Bill C-213 (Historical)

Canada Pharmacare Act

An Act to enact the Canada Pharmacare Act

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.

Consideration of Government Business No. 39

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, just to confirm, now that the motion has passed regarding Motion No. 39, I lose my unlimited time and I now have a 20-minute slot. Therefore, I will have to share my time with the member for Cumberland—Colchester, even though I would have enjoyed continuing to speak to an issue that I hold very dear to my heart, which is the approval of drugs for rare diseases in Canada and how patients can get access to them. Those two words actually only appear once in the legislation.

People with a rare disease are some of the most needy patients in Canada. As I said during the debate on Bill C-213 back in 2021, the hardest medication to get in Canada is the one that is not approved and not available because the manufacturer will say that Canada is too complicated, too difficult and it is not worth its time to try to get it onto our market. That is because of all the regulatory hurdles and steps that exist that make it very difficult for patients with rare diseases to get access to the drugs they need.

We saw this with cystic fibrosis drugs for patients who were trying to get access to Trikafta. It took many years from the time when it was available to patients in America to when it was available in Canada, and it was regulatory hurdles that made it much more difficult to do so.

Now that the government has passed this gag order on the gag order, it will direct the Standing Committee on Health on how it will consider the matter.

I want to draw the attention of the House to the debate on May 6, page 23051, where the Minister of Health responded to a question from the member for Berthier—Maskinongé about the timelines and why the Liberals were limiting debate. At the time, the minister said, “ there will be time for the committee to conduct a study.” I would put to members and constituents back home that a potential 10 hours of witness testimony at a committee is insufficient time to consider this pamphlet of a bill that the NDP-Liberal coalition is pretending is pharmacare. I have read the legislation in full, so I will comment on its contents as well.

The minister went on to say, “Yes, it is important to debate. However, there is plenty of time for debate in committee and during the rest of the House process. It is time to get on with it and move forward.” With this programming motion, the Liberals have essentially ordered the MPs on the committee to only consider it for a few more hours and then send it back here. In fact, after this bill has passed, there is now only one more day left for amendments to be considered. How can amendments be proposed without hearing from officials and witnesses who might bring forward amendments that would be of value to be considered by parliamentarians on that committee? It seems this is completely backward.

I want to comment on the issue of Conservatives delaying the bill, because this is a favourite talking point now of the Liberals and their colleagues in the NDP. I want the member for New Westminster—Burnaby to pay close attention to this. The bill was tabled on February 29. I would suggest that almost three and a half years into this mandate, this bill was not a priority of the government. Second of all, this bill was considered on April 16, May 6 and May 7, three days of consideration by the House of Commons. There were secret negotiations held between the Minister of Health, because he actually said it on the record, and whichever person on the NDP side who was negotiating so they could cobble together this particular piece of legislation.

I would put to members and my constituents back home, who deeply care about patients with rare diseases like I do, that there is nothing in this particular piece of legislation for them. It is not the job of the House of Commons or members of Parliament to simply ratify a secret deal reached between the Minister of Health and the NDP negotiator or negotiators. Our job is to debate, to bring forward ideas and potential amendments from expert witnesses, stakeholder groups and individuals back in our ridings who deeply care about this issue.

I will also mention that although Quebec has been mentioned several times, there is another province that has said openly it will not participate in this pamphlet of a pharmacare plan. It is Alberta, where I am from. Successive ministers of health have said they will not participate in it. One of the talking points I have heard is that we have a patchwork system right now in Canada. Saying “patchwork” is a way to kind of denigrate the hard work of the public servants in the different provinces in Canada who work for these public insurance plans. They are all over.

In fact, in Alberta, Blue Cross is available to anyone who wants it. There are lots of different public insurance plans. There are lots of public servants who work for them, and they work very hard to make sure they cover as many Albertans as possible. My province has said no and Quebec has said no, so we still have a patchwork. Even if this bill passes, even if it were to follow through on all the principles, the highfalutin language that I hear from the Liberals and the NDP on this, there will still be a patchwork in this country. We cannot force a province to participate.

As clause 6 of the pharmacare legislation clearly states, nobody's medication will be paid for. There are separate agreements that would have to be reached with each province. It says very clearly in subclause 6(1) of the pharmacare legislation, “in order to increase any existing public pharmacare coverage”. That would suggest that every single province has to either create or drastically expand a plan or successive series of plans that are single-payer, because that is one of the principles referred to again in that section.

If a province does not do that, it cannot negotiate a deal for future medication to be covered. No medication will get covered for either diabetes or contraceptives when this legislation passes. There will be none because no agreements have been signed yet. Alberta has said no, Quebec has said no, but the patchwork will continue.

I will move on to the legislation as I do want to mention this. Like I said before in a prior debate, there is a Yiddish proverb I used after listening to the minister's speech when he introduced Motion No. 39. He seems to think that pearls flow from his mouth because when I compared his speech at second reading on pharmacare, Bill C-64, and his speech on Motion No. 39, they were almost identical.

The minister actually used the exact same three anecdotes to make the case for why this plan is necessary. In the summary of the legislation, when the contents are reviewed, it gets into a lot of areas of provincial jurisdiction. This should be exclusive provincial jurisdiction. It is starting to interfere with how the provinces manage their public health care plans.

I will mention here that nobody with a rare disease will be covered by this piece of legislation. Nobody will be covered, whether someone has phenylketonuria, PKU, whether someone has cystinosis and needs Cystagon, or whether someone has MS, which is, I would say, the most common rare disease in Canada. None of their medication will be covered. If someone's kids have a rare disease, or a family like mine has Alport's syndrome, none of their medication will be covered by this piece of legislation.

The “Funding commitment” in clause 5 reads, “beginning with those for rare diseases. The funding for provinces and territories must be provided primarily through agreements with their respective governments. Then it goes on to talk about “payments” in clause 6 and completely contradicts clause 5 because it says, “for specific prescription drugs and related products intended for contraception or the treatment of diabetes.” In fact, there will be no payment plan for anything else. There cannot be because this legislation will not do any of those things. Nobody with a rare disease will be covered once this legislation passes.

I have been, I hope, consistent in this place about rare disease patients for the past nine years. That is the focus of my opposition to national pharmacare because it will not help them. Like I said, the hardest medications to get in Canada are the ones that are not approved in Canada. All the changes the government has done to the Canadian Agency for Drugs & Technologies in Health, CADTH, as well as all of the changes made to the Canadian Drug Agency, the PMPRB and the PCPA have been repetitive. The same mistakes are being repeated here.

The government says it is going to do bulk buying. Bulk buying is already done. It is done by the provinces through the PCPA. The government has an agreement for generics as well, which are not covered in this particular piece of legislation. There is no direct reference to generics. There is no direct reference to patented medication. It does not talk about those things. It takes years to get those drugs approved in Canada.

I would put to members and my constituents back home, who have emailed me because they are all so worried about this, that this is a pamphlet of legislation. The substance will be in the agreements that may come in the future. There are already two provinces that have backed out and other provinces are considering doing the same. Why is it that, since 2019, when the government announced it was going to fund drugs for rare diseases at $1.5 billion, it has done nothing? Not a single medication prescription has been filled for anyone I know with a rare disease in Canada. That money is just sitting there. The government has only started to put out RFPs to consider creating registries for rare disease patients. Registries, not medication. Most of the money remains unspent. The government has not done anything. That is the same thing that will happen here: a series of broken promises, unkept promises. The Liberals are being helped by the NDP to do this, giving people false hope.

I tell people who enter my office that the last thing I want to do is give false hope. I have two serious rare diseases in my family. Families who have rare diseases like mine cannot wait for the government to get its act together again.

Royal Recommendation for Bill C-237

[Louis Plamondon, Bloc, Bécancour—Nicolet—Saurel, QC]

Madam Speaker, I appreciate your intervention.

Only the specific conditions of the Canada Health Act are affected. The Speaker has ruled on many occasions that playing within these standards does not generate or reallocate an expenditure and therefore does not require a royal recommendation.

In the 27 years since the start of the 35th Parliament, when bills began to be tracked in the LEGISinfo parliamentary module, no fewer than 31 private members' bills have proposed amendments to the Canada Health Act.

All of them added new conditions. Some required the province to develop new services in order to receive the Canada health transfer. Others imposed requirements on how health services had to be delivered in order to receive the transfer. Others prohibited access to the Canada health transfer for provinces that provide certain free services, in this case abortion. I will let the members guess which party recommended that.

The Chair did not require a royal recommendation for any of these bills, not one. Of course, not all of them were on the order of precedence, so the Chair did not have to rule on many of them. However, in some cases, the Chair did have to do so.

Take Bill C-282, introduced during the 36th Parliament by the Liberal member for Ottawa—Vanier, the late Mauril Bélanger, a great defender of the rights of Franco-Ontarians. He introduced the bill in response to the crisis surrounding the Montfort Hospital, a francophone hospital in Ottawa that the Ontario government had tried to close.

The bill introduced a new condition in the Canada Health Act to set new language requirements for French-language services in the provinces and English-language services in Quebec. If the province did not meet these conditions, the minister could cut the transfer. The bill was placed on the order of precedence without the Chair indicating that it required a royal recommendation. It was subsequently debated.

If members consult the March 19, 2003, Hansard, they will see that the Parliamentary Secretary to the Minister of Health spoke on behalf of the Crown in the debate. He never made any mention of a royal recommendation. On the contrary, he asked members to refer the bill to the Standing Committee on Official Languages before second reading because “The federal government cannot and must not act unilaterally in a shared provincial jurisdiction. Any decision to broaden the scope of the Canada Health Act requires extensive consultations with the provinces”. In short, he asked the House not to pass the bill, even while recognizing that it had the right to do so.

I will give another example, that of Bill C-213, an act to enact the Canada pharmacare act, which was introduced by the member for New Westminster—Burnaby and voted on by the House at second reading on February 24, 2021. This bill basically creates a new transfer.

According to clause 4 of this bill, “The purpose of this Act is to establish criteria and conditions that must be met before a cash contribution may be made in respect of public drug insurance plans.” After setting out the specific conditions, the bill indicates that the minister “may” make a transfer to the provinces to fund a provincial drug program.

It is important to note that the bill does not set out a specific amount. I understand that it was specifically written that way so as to not generate any new spending and therefore not require royal recommendation. It worked. Even though the bill created a new transfer, even though it set out specific goals and conditions, it did not require royal recommendation because it did not generate any new spending.

If we apply the same logic to Bill C-237, we can come to only one conclusion. This bill does not require a royal recommendation.

Concurrence in Vote 1—Department of Transport

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

Mr. Speaker, I just want to say that I am coming to you from the traditional unceded territory of the QayQayt First Nation and the Coast Salish peoples. I thank them for this privilege.

I would like to start off by paying tribute to frontline workers, health care workers and emergency responders across the country. We have seen over the last 15 months, as our country has entered into this unparalleled health crisis, incredible bravery and incredible dedication on behalf of all those Canadians who have tried to keep us alive and well, and who continue to serve us during this pandemic.

Now, we can look, and there is a potential light at the end of the tunnel, as we start to see, slowly, the number of infections going down. We still have much work to do, there is no doubt, but we can start to envisage what kind of society we can actually build post-COVID.

I do that from my background as a financial administrator. As members know, I started out my adult working life as a factory worker and eventually was able to save up enough money to go back to school and learn about finances and financial management. I was able, fortunately, to use that in a variety of social enterprises and organizations.

The one thing I learned that is fundamental, when we talk about financial administration, is that we have to follow the money to see what the priorities of a social enterprise, business or organization are. What the priorities are is often dictated by where the flow of money goes. In this debate and this discussion around the main estimates and where we are as a country, it is fundamentally important to ask the question “Where is the money flowing to?” That is why this main estimates process and this debate tonight are so fundamentally important.

As members well know, in our corner of the House, and this dates back to the time of Tommy Douglas, within the NDP we have always believed that it is fundamentally important to make sure that those who are the wealthiest in society pay their fair share. Tommy Douglas was able to, in the first democratic socialist government in North America, actually put in place universal health care. He was able to do that because he put in place a fair tax system.

We can look at the NDP governments since that time. I am certainly not telling tales out of school. As members are well aware, the federal ministry of finance is not a hotbed of New Democrats. However, the federal ministries of finance have consistently, over the last decades, acknowledged that NDP governments have been the best in terms of balancing budgets and providing services for people. That is the same approach that we will take, one day, to provide the type of stewardship that we believe is fundamental to renewing our country, providing the supports, and building a society where everyone matters.

Let us look at where the current government stands, in terms of that flow of money. Prior to the budget, we put forward, and it should have been reflected in the estimates process, a variety of smart ideas that other countries have already incorporated as we go through this pandemic. We believe that we should be putting into place, as other countries have done, a wealth tax. We should be saying to the billionaires and the ultrarich of this country that they have to pay their fair share. They benefited from this pandemic and their wealth has increased, and now they have to give some of that back, to make sure that we all have the wherewithal to move forward.

We also proposed a pandemic profits tax, because we have seen in previous crises, like the Second World War, that putting that type of practice into place ensures that companies maintain the same profit levels but are not profiting unduly from the suffering that so many people have experienced through COVID-19.

We have also been foremost with regard to cracking down on overseas tax havens. As members know, I have spoken out about this. The member for Burnaby South, our national leader, the member for Hamilton Centre and the rest of the NDP caucus have been vociferous in this regard because these lose an astounding amount of taxpayers' money every year. They are the result of both Conservative actions and Liberal actions.

The Parliamentary Budget Officer pointed out two years ago that Canadians lose $25 billion every year to overseas tax havens. That $25 billion could meet an enormous amount of need. It could serve in job creation or the transition to a clean energy economy. All of those things could be accomplished, but what we see is an intricate network of tax havens that has built up over the years because of both Conservative and Liberal government decisions. The cost to Canadians is profoundly strong when we think of $25 billion a year in taxpayers' money being lost to overseas tax havens.

When we couple that $25 billion with a pandemic profits tax, which the Parliamentary Budget Officer evaluated at $8 billion, and a wealth tax, which would bring in $10 billion a year, we start to see what financial underpinnings could be put into place to actually meet the needs of Canadians across the country. We often see that there is a flow of money to the ultrarich: the wealthiest banks and billionaires in this country. At the same time, we often see that those who have the most critical needs do not even get a trickle of that financial flow.

At the beginning of this crisis, where did the government decide to flow its money? We know this now. This is no secret. In fact, the Liberal government seems to be proud of this fact. Within four days of the pandemic hitting in Canada, an astounding, unbelievable, record amount of $750 billion was made available in liquidity supports to Canada's big banks through a variety of mechanisms and federal institutions: OSFI, the CMHC and the Bank of Canada. That is $750 billion. It is unparalleled in our history and unprecedented.

If we go back to the Harper government, there were criticisms at that time because during the global financial crisis $116 billion in liquidity support was provided to the banking sector. Of course the banking sector prospered enormously from it, but $750 billion is so difficult to get our minds around. It is a vast amount of money. It is a colossal flow of an unprecedented amount of cash in liquidity supports to the banking sector.

The banks have responded accordingly. There were no conditions attached. They jacked up their service fees, as so many Canadians know. They did not reduce their interest rates to zero, as we saw in the credit union movement. Credit unions, such as Community Savings Credit Union in Vancouver, reduced their line of credit interest to zero and their credit card rates to zero because they knew Canadians were suffering. Canadians had to struggle to put food on the table, and the credit union sector in many respects responded to that, but the banking sector did not. It just kept seeing that money roll in. During the pandemic, its profits have been $60 billion so far. It is unbelievable.

I pointed out earlier that there is no pandemic profits tax and there is no wealth tax. Canada's billionaires have increased their wealth during this pandemic by an astounding $80 billion, yet there are no measures for any sort of fairness or to make sure the ultrarich pay their fair share. We can follow the money and see, with the Liberal government, that as we went through an unprecedented crisis its first and foremost thought was for the banks and billionaires of this country. This is unique in the responses of governments through crises in the past.

During the Second World War when we needed to win the battle against Nazism and fascism, the federal government put into place an excess profits tax and wealth taxes to ensure that we had the wherewithal to win the war effort. After the Second World War, we were able to build an unprecedented amount of public housing, hospitals and educational institutions across the country and to build the transportation sector. The country boomed in so many respects because the investments were there starting with a fair tax system, but not this time. There is no wealth tax, no pandemic profits tax and no cracking down on overseas tax havens.

What did the NDP do? We hear rumours that the Prime Minister desperately wants to call an election, and we will all be asked what we did during the pandemic.

Under the leadership of the member for Burnaby South, the NDP went to work immediately. We saw the huge amounts of money that were made available to the banking sector right off the bat, and we started pushing for an emergency response benefit that could lift people above the poverty line. We forced and pushed because we had seen from the best examples of other countries that we needed to put in a place a 75% wage subsidy. We pushed hard, as members know, to make that a reality.

The track record is very clear. We pushed in the House of Commons for supports for students, seniors and people with disabilities, with the big caveat that the Liberal government never put in place wholesale supports for all people with disabilities. It has now asked them to wait three years before there is any hope of support. People with disabilities will have to wait three years while banks had to wait four days in the midst of a pandemic. That is the national tragedy we see with the flow of money going to the ultrarich, the wealthiest, to make sure that banks and billionaires benefit first.

New Democrats fought those fights and won many of them over the course of the past year. I know that has made a difference. We still see suffering. We still see people lining up at food banks in unprecedented numbers. Tragically we still see people with disabilities who are barely getting by. Tragically we still see people closing, for the last time, the doors of businesses that they may have devoted their lives to building up. These are community businesses that served the public and created jobs in communities across this country, but in so many cases those small businesses have had to close their doors. Nothing could be more tragic.

As we come out of such a profound crisis, we see many people being left behind; however, the government has put forward a budget that slashes the CERB benefits even more. The CRB was slashed from $500 a week to $300 a week, which is below the poverty level. We see the government responding to the economic crisis of seniors by saying that those over 75 get a top-up on their OAS to lift them up to the poverty line, but those under 75 are out of luck with the government.

That contrasts vividly with the government paying out money through the wage subsidy to profitable companies that then paid huge executive bonuses or often paid dividends to their investors. The government says that is okay, despite the NDP's warnings from the very beginning that it had to put measures into place. It is not a problem: It will recover money elsewhere, but then it slashes the CERB benefits for people who need them the most.

What does this mean, in terms of an estimates process, and how would the NDP approach the issue of making sure we meet the needs of Canadians and respond to the crisis that so many people are living through in this country? As I have already mentioned, New Democrats would tackle it from the revenue side. We would make sure that the ultrarich pay their fair share. We would crack down on overseas tax havens. The government never introduced a single piece of legislation that adequately responded to the crisis in financing we see with the hemorrhaging of $25 billion a year to overseas tax havens.

The CRA was before the finance committee last week. The year before, I asked who had been prosecuted in the Panama papers, the Bahama papers, the Paradise papers and the Isle of Man scam. A year ago, CRA was forced to say it had never prosecuted anybody. This year I asked the same question, and the result was exactly the same. No company and no individual has ever been prosecuted. We have thousands of names of people who have been using these particular strategies to not pay taxes, yet the CRA has never had the tools in place to take them on.

New Democrats would make sure that everyone pays their fair share, that the ultrarich actually pay their fair share, that billionaires do not get off scot free and that the companies that try to take their earnings overseas have to pay income tax and corporate tax. We would make sure of that.

What would we do in the estimates? What would an NDP estimates process look like? We have already seen signs of that over the past year. We have been tabling legislation, bringing forward bills and making sure that we actually put into place the programs Canadians need.

Members will recall I tabled Bill C-213, the Canada pharmacare act, ably supported by my colleagues for Vancouver Kingsway and Vancouver East. We brought that to a vote with the support of 100,000 Canadians who had written to their members of Parliament. Liberals and Conservatives voted that down, even though we know pharmacare is something that will make a huge difference in the quality of life for Canadians. It is estimated that 10 million Canadians cannot pay for their medication. Hundreds die every year because they cannot afford their medication. For thousands of others, families are forced to choose between putting food on the table and paying for their medication. We can end that suffering. At the same time the Parliamentary Budget Officer, that independent officer of Parliament who can tell us with such accuracy what the net impacts of policies are, has told us we would save about $4 billion overall as a people. We would be able to reduce the costs of medications, so the estimates process would include universal public pharmacare in this country.

As we saw with the member for St. John's East just last night, we would be bringing in dental care for all those who do not have access to dental care. Why is that important? We heard yesterday about a person in Sioux Lookout, Ontario, who passed away because they did not have the financial ability to pay for the dental work that was vitally important for them to be able to eat. These are tragedies that are repeated so often in this country.

What else would we see in the estimates? The guaranteed livable basic income was brought to the House of Commons by the member for Winnipeg Centre. We have seen how so many members of our caucus have fought for the rights of indigenous peoples. It should be a source of shame for the government that dozens of indigenous communities still do not have safe drinking water, six years after the Prime Minister's promise. As the member for Burnaby South said in response to a question from a journalist, how would we ever accept the cities of Toronto, Vancouver or Montreal not having safe drinking water? It is simply astounding, yet we have no wealth tax or pandemic profit tax in place. We have no set of priorities that allows us to ensure that all communities in this country have safe drinking water.

We saw the incredible tragedy of the genocide in residential schools. There are first nations communities that do not have the funding to find their missing, murdered, dead and disappeared children. This has to be a national priority as part of reconciliation. It cannot simply be pretty words. We have to act, and that means ensuring that when we say “follow the money”, it is no longer the very wealthy or ultrarich who receive the vast majority of federal funds, but the people across this country, indigenous peoples, who get the supports that they need and the quality of life they deserve.

There is the issue of the right to housing. Again, it would be part of our estimates to ensure that all Canadians have roofs over their heads at night. This is not rocket science. It takes investment. Other countries have had the right to housing instilled. In a country with a climate as cold as Canada's, housing should be a fundamental right of every Canadian.

We would provide supports to peoples with disabilities, students and seniors. People have been struggling through this pandemic, yet students are still paying their student loans, seniors are being denied the increased OAS if they are under age 75 and people with disabilities are being asked to wait three years. The Prime Minister wants to pump $20 billion into the TMX pipeline instead of investing in clean energy that would result in hundreds of thousands of new jobs.

The estimates process with an NDP government would be different and better. We will continue to fight for a country where no one is left behind.

Pharmacare

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Madam Speaker, I asked a question some time ago and today, on Lou Gehrig Day, I want to share my discontent with the answer I received.

I owe my life to our public health care system. I simply would not be here today without it, so, like most Canadians, I cherish our public health care system. It is a system that is based on the principle of “access to health services without financial or other barriers”. However, our system has massive holes in it, holes that belie the principle, holes that force Canadians to choose between their health and their other basic needs.

It is time to fix the holes in our health care system. It is time to live up to the promise of access without financial barriers. It is time for a national pharmacare program so no Canadian should have to face the impossible choice between paying for groceries and filling a prescription, and yet that is exactly what happens for one in five families in Canada.

In my riding of Edmonton Strathcona, I listened to a woman describe cutting her pills in half, hoping for relief while hanging on to the few remaining pills she has left until the end of the month. One senior told me how she is sharing her medication with her husband, two trying to get by on the medicine for one. A young man in my riding urged me to get pharmacare passed, not because he needed prescription drug coverage for his own family, but because his daughter's friend was going without her medication due to cost. Too many Canadians know exactly what I am talking about, and when COVID-19 hit, even more became aware. Millions of Canadians who lost their employment also lost their prescription drug coverage, at least temporarily. They suddenly got a glimpse of what their neighbours experience on a daily basis. Our eyes are open. We know now how vulnerable we really are.

Canadians have been waiting 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, study after study, including the Liberals' own Hoskins report in 2019, all saying the same thing: Canadians need pharmacare and pharmacare will save Canadians money. I do not know what is more disappointing, 23 years of broken promises or the stubborn refusal to even acknowledge the reality of so many Canadians.

The Conservatives' position on pharmacare is one of the most cynical things I have ever heard. The Conservatives have said in this House that 98% of Canadians already have access to prescription drug coverage, so we do not need pharmacare, but what they are really saying is that 2% of Canadians live with pre-existing conditions that make them uninsurable, and everyone else who does not have a drug plan should just go out and buy one from a private insurance company. I have news for the Conservatives. The seven million Canadians who cannot afford to pay for their medications cannot afford to pay for private insurance either. Telling these Canadians that they have access to medications is a slap in the face. I mean, we all have access to a Lamborghini, right?

The cynical nonsense has to stop. In February, this House debated Bill C-213, sponsored by the NDP member for New Westminster—Burnaby, which would have created a national pharmacare act. In a survey conducted by the Angus Reid Institute, nearly nine in 10 Canadians support a national pharmacare program. Only big pharma and the insurance industry are opposed, and yet the government joined with the Conservatives to vote this bill down.

Canadians are done with excuses. The time is up. Canadians want and deserve a national universal pharmacare plan now.

Budget Implementation Act, 2021, No. 1

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Mr. Speaker, I appreciated the member mentioning child care in his speech. Child care has always been very important to me and to the constituents of Cowichan—Malahat—Langford. It is something I strongly campaigned on back in 2015.

My question is about the Liberal standard with respect to negotiating with the provinces. In Bill C-30, under division 34, we see that a legislative framework has been set up to get the early learning and child care system put into place, yet when the NDP came forward with a similar legislative framework in a version of Bill C-213 to set up pharmacare, the Liberals voted against it. Why was that?

Second, when can constituents in my riding and across Canada expect to see action on pharmacare, so that working families are no longer suffering under the huge burden of costs associated with unexpected pharmaceutical medications?

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, it is great to see the Liberals supporting child care in this budget. It is something I ran on quite proudly back in 2015, and I agree with her that it would make a huge difference.

My question is regarding the Liberal standard for engaging with the provinces on these sorts of initiatives. This budget implementation act is setting up the legislative framework for the minister to engage with the provinces to get child care up and running.

However, when it came to Bill C-213, which was NDP legislation to set up a legislative framework for establishing a national pharmacare system, the Liberals voted against it. It seems as though the goal posts are shifting. Could the member clarify for the House what the Liberal standard is for engaging with provinces when trying to build up these national programs?

Finance

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I have to shake my head at the most recent intervention by the member for Kingston and the Islands complaining about the NDP when he conveniently forgets the fact that the Liberals had majority governments in 1993, 1997 and 2000. Why did they not use that time to get child care done?

The member for New Westminster—Burnaby has been in the House for a while and has been witness to things that would give a lot of people cynicism in politics. He saw Jack Layton's climate change bill killed in the Senate. He saw his most recent bill, Bill C-213, voted down by the Liberals who profess to have an interest in pharmacare.

When it comes to things such as tackling climate change, health care and poverty, our approach has always been that those investments are really important at the front end. They might seem costly, but they will have measurable impacts on people's lives at the back end. Those investments and dollars can have real, tangible results for people.

The member touched on some of those aspects in his speech, but could he expand a little more on how these investments are so important to addressing the very real and evident gaps that so many people in all of our ridings are facing daily?

Financial Statement of Minister of Finance

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Mr. Speaker, I just got a phone call from the 1997 Liberal election platform, and it is still wondering when its pharmacare promise will come to be. I had to go all the way to page 238 to see only a half-page reference to a universal national pharmacare system.

How much longer will Canadians have to wait? The Liberals had an opportunity with their vote on Bill C-213 to set up a framework modelled on the Canada Health Act, but cynically voted against that opportunity. I am wondering how many more years Canadians will have to vote for this critical part of our health care system for it to be finally established.

Opposition Motion—Long-Term Care

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Mr. Speaker, I very much appreciate having this opportunity to participate in today's debate on behalf of the good people of Cowichan—Malahat—Langford. I have been listening to the debate throughout the day. It has certainly been, at times, very frustrating to listen to. We have taken this opportunity to identify a clear problem. We know the solutions that are out there, but we still seem plagued by the government's inertia to actually step up and do the right thing.

I want to start by expressing one very key point, which is that our parents and grandparents built this country. Whether they were born here or they immigrated here, this country is the way it is today, with all of its strengths, because of the work they put in. As they age, they deserve to live in comfort, dignity and safety. However, because of decades of cuts, underfunding and privatization, our continuing care system, our long-term care homes system, is broken.

This pandemic has very much revealed so many shortcomings in our society. It has shown the precariousness of work. It has shown where the gaps are in our social safety net. It has shown how vulnerable workers, those with the most to lose, are often at the front lines of the pandemic. They have most often been the ones at risk of both contracting COVID-19 and of bringing it home and spreading it to their loved ones. We really need to take a hard look at ourselves as a country and make some notes of what went wrong, and most important, how we can improve.

We have seen the cost of government inaction and neglect. We have seen the devastating loss of loved ones in long-term care centres across the country. In fact, it was so devastating that we actually had to send in the army to help out. The reports that emerged from those interventions were absolutely shocking. We had army medical staff finding residents who were dehydrated, who were starving, and who were left lying in their own feces and urine. There were residents who had fallen on the floor and could not get up, and some who had passed away in their beds with no one noticing. We have utterly failed to protect long-term care residents and workers through this pandemic, and it is absolutely a national disgrace. We owe our seniors so much more.

Today, New Democrats are using our one opposition day in this supply cycle to highlight the sorry state of our long-term care system and the fact that 82% of COVID deaths in Canada happened in long-term care, the highest proportion in the OECD. There have been over 12,000 long-term care resident and worker deaths in Canada since the beginning of the pandemic.

By acknowledging these incontrovertible facts, we are calling on the House today to take action. This is an opinion of the House. The House is calling on the government to take action. We want to see the transition of all for-profit models to non-profit models by the year 2030. We want to see our federal government working with the provinces and territories to stop licensing any new for-profit care facilities. We want to make sure that measures are in place to keep all existing beds open during that transition. We also want to see an additional $5 billion invested over the next four years in long-term care, and we want that funding tied to the principles of the Canada Health Act. We want to boost the number of not-for-profit homes.

There is a very clear precedent in what we are trying to do. In fact, our public health care system is based on this type of federal leadership. When we look at the for-profit model, unfortunately the facts are there for everyone to see. It is impossible for us to argue with them. This has been documented in the news. We have heard the harrowing stories of families who have had to deal with the loss of a loved one in a long-term care facility, of the grandparents whom grandchildren are no longer going to see, and of the entirely avoidable deaths.

For-profit homes have seen, tragically, worse results than other homes. They have had far more and deadlier COVID outbreaks. At the same time, we see these big, for-profit operators getting public subsidies, like the Canada emergency wage subsidy, though I acknowledge it is an important measure in this pandemic and has helped many workers keep their jobs. However, when we have a large corporation taking the wage subsidy while paying out dividends to its shareholders and also experiencing this loss of life, that, to me, goes against the spirit of the COVID interventions that our federal government is providing. It is a part of this national disgrace, and we need to have a full reckoning of how that money was spent.

Research has shown that the homes run on a for-profit basis tend to have lower staffing levels, more verified complaints, more transfers of residents to hospitals as well as higher rates for both ulcers and morbidity. This is the fundamental problem here, because when we come to this relationship between profit and care, I think that care is always going to lose out, because shareholders need their dividends, executives need their pay increases and stocks need to climb in value. When it comes to making a profit, it is a fact that private enterprises are going to be managing these facilities with an eye for what they call “efficiencies”. These efficiencies are usually found with the chronic understaffing, low worker pay, reduced investments in equipment and so on. When it comes to profit and to care, I am sorry, but those two concepts do not belong in the same sentence together. I believe that national standards could include basic references to the standards of care that we want to see in our facilities, including in employee health and well-being and pay.

I have been listening to today's debate, and I hear my Liberal colleagues repeatedly falling over themselves to find a reason to vote against the motion. What they often bring up is provincial jurisdiction. We all acknowledge provincial jurisdiction in the delivery of health care services, but there are ways to show federal leadership.

I believe that the Liberals' motto these days when it comes to bold, innovative leadership on the health care file is: Why go all the way when we can go only go half the way? We saw that with their vote against Bill C-213, brought in by the member for New Westminster—Burnaby, on something that was based on their own report and that would follow the principles of the Canada Health Act. We have another proposal to bring forward on national dental care. Here we are using our opposition day motion to propose some basic standards for long-term care homes in the for-profit model.

When we look at the Canada Health Act, it very clearly recognizes provincial jurisdiction, but it puts in place basic principles for provinces to comply with if they want those federal transfer funds, and we are proposing something similar for long-term care. We already have the principle of public administration, comprehensiveness, universality, portability and accessibility, and no one argues about those principles anymore. They are an enshrined part of our health care system, fully recognizing the provincial jurisdiction over health care delivery, but also recognizing that the federal government can play a leadership role with its power of the purse. I remain disappointed in my Liberal colleagues for finding yet another way to vote against a bold proposal when it comes to health care, because health care is top of mind for so many Canadians today, whether it is pharmacare, dental care or serious reform of our long-term care system.

I will conclude by saying that families really want to know that their loved ones are getting the best possible care. If we poll Canadians, we will see an overwhelming majority of Canadians in favour of bringing long-term care facilities under the jurisdiction of the Canada Health Act. An overwhelming number of Canadians want to see government investments to rebuild health care and other public services that were previously cut. We have promise Canadians that our seniors are going to have safe and dignified care, and that families will know that their loved ones will have the care they deserve with proper standards in place.

I appreciate the opportunity to have taken part in today's debate, and I welcome any questions.

Pharmacare

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, COVID-19 has put enormous strain on the budgets of families. With jobs lost or hours reduced, many have seen their health benefits cut or eliminated altogether. Every month, Canadians are making tough choices between paying for medication, rent, utilities and groceries.

The Liberals first made their pharmacare promise 24 years ago, but two days ago they cynically voted against Bill C-213, which would have established a national pharmacare framework modelled on the Canada Health Act.

Why do the Liberals consistently raise the hopes of working families, only to crush them when the time comes to act?

[Jagmeet Singh, NDP, Burnaby South, BC]

Mr. Speaker, today the Prime Minister has a choice. Will he stand on the side of people who cannot afford the medication they need and desperately need help, or will he stand on the side of big pharma, which does not want to see medication coverage for all?

The Liberal government's own report states that the Canada pharmacare act is one of the key steps in establishing medication coverage for all. That is exactly what our New Democratic bill would do.

Will the Prime Minister be voting in favour of our bill to bring in medication coverage for all Canadians, yes or no?

Health

[Jenny Kwan, NDP, Vancouver East, BC]

Mr. Speaker, it has been decades, and it is still all talk and no action.

The Prime Minister criticized Harper's health care cuts to the provinces, but then kept the cuts to the funding. No wonder the provinces do not trust that the federal government will keep any commitment on pharmacare.

The Liberals are running out of time and out of excuses. Later this month, every single MP will have an opportunity to vote on the NDP’s Bill C-213, the Canada Pharmacare Act. They can either tell their constituents that they stand with everyday Canadians or they stand with big pharma. They can help realize savings of roughly $4.2 billion annually, as indicated by the Parliamentary Budget Officer’s report. They can break the trend of the Liberals' broken promises to Canadians and support meaningful action to realize universal pharmacare once and for all.

The choice is theirs. I call on all members to support the NDP's Bill C-213.

[Jenny Kwan, NDP, Vancouver East, BC]

Mr. Speaker, Canada is the only country in the world with a universal health care system that does not provide universal prescription drug coverage outside of hospitals. People in Canada pay among the highest prices in the world for prescription drugs due to our patchwork of 100 public and over 100,000 private drug plans. As a result, we lack purchasing power and many Canadians do not get access to drug coverage. The Liberals have promised universal pharmacare for Canadians decade after decade, and there is still no universal pharmacare.

The NDP tabled the Canada pharmacare act in February 2020. Immediately following the last election, the NDP began working to draft a legislative framework to enable the implementation of a universal, comprehensive and public pharmacare program. It is based on the recommendations of the Hoskins Advisory Council on the Implementation of National Pharmacare, and modelled on the Canada Health Act. The proposed Canada pharmacare act specifies the conditions and criteria that the 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. Universal public drug coverage has been recommended by commissions, committees and advisory councils dating as far back as the 1940s.

People across Canada are making impossible choices every day because they cannot afford their prescription medications. Millions of Canadians have inadequate prescription coverage or no coverage at all. Sixteen per cent of people in Canada have gone without medication for heart disease, cholesterol or hypertension because of the cost. Over the past year alone, one in four Canadians was forced to avoid filling or renewing a prescription drug due to its cost, or to take measures to extend a prescription because they could not afford to keep the recommended dosage schedule.

Even those with private coverage are seeing their employer-sponsored benefits shrink, a trend that has accelerated due to the economic impacts of COVID-19. In fact, Canadians are twice as likely to have lost prescription drug coverage as to have gained it over the past year. The amount of prescription drugs spending paid out of pocket in Canada in 2016 was $7.4 billion. Universal public pharmacare would extend prescription drug coverage to every single Canadian while saving us billions of dollars every year. The final report of the Hoskins advisory council found that once fully implemented, universal public pharmacare would reduce annual system-wide spending on prescription drugs by $5 billion. Businesses and employees would see a benefit to the tune of $16.6 billion annually for businesses, and families would see their out-of-pocket drug costs reduced by $6.4 billion per year, collectively.

I ask the members to support this bill. Over 13,000 academic experts in the health care and public policy community support this. It is time for us to act. It is time to put the needs of Canadians ahead of big pharma.

Economic Statement Implementation Act, 2020

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, my hon. colleague talked about having a bold agenda, and the NDP has actually been doing that in real time.

I wonder if the member supports Bill C-213, the pharmacare bill we put forward; Motion No. 46, which would guarantee a livable income and dental care; and certainly Bill C-232, my private member's bill that supports a bold climate agenda. It is a climate action emergency framework that is about bold work. The NDP is doing it in real time.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, seeing as this is my first speech in 2021, I want to start by wishing all of my colleagues a happy new year. I also wish a happy new year to my constituents of Cowichan—Malahat—Langford. I know we are all very hopeful that this is the year when we finally turn things around.

The experiences of this pandemic have shown that we are not, in fact, all in this together. What is closer to the truth is that we are in the same storm, but we are in different boats. Some of those boats have certainly been much better at weathering this storm than others. Indeed, many have sunk. We have people right across the country who are in extremely dire straits and, in the immediate future, things are not going to get better. We are still in a very rough patch.

All around my riding, I have been witness to people who have lost their jobs, to small business owners who have shuttered their doors forever, and to many who are very much struggling to stay afloat. It is an open question as to whether they will continue to be able to do so.

We are now dealing with an outbreak in a local first nation. Cowichan Tribes has seen an outbreak of COVID-19 that, unfortunately, has led to a strong rash of racist incidents, which I am joining other community leaders in my riding to condemn.

I also want to acknowledge that many people have stepped up to the plate to support those who have been affected by the pandemic. I want to acknowledge the work of the local chambers of commerce. I have five chambers of commerce in my riding, and they have all been very strong advocates for their members and for the needs of small businesses throughout the region.

Families and workers continue to be concerned about the impacts of job losses and the worsening situation that we find ourselves in. When we come to actual measures that are going to provide assistance, while some parts of Bill C-14 are good, unfortunately it is a continuation of half measures. Given the magnitude of the COVID-19 pandemic, including where we have been, where we are and where we are going for the foreseeable future, it is extremely important for us, as a House of Commons, to seize this opportunity to strengthen our social safety net by investing in programs that directly help people.

From the beginning, the goal of the NDP caucus has been to get more help to more people, more quickly. That has been our focus for the last 10 months. I believe that we were very successful in leveraging our position in a minority Parliament by working with the government and with our Conservative colleagues to make sure we could do things like increase the amount of the emergency response benefit. We managed to have that increased to $2,000 a month and we also managed to have it extended.

It was great to see our leader, the member for Burnaby South, join with the Canadian Federation of Independent Business and unions like UFCW, Unifor and the United Steelworkers to ask the government to increase the wage subsidy from the initial 10% to 75%.

We have consistently pushed for more and stronger payments for students, for seniors and for persons with disabilities.

We were able to secure Canada's very first paid sick leave. That is incredibly important in the middle of a health crisis, because we do not want to see workers making the impossible choice between their health and their ability to earn money. If we are going to get through this pandemic, we absolutely must give workers a way to stay home if they are feeling sick. It is a way to not put anyone else in danger of catching COVID-19.

I looked back at the speech that the finance minister delivered in November: the fall economic statement. Bill C-14, the bill we are discussing today, is meant to be the implementation act of that speech.

It is quite clear to all parliamentarians that we are not going to effectively get through this pandemic until we see a very strong rollout of Canada's vaccines. I know that the government has consistently come forward with the message of how much it has invested in vaccine agreements and how much it has secured in a domestic supply, but it has become clear, over the last number of weeks, that there are some holes.

Not to play politics about it, but it is really our job in the opposition to hold the government to account and ask these probing questions. Why is there a delay in the vaccine rollout? Why is Canada not receiving any doses in some weeks and going forward?

My colleague, the member for Vancouver Kingsway, in the emergency debate last night referenced the fact that this is the third time in two weeks that the federal government's delivery schedule has been revised downward. Canadians have questions about that, and I believe it is incumbent upon the federal government, the Liberals, to be up front and honest about where we are at and to provide answers to those very important questions.

When we look at Bill C-14, we see that it is proposing a series of measures, including allowances for young children, a suspension of interest on student loans and an increase in the borrowing limit. I know my Conservative colleagues have great concern over that aspect, but if we look at the desperate times we are in, we can see that we absolutely need to have the federal government step in and provide that important backstop. The alternative is to have more and more businesses falter, never to open their doors again, and recovering from the economic circumstances in which we find ourselves will take so much longer.

I will concentrate on one particular aspect of the bill that has great significance for my riding. It is the fact that $64.4 million is being allocated for mental health and substance use in the context of COVID-19. Here in the Cowichan Valley, as in many parts of the country, we are still suffering through an opioid epidemic. Indeed, British Columbia posted record numbers of deaths last year from opioid overdoses. We have consistently asked the federal government to step in to do more to address this crisis, to provide more financial resources to the provinces, to declare a national health emergency and to start finally treating this problem like the health issue it is. We have to seriously look at criminal justice reforms and at decriminalizing possession of small amounts of illicit substances so that people do not have to fear the criminality of their actions and can actually get the help they need.

There were some missed opportunities, as I alluded to earlier. If we are going to make those bold policy fixes that are truly going to help Canadians get out of this crisis, we need to see massive investments in child care. It is one thing to give parents a financial contribution, but they will not be able to make much use of it if child care spaces are not available. I know that in Langford, which is one of the most rapidly growing urban centres in all of Canada and is full of young families, the lack of good available child care spaces is a huge concern to so many young parents and families.

Similarly, on pharmacare, I am glad to see the member for New Westminster—Burnaby stepping up to the plate with his Bill C-213, which would actually put Liberal promises into NDP action. This would make a huge difference, along with dental care, in actually addressing some of the real costs that so many working families have on their budgets.

We also need to have a serious conversation on how we are going to finance all of this. We have to have a serious talk about implementing a wealth tax to make sure that those very wealthy individuals and corporations that benefited from this pandemic and made profits in the billions of dollars are contributing their fair share and that the payment does not fall on the shoulders of working families.

The Liberals also missed a golden opportunity to fix the wage subsidy, in that start-ups that did not have payroll accounts before March 15, 2020, still cannot qualify for the emergency wage subsidy. I have one business in particular, V2V Black Hops Brewing, an amazing social enterprise that does work in my riding for veterans, that cannot qualify for the wage subsidy because of the payroll account issue. I implore my Liberal colleagues to please fix that in legislation, and this bill was a missed opportunity.

I will conclude by saying that Canadians can no longer wait for half measures. We need bold, decisive action.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Mr. Speaker, I would like to thank my colleague from New Westminster—Burnaby, and also congratulate him on Bill C-213. It is a perfect example of us once again taking Liberal promises and putting them into NDP action.

I listened very attentively to his speech, and he is right. It is not so much what is in Bill C-14, but what is missing. For me, a particular issue affects the city of Langford in my riding. A start-up business, V2V Black Hops Brewing, did not have its payroll account in place before March 15. Here we are, 10 months into the pandemic, and it is still unable to qualify for the emergency wage subsidy.

Perhaps my colleague, in his role as critic for finance, and with the incredible work he has done with the member for Courtenay—Alberni, could answer the question why, after all this time, the Liberals are still excluding start-ups from accessing this important wage subsidy? So many of them are struggling. Indeed, I fear many are going to go out of business.

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

Mr. Speaker, I think the debate tomorrow on vaccine distribution will be extremely important. I know that many parliamentarians from across the country will want to participate.

Before we rose for question period, I had raised issues with Bill C-14, but not in terms of content. The content is, in a sense, a small step toward meeting the challenge of the pandemic, but what could have been in the bill and what could have been in the fall economic statement but was not is the real problem, I think, with Bill C-14. It is not the content, but what is not in there and what could have been presented. In the midst of the worst pandemic that Canada has experienced in a century and the worst economic crisis since the Second World War, one would think that in combining those two things, the fall economic statement and the bill that emerged from the fall economic statement would have met the challenges that Canadian families are facing.

Even coming into the pandemic, Canadian families were beset and burdened with the heaviest level of family debt that exists among industrialized countries. The average Canadian family has more family debt than a family in any other industrialized country. That is in part because of decisions made over the last couple of decades that have pushed Canadian families down, including the unravelling of the social safety net and the emphasis on providing perks and tax holidays to the very wealthy and the most profitable corporations, rather than making the public investments that would make such a difference in the lives of Canadians. Then the pandemic hit, and Canadians are experiencing incredible challenges.

In my riding of New Westminster—Burnaby and in every other corner of this country, Canadians are facing daily challenges to put food on the table and keep a roof over their heads, yet within Bill C-14 we do not see any bold attempt to meet those challenges. It is indicative, I think, that the new American president, Joe Biden, within the span of his first five hours and the executive mandates that he signed, has proven to be more proactive while using government machinery to work in the interests of the people than the current government has in five years. It is five hours versus five years. That is the real disappointment of the current Prime Minister and the current government.

What do we see in Bill C-14? Instead of investments in building a national child care program that we know Canadian families will need as a national network of universal child care as we emerge from this pandemic, hopefully in the next few months, we see scant support given to Canadian families in dealing with the crisis in long-term care. Instead of putting it under strict national standards and making sure that there is adequate funding for long-term care for our seniors, we see a small amount compared to what was given to the banking sector and no real attempt to address the crisis in long-term care.

We saw $750 billion in liquidity supports given to the banking sector through a wide variety of federal institutions within days of the pandemic hitting. Government MPs might say that this was liquidity support to help the banking sector; the banking sector so far in this pandemic has received profits of $30 billion. That should absolutely not have been the first objective of the government. There is a contrast between that $750 billion and what people with disabilities, people who are struggling to keep a roof over their heads, have actually received in support. I and other members of the NDP caucus, including our leader, the member for Burnaby South, have raised this issue numerous times. It took not one or two, but half a dozen fights to get a $600 one-time payment paid to a minority of people with disabilities across the country, yet we have seen $750 billion going with alacrity to the banking sector.

We see an interest-rate holiday for students when they are struggling to pay for their student loans. During this pandemic, as I mentioned, the banking sector has had $30 billion in profits. Canada's billionaires have had over $50 billion added to their wealth in the pandemic.

However, we see a government that steadfastly refuses to put in place what the member for Burnaby South and the NDP caucus have called for. The vast majority of Canadians, when they are asked in public opinion, say the same thing: that we need to put in place a wealth tax. We need to put in place a pandemic profits tax. We had those measures in the Second World War. It meant that we were all in this together, and it also meant that the federal government had the wherewithal to ensure that Canadians had the investments they needed as we emerged out of the Second World War.

We brought this forward in the House along with provisions for a guaranteed livable basic income, a right to housing and universal pharmacare. Government members voted against those measures despite the fact that they were supported by the vast majority of Canadians.

Next month, parliamentarians will have a second chance on universal publicly administered pharmacare, because Bill C-213 will be voted on in less than a month. Across the country we have seen thousands of Canadians write to their members of Parliament to say, “Vote yes on Bill C-213,” above all because in this pandemic a number of Canadians have lost their drug coverage. Ten million Canadians have no access to the medications that their doctors prescribe as necessary. There will be a second chance for that, and a second chance for the government to bring forward the bold ideas that the NDP has been proposing in a budget that should be tabled this spring.

I hope that the government will repair the mistake that it made in the fall and provide the supports that Canadians need.

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

Madam Speaker, I would like to wish everyone a happy new year.

We are jumping right into issues that will have a major impact on the future of all Canadian families across the country during the pandemic. I would like to start by talking about some of the impacts we have already seen. I know that my speech will be interrupted by question period and that I will finish it after that.

I would like to start by emphasizing how important it is for all parliamentarians to work together to mitigate this crisis, a crisis that is having a massive impact on every city and town in Canada and leaving no part of the country unscathed.

Just this weekend, we commemorated the sad one-year anniversary of the first COVID case in Canada. Since the identification a year ago of the first COVID case, 20,000 Canadians have died as the pandemic has ravaged this country.

I think all of us understand the importance of underscoring the incredible courage and bravery of front-line health care workers. They have gone to work often at peril of their lives, and dozens have perished during this pandemic. The impacts of COVID have been devastating, and we as parliamentarians need to underscore their courage and dedication in a time of immense tragedy, when in each and very case those health care workers were putting their lives on the line.

We are going through a pandemic that will have repercussions for years to come. I think back to the Spanish flu epidemic and the lessons we can pull out of what was such a tragic pandemic a century ago. In so many cases and in so many countries, the financial and economic repercussions of the Spanish flu, even after the actual pandemic itself had lessened and then ceased, were felt for over a decade afterward, so my comments today are not just about what we need to do now, but also about what we need to do over the course of the next decade. This is when the financial and economic repercussions are felt.

We need to be bold. We need to take action in a way that not only brings Canadians through this pandemic, hopefully safely and with their health intact, but lays the foundation for rebuilding afterward in a way that ensures that the decade-long economic and financial repercussions that will hit so many Canadian families will actually be addressed by the federal government, and it will provide supports to communities right across the country.

Bill C-14 is certainly not a bold response to the pandemic's devastating repercussions. A closer look at what is in this bill makes it clear that the government does not know how to respond boldly to all the challenges Canadians are facing.

When I look at the substance of this bill, I can see that it is a long way from meeting the expectations of Canadians going through this pandemic and taking a financial and economic hit. Overall, this bill offers a little help, and that is good. A little help is better than nothing, for sure.

It is important to say that the government could dare to do more and go much further. As the leader of the NDP, the hon. member for Burnaby South, and the entire NDP caucus have already made very clear, help is needed now. We need to look at each and every element of the bill and see what is missing.

Long-term care is getting help, help that is clearly needed. We are seeing that the epicentre of this pandemic is in Quebec's long-term care homes and in long-term care centres across the country. In these places, we are seeing thousands of deaths resulting from a lack of rules aimed at reinforcing standards of care provided there.

Our seniors deserve better in all the services they receive. A billion is not much when we look at what the government has done since this crisis began. From the beginning, we have seen the government offer $750 billion to Canada's major banks. Government members will say that this liquidity support is not just coming from the government, but from a number of sources. The fact remains that in the few days when the pandemic hit hardest in March, the government had to act quickly, and its first act was to provide $750 billion to Canada's major banks. The government's first instinct was to say that it needed to come to the aid of Canada's banks, and it made $750 billion available to that sector.

If all the expenditures under this bill are spent, seniors will receive just under $1 billion. The ratio is 750 to one: $1 billion for Canada's seniors, who have died by the thousands during this pandemic, but $750 billion for the banking sector, which has already made $30 billion in profits since the pandemic began. What message is the government sending by throwing so much money at Canada's big banks? Is that our priority?

Meanwhile, this bill has only crumbs to offer, and that includes the Canada child benefit. Yes, $100 a month certainly helps, but what is really needed right away is a $2-billion investment to lay the foundation for a national child care system. The unemployment rate continues to rise, and economic difficulties have existed since before the pandemic. Canadian families already had, on average, the highest level of family debt among the most industrialized countries as a result of policies put in place by previous Conservative and Liberal governments. The government could have done better, much better, and been bold enough to do more than simply offer $100 a month to families struggling to keep their homes and put food on the table.

The bill also mentions student loans. The government is suspending student loan interest payments. However, students trying to get through this crisis as best they can still have to repay their student loans. Even if interest rates are lower, the amount of the loans is minimal when we think of all the difficulties they are experiencing. Just compare the amount of student loan interest that has been suspended with the $750 billion in liquidity supports given to major Canadian banks.

With respect to pharmacare, next month we will have the opportunity to vote on Bill C-213, which will establish the legal framework for pharmacare. I must say that we are seeing strong support for this bill across the country. As a Bloc Québécois member mentioned, dozens of Quebec municipalities have just expressed support for this bill, which will establish a universal pharmacare plan that all Canadians will be able to access. Unions in Quebec and across Canada are also calling for a plan that will leave no one behind.

With the pandemic, we are talking about tens of millions of people who do not have access to a pharmacare program, either because they lost their job or because they do not have access to a protection plan through their employer. Bill C-14 could have included certain aspects that the NDP will bring forward during the vote in Parliament next month, but right now, that too is being left out.

I know that my time is nearly up, but I would like to say that the most disappointing thing about this bill, even though some aspects are rather positive, is the government's lack of ambition at a time when Canadians are going through an unprecedented crisis.

Fall Economic Statement

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

Mr. Speaker, I would like to start off by saying that a big part of this economic update touched on things that have happened over the course of the last few months. As members are well aware, when we first hit the pandemic, the government was certainly willing to work with opposition parties, and the NDP stepped up.

Members will also recall that the first action of the government during the pandemic was to offer supports to the banking sector with about $750 billion in liquidity supports from a number of different federal institutions. That was a bold move. It is not matched by any boldness to actually support regular Canadians at this stage in the pandemic.

We are well aware of what the member for Burnaby South did. The entire NDP caucus stepped up with a series of proposals that we knew would make a difference in the lives of Canadians. Canadians have really struggled through this pandemic. They are still struggling. We believed that there needed to be a series of measures that would make a difference in the lives of individuals as they struggle to put food on the table and keep a roof over their head.

We needed measures to support small businesses. People often give their lives to their small businesses, and we want to keep them operating so we can avoid the tragedy of people turning the key in the lock for the final time as they leave that small business behind. That was the measure that was brought to this pandemic response. This is what we proposed and pushed the government to put into place.

We had the emergency response. When the government had a series of holes in the emergency response benefit, we pushed for the student CERB as well, and we pushed for a 75% wage subsidy. The member for Burnaby South was very eloquent in this regard. Other countries had already done that, and we believed firmly that Canada needed to put in place a 75% wage subsidy too to make sure that businesses could continue to operate and people could continue to work.

We then pushed support for seniors through this House. We pushed for a moratorium on student loans. We did not think that students should have to pay back their loans to the federal government during a pandemic. We pushed for supports for first nations communities. A number of members from our caucus were very strong in pushing the government to provide those supports.

We also pushed for supports for the people who were not receiving supports through other means. That is why we pushed for things such as the Canada recovery benefit. The member for Burnaby South, numerous times, pushed for a national sick leave, which is historic in nature. It means that people who are unfortunately not able to work because of their sickness, or are concerned about catching COVID-19, could actually, for the first time, take that paid sick leave and not have to choose between putting food on the table or doing the right thing. That paid sick leave is historic, and we believe it should be made permanent as well.

We provided and pushed for sectoral supports for a variety of industries. Members of this caucus, including the member for Courtenay—Alberni, who is our small business critic, pushed for an emergency rent subsidy. We pushed for very strongly for this and for our supports for people with disabilities. These are two areas in which the government basically only did a part of what was needed to be done to provide those supports and make sure that those Canadians had the wherewithal to get through the pandemic.

Originally the emergency rent subsidy the government rolled out was a program through a company that had ties to the chief of staff of the Prime Minister. The initial program that was rolled out was actually with a commercial mortgage company, and it was for landlords who held commercial mortgages. This is very clearly inadequate and a very strange approach.

We continued to push for the second emergency rent subsidy, which is a much better program. That program has not been retroactive for the course of the spring and summer. It should be because many of the businesses that went through all those difficult periods in the spring and summer are now living through these difficult periods in the fall. They need the wherewithal, and they need those supports.

We continue to press the government to make that rent subsidy retroactive to the spring for those business owners who were not able to benefit because the program is so complicated. It is actually a failed program in so many respects. With this new rent subsidy program, which the NDP applied pressure to bring to bear, those business owners would actually be able to benefit from it.

For people with disabilities, I have expressed on the floor of this House my deep disappointment. While the banking sector got three-quarters of a trillion dollars within the first days of the pandemic, the government had to be pushed and prodded repeatedly. The member for Elmwood—Transcona, the member for Hamilton Centre and other members of the NDP caucus pressed the government repeatedly, and finally, after an eight-month wait, the Liberals put in place partial supports. They are only for people with disabilities who are registered and exist in the federal database.

There is no doubt that there are many other people with disabilities who need support. The only way for them to receive support is with planning and forethought to make sure that those who are registered provincially for disability programs get supports. In short, what the NDP brought to bear was a series of measures that would make a difference for people, and we will continue to do this.

This is where my disappointment lies and our disappointment with the fall economic statement. We believe that those supports need to be continued. There needs to be a sense that all Canadians matter, that we can all come through this pandemic, and that, coming out of the pandemic, we can actually put in place a very solid foundation for Canadians in the future.

However, the government has refused to do this. With the fall economic statement, the Liberals have refused to take any of the revenue measures that have been suggested, not only by the NDP but by many forward-thinking people who are thinking ahead.

The Parliamentary Budget Officer is an independent officer. All Canadians can rely on his advice. He said, very clearly, that with the fiscal situation of the country there are only two alternatives. One is to cut those services and supports to people, otherwise known as program cuts or austerity.

Liberals may laugh at that, but they also laughed at austerity when we suggested it back in Paul Martin's day, and we know the result. The cuts in programs have an impact even to the present day. Ending the national housing program for the justification of austerity meant that today there are people who remain homeless because the federal government stopped building affordable housing, which is so necessary for so many Canadians.

We look at the fine print. We in the NDP do not only look at what is said, the basic speech and the basic balance sheet of this economic statement, we also look at the details. The summary statement of transactions clearly indicates that the government is planning substantial cuts in program expenses next year. Many of those program expenses came through COVID-19. The intention of the government is not, on the revenue side, to put in place supports that make our rebuilding sustainable. Instead, it is making the choice of looking to wind down programs of support without looking to replace them with other programs that can make a difference in people's lives.

Members will recall that so far during this pandemic, Canada's billionaires have added to their wealth in the order of $53 billion. Canada's big banks, who received that massive dose of liquidity support within days of the pandemic hitting, are looking at substantially increased profits. In the next few days, when each of the big banks release their latest quarterly figures, there is no doubt that we will see an increase, just as we did in the spring and the fall. They have had $15 billion in profits so far during this pandemic.

The reason 90% of Canadians support a wealth tax is they see that discrepancy. They see that contradiction of billionaires having massive increases in wealth, some web giants having massive increases in profits and significant profits for the banking sector through the pandemic, while so many Canadians are struggling to put food on the table, making ends meet and keeping a roof over their heads. Many small business people are struggling to keep that small business operating. They see the contradiction between the banking profits and the addition to billionaires' wealth of over $53 billion. They are well aware of the massive amounts of money we lose every year to overseas tax havens.

As the House is aware, the Parliamentary Budget Officer, as an independent officer of Parliament, has advised all parliamentarians that we lose over $25 billion each and every year to overseas tax havens. That means that over the last five years under the Liberal government, over $125 billion have been lost to overseas tax havens. When we talk about the supports Canadians need now, those massive amounts of money have not been diverted to help Canadians, but rather have served to pad the bottom line of some of Canada's wealthiest people and some of Canada's most profitable corporations.

We also have the web giants. During this pandemic, we have seen substantial increases in profits by the web giants like Facebook, Amazon, Netflix and Google, yet they do not pay corporate taxes in Canada. The measures announced today, which only talk about implications around the GST-HST, are minor compared to the impacts of those web giants not paying that corporate taxation.

As well, we have seen significant subsidies going to oil and gas companies. The government wants to spend what could be up to $20 billion on the Trans Mountain pipeline. The private sector walked away from this project, a project that has profound implications for the climate emergency. The government is intending to spend money on this project. The PBO will define that in the next week or two. It has been asked to produce a study and the bottom line in the rapid rise in construction costs. However, we are looking probably in the order of $20 billion that the government wants to spend on a project that is not financially viable. Basically, it will have dramatically negative impact on any hope of Canada meeting its obligations to meet the climate emergency.

The question is very simple. Why does the government's priority always seem to be billionaires? Why is protecting that increase in wealth and those profits more important than ensuring we take care of regular people?

I mentioned people with disabilities earlier. Most of them have not had access to even that one-time emergency benefit of $600. Getting that $600 makes a dramatic difference in a person's life. A constituent of mine was unable to get medication for a number of months. With the $600 the person did receive, they were able to get their medication for the first time in months.

When we think that most people with disabilities are suffering the same type of financial challenges through this pandemic and were not able to receive even that one-time payment, we can understand there has to be higher priorities than allowing Canada's billionaires to increase their wealth by tens of billions of dollars and Canada's banks to reap the profits they have during this pandemic, and having the web giants not pay a dollar in corporate tax. The priorities of the government really do not seem to be in conjunction with what most Canadians are feeling through this pandemic.

It is really a matter of billions of dollars for billionaires.

When we look at this economic update as a whole, the government is giving Canadians crumbs compared to what is needed. Meanwhile, as I said, the government is not putting a tax on wealth or excess profits, web giants are not being required to pay business taxes, and tax havens are having a huge impact on the money laundering that we see across the country.

What is more, the government is still refusing to implement a public registry of beneficial owners, which would enable us to put an end to money laundering. The government could have and should have made investments in a different approach in this economic update. I am thinking about measures like pharmacare, which people across the country are calling for. I will come back to that later, but the reality is that pharmacare is essential. We have seen that. Coming out of this pandemic, people are still going to be in great need of a pharmacare program.

There is also child care and the day care system. That comes up all the time, but it is a shortcoming of this economic update. The issue of affordable housing is even more critical right now because so many Canadians are struggling and having difficulty finding affordable housing because there is a shortage of it across the country. Some members of the Liberal Party are saying that it is okay. I can point out every cut that was made under Paul Martin's government, which are, of course, still having an impact on today's lack of affordable housing in Canada.

Of course there is the climate emergency. Trans Mountain might end up costing us up to $20 billion. The Parliamentary Budget Officer calculated some estimates that will be released in the coming weeks. We already know about nearly $13 billion to which is added nearly $5 billion for the cost of acquiring the company, while the private sector saw no interest in Trans Mountain. Of course, we are in a context where the government is prepared to pay any price for this project, even though the private sector does not think it is profitable and did not want to invest in it. We know full well that the repercussions on the environment will be enormous.

These are not minor decisions. This is a series of decisions and Canadians are the ones who will pay the price for these bad decisions. The choice is very clear. We have to prioritize the needs of the people instead of always prioritizing corporations that make huge profits. We have to stop thinking that billionaires have to come first.

On this side of the House, we do not agree that we must not tax excessive profits, wealth, or the profits of web giants, and that these companies should not even pay a corporate tax just as everyone else in the country does. We do not agree that we should continue with the Trans Mountain project, no matter the climate cost to be paid and no matter the cost of construction. The private sector does not want to have anything to do with the project and taxpayers will have to pay for Trans Mountain.

That is why we can say that this economic update is extremely disappointing. This government refuses to think clearly, make good investments and take charge of its revenues. The Parliamentary Budget Officer was very clear about that: Either the government cuts services and the assistance it provides to people, or it increases revenues. There is a significant amount of missing revenue, and the government refuses to collect it.

What is missing from this economic update that could have made a difference?

We have the regular reference to pharmacare, which has been written for the last five years, and the government keeps saying that eventually it will do something about it. However, commitments for pharmacare have been made for over a quarter of a century and we still do not see or have in place a universal pharmacare program that provides supports for everybody.

Ninety per cent of Canadians support universal, publicly administered pharmacare in this country, so we are talking about a broad public consensus. Why is that? It is because we know that hundreds of Canadians die every year because we do not have universal, publicly administered pharmacare.

We know as well that a million Canadians are trying to pay for their medication now in a pandemic. They have to make the desperate choice between putting food on the table, heating their home and paying for their medication. In a country as wealthy as Canada, for anybody to be forced into that position is simply irresponsible governance. When a government puts a person in that position, the government is neglecting that person's basic needs.

The reality is that pharmacare brings a huge cost savings to Canadians. The Parliamentary Budget Officer, an independent, non-partisan officer of Parliament whose reports are well worth reading, says that we would save $4 billion overall as Canadians. Businesses would save about $6 billion, and individuals who are paying for medication out of their pocket now would save about $5 billion.

What the economic update should have announced, instead of the direction the government took, is that we are moving to get pharmacare in place now, that we are actually going to put in place the steps that are needed and that we are going to sit down with the provinces. We already have an NDP bill on this, Bill C-213, which is coming up for a vote in February. Thousands of Canadians have written to their members of Parliament urging them to support Bill C-213, which is the legal framework for universal, publicly administered pharmacare.

The Liberal government should have said that it was going to sit down with the provinces now because it understands, from this pandemic, that it is time it actually put in place a universal pharmacare program in this country. It is long overdue. It should have happened 50 years ago, and the cost to Canadians has been enormous ever since. Now that we have a bill that would actually set the legal framework, the government should have sat down with the provinces to negotiate the financial framework and made sure that pharmacare became a reality in 2021. That should have been in the economic update.

What also should have been in the economic update is a real commitment to child care. Child care advocates across the country know how important child care is for our economic prosperity. The reality is that for every dollar invested in national child care, we get about six dollars in economic stimulus. It is probably the best investment a country could make. Countries that have universal child care programs know that with the participation of families and women in the workplace, there is a huge economic boon that happens when investments in child care are made.

Tragically, in this economic update, the government just basically drew the line on the next steps that should have been phase two for national child care. It basically stopped at phase one and said that was enough. However, the reality is that Canadian families are spending up to $2,000 a month per child because there is no child care. We need to turn this around and put in place a child care program.

We already know from child care advocates the investments that are needed. The investment for next spring would need to be $2 billion or more. The government is not even providing half of that amount and is basically freezing it at an amount that is well below what is needed for national child care.

A constituent of mine named Michelle works with her family and children. She says trying to find a child care space has been a real struggle. She has been able to substitute in with a local child care facility, which is filled up, so her child can sometimes have access to it, but she is like so many other families across the country struggling with child care costs of up to $2,000 per child. They think this needs to happen. It is surprising to me that the government has not taken the opportunity, in looking to build back better, to build into the framework coming into 2021 a universal pharmacare plan and a national child care plan.

If we are looking to build back better, we need to establish the revenue foundation. We need to put into place the measures I spoke about earlier. We cannot keep giving $25 billion away to overseas tax havens. We cannot refuse to put in place a wealth tax next to this profits tax when billionaires have increased their wealth during the pandemic by $53 billion. If we do not put in place the revenue foundation, it will lead to, as the Paul Martin government found out, austerity and cuts.

When we look at the fine print of this document, we see that once we get past the spring, the government intends to dramatically decrease the number of supports that are going to regular Canadians. This should give everybody pause, because it is exactly what happened when Paul Martin was finance minister and we saw cuts to the national housing program, which was eradicated for a generation. We continue to deal with the fallout of those cuts.

We also have to deal with the climate emergency. We have the pandemic and the climate emergency occurring at the same time. The government is making these massive investments, up to $20 billion, in ramming through Trans Mountain when indigenous people have raised huge concerns and when there is a variety of very legitimate criticism of the government in this regard. The government cannot pretend to be working on the climate emergency when it builds a massive pipeline that will undercut anything else that it does.

This economic update should have had an announcement that the government was not going to pour more money into Trans Mountain, the $20 billion. Instead, the Liberals should have announced a shift to clean energy. That $20 billion could have been used to create hundreds of thousands of jobs in the clean energy industries.

We know that in the United States, with the change in government, the most recent projections indicate that the clean energy sector will quadruple over the next 10 years. Canada could be in a position to take advantage of that if the federal government worked with the provinces on clean energy production and on ensuring clean energy investments. However, instead, the Liberal government is building a pipeline. It makes no sense. It means the direction the government is taking in this document is simply not sustainable.

There are issues like affordable housing and investment. Affordable housing and the right to housing that the NDP brought to the House just a couple of weeks ago are fundamental in ensuring that the needs of indigenous communities are met. They are fundamental and yet what we see from the government is an approach that prioritizes the needs of wealthy Canadians and Canada's most profitable corporations over the needs of Canadians from coast to coast to coast. This is what is most disappointing about this economic update.

There are some measures that we could all say we can support. Those measures are all below what is required in this time of a pandemic and at a time when so many Canadians are suffering. So many Canadians want to see a difference in this country, with a federal government that has quite often neglected so many fundamental issues, whether it is the climate emergency, the needs of indigenous communities, the need for affordable housing or putting in place pharmacare and national child care. Those are all legitimate needs that have not been met for years and yet the government continues to prioritize other things. The result is something that Canadians will say, particularly when they read the fine print, this is not the direction they want to see going forward.

What would the NDP have been announcing today? If we had been making this economic update, what would we be saying? Of course we would be talking about the programs that we would have put into place over the course of the last few months. I would say we would very clearly have taken a different and better approach in terms of the pandemic. Some of the suggestions and things we pushed, fought for and negotiated on are in place during this pandemic and some are not.

Some things are absolutely fundamental to us. First off, for people with disabilities, months ago we would have sought to get the provinces on board to make sure that the pandemic payment that went out to people with disabilities went to every single person with a disability across the country. We would have made absolutely sure of that. It would have meant a couple of months of preparation, but it would have made a difference. There is no doubt.

On the rent relief program that New Democrats had pushed and prodded the government to bring to bear, we would have made it retroactive for all of the businesses that simply could not access the program when it was originally set up. We would be making sure that those businesses could take advantage of that retroactively.

We would be making sure that the many holes we saw through the pandemic response were filled. That is an effort that we undertook. When we saw the government leaving holes, we fought back, negotiated and pushed to make sure as many holes as possible were filled. We would have taken the approach that everybody matters and we should not leave anybody behind.

In the economic update today, New Democrats would have been announcing that we are putting in place adequate funding for the next stage in the national child care program and we would have made sure that funding was available so that Canadian parents and families could see the next stage of child care funding being put into place, the national child care program that has seen delay.

If it were up to New Democrats today, we would have said no more money for oil and gas subsidies, that we need to focus on the climate emergency, we will not be spending $20 billion on Trans Mountain and would make sure that money goes to ensure clean energy development and jobs. We would be investing in indigenous communities. We would be making sure that the shortchanging that has created so much suffering and so many crises in indigenous communities was ended and the supports were in place for health care, housing, clean water, all of those things.

We would have made sure that today we were announcing an affordable housing program that ensures the right to housing and would put into place something that, within a short period, would actually end the homelessness crisis we are seeing in our country and that has been aggravated by the pandemic.

We would have made sure that we pay for these things by putting into place the revenue measures I mentioned earlier.

The first would be an excess profits tax, as we had in the Second World War because Canadian governments understood the importance of making sure that, when we are all in this together, everybody pays their fair share. We would have made sure that there was in place a wealth tax so Canada's billionaires with their $53 billion in additional wealth during this pandemic paid their fair share. We would have made sure as well that the web giants actually paid a fair share of corporate tax, instead of taking the windfall profits they made during this pandemic and simply doing whatever they wanted with it.

In this economic update we would have ensured the legislative tools to crack down on overseas tax havens, which costs $25 billion every year that Canadians simply cannot afford.

We would have been building a country where everybody matters and where nobody is left behind. We would have taken a different approach on this economic update.

National Framework for Diabetes Act

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, these days the world is focused on a pandemic, but that does not mean we have to forget about the myriad of other illnesses suffered by humanity. That is why I am happy to voice my support for Bill C-237, which would require the Minister of Health to develop a national framework for diabetes prevention and treatment in consultation with the provinces, indigenous groups and relevant stakeholders.

I support the bill because I believe we truly need a new national diabetes strategy. That strategy should be based on the diabetes 360° framework developed in 2018 by Diabetes Canada and dozens of other stakeholder groups. I also believe that the Government of Canada must support indigenous-led diabetes programs, services and research; prioritize food sovereignty; provide access to appropriate care and treatment options; and raise awareness about gestational diabetes and the increase in diabetes among young indigenous women.

I also strongly believe that there is an urgent need for a national approach to pharmacare that would ensure all Canadians living with diabetes have access to the medications they need when they need them. This must include coverage for diabetes devices and supplies, such as test strips, syringes, insulin pumps and continuous glucose monitors.

We all know the story of Frederick Banting and Charles Best, who, with their colleagues James Collip and John Macleod, discovered insulin in a University of Toronto lab in 1921. This discovery revolutionized the treatment of diabetes worldwide and remains among the most celebrated medical discoveries in Canadian and even world history. Diabetes was formerly a death sentence for young people who developed the disease, but now they could look forward to long and productive lives.

We are on the eve of the centenary of that discovery, and one would think that we could celebrate that centenary with pride. Unfortunately, the scourge of diabetes is, in many ways, far worse than it was 100 years ago. Canada has one of the poorest records in the world, and it is getting worse.

Every three minutes a Canadian is diagnosed with diabetes. The number of Canadians with diabetes has doubled in the last 20 years. Right now, one in three Canadians either have diabetes or have a high risk of developing it. It is an epidemic. People who are 20 years old in Canada have a 50% chance of developing diabetes in their lifetime. For first nations people, that risk is 80%.

The health care costs of diabetes will top $40 billion by 2029. Diabetes causes 30% of strokes, and it is the leading cause of blindness. It causes 40% of heart attacks, 50% of cases of kidney failure, and 70% of leg and foot amputations. It reduces lifespans by five to 15 years, and about 7,000 Canadians die each year as a direct result of diabetes.

Thankfully, there is a plan for how to fight this scourge. Diabetes Canada has developed a detailed plan called diabetes 360°, which could dramatically improve our rate of diabetes and reduce the significant impacts it has on the health of Canadians. It will cost money, but that investment will repay itself a hundred times over in savings to our health care system.

The goal of diabetes 360° is to have 90% of Canadians living in an environment that preserves wellness and prevents the development of diabetes, 90% of Canadians aware of their diabetes status, 90% of Canadians living with diabetes engaged in appropriate interventions, and 90% of Canadians engaged in interventions achieving improved health conditions. Diabetes 360° must be the basis for any national strategy.

When Dr. Banting discovered insulin, he gave the rights to that discovery to the University of Toronto, so that diabetics around the world could have affordable access to this life-saving drug. However, times have changed, and many of the monitoring and injection devices are very expensive. Many Canadians living with diabetes are unable to afford the medications, devices and supplies they need.

This cost related non-adherence can lead to avoidable complications and mortality, and that is why there is an urgent need for a universal, comprehensive and public pharmacare plan to ensure all Canadians have access to the medications they need when they need them. As I mentioned, this must include coverage for devices, such as test strips, syringes, insulin pumps and continuous glucose monitors.

The Canadian Federation of Nurses Unions produced a report that found that 57%, over half, of diabetics in Canada reported failing to adhere to their prescribed therapies due to affordability issues related to those medications.

According to the Juvenile Diabetes Research Foundation Canada, 830 young and middle-aged diabetics in Ontario die each year because of poor access to insulin. That could dramatically change if all Canadians had access to the medicines they need, but they do not.

Canada is the only country with a universal health care plan that does not include free access to prescribed medications. Some 10% to 20% of Canadians report not filling their prescriptions because they simply cannot afford the cost. That non-adherence costs all of us in added hospital stays and extra pressure on our health care system.

A universal, single-payer public pharmacare plan would save over $4 billion per year because we could get better deals on our drug costs. Right now, we pay more for drugs than almost any other country in the world.

All Canadians would benefit from a public pharmacare system, but diabetics would benefit more than most, because they would be assured of access to insulin and the monitoring equipment they need to manage their disease to stay alive.

Canada should be proud of its history in the treatment of diabetes and the discovery of insulin, but right now, we are at the bottom of the list when it comes to treatment, hospitalizations and needless deaths. We need to turn this trend around.

Bill C-237 would go a long way to achieve this turnaround by mandating the creation of a national framework. However, for rapid and lasting success we need real government leadership and investment in community health programs and public pharmacare to make a real difference in the health of Canadians.

I call on all members here to support Bill C-237, and even more importantly, Bill C-213, the bill calling for a universal, publicly funded pharmacare program tabled by my colleague the member for New Westminster—Burnaby. That program would save billions of dollars in public expenditure and most of all, would save thousands of lives of people, young and old, who suffer from diabetes and other ailments across the country.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, I thank the member for the important bill before us. I fully support it.

She has pointed that from the start, Canada has been a world leader in the technology of treating diabetes. However, we are really near the bottom of the pack when it comes to access to treatments, needless hospitalizations and needless deaths. That is because half of the diabetics in Canada cannot afford to pay for their insulin and the devices they use to monitor it.

I am wondering if the member and her Liberal colleagues will be supporting Bill C-213, the NDP bill on a publicly paid universal pharmacare plan, which would solve this problem once and for all.

Health—Main Estimates, 2020-21

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Madam Chair, that still was not an answer. I will move on.

The NDP has introduced Bill C-213 in this House to create a structure to establish universal public pharmacare in Canada. The minister would also be aware that this bill mirrors the Canada Health Act by allowing any province that agrees to provide necessary prescription drugs to their residents at no direct cost via our public health care system would receive federal funds to do so.

This is exactly the same way we fund all other covered medical services, from hip replacements to cataract surgery to broken arms. Will the minister support this bill?

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Chair, the minister knows the NDP introduced Bill C-213 in the House to create a structure to establish universal public pharmacare in Canada.

She is also aware this bill mirrors the Canada Health Act by allowing any province that agrees to provide necessary prescription drugs to its residents, at no direct cost via our public health care system, to receive federal funds to do so. This is exactly the same way we fund all other covered medical services, from hip replacements to cataract surgeries and broken arms.

Will the minister support our bill?

Opposition Motion—Pharmacare

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Mr. Speaker, I am pleased to rise today to speak on my party's opposition day motion on pharmacare. I have to say that my twentysomething self would be somewhat perplexed that I am actually doing this, and that is not just to think that as a gay man I might be an MP, but also that we still have not finished Tommy Douglas' dream of comprehensive public free health care.

Strangely, we have convinced ourselves we already have that. We seem, somehow, to be turning a blind eye to the gaps in that system. Tommy always thought it would be a step-by-step process, but that eventually we would get there. I think we have to ask ourselves how we have convinced ourselves for so long that pharmacare and dental care should not become part of our comprehensive public health care system.

I am very pleased to sit in an NDP caucus, led by the member for Burnaby South and by the member for Vancouver Kingsway on this important question of how to advance toward the goal that Tommy set so many years ago. It is a caucus that has put forward clear and achievable plans to fill those gaps.

When the Liberals proposed the so-called middle-class tax cut last December, we proposed in return that we limit the benefits of those cuts to those earning less than $90,000. With the savings from limiting that tax cut's benefits to the rich, we could in turn finance a dental care program for everyone earning less than $90,000 a year.

There is a practical step we could take and a way to pay for it, one that is clearly within our means and clearly doable. I am hoping, after we debate pharmacare, that we will move to that next stage of debating dental care in this Parliament.

As promised by our leader, our first private member's bill that is going to be brought before the House here will be by the member for New Westminster—Burnaby, Bill C-213. This lays out a specific plan for pharmacare, based on the principles of medicare. Once again, this is a program that is universal, comprehensive, accessible, portable and publicly administered.

My twentysomething self would also be perplexed about why we do not already have this. When Tommy Douglas set out his dream, first in the provincial campaign in 1960 in Saskatchewan, he knew it would be difficult, he knew it would be step by step. In 1962, when he tried to add doctors' visits to the existing hospital insurance plan, he had to face down a 23-day doctors' strike.

We know there will always be people who will step forward, who will say there are so many reasons why we should not take the path we know is the right path.

In 1965, B.C. joined Saskatchewan with a hospital and doctor visit insurance plan, and then in 1966, in Pearson's second minority government, we had a federal government that finally offered financial assistance to provinces that had such a universal plan. Sure enough, within 10 years, we had public health care plans established in every province across the country.

When Tommy moved to the federal level, he brought his dream with him. In 1961, he became the leader of the newly established NDP. In the first platform the NDP put forward, specifically, a proposal to have a pharmacare program on the same principles as a medicare program. Unfortunately, it has taken us a bit longer than I think Tommy thought it would to get an NDP federal government. I know that, because in his last term I had the great privilege of having Tommy as my MP.

Along the way there were other reasons to be optimistic about pharmacare. I guess I would have to admit that. First of all, as previous members have mentioned, we have had numerous commissions, advisory councils and studies dating back 60 years, probably to the first one that I saw, recommending a universal pharmacare program.

One would think we would get to this. Skipping over all that time, last June we had the Hoskins report from the Liberal government's own appointee. A Liberal from Ontario sat down and worked through all of the issues, and ended up recommending the same thing that we have all known we needed, according to the five principles of the Canada Health Act. It was something he judged we could implement by January 1, 2022.

Perhaps today's motion is the first step toward that date: January 1, 2022. I really hope it is. I am encouraged by the things I have heard from previous Liberal speakers, that they are going to support this motion. This motion commits the House to moving forward on pharmacare. It is not just an expression of opinion, as opposition day motions sometimes are. It is a commitment, if it is passed by the majority, that we will actually do something to get pharmacare in place.

I would hope that action would occur quickly. The NDP has offered that opportunity with our private member's bill.

However, we would not be disappointed if the government introduced a bill even before that and decided to move it through expeditiously as a government. I am not seeing that happen, but maybe today this opposition motion marks a change in direction toward finally getting this done.

Let me talk for a moment about why we should be doing universal pharmacare, and in doing so I could talk about savings to the health care system. The Hoskins report was very clear that overall expenditures on prescription drugs in this country would drop by about $5 billion a year. This would come from a number of sources. One is, of course, that we would get the ability to negotiate lower prices for drugs through strategies such as bulk buying of drugs, increasing generic substitutions and also eliminating administrative costs.

For those members in the House who like to go on about bureaucracy, let us look at the patchwork system we have across the country with literally more than 1,000 health care plans all being administered to accomplish the same purpose. The Hoskins report was very clear about the savings overall to the system if we adopted a universal, comprehensive and publicly delivered pharmacare program.

I could talk about the savings that would come to the health care system through better health outcomes. This goes beyond that $5 billion. What it would really mean is if we remove the barrier of cost for people to actually get the treatment they need, in terms of prescription drugs, they are going to be healthier. That would reduce the stress on our already overburdened health care system.

This would mean that we could do more with the same resources we have now if we did not have people who end up in the emergency room, in the hospital or ill because they could not afford their prescription drugs. That is an additional savings that would not show up in dollars, but it would show up in less stress on the dollars we are already devoting to our health care system.

I could also talk about savings to business. This may be a strange one for some people to think about, but there would be important savings to businesses here from adopting this kind of national comprehensive program. Right now, businesses and their employees jointly spend about $16.6 billion in expenditures on drug plans. What happens to that money? That money takes costs away from businesses and their employees and transfers it over to be shared by all of us through the taxation system.

Therefore it would reduce the burden that businesses have to carry, but also, and here is where I am going to be an advocate for small business again, a comprehensive universal plan like this would help level the playing field for employment in small business. Lots of small business owners tell me they have trouble getting the highly skilled help they need because the scale of their operation is not big enough for them to offer a good drug plan. If we have a comprehensive public plan, when it comes to hiring employees, small businesses can compete with the big companies that already have those benefit plans.

We can understand why people might prefer to work at a small business in the community they are from, but have to think about their family when it comes to drug protection. Maybe they would choose their second choice as an employer and go with a big company because of the drug plan that it offered, and the safety and security that it would appear to offer their families. There would be an important benefit for small business by this levelling of the playing field when it comes to prescription drugs.

I can also talk about equity. A good reason for a national pharmacare program that is comprehensive and universal is that the patchwork we have now means that the treatment people get in Canada depends on which province they live in, who their employers are and how big their wallets are. That is certainly something that I, as a Canadian, do not believe we aspire to in this country when it comes to the health of our citizens.

The real reason I believe we should have a public universal program for pharmacare is its impact on ordinary families. Let me take a minute to talk about what this really means in everyday situations.

One in five Canadian households reports a family member who in the past year has not taken his or her prescribed medicine due to its cost. This means more sick days in families and, in many cases, means earlier deaths in families because people were not taking their proper prescriptions.

More than three million Canadians per year report that they are unable to afford one or more of their prescription drugs, and there are the same outcomes. It is bad for families, bad for their health and bad for the health care system.

Almost a million Canadians reported that each year they cut back on food or home heating in order to pay for their medication. This is a cruel choice that we are forcing on Canadians who do not have prescription drug coverage.

Finally, Canadian adults are two to five times more likely to report skipping their prescriptions than those who live in a system which already has a comprehensive and universal public program.

Here in 2020, we are at a historic moment. The Liberals have a minority government. Universal health care came through a Liberal minority government. Well, here is another opportunity to move forward. We in the New Democratic Party have presented proposals consistent with the Hoskins report, which will help us get a detailed plan in place.

Today we have the motion from the member for Vancouver Kingsway before us, a motion that will commit us to move forward to where we all want to go in this country.

Opposition Motion—Proposed tax changes

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

Madam Speaker, I enjoy hearing from the minister, but I am a bit perturbed. I have been door knocking in Ottawa—Vanier, because there is a provincial by-election going on. People in Ottawa—Vanier, the minister's own riding, are talking about the importance of having access to basic dental care.

What the Liberals are offering this morning is unbelievable, in the same way that for 23 years they have been committing to pharmacare and studying pharmacare and have not been willing to move forward on it. Now there is a bill, Bill C-213, that all members of the House will be voting on in just a few months' time that will enshrine and put into place pharmacare, finally after 23 years, but the Liberals seem to be proposing more studies on dental care.

There are millions of Canadians who need basic dental care. The NDP's proposal does not increase costs. Why are the Liberals reluctant to endorse the motion we are debating today?

Canada Pharmacare Act

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

moved for leave to introduce Bill C-213, An Act to enact the Canada Pharmacare Act.

Mr. Speaker, I am honoured to introduce the Canada pharmacare act, a historic step in the history of our country.

The bill is seconded by the member for Burnaby South and supported by millions of Canadians across the country, like Jim, who has to beg at the entrance of Parliament Hill to find the money each month to pay for his medication, and Cole, a constituent whose family pays $1,000 a month for medication that keeps one member of their family alive.

The Canada pharmacare act would ensure universal, comprehensive public pharmacare that is accessible and affordable, the very principles of universal medicare. This would save Canadians billions of dollars. It would save the lives of thousands of Canadians who die from preventable causes because they lack medication coverage.

The Canada pharmacare act will benefit millions of Canadians. If members support this bill, we can tell everyone that our country is finally getting pharmacare.

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