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.

National Framework for Diabetes Act

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

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

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

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

Health—Main Estimates, 2020-21

[Heather McPherson, NDP, Edmonton Strathcona, AB]

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

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

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

[Don Davies, NDP, Vancouver Kingsway, BC]

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

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

Will the minister support our bill?

Canada Pharmacare Act

[Don Davies, NDP, Vancouver Kingsway, BC]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[The Chair, Liberal, Ginette Petitpas Taylor]

No. Thank you so much for that. That's great.

Perhaps now we can proceed through each item. To be efficient with our time, we could maybe just go through them item by item, and if there are no questions or comments, we can dispose of them fairly quickly. We'll be able to address the ones for which there is debate.

Does that sound appropriate to everyone?

We'll start off, then, with Bill C-210. Does anyone have any issues or comments about that one? No.

Next is Bill C-238.

I see there are no comments, so we'll move right along to Bill C-224. Good.

Next is Bill C-215. No comments.

Next is Bill C-204, and now Bill C-229.

I'm not going to jinx it, but we're on a roll.

Now we have Bill C-218 and a motion, M-34.

Next we have Bill C-214, Bill C-220, Bill C-221, Bill C-222 and Bill C-213.

I love working with women.

Next is Bill C-223, followed by M-35.

Now we have Bill C-206, Bill C-216, Bill C-208, Bill C-205, Bill C-237, Bill C-225, Bill C-228, Bill C-236, Bill C-230 and Bill C-232.

Opposition Motion—Pharmacare

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Opposition Motion — Proposed tax changes

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

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

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

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

Canada Pharmacare Act

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

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

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

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

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

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

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