

Like the Canada Health Act, the Canada pharmacare act specifies the conditions that provincial and territorial prescription drug insurance programs must meet to receive federal funding. This includes the core principles of public administration, comprehensiveness, universality, portability and accessibility. The Canada pharmacare act would establish a new Canadian pharmaceutical policy by declaring that it would be the duty of the Government of Canada to facilitate access to prescription drugs without financial or other barriers in order to protect and promote the physical and mental well-being of Canadians.

The overarching purpose of universal public pharmacare is simple. It will ensure that all Canadians get access to the medication they need regardless of their ability to pay. For too long, prescribing decisions in Canada have been influenced by industry profits, marketing and lobbying efforts. Instead, decisions about what drugs are covered ought to be based on empirical evidence and the best health outcomes for patients.

To accomplish this, formulary coverage must be managed by an agency that is arm's length from government and free of industry interference. As such, New Democrats believe that it is imperative to construct a comprehensive public drug list that meets this goal.

For this reason, the Canada pharmacare act would give the federal health minister the authority to work with the provinces and territories to establish an independent drug agency with the mandate to the following: assess the clinical and cost-effectiveness of prescription drugs compared to other treatment options; advise on which prescription drugs, supplies and devices should be covered; negotiate prices and supply arrangements with drug manufacturers; provide advice to health care practitioners and patients on how best to use prescription drugs; and monitor the safety and clinical effectiveness of prescription drugs.

New Democrats are also very mindful of the need to ensure that Canadians with rare diseases and disorders are well served and that promising drug therapies are accessible. We believe that special care must be taken to ensure that drug listing decisions are responsive to these requirements and future pharmaceutical innovation. Ultimately, the goal must be to construct a broad, comprehensive, national drug list that all provinces and territories agree to cover, without cost to their residents, in exchange for federal transfers. This is the premise of our successful medicare system. It works and it is deeply valued by Canadians.

Importantly, New Democrats believe that pharmacare is an important piece of a large, comprehensive pharmaceutical policy reform. In addition to public pharmacare, Canada needs the re-establishment of public drug manufacturing in Canada, an intellectual property innovation fund that ensures taxpayer-funded research is commercialized for our citizens' benefit, patented medicine pricing transparency and the use of compulsory licencing when drug companies refuse to make patented pharmaceuticals available to Canadians on reasonable terms.

To situate this legislation in its historical context, it is important to remember that universal public drug coverage was always intended to be part of the medicare. In 1961, the Royal Commission on Health Services was appointed by Progressive Conservative prime minister John Diefenbaker to study the concept of universal public health care. Mr. Diefenbaker appointed a fellow Conservative, Justice Emmett Hall, to chair that royal commission.

In 1964, the Hall commission released its report, which surprised many by recommending the adoption of the comprehensive health insurance program based on New Democrat Tommy Douglas's Saskatchewan model. In response, some provincial premiers charged that this approach was an intrusion into their jurisdiction, and there was reluctance to proceed within then prime minister Lester Pearson's Liberal caucus. Ironically, we hear much of the same claptrap today.

However, because Canadians had elected a minority Parliament in 1963, with New Democrats holding the balance of power, Tommy Douglas was able to leverage this influence and work with the Pearson government to advance the implementation of medicare, and indeed they did. In 1966, Parliament adopted the Medical Care Act by a vote of 177 to two.

At that time, it was understood that prescription drugs and other essential health services would incrementally be integrated into medicare. In particular, the urgent need to provide coverage for out-of-hospital prescription drugs was specifically highlighted by the Hall commission. However, over a half-century has now passed and, despite repeated studies, proposals, pledges and solemn political promises in campaign platforms, Canada remains the only major country that offers universal health care without some form of universal pharmaceutical coverage. This is not just unjust; it is perplexing from both a health and fiscal perspective.

Canada's failure to implement universal public drug coverage means that at least 20% of Canadians, some seven and a half million Canadians, cannot access the medicine they need when they need it. One in four Canadians is forced to avoid filling or renewing a prescription due to cost, or skips doses because they cannot afford it. To add injury, Canadians pay among the highest prescription drug prices in the industrialized world, due to our U.S.-style private patchwork approach to drug coverage. Even those with private coverage are seeing their employer-sponsored benefits shrink, a trend that has accelerated due to the economic impacts of COVID. In fact, Canadians now are twice as likely to have lost prescription drug coverage as to have gained it in the past year. Worst of all, Canadians die each year simply because they cannot afford the medicine they need.

It is time to finally address this serious deficiency. Evidence has been clear for decades that universal public pharmacare would expand coverage and improve outcomes, while reducing costs for Canadians. Most recently, the Liberals' own Hoskins advisory council found that universal public pharmacare would reduce annual system-wide spending on prescription drugs by $5 billion through the negotiation of lower drug prices, increased generic substitution and streamlined benefits administration. The Hoskins report also found that businesses and employees would see their prescription drug costs reduced by $16 billion annually under pharmacare, and families would see their out-of-pocket drug costs reduced by over $6 billion.

Under this NDP bill, the average Canadian family would save $500 per year and the average employer would save $600 per employee. Universal public drug coverage would also mean long-term savings for our public health care system when those who cannot afford to fill prescriptions achieve improved health outcomes. Yes, it is a fact. With universal, comprehensive and public pharmacare, we can cover every single Canadian's prescription medicine and devices and save billions of dollars every year.

In public life, it is rare to find such an effective policy innovation staring us in the face. Only the most obtuse right-wing ideologue or courage-challenged centrist could fail to see the clear health and economic benefits of this necessary and sensible public policy. It is time and Canadians know it. Polls repeatedly demonstrate astronomical support for public pharmacare because, as with medicare, Canadians know a good idea when they see it. Just as establishing universal hospital and physician care took courage and cross-partisan collaboration, so too will the implementation of pharmacare.

I urge all parliamentarians to join us at this historic hour by supporting the swift passage of the Canada pharmacare act. Let us follow in the brave footsteps of those who served before us, and march forward together toward a more just and healthy society for all.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 7:05 p.m.
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Conservative

The Deputy Speaker Conservative Bruce Stanton

We have only a couple of minutes left in the time for Private Members' Business this afternoon, but we will get started with the next speaker. He will only have about a minute and a half, but he will have the remaining time when the House gets back to debate on the question.

Resuming debate, the hon. member for Niagara Centre.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 7:05 p.m.
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Liberal

Vance Badawey Liberal Niagara Centre, ON

Mr. Speaker, it is a pleasure to be here this evening to speak about universal pharmacare.

I want to start by congratulating the member for New Westminster—Burnaby for beginning the conversation with all 338 members of the House of Commons on this very important issue. I say that because it is going to be up to all of us, not one party, not some parties or others throughout the different levels of government, but all of us working together in the House of Commons and at all levels of government, provincial and territorial, who are going to be part of the process of putting this in place. We want to ensure that we in fact get this right and strengthen the universal medicare program that Tommy Douglas championed many decades ago.

As was said earlier, no Canadian should have to choose between paying for prescriptions, putting food on the table, putting their children through school and living the life that every Canadian should live. That is why we, as a government, have done more than any government in a generation to lower drug prices, and have included new rules on patented drugs that will save Canadians over $13 billion annually.

I want to emphasize two points. First, this is an important program to move forward with. Second, all of us at all levels of government, in the House of Commons and provinces and territories, can and will work together to ensure that we bring universal pharmacare to this great nation.

Canada Pharmacare ActPrivate Members' Business

November 18th, 2020 / 7:05 p.m.
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Conservative

The Deputy Speaker Conservative Bruce Stanton

The hon. member for Niagara Centre will have eight minutes remaining in his time when the House next gets back to debate on the question.

The time provided for the consideration of Private Members' Business has now expired and the order is dropped to the bottom of the order of precedence on the Order Paper.

The House resumed from November 18, 2020, consideration of the motion that Bill C-213, An Act to enact the Canada Pharmacare Act, be read the second time and referred to a committee.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 7 p.m.
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Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Mr. Speaker, it is a pleasure to rise tonight to speak to the bill on pharmacare. I want to thank the member for New Westminster—Burnaby for bringing it forward. I am sure the reason he has brought it forward is to call for action. There has been a lot of talk about pharmacare but, to be fair, there has not been a lot of action.

By way of background, the Liberals have been talking about pharmacare since 1992. They have been studying and talking, but nothing really concrete has come forward. Therefore, I am glad to see we are talking about this tonight.

Members may want to pay heed to my commentary. As a former shadow health minister, I was on the health committee when we studied pharmacare. We have heard all kinds of testimony from every province and territory and from all sorts of Canadians about what they think about pharmacare as well as on related topics, like the drug approval process and rare disease medications, which are also important and need to be addressed.

All parties in the House are looking for a common outcome. We all want to see Canadians have access to prescription medications. The discussion is about the best route to get there. This bill proposes to put everybody on provincial coverage essentially. That may be an oversimplification, but that is what it is.

If we look at the situation today, between 95% and 98% of Canadians have prescription drug coverage, depending on which report we look at and depending on the types of coverage. Many people have private plans. Those private plans typically cover more than 14,000 medications compared to the public plans that cover 4,000 to 5,000 medications. The private plans cover, in addition to the medications, many services. People are getting physiotherapy, orthotics, various and sundry, with their plans. However, not a lot of people who have a private plan would want to give that plan up to go on a public plan that would have less coverage. That is certainly one issue.

Most provinces have a plan that covers people. There are some exceptions. For example, in Ontario, people under 24 get coverage. If they are over 65, they get coverage. If they are on social assistance, they get coverage. Otherwise, unless they have a private plan, there is no coverage. There are some gaps there.

The other gap happens in the Atlantic provinces. In some cases, there is a plan there, but because the list of approved drugs is small, many people cannot get coverage for the particular drug they are taking.

This brings up an important consideration when we talk about the bill. The member's bill talks about the Canada Health Act and its requirements for accessibility and universality. If we talk about universality, it is difficult to have that in different provinces when each province has a different list of drugs that are covered. This is called a formulary.

Some Canadians move between provinces to get coverage for the medication they need because is not covered by their province. Through consultation and discussion with the provinces and territories, we could come to a more common list of medications that would be covered. That would go a long way.

Many people who do not have coverage may not be aware that they have access to a provincial plan. There is an opportunity to increase awareness in that way, and that should be done.

On the cost of these systems, the cost of transferring and putting everybody on provincial plans has been estimated. The Liberal proposition was for a single-payer federal system of pharmacare, and the Parliamentary Budget Officer costed that at about $20 billion a year. However, some of the costs we were paying for prescription drugs were underestimated by about another $20 billion. Therefore, we are looking at about $40 billion a year for that. I think there was a lot of resistance in the public to that idea.

We have seen what happens when the federal government tries to implement things. For example, the Canada Revenue Agency has a 30% error rate with the advice it gives people and is not always friendly on the phone. I do not think people would necessarily want their prescription medications administered in that kind of system. However, people are fairly happy with the provincial systems, so filling the gaps that way is one option.

Other options could be considered, and it is certainly worthwhile thinking about them. C.D. Howe published a report that said if we put the people who did not have coverage on the existing provincial plans, the cost would be about $2.2 billion a year. That would be reasonable.

As an engineer, when I was a contractor, I had to buy my own benefits. For $1,200 a year, I could not only have prescription drug coverage but I could have dental and medical coverage. On a volume discount, if we take the 2% to 5% who do not have coverage and add it up, that is about $2 billion a year. There is an idea where people could go on government benefits.

There are a lot of ways to approach this and the discussion needs to be about which way makes the best use of taxpayer money and takes advantage of some of the systems already in place.

Let me talk for a minute about rare disease medications, because this proposal would do nothing to address some of the issues with respect to that.

Today, to get coverage for rare disease medications, private insurance companies pool their money so not any one company has to take the risk of these very expensive medications, some of which cost $250,000 a year or a million dollars a year. If the government infused money into that pool on the condition that everybody would get their rare disease medications covered, that would be another great way to ensure people would have coverage for some of the most difficult to cover drug costs.

Access to medications also depends on ensuring that drug companies want to market their drugs in Canada. Unfortunately, the Liberals have put changes in place to the drug approval process which will make the process longer and more costly. As a result, many companies do not want to market their medications in Canada because we are a small population and they would have to operate at a loss. This has also impacted the number of clinical trials happening in Canada. The government needs to definitely reconsider that poorly thought out policy.

If we look at some of the examples of innovation happening in the world, Chile has a great funding model that is infusing money into a rare disease fund, but also allowing people to buy government bonds that also kick into that fund. There are a number of innovative ideas around the world at which we should take a look.

I look forward to working with my colleagues on this bill toward the common goal of getting prescription medication access for all Canadians. A number of things could happen to our benefit out of this. We would have better volume leverage and could reduce the cost of drugs and take away some of the co-payer issues that provide barriers. I look forward to discussing all these things with my colleagues when this comes to committee.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 7:10 p.m.
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Bloc

Luc Thériault Bloc Montcalm, QC

Mr. Speaker, Bill C-213 builds on the Canada Health Act to establish a universal, comprehensive, single-payer pharmacare program.

The federal government would simply provide money to the provinces who would put in place a pharmacare program that meets the criteria it sets. The federal government can impose sanctions if it deems that the province's pharmacare program does not meet the federal criteria. The bill also creates a drug agency responsible for approving the drugs covered by the program and negotiating drug purchases.

The Bloc Québécois is against this bill primarily because we represent the voice of Quebec in Ottawa. If the government did not need NDP votes to stay in power, it would never accept the centralist agenda of this bill that completely violates Quebec's jurisdiction. In fact, the National Assembly of Quebec was unanimous on June 14. I will read the motion that was passed unanimously by all the parties at the National Assembly of Quebec: Québec solidaire, the Parti québécois, the Quebec Liberal Party and the Coalition avenir Québec.

The motion reads:

THAT the National Assembly acknowledge the federal report recommending the establishment of a pan-Canadian pharmacare plan;

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

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

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

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

When our National Assembly speaks with one voice on an issue dealing with Quebec-Ottawa relations, we in the Bloc Québécois pay attention and make sure that that consensus is echoed in the House of Commons of Canada. Given that the National Assembly was careful to specify that Quebec would refuse to adhere to a pan-Canadian pharmacare plan, we would find it strange to ask for a program that would not apply back home.

The NDP adopted the Sherbrooke declaration in 2005, in which it said it recognized asymmetrical federalism and intended to give Quebec the systematic right to opt out, so it is odd that the New Democrats now seem to be writing off Quebec.

There is no question that health is a Quebec jurisdiction. The Bloc Québécois finance critic, my hon. colleague from Joliette, took a similar position before the Fédération des travailleurs et travailleuses du Québec, the FTQ. His position echoed that of the FTQ.

Let me quote from a statement from the FTQ, a labour organization that has been advocating for a universal public pharmacare program:

For the FTQ, the terms and conditions of a public, universal pharmacare program must first and foremost be discussed in Quebec and established according to the needs of its people.

That is why Quebec must be able to opt out with full compensation from any pharmacare plan...

Furthermore, the federal government cannot discuss pharmacare without addressing the problems in health care funding....The Liberal government's desire to expand public coverage of health care by including prescription drugs is not consistent with its intention to limit health transfers to the provinces....To ensure the viability of Quebec's health system, the portion of federal funding must be increased.

If Ottawa wants to move forward with its national pharmacare plan, Quebec must have the unconditional right to opt out with full compensation. Ottawa must respect the solemn moment on June 14, 2019, when the Quebec National Assembly unanimously adopted a motion calling on Ottawa not to interfere in Quebec's jurisdictions and to provide full and unconditional financial compensation.

It was impossible for the member for New Westminster—Burnaby to not be aware of this when he introduced his bill.

Quebec is a progressive nation. It is surprising that the NDP, which calls itself progressive, wants a nation that lags behind ours to tell us what to do. Generally speaking, Quebec society has more comprehensive social programs than Canadian society. Quebec has the best family policy on the continent, which includes parental leave and child care. Quebec has the best access to post-secondary education and the most progressive taxation on the continent. Furthermore, Quebec has a pharmacare plan that leaves no one behind. Everyone is covered by insurance.

Although it is not perfect, our situation is unlike any other in North America. Quebec's pharmacare plan has been leading the pack among Canadian provinces and territories since 1996. Quebec will not entrust the development of its social programs to the neighbouring nation, whose coverage does not compare to ours.

The members of the Quebec National Assembly are unanimously opposed to this initiative. The members of the Bloc Québécois, who rise in the House to impart the general consensus of the Quebec National Assembly, will not compromise at the expense of Quebeckers to salvage some votes in the west, in the east or in Ontario. Not to mention, Ottawa is not even able to manage its own affairs. Just look at the firearms registry, which ended up costing $2 billion, or the Phoenix pay system; and yet people think Ottawa should manage our pharmacare program?

Quebec is quite capable of improving its own program without surrendering its autonomy. The $3.6-billion price tag for Quebec's public pharmacare plan is fully covered by the Régie de l'assurance maladie du Québec, or RAMQ, which covers health care costs. What Quebec needs is an increase in health transfers.

Since 2017, the health transfer escalator has been capped at 3%, but health care system costs are going up by about 6% because of factors like technological advances and the aging population.

The Bloc Québécois is asking Ottawa to respect the wishes of Quebec and the provinces and increase its share of health care funding from 22% to 35% unconditionally. Let us not forget that, back when the Canadian system was created, federal funding covered 50% of the cost.

The Bloc Québécois is also opposed to the creation of a Canadian drug agency that would tell Quebec how to use its drugs. Quebec is already managing its public prescription drug insurance plan expenses itself through the pan-Canadian Pharmaceutical Alliance, the pCPA, and the national institute for excellence in health and social services, or INESSS, and Quebec's system has rigorous criteria.

The INESSS supplies Quebec with its own expertise and updates the list of drugs covered by the RAMQ, Quebec's health insurance plan. A new Canadian drug agency would just duplicate the work being done in an area that is not under federal jurisdiction. That is nonsensical.

That is why I moved a motion on October 26 at the Standing Committee on Health to study how reforming patented medicine pricing could affect the whole life sciences ecosystem and patient access to innovative therapies.

During the election campaign, the Liberals said they wanted to do something about the cost of drugs used to treat rare diseases. They reiterated that intention in the throne speech, but we are still awaiting the strategy. The federal government needs to give us more details about its plans. Most importantly, it needs to tell us whether it intends to harmonize its rare disease strategy with Quebec's.

In closing, recognizing that Quebec's plan is the best one on the continent and emphasizing that Quebec has the right to decide does not mean that our plan is perfect, but Quebeckers are perfectly capable of managing it. The NDP and the Liberals have a harmful obsession with wanting to interfere and wanting to decide for Quebec where Quebec should spend its money. Rather than clinging to its centralizing vision, the government should instead agree to Quebec's demands and permanently and substantially increase health transfers so that Quebec can take care of its people.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 7:20 p.m.
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NDP

Jagmeet Singh NDP Burnaby South, BC

Mr. Speaker, I appreciate the opportunity to share my thoughts on this very important bill. It is an immense honour for me to take the mike right now and speak to my colleague's bill. I want to thank my colleague from New Westminster—Burnaby for bringing this bill forward. This is a very special opportunity that we have right now to make a massive difference in the lives of Canadians.

In Canada in this pandemic, we have seen millions of Canadians lose their jobs, and when they lost their jobs, they also lost their benefits. That means millions of Canadians were not able to purchase the medication they needed. This is on top of the millions of Canadians who already simply cannot afford their medication. Whether they do not have coverage at all or have coverage that costs too much, very, very many Canadians are not taking the medication they need because they simply cannot afford to.

I have spoken to so many families and so many people who tell me of the pain of not being able to afford their medication. I think of a family in which the father works in construction, and he has a heart illness that requires him to take medication to stay healthy, but he cannot afford that medication, and on top of that, his children need medication. Therefore, he has to choose not only between paying the bills or buying his medication, but also between buying the medication either for himself or for the children he loves. That is an impossible position to be in, and he is not alone. There are so many families that face the same decision.

We know that one out of five Canadians are not taking their medication, simply because they cannot afford to. We know that when someone cannot treat an illness, they end up at the worst stage of that illness, and it costs the system and the family and the person so much more. Having universal access to medication so that everyone in our country could afford it would dramatically improve the lives of everyone.

The Liberals have been promising universal pharmacare for 23 years. They promised again in 2019, but have people seen any difference in their lives when it comes to accessing medication? They have not. We have seen, sadly and again and again, that the Liberal government sides with the pharmaceutical industry instead of with Canadians who are desperate to stay healthy and afford their medication.

We have a concrete solution. The solution is to use the combined power of our entire nation to negotiate better prices so that everyone in our country can afford medication. This is so important. This is an opportunity to save lives. I am asking everybody to think about the millions of Canadians who cannot afford medication, to think about our health care system that allows someone to go to a doctor and be diagnosed with an illness but not to be able to afford the medication they need to stay healthy, to think about the only health care system in the world that provides universal health care but does not include medication coverage, and to pick up their phone and call their local MP.

I ask people to sign petitions and write letters. We have a week left. This vote on the first step to establish the first-of-its-kind, free medication coverage for all Canadians is next week. We can put pressure. We can show that this is the way forward and we can win. People have shown the power of organizing; they have shown again and again that when people come together, we fight and we win.

Once implemented, medication coverage for all Canadians would mean that no one in our country would have to worry about paying for medication. If someone needed medication in this country, they would use their health card and not their credit card. That dream can be a reality, and once implemented, it would establish a savings of at least $4.2 billion that could be reinvested into our health care system.

Here is an opportunity for the Liberal government to back up its words. Its own report states that one of the key steps to establishing a universal public medication-for-all system is to pass a pharmacare act like the one we have proposed. It is far past time to pass such a measure and deliver universal pharmacare to Canadians. Let us get it done now.

No one should have to choose between paying the rent and filling a prescription. One in five Canadians is not taking the medication they need because they cannot afford it. Many Canadians are cutting their pills in half or even deciding not to buy their medication at all because they cannot afford it. Too many people are ending up in the emergency room or in the hospital for an extended stay because they cannot afford to take the medication they need. Hundreds of people are dying prematurely every year. Even those with private insurance are seeing the coverage offered by their employer decrease. People are in more precarious jobs, and their family budget is getting tighter and tighter. We need to help families, not make their lives more difficult.

I have met many families in Quebec who say that it is getting harder and harder to buy private prescription drug coverage. It is getting harder and harder to get drug coverage and buy medication. I spoke with unions that represent thousands of workers, and they all say that prescription drug insurance cost workers too much.

It is essential to have fully public pharmacare in Quebec and across the country. Canada is the only industrialized country whose health insurance does not include universal, public coverage of prescription medication. That does not make any sense.

The Liberals have not stopped breaking promises for the past 23 years. They would rather protect the profits of big pharmaceutical and insurance companies than help people. In 2019, they made yet another promise to introduce pharmacare, but they have done nothing concrete since to keep that promise. The Liberals say all the right things in public, but they keep putting powerful pharmaceutical companies' profits ahead of people's needs. They now have an opportunity to vote for our bill to give Canadians a comprehensive universal pharmacare program.

This bill is the first step toward creating a pharmacare program. If the Liberals really want to help Canadian families, they can work with us to provide the universal pharmacare program people need.

I invite all Canadians to contact their MP and ask him or her to vote in favour of a universal public pharmacare program. We must vote in favour of Bill C-213, a bill to help families and save lives.

I am grateful I had the opportunity to share these words. Again, we have an opportunity to save lives, to help families and workers. It is essential that our health care system cover everyone and that also means providing a universal pharmacare program. Together, we can do this. I invite everyone to demand that we undertake this next step towards a universal, comprehensive health care system.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 7:25 p.m.
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Dartmouth—Cole Harbour Nova Scotia

Liberal

Darren Fisher LiberalParliamentary Secretary to the Minister of Health

Mr. Speaker, I am pleased today to address Bill C-213. As all members know, I firmly support national universal pharmacare and the government knows that pharmacare is the missing piece of universal health care in the country. Pharmacare must remain a priority for all members in the House.

Implementing national universal pharmacare is one of the government's top priorities, as reiterated in the September 2020 Speech from the Throne and in the 2020 fall economic statement.

No Canadian should have to choose between paying rent or paying for needed prescription drugs. Too many of my constituents, too many Canadians, are experiencing this every day. The COVID-19 pandemic has exposed many unfortunate truths in the country and one of those truths is that too many Canadians are also a step away from this unfortunate reality.

While drug coverage is an area of provincial-territorial jurisdiction, the pandemic has reminded us that collaboration between governments is essential to support the health of Canadians. The federal government recognizes the important role that both orders of government must play to ensure all Canadians have the drug coverage they need. We understand that the federal government must support provinces and territories as they implement pharmacare so it will become an enduring element of our health system. This simply is not achieved by imposing federal legislation without consultation and without co-operation of our partners at the provincial and territorial level.

I firmly support national universal pharmacare and I will continue to work tirelessly with our government to move it forward. I will be opposing this private member's bill. The issue at the heart of the bill and the reason I will be opposing it is that it discounts the need for co-operation.

We know that in order to make national pharmacare a reality in Canada, we need to recognize the key role the provinces and territories play in providing health care for their citizens. The bill misses the mark and overlooks a wealth of experience built up about how to do that, not in Ottawa but in Dartmouth, Victoria, Quebec, Charlottetown and all across this amazing country.

Establishing universal pharmacare successfully requires a collective approach, a collaborative approach, where the federal government works with and through the provinces and territories. Unilateral federal action to impose national universal pharmacare as proposed under Bill C-213 would be akin to establishing public medicare for hospital and physician services without prior discussion with provincial and territorial governments and health system stakeholders. Such unilateral action would contradict commitments the Government of Canada has made over the past three decades to take a collective approach to social policy issues of a national concern.

The government must be careful not to disregard the vital role that provinces and territories currently play in designing and delivering public drug coverage in Canada. Over time, provinces and territories have developed more than 100 distinct public drug plans, typically designed to provide coverage for vulnerable groups, including seniors and people on social assistance. If we are going to transform a complex patchwork of drug coverage into a national pharmacare program, we must do it in collaboration with our partners, relying on the considerable expertise that jurisdictions have in this area.

Our government has been clear in its commitments to national pharmacare. Now is the time for governments to take action and make it a reality. Co-operation from provinces and territories will not just get pharmacare up and running; it will ensure it continues to operate smoothly well into the future.

In the 2020 Speech from the Throne and the fall economic statement, the government reiterated its intention to accelerate steps to implement national universal pharmacare, including a rare disease strategy to help Canadian families save money on high-cost drugs; establishing a national formulary and a Canadian drug agency to keep drug prices low; and, perhaps most important, working with those provinces and territories that are willing to move forward without delay. We all know that actions speak louder than words, which is why I am pleased to say that our government has already started taking these steps.

In November, the government initiated discussions with provinces and territories on the strategy for high-cost drugs for rare diseases. Earlier this month, the government began engaging with key partners and stakeholders, including patients and patient groups. As public engagement continues, our government will also consult with clinicians, academics, researchers, health technology assessment organizations, pharmaceutical manufacturers, private insurance providers and indigenous partners.

Budget 2019 also announced $35 million over four years to establish a transition office. This office is being created to provide dedicated capacity and leadership to advance work on pharmacare-related priorities.

We are committed to taking the appropriate next steps to implement national universal pharmacare. We are rolling up our sleeves and putting the resources in place to make it happen. First ministers have initiated a dialogue on health care funding, and that conversation will continue. In parallel, the Minister of Health will seek to establish a collaborative process with willing provinces and territories to define the broad terms of the pharmacare plan.

As I have said, our government fully supports national universal pharmacare and will continue to do the work needed to make sure this becomes a reality for all Canadians. Although we support the spirit of Bill C-213, we recognize that imposing this criteria on the provinces and territories without working with them would be premature and would not build national pharmacare as an enduring final piece of Canada's universal health care system.

People do not frame and put a roof on a house without building a strong foundation first. That is why we are moving forward with willing jurisdictions to build a collective commitment to national pharmacare, guided by the advisory council on the implementation of national pharmacare.

Turning our current patchwork of drug plans into a coherent, comprehensive approach that benefits all Canadians will be no small feat. As we move forward, we need a thoughtful conversation about how best to meet this challenge together. We must work with the provinces and territories, as I have said, to implement a national pharmacare plan that works well for our residents. We must work with first nations, Inuit and Métis governments and representative organizations to make sure national pharmacare is appropriate for their communities. We must work with patients and providers to make sure a national pharmacare plan gets Canadians the drugs they need.

I am looking forward to discussions with provincial and territorial counterparts. Together, we are making progress toward a pharmacare program that will meet the needs of all Canadians from coast to coast to coast.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 7:35 p.m.
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Conservative

Tom Kmiec Conservative Calgary Shepard, AB

Mr. Speaker, the most difficult medication to buy is the one that is not available in Canada. It is the one someone finds out about after going to their doctor and being told that it is in the United States, and if they were an American citizen, they could get access to it. However, since they are a Canadian, they cannot. That is the news that too often happens to patients with rare diseases and to their families. My family is one of those families. The families dealing with cystic fibrosis, with SMA and with cystinosis are other ones. The list goes on and on.

Bill C-213 is a solution looking to address the wrong problem. The problem is access, and access is what I want to talk about this evening.

I have gone through the speech by the member for New Westminster—Burnaby. My colleagues from Calgary Nose Hill and Sarnia—Lambton went over a lot of territory in pointing out what is wrong with this particular piece of legislation.

The legislation is trying to address the wrong problem. I want to demonstrate that by sharing some of the issues I have with what the member for New Westminster—Burnaby said and address them piece by piece to demonstrate why this is the wrong bill.

It does not achieve any goals. The goal should be to provide access to patients in Canada through greater choice in drugs, drugs that will actually ensure they get over their condition or that will provide a therapy that reduces their symptoms, instead of looking at their American counterparts, citizens of America. Some of them are dual citizens, and they, for example, can have access to that medication when they go to the United States, but they cannot access it here in Canada unless they are one of the very few who have a special access program for it.

One of the NDP members mentioned that currently in Canada we have a patchwork of provincial systems. We know that in Canada, 90% to 98% of Canadians have access to some type of either private or public insurance. In fact, nearly all the provinces have a public insurer. In Alberta, it is the Alberta Blue Cross that people can get access to.

Two provinces that I am aware of have already said they will not participate in national pharmacare. In November of 2019, Alberta finance minister Travis Toews sent a letter to the federal government indicating that the provincial government, the Government of Alberta, would not participate in national pharmacare. It will want an opt-out. Members for the Bloc have said that their provincial government will not participate either. What will happen? We will have a patchwork system again. Again, because this bill does not consult with anybody or ask the provinces what they are thinking or recognize that it is in the jurisdiction of provinces, it does not achieve any of the goals.

Speaking of access, the Ontario government, the previous government, took a bunch of people and put them onto OHIP+. It transferred 2.1 million Ontarians who already had private plans onto a public plan at a higher cost, a plan that provided worse coverage than what they had before. I had many people explain their particular situation. They liked their private plan.

When a survey is done to ask people if they like the private plan they are on or the public plan they are on, most Canadians, by a wide majority, say that they do like the plan they are on. I agree that there are people who have difficulty paying for some of the copayments, but this bill does not address that. This bill proposes to centralize everything in Ottawa and then figure it out later.

I have come to believe, after five and a half years here in Ottawa, that when someone says they will figure it out later, it usually will cause harm to Canadians in the long term, especially if they are one of those one in 12 Canadians dealing with a rare disease. Many people have someone in their life who has a rare disease. I have three children with a rare disease. I had a daughter pass away from a different rare disease three years ago.

The problem in Canada, as I said, is being made worse by federal government action through the PMPRB. This problem will not be addressed through anything in this particular piece of legislation. This measure is coming forward because of a false belief that it could somehow artificially reduce the price of medication coming into the market in Canada.

There is a PBO estimate that has been provided and repeated now by several members that the total spent on public health care will be reduced by $4 billion to $4.5 billion. They call it the universal discount. Actually, if we look at the data in the PBO report, 25% is completely random. This is one of the rare times when I disagree with the methodology used by the PBO. This 25% discount is already happening through the pCPA, the pan-Canadian Pharmaceutical Alliance, which is used by the provinces to negotiate with manufacturers. They are basically assuming an extra 25% discount “just because”. I do not think that is the way statistics should be done and I disagree with the analysis.

In fact, one of the members on the NDP side then went on to quote New Zealand as a good example of how it had been able to reduce drug costs. What people in New Zealand do not want to have is a rare disease. There is very little access to rare disease medication or the latest and greatest most innovative drugs to address their condition. There are countless examples online of New Zealand citizens fleeing to other countries to obtain access to medication. New Zealand is the worst example anywhere in the world if people have a rare disease.

There is a Yiddish saying, “He who runs away from fire, falls into the water” and that is what is happening here. There is a problem and the solution that is being called upon is a centralization of all the plans in Canada to wipe out the architecture, the jobs, the system that many Canadians rely on and generally like. It is not perfect; there are issues with it. We are running into a system, we are going to fall into the water and drown. Things would be made worse by the changes being proposed.

On the issue of PMPRB's costing, for example, we often talk about rare disease drug costs and how it puts a huge dent in provincial budgets. If we look at non-oncology drugs, 70% of what the PMPRB says is for rare disease medication is actually being used for secondary uses. Therefore, if people have a rare disease and there is a drug for, it is given by a doctor and it is used, but then there has to be a second, third or fourth usage. The medical system says that it can be used for those other purposes. That is being included in the final statistics. It is wrong to say that rare disease patients will cost the system more when in fact different types of medication are also used for other purposes or uses.

According to the annual report of the PMPRB, the changes in the cost is 2.5% to 2.6%. I will credit the Canadian Forum for Rare Disease Innovators for these statistics and these points. It is very compelling evidence that the costs for rare diseases are not caused by rare disease patients. In fact, it is other uses for the same innovative medicine that is coming to Canada. To reiterate my point, the hardest medication to purchase in Canada is that which is not available in Canada.

I want to take a moment to credit and thank Alberta Minister of Health, Tyler Shandro, for his January 17 interim agreement for Zolgensma, which is a groundbreaking, innovative medication for children with SMA type 1 spinal muscular atrophy, one of the most dangerous conditions that will kill children if they do not get access to a type of medication. This is the same minister who compassionately approved and ensured there was access in Alberta quickly for Spinraza, three weeks after he was named minister. I told him I would hound him until he made it happen. To his credit, he did, and compassionately years later he ensured there was access to Zolgensma for children under age 18 in Alberta. I do not believe a national pharmacare minister like that could act as quickly as a provincial minister could acct when he feels the pressure from constituents, residents and elected officials.

We have Cystinosis, examples of cystic fibrosis, and Trikafta and Orkambi. There is groundbreaking medication out there being made available to people living in other countries that is not available here. The bill would not fix any of those issues. There are other solutions to fill the gaps in place and I would love to discuss those solutions and look for ways to improve the system in different matters.

The member for Calgary Nose Hill brought up a few of them, so I will reiterate them. Common drugs are classified in different countries as over the counter. Australia does an amazing job of this as does the United Kingdom. We can look at what the public health spends on certain medications and maybe find a lower dose that could be available over the counter. Some antibiotics come to mind. Some estimates suggest that just three of those drugs could save $1 billion a year on drug spending.

There are other things we could do to reduce the bureaucracy in the system. Too many Canadians are trapped between the CADTH approval and the pCPA reimbursement agreement.

What I care most about is access for patients with rare diseases. Bill C-213 does not achieve any of those goals. I cannot support it.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 7:45 p.m.
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Conservative

The Deputy Speaker Conservative Bruce Stanton

Before we resume debate with the hon. member for Edmonton Strathcona, I will let her know that we are just short of the 10 minutes that are usually allocated, with leaving five minutes for the sponsor of the bill to have his right of reply.

Let us get started, and I will give her the signal as we get close to that time, which is around eight minutes or so.

The hon. member for Edmonton Strathcona.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 7:45 p.m.
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NDP

Heather McPherson NDP Edmonton Strathcona, AB

Mr. Speaker, I am delighted to speak in support of Bill C-213, sponsored by the member for New Westminster—Burnaby.

This bill is historic. It is a bill that would give us the potential to make history by finally getting pharmacare to Canadians who so desperately want it.

We have heard today that approximately one out of every five families in Canada struggles to pay for prescription medications, and we know that the claim that all Canadians have access to medication just is not true. It is not accurate. These are not statistics. These are real families.

Before COVID-19, when I was able to knock on doors and talk to constituents in person, access to prescription medicine was the number one issue I would hear from people. I remember talking to a man who struggled to speak as he was caught up with emotion. He talked to me about skipping days taking his blood pressure medication, hoping that he would get by: that he would make it and would not die. I spoke to a senior in my own neighbourhood who was sharing a prescription with her husband, because they could not afford both. I will never forget talking to one young father who implored me to get pharmacare passed. It was not because his family needed it. His family was doing quite well, but he knew families at his daughter's child care centre who did not have access, and he wanted to make sure that those children were taken care of. This was all before the pandemic, and before things got worse.

There is no doubt that COVID-19 has made Canadians' ability to access medication so much worse. Millions of Canadians who lost their employment due to COVID-19 also lost their prescription drug coverage. People who could count on their health plans before COVID no longer could.

In Alberta, when we were entering the pandemic about a year ago, our provincial Conservative government cut drug benefits for seniors, spouses and dependants so 46,000 people, mainly with ongoing health issues, including dependants living with disabilities, were suddenly without coverage. I find it shocking that the member of Parliament for Calgary Shepard can speak of Minister Shandro as being compassionate, when 46,000 Albertans lost their drug coverage. Many Canadians were facing the stark reality that our medicare system was not going to be able to keep them healthy. This pandemic has opened their eyes, and COVID-19 has shown us just how vulnerable we are.

Canadians have been waiting for this. Canadians have been waiting for nearly 60 years to get prescription medications included in our health care system. Twenty-three years ago, the Liberals first promised Canadians a national pharmacare program, and they have been repeating that promise ever since. We have had five public commissions on pharmacare, and study after study. If the member for Calgary Shepard does not want to believe the PBO report, perhaps he will believe the Hoskins report. All of these reports said the same thing: Canadians need pharmacare, and pharmacare will save Canadians money. However, here we are.

As Canadians face an unprecedented health crisis with COVID-19, there is another health crisis that we can and need to fix right now. Millions of Canadians are without access to medication, and we can fix that with Bill C-213. We need to vote yes to Bill C-213.

We have an obligation to learn from COVID-19 as well. We have a duty to Canadians to create a better Canada that will be more resilient to the crises of the future, including the next pandemic. We must build systems that protect all Canadians, not just some Canadians and not just Canadians who can afford it. When everyone has access to the medication they need, they are healthier and the burden on our health care system is lessened. It is really that simple.

The government has floated the idea of partial pharmacare that is not universal. That is not what Canadians want. Canadians want a simple program that includes everyone. Canadians want to go to the pharmacy and pick up their medications. That is the system we want, and that is the system we need: a national universal system protected against people like Jason Kenney who are determined to undermine it, and a system that will actually save Canadians billions of dollars.

There is something else vitally important that we have learned from COVID-19: Canada has the capacity to do this. We saw how fast Canada moved when the pandemic was declared.

The cost to enact pharmacare is pennies on the dollar compared to the savings. Pharmacare will save families on average more than $500 a year, whether they are insured or not, and employers and small businesses will save $600 a year per job. Pharmacare will reduce emergency wait times and free up more hospital beds for those who need them. It will save the government billions.

I urge this House to follow the recommendations of the Hoskins report and apply them by supporting this bill. The Hoskins report recommends that the federal government enshrine the principles and national standards of pharmacare in federal legislation separate and distinct from the Canada Health Act. The Hoskins report also recommends that the five fundamental principles of medicare embodied in the Canada Health Act also be enshrined in federal pharmacare legislation. Those principles are universality, comprehensiveness, accessibility, portability and public administration. The Hoskins report also proposes that this legislation come into force no later than January 1, 2022.

Now is the time. Now is the time we can do this. As parliamentarians, this is something we can give to Canadians right now, at a time when they need it more than ever. Today is the day to support pharmacare for all. I implore my colleagues within the House to vote yes on Bill C-213.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 7:55 p.m.
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NDP

Peter Julian NDP New Westminster—Burnaby, BC

Mr. Speaker, it is rare that we have an opportunity in the House of Commons to make a difference in the lives of so many of our constituents. As we well know, over 90% of Canadians support the idea of putting in place public, universal pharmacare. Over 90% means that in every single riding across the country, the vast majority of Canadians support public, universal pharmacare.

When Canadians are asked what they are proudest of among our institutions, it is our universal health care system. Of course, the Canada pharmacare act would put in place the same principles around pharmacare that we already have in place around universal health care.

Any member of Parliament who consults with his or her constituents will get the same reply. Canadians want to see this. Particularly with the pandemic and the devastating impacts that we have seen both on the health and the financial well-being of so many Canadians, it is absolutely essential that we move forward and put in place public, universal pharmacare, which Canadians are asking for and desperately need.

We have been at this debate for a few months. Tens of thousands of Canadians have participated. They have participated by emailing their member of Parliament, by phoning their member of Parliament and by telling their member of Parliament to vote yes on Bill C-213.

During this debate, we have seen a number of facts come to light. We were made aware, through this debate, that millions of Canadians have no access to a drug plan. They have to struggle to pay for the medication their doctor has prescribed for their health and well-being. We have also learned that hundreds of Canadians die each year right across the country because they cannot afford to pay for their medication. Through this debate, we have also learned that for 60 years Canadians have been waiting to have the public, universal pharmacare they so desperately need.

The Hoskins report points out very clearly what the road map is, which is that we have to lay the foundation by ensuring we have the same principles around public, universal pharmacare that we already have around our public, universal health care system.

It would be dangerous to say no to this bill, because that would reject public, universal pharmacare. It would reject the expansion of our public health care system that Canadians are looking for, and it would reject the advisory council's Hoskins report. It would mean that there is no foundation to build the public, universal pharmacare that Canadians so desperately need.

During these debates we also learned that many people in Quebec are calling for a universal pharmacare program. Currently, many Quebeckers are not covered, and that is why the major unions are calling for this type of public, universal program. More than 40 or so municipalities in Quebec are calling on MPs to vote in favour of Bill C-213. There is widespread support.

We have also learned that dozens of organizations with millions of members are asking all members of Parliament to vote yes on Bill C-213. We have doctors and nurses right across the country who are saying that it is absolutely vital for Canadians' health and well-being. We must listen to those voices.

I mentioned earlier this is a historic moment. It is one of those moments that determine the strength members of Parliament have in consulting with their constituents, and we need to think of our constituents at this key decision point in our history.

I am thinking of Cole and his family. He is a constituent in high school whose family struggles with $1,000 a month in drug costs. Those drug costs, that medication, keeps the father of the family alive. That family struggles and every day has to decide how they can pay for that medication and whether they can also put food on the table and a roof over their heads.

Around kitchen tables right across the country, there are millions of Canadian families who are in the same situation. I ask members of Parliament to think of their constituents, more than 90% of whom who support this bill. If members of Parliament do that, I have no doubt they will vote yes next week on Bill C-213, the proposed Canada pharmacare act.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 8 p.m.
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Conservative

The Deputy Speaker Conservative Bruce Stanton

Accordingly, the question is on the motion.

If a member of a recognized party present in the House wishes to request either a recorded division or that the motion be adopted on division, I ask them to now rise and indicate so to the Chair.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 8 p.m.
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NDP

Lindsay Mathyssen NDP London—Fanshawe, ON

Mr. Speaker, we request a recorded vote.

Canada Pharmacare ActPrivate Members' Business

February 17th, 2021 / 8 p.m.
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Conservative

The Deputy Speaker Conservative Bruce Stanton

Pursuant to an order made on Monday, January 25, the division stands deferred until Wednesday, February 24, at the expiry of the time provide for Oral Questions.