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.

Canada Pharmacare Act

[Darren Fisher, Liberal, Parliamentary Secretary to the Minister of Health]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Jagmeet Singh, NDP, Burnaby South, BC]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Luc Thériault, Bloc, Montcalm, QC]

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

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

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

The motion reads:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 afer 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 are 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.

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

Thank you very much.

I'll move now to you, Mr. Arango. You talked very eloquently about pharmacare. There's going to be a historic vote—this will be the first vote ever on pharmacare legislation in Canada. It will be NDP Bill C-213 in February, which would put into place the legal framework around pharmacare, including universality, public administration, portability, accessibility and comprehensiveness.

Is the Heart and Stroke Foundation supporting that legislation so that we can put in place the legal framework that would allow us to bring in national universal pharmacare?

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

Thank you very much, Mr. Chair.

Thanks to all our witnesses for being here. We hope that you and your loved ones are safe and healthy during this pandemic. It's very good of you to give testimony today that will hopefully form some of what we should see in a spring budget.

I'd like to start with you, Mr. Villeneuve. First, our thanks go to all the front-line workers and nurses across the country who have shown such courage during this pandemic.

I have three questions.

What you're calling for is an investment, the demographic top-up transfer, that is slightly less than the cutbacks we've seen over the last five years. I'm wondering whether that demographic top-up is in addition to restoring the full health care funding that was slashed by the former Harper government and continued by the current government. We've seen the impacts of that.

My second question is around long-term care. What do you think is needed? Should long-term care really come under the Canada Health Act as part of ensuring that there is publicly administered long-term care and long-term-care standards across the country to avoid the nightmare that we have seen repeated numerous times, often in private long-term care homes, over the course of the last few months?

The third is on the issue of pharmacare. We have Bill C-213 before the House of Commons, the Canada pharmacare act. MPs will be voting on it in February. It would provide the legal framework for universal, publicly administered access to medication. To what extent do you think, and do Canada's nurses think, it would be a good idea to have universal pharmacare to add to and strengthen our health care system?

Those are my three questions to start. Thank you.

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 chose 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 as 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 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 have 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 percent 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.