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.

Opposition Motion—Federal Intrusions in the Exclusive Jurisdictions of Quebec and the Provinces

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

Mr. Speaker, it is great to see the member for Winnipeg North stand in this place to loudly proclaim his support for the important programs of pharmacare and dental care. This is even more so due to the fact that, in the 43rd Parliament, when it came to Bill C-213, introduced by the member for New Westminster—Burnaby, and a motion on dental care, which was introduced by former MP Jack Harris, that member and the entire Liberal caucus voted against those measures. They voted against pharmacare and against dental care.

I am glad to see that, on the road to Damascus, the Liberals have arrived at their conversion. I just want to know what changed. What led the Liberals to suddenly have this vision that these were, in fact, the right programs to put in place now? Could it be that the New Democrats forced them to do it?

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.