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.

Royal Recommendation for Bill C-237

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

Madam Speaker, I appreciate your intervention.

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

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

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

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

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

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

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

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

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

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

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

Pharmacare

[Heather McPherson, NDP, Edmonton Strathcona, AB]

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

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

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

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

Canadians have been waiting nearly 60 years to get prescription medications included in our health care system. Twenty-three years ago, the Liberals first promised Canadians a national pharmacare program, and they have been repeating that promise ever since. We have had five public commissions on pharmacare, study after study, including the Liberals' own Hoskins report in 2019, all saying the same thing: Canadians need pharmacare and pharmacare will save Canadians money. I do not know what is more disappointing, 23 years of broken promises or the stubborn refusal to even acknowledge the reality of so many Canadians.

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

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

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

Budget Implementation Act, 2021, No. 1

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

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

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

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

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

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

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

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

Finance

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

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

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

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

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

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

Thanks very much, Mr. Chair.

I'd like to turn to Mr. Yussuff for a question.

I'd like to thank you for being such a strong advocate for public universal pharmacare. As well as the Canadian Labour Congress, we've had labour activists across the country who have really been fighting for public universal pharmacare. Particularly with this pandemic and the number of people who've lost their jobs, we're seeing an increasing number of people who have no medication plan at all. That's why the Canada pharmacare act that was brought forward in February—and endorsed by the CLC, as you know—was so important. Government voted that down. That would have structured pharmacare on the same basis as our universal health care.

The Hoskins report called for funding this year to negotiate with the provinces to set things in motion. There was no new funding available for pharmacare at all in this budget. Many people are saying that this is abandoning pharmacare and that pharmacare and child care could have been discussed and negotiated with the provinces together.

Could you outline the importance of having public universal pharmacare for workers and for the millions of Canadians who have no medication plan and who struggle to pay for their medication, particularly in a pandemic?

Financial Statement of Minister of Finance

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

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

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

Opposition Motion—Long-Term Care

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Pharmacare

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

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

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

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

Canada Pharmacare Act

[The Speaker, Liberal, Anthony Rota]

It being 3:38 p.m., pursuant to an order made on Monday, January 25, 2021, the House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-213 under Private Members' Business.

Call in the members.

The House resumed from February 17 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.

Pharmacare

[Jagmeet Singh, NDP, Burnaby South, BC]

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

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

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

Canada Pharmacare Act

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

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

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

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

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

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

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

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

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

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

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

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

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

[Heather McPherson, NDP, Edmonton Strathcona, AB]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Tom Kmiec, Conservative, Calgary Shepard, AB]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[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.

[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)