Bill C-64

Pharmacare Act

An Act respecting pharmacare

This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and obliges the Minister to make payments, in certain circumstances, in relation to the coverage of certain prescription drugs and related products. It also sets out certain powers and obligations of the Minister — including in relation to the preparation of a list to inform the development of a national formulary and in relation to the development of a national bulk purchasing strategy — and requires the Minister to publish a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products. Finally, it provides for the establishment of a committee of experts to make certain recommendations.

Pharmacare Act

[Mark Holland, Liberal, Minister of Health]

moved that Bill C-64, An Act respecting pharmacare, be read the second time and referred to a committee.

Mr. Speaker, it is my pleasure to rise.

I want to start by extending gratitude to the member for Vancouver Kingsway for his extraordinary work throughout this process. It was a long, hard discussion to find a place of meeting, but it is an example of what is possible when we, in this chamber, focus on getting things done and focus on working together, rather than focusing on what divides us. I think that sometimes we fundamentally misunderstand the purpose of democracy, which is to build consensus, to find points of commonality and to pull people together to find common ground; it is not to find differences or to sow division.

I also want to thank so many phenomenal colleagues on our side who have dedicated, in some cases, decades to fight for the moment when people are not forced to make a choice between the medication they need to stay healthy or the essential goods and services they need to stay alive, whether that be their rent or their food.

In the 1960s, we launched national medicare, but we forget how challenging that was. It was an incredibly turbulent period to actualize it and to bring it to reality. The dream had long existed, but to bring it to bear was extraordinarily difficult. However, at that moment in time, there were certain things left out, one of which was medicine. That was partially because, at that point in time, the number of medications available were very limited. They were typically prescribed in a hospital setting. They did not have the uses and abilities, and they were not as essential as they are today. Certainly, that dynamic has changed, and this means a new dawn for health.

I am going to talk specifically about pharmacare and the legislation therein, but before I do, I will paint a broader picture of the circumstances it faces.

Like all countries, everywhere in the world, the vast complexity of our health systems is overwhelming. We are driving down a highway at a 100 kilometres an hour, recognizing that we cannot slow down, and we have to change the engine while we are driving. Due to that difficulty, most health systems had not done the hard work of transformation, of really stepping back and looking upstream at how we deal with prevention and deal with reducing the amount of chronic disease and illness that exists within our system.

Then the pandemic hit, and in the pandemic, everywhere in the world, the strains and cracks in our health system were laid bare. Health care workers were asked to carry a burden that was impossibly large, working night and day to try to keep their communities safe, and carrying a load beyond imagining. However, in that moment, here in Canada and in a few places elsewhere in the world, we saw something I think quite remarkable happen, which was that in that chaos, there was one purpose in our system. Doctors, nurses and personal support care workers showed us the possibility of what happens when we move with one purpose, with one direction, and when we focus on people's health and nothing else. We could set aside egos, jurisdiction and turf, and we could make things happen. In an incredibly brief period of time, Canada's pandemic response was indeed one of the best in the world with one of the lowest death rates anywhere in the world. We had unbelievable support for the people working within the system and for one another for that period of time.

Then, challenges resumed. The pandemic began to recede. A war erupted in Europe. Global financial turmoil ensued. We forgot the lessons of the fruits of co-operation and of working together, and many of those divisions returned. Within our health system, we saw a workforce who had carried far too much and was dealing with burnout, yet still had the extraordinary weight of a system that needs to change. We saw, for the population, that health was a bit of a hot plate. People's experience of the pandemic was trauma, really, for everybody. It was especially so for health care workers, but nobody was saved from the traumatic experience of going through the pandemic.

I would say that it is the responsibility of not just this government, but also every government in this country to remember the incredible heroism of those who were working in the health workforce during those dark hours of the pandemic, and with that same spirit of co-operation and determination, to not focus on what divides us or what makes us different, but to focus on what can be done. That is no more important in any area than it is in health. Canadians do not care much about what political party someone is from. They do not care much about whose jurisdiction it is; they want to see results.

That is why the $200 billion that we put forward to invest in health care over the next 10 years was so critical. It required an agreement with every single province and every single territory to develop a plan to deal with the crisis of today, to tackle those issues within our health system around the workforce, the backlogs, the health data and the sharing of patient information, to deal with issues like administrative backlogs, things that are legacies that do not make sense, and to work with every province and territory, regardless of its stripe.

Whether it was Adriana LaGrange in Alberta, Adrian Dix in B.C, Michelle Thompson in Nova Scotia or Bruce Fitch in New Brunswick, and so forth, in every instance, that spirit of co-operation pervaded our negotiations. There was a profound understanding in those conversations that we have to be bigger than our partisanship and have to find commonality. As a result, we have had extraordinary agreements signed with all the provinces and territories, in a short period of time, to lay out the next number of years and to see what that health transformation will look like.

That spirit of co-operation was also seen in Charlottetown, where we were able to have an agreement on some things that are really essential: health data; looking toward interoperability and how our systems work together with a digital charter; reducing wait times for recognition of foreign credentials, taking it down to a 90-day service standard. We were also able to work later with the College of Physicians and Surgeons to take a process of credential recognition that is normally a couple of years and were able to get it down to a couple of months.

The other thing these agreements and conversations did, which I think is critically important for the future of our health system, was to establish common indicators, meaning that every province will have the same indicators for their health system, so that whether someone is a Quebecker in Quebec or a Manitoban in Manitoba, one can see how their health system is faring, not by anecdote but in data, and that can be compared against other provinces. Making sure those indicators are there is essential. It is so important that people feel that positive change, that they experience it in outcomes and that it is also measurable in data.

In our federation, as we are making changes and interventions, that ability to have data and to see how we are moving the needle is essential. What one measures, one achieves. For the first time in these health agreements, we have set these essential tools of measurement to be a key component of our health system.

We can then turn to dental care. There are some who say that this is just a boutique intervention, something that is a one-off, but it is actually part of a broader vision of health. Imagine that in this country there are nine million people today who do not have access to dental care. I want to thank my predecessor, the former minister of health, now the minister of procurement, the hon. member for Québec, for his extraordinary work to get us to this point in dental care. I want to thank the NDP and the member for Vancouver Kingsway for their work with our caucus in a common purpose to make sure that we pull together over health.

[Peter Julian]

Hear, hear! Thanks to the NDP.

[Mark Holland, Liberal, Ajax, ON]

Yes, I want to thank parliamentary co-operation.

Madam Speaker, I would say to this place that this is what we were intended to do. When we were elected as members of Parliament, we are not here to shout things at each other, to belittle each other or to put each other down. We are here to listen to each other. The purpose of debate is to ensure that we take each other's ideas and that we find common ground. In this bill, Bill C-64, in pharmacare and in dental care, we are embodying exactly what I believe our constituents elected us to do.

Right now, we have 1.8 million seniors who, in many cases, have never had access to oral health care in their lives. I talked to a denturist who knew a senior who has not had new dentures for 50 years. They lost their dentures and had no money to replace them. The denturist talked about the dignity and the way that senior felt, knowing that they were going to get new teeth and that they could go out in the world, feeling that somebody cared about them. Let us think of the extraordinary nature of that.

When going to seniors homes and when talking to people who work with seniors, they ask if this is really going to happen. They talk about the dignity that comes from it. It is not only about that healthy smile or that they are not going to wind up in an emergency room for an avoidable procedure, but also about the dignity of saying that we care about them, that we see them and that their health matters.

We have one of the most extraordinary health care systems in the world, but it cannot be the best health care system in the world unless oral health is part of the equation. When we do not take care of oral health, when we are not there for oral health, then the costs, not just in terms of social justice but also in terms of health outcomes, are entirely unacceptable. I would submit that is not the country we want to live in.

I am also extraordinarily proud that, about two weeks ago, the Minister of Families, with many of us there, launched the national food program. When I was at the Heart and Stroke Foundation, I advocated for fiercely for that, knowing when a child goes to school hungry, it is impossible to learn, and when a child is denied nutrition, it has devastating effects on their health. It is so sad to say that the research shows just one healthy meal a day has a dramatic change on health outcomes for children. The other thing it does is to give kids a taste for what nutritious food is. They develop their palates, and for their whole lives, their nutrition and nutritional profile is changed.

An essential part of being upstream and avoiding illness and sickness is dental care, a national food program and, yes, action on pharmacare. This is a big task. We know that some 21% of Canadians are struggling to meet the financial burden of being able to afford their medicines. We took essential action on bulk purchasing, reducing the cost of medicine in this country by hundreds of millions of dollars, by working with provinces and territories to do bulk purchasing.

We are taking critical action in P.E.I., with a plan for Islanders, on a pilot basis, to improve affordable access to prescription drugs. Since June 1, 2023, we have been able to reduce copays to five dollars for almost 60% of medications regularly used by Islanders. P.E.I. residents have saved more than $2 million in out-of-pocket costs. This was a precursor to show us what could happen. Whether one goes to P.E.I. or other provinces, and I know that the member for Malpeque talks a lot about this, they will hear about the difference it is making in the lives of people, having medication taken off the table as a concern. It is absolutely huge.

We also launched, in March 2023, a national strategy for drugs for rare diseases, with an investment of $1.5 billion over three years because we know that drugs for rare diseases can be cripplingly expensive, yet they are absolutely vital to keep people alive.

I will give one quick story before I talk about the bill in front of us and about the action we are taking. I had an opportunity a few weekends ago to be in the United States with my partner. We watched someone in front of us collapse. That person was obviously not a person of means. As they came to and I called 911, the thing that person was worried about was not their health, but it was how much money they were going to have to spend. How much money did my call to 911 burden that person with?

We do not want to be in a place, with any element of health care, where somebody of limited financial means, through no fault of their own, is in a circumstance that they cannot afford care, or where nurses on the front lines, taking care of patients and investing their entire lives in trying to make things better, are not given the opportunity to get proper health care for themselves.

Why these drugs? Why did we start with diabetes medication and with universal contraceptives? Let me start with diabetes medication. I want to thank the member for Brampton South for her fantastic advocacy on diabetes specifically. There are 3.7 million Canadians, and it is a growing number, who have diabetes. When I had a conversation in Ottawa with 12-year-old Raina, she summed it up better than anybody else. She said that as a 12-year-old it is really hard in this world, and that no 12-year-old should have to worry about all the problems of the world and also how they are going to afford their medication. If 12-year-old Raina can get it, then this House can get it.

When a person does not have access to their diabetes medication, it means they risk heart attack, stroke, kidney failure, blindness and amputation. I was talking to Sarah in a diabetes clinic, who told me about patients who were reusing syringes because they could not afford them. The risk of blood-borne disease is terrible. That is not the country we should live in, so we all need to rise to this moment to say that for people with a precursor disease like diabetes, which is so indicative of whether they will have future chronic disease and illness, it is essential that we are there with medication for people.

On contraceptives, let me just give one example that illustrates the case. Oral contraceptives cost $25 a month and have a 9% failure rate. The IUD costs about $500, lasts five years and has a failure rate of 0.2%. What it means is that a person who does not have money ends up choosing the birth control option that is cheaper, which has a 9% fail rate and means they are more likely to wind up with an unwanted pregnancy or a sexually transmitted disease if they are not able to make the choices that give them autonomy over their own body and their reproductive health and future.

Therefore, it is absolutely essential, and not only for health. For example, in British Columbia, it has been demonstrated by UBC that it is saving more money with this initiative than it costs to roll it out. That is similar to what we are going to see in diabetes. This has such a powerful effect in prevention that it actually reduces costs overall.

The message it sends to women about their bodies and about their sexual and reproductive rights and autonomy is essential, which is that in this country, no matter where she is, a women will get what she needs to have control over her future and her body. That is a powerful statement, and it goes beyond just contraceptives as a drug.

As a very young person, when I was very, very young, I was exposed to sexual violence. That experience, in a family that did not talk about sex and did not have a conversation about what healthy sexual relationships were, had a devastating effect on my life, my self-esteem and my ability to stand up for myself at different moments in my life. It is difficult for somebody who does not have the information about their sexual health, who is not told that sex would never have anything to do with violence, that violence is about control and sex is about connection, that sex should always be consensual, should never be exploitive, should never involve violence and should always involve what a person wants for their body, that it should be pleasurable and it should make them feel like themselves.

As a health minister, it should not be in any way controversial for me to say those things to people. Whether a person is in a marriage or intersecting for the first time with somebody else sexually, they need to understand it is okay to be themselves and that as long as it conforms to those things, such as that sex should be pleasurable and that one should be empowered in one's body and have access to the reproductive medicines one needs to make choices about one's life, it is going to save lives, because the second-leading cause of death for young people is suicide. We lose about 500 kids every single year, and way too often it has to do with them not feeling comfortable in their own bodies. We have to end that.

In totality, looking at all of these actions, this is a new dawn for health, dealing with the crisis of now and also looking at prevention, so that we can build on what we started in the 1960s and ensure that all Canadians have access to the greatest health care system in the world.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, those were interesting comments from the Minister of Health. He talked about the incredible results that he thinks he is getting with these new programs. Oddly enough, the backlogs for care in Canada have never been worse: It is 27 and a half weeks from the time of seeing a primary care provider to getting treatment from a specialist, the worst it has been in 30 years.

With regard to the Canada dental care program, he wants to talk about how many people have signed up for it. Although we know he will go on with the fantastical speech he has made here in his incredibly fact-devoid fantasy, the question that would remain for his great dental care program is this: How many dentists have actually signed up for the program?

Very specifically, how many dentists in Atlantic Canada and, specifically, how many in each province of Nova Scotia, New Brunswick, Newfoundland and P.E.I. have signed up for the dental care program?

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, it was true in the 1960s and it is true now, that there are purveyors of doom.

There are those who try to push people to despair. When one does not believe in a public health care system, what does one want people to do? One wants people to despair, because nothing comes from despair. All change comes from looking at what is hard and true and driving for change.

Let us talk very specifically. Every health care system in the world is facing extraordinary backlogs as a result of COVID and stress on their system. It is a question how we meet that. These 13 agreements and these investments of $200 billion are demonstrating that we are meeting that challenge. In these plans, in articulated detail, is exactly how we are going to get to the health system Canadians deserve.

With respect to dental care, we have thousands and thousands of dentists who have signed up across the country.

Secondly, just on Thursday, I met with the dental associations, and I can tell the House that we are down to a couple of minor issues and that I am extraordinarily confident that over the next number of months, we will see virtually every dental office in the country participating in this program.

[Luc Thériault, Bloc, Montcalm, QC]

Madam Speaker, the minister spoke about a lot of things. I feel he spoke very little about Bill C-64. However, when we talk to him about Quebec’s interests, he rises in the House and always says that the Bloc Québécois is looking for a fight. Quebec has been administering a mixed drug insurance plan for the past 28 years, but the minister never sat down with Quebec before making his announcement to see how Quebec manages this and how much it might cost.

Does the minister know how many prescription drugs are covered by Quebec’s drug insurance? Has he sat down with the health minister, who says that Quebec does have constitutional rights? When the minister says we are looking for a fight, he should add the word “constitutional”. It is as though we Bloc members have more respect for Canada’s Constitution than he does, despite his party having done all it could to prevent Quebec from signing the Constitution in 1982. Is he aware that the minister wants nothing to do with his pharmacare plan as proposed?

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, there is no denying that Quebeckers’ interests are absolutely the same as those of everyone else in the country. Everyone wants access to a health care system that works properly for all.

As for the questions surrounding drug insurance, I have had some really good conversations with Minister Dubé in Quebec. There is a clear spirit of co-operation.

If one goes looking for a fight or problems, they are easy to find, but the idea is to find solutions and a way to work together to resolve the situation, to improve people’s health across the country. For example, it is absolutely essential that we take into account the indicators for Quebeckers, so that we can compare and contrast how things evolve in their system and how they evolve in the other provinces and territories. This is a very good thing to do, and it is also good to see where the federal money is in the plan. That is why it is more important to co-operate than to pick a fight.

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

Madam Speaker, I would like to congratulate the minister for working attentively with the effective NDP opposition to actually bring about this historic debate today. It is going to make a difference, on average, and I point this out to the Conservatives, to 18,000 constituents in each of the Conservative ridings across the country.

I wanted to reference one of my constituents, a Burnaby, B.C. resident, Amber Malott. She learned she had diabetes when she fell into a coma just before her 21st birthday. With all of the types of insulin and injections that she takes, her monthly bill on insulin because of her diabetes is close to $900. We saw last week the disgraceful exhibit of Conservatives blocking even bringing this bill forward to the House. They blocked it from the kind of debate we need to have on this bill. Conservatives have indicated they would like to destroy this initiative.

What would be the impact on people like Amber if the Conservatives had their way?

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, I want to thank the hon. House leader for the NDP. I am very pleased to work with him again in his role as the critic for health. He is absolutely right. I appreciate that these were not always easy conversations. They were indicative of the conversations we had when we were both House leaders. Finding that common ground, as two different parties, is often difficult.

I think, for people like Amber, we can see what the difference is. The cost consequence for Amber of not being able to have access to the life-changing medication she needs, let us be very direct, could be devastating. It could mean that Amber winds up with a heart attack or stroke. It could mean that she has a limb amputated or that she dies. It certainly means that Amber is less productive, less able to contribute to society and almost definitely going to have an earlier death. The cost of not providing that medication is far superseded by those negative outcomes, not just as a matter of social justice but as a matter of material cost.

Are the Conservatives going to be there for Amber? Are they going to be there for people who need their diabetes medication? Are they going to vote for their constituents who need these medications, or are they going to vote against them?

[Michael Coteau, Liberal, Don Valley East, ON]

Madam Speaker, I am proud to be part of a government that is bringing forward new national programs like child care, student nutrition, a dental plan and pharmacare. It has been decades since a government in this country has moved forward with such massive programs. In fact, we have not seen this type of movement for many decades. I would like to ask the minister about the relationship we have with the provinces and territories as we move forward.

As you move forward, what has been the response by some of the key people, like ministers and stakeholders in other provinces, for this specific plan?

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

I will remind the hon. member to speak through me, please.

The hon. Minister of Health.

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, I thank the member and my friend for an important question. I have been so encouraged by the conversations that I am having with every provincial health minister across the country, regardless of their stripe. Whether I am talking to Everett Hindley in Saskatchewan or Uzoma in Manitoba, the conversations have been incredibly productive and positive. They are focused on how we get people the care they need.

I would challenge the Conservative opposition. They talk about wanting to destroy dental, how they do not want pharmacare and how they are going to block the national food program. They tell people not to dream about it and that they cannot have it. They tell people not to dream that they can get medication. They say not to dream that they can have dental care. The Conservatives are going to make sure it does not work. They are going to call dentists and scare them. They are going to give them false information. They are going to work against people getting care, for political reasons.

I think we should listen very carefully to what the Conservatives say. Are they asking questions about how they can help or how they can ensure that people get dental care? Are they asking questions about the problems that dentists have and how we can help fix them because they want to make sure people get dental care? No, they are saying to give up and have despair, and that they cannot do it. Shame on them for it.

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, hopefully today we will move into reality as opposed to the fantasyland that has been painted by the Minister of Health.

When we look at it, the pharmacare program that is being introduced is really about the preservation of the costly coalition. We also know that Canadians are not going to be fooled by the foolishness that has been presented in the House this morning. We know that the other plan its members have is to clearly extend the date of an election so they can access their pensions. The worst state of being a politician one could possibly imagine is to be self-serving, when all of us who come to the House know we should be here for the benefit of Canadians. That is clearly not the case with the costly coalition members. Rather, it is about their preservation, which they have made very clear throughout Canada, which is an essential part of their ability to keep this inept government in power for as long as they have. That is the first part that Canadians, of course, are well aware of.

The other thing that Canadians are well aware of is the state of coverage with respect to pharmacare.

My Bloc Québécois colleagues are well aware that pharmacare falls squarely within provincial jurisdiction.

We know that 97.2% of Canadians are already eligible for some form of prescription drug coverage, which is not some funny Conservative talking point. It comes from Stats Canada, CIHI, CLHIA and the Conference Board of Canada. Therefore, when we look at the numbers, it becomes very simple to understand that there is a gap of about 1.1 million Canadians who struggle without coverage for pharmacare. I think it is important to point that out because we are attempting to have an honest conversation here.

We also know that the numbers of those who are uninsured have decreased precipitously since, for instance, the Ontario government introduced OHIP+. It is also interesting that the minister talked a bit about his historic meetings with all the provincial ministers of health, which I also chose to undertake myself. When I did, what those provincial ministers of health made clear was not the rubbish the federal minister brought forward, but that they in no way, shape or form want another large federal program dropped on their heads to fund, which, as I said in French, is clearly a provincial area of responsibility, the delivery of health care. Oddly enough, the federal Minister of Health himself pointed out that the delivery of health care is a provincial responsibility and not that of the federal government, despite the fact he continues to intervene in moving the responsibility from the provincial authority to the federal government.

I did have an opportunity to mention this bill, and I would like to expand upon that. The bill would create another government agency, which is exactly what Canadians would like to have, more bureaucracy and more gatekeeping. It would create the Canadian drug agency, which would cost about $90 million to create and perhaps another $30 million or $35 million a year to continue to exist as time goes on. However, who worries about monetary policy? It is certainly not the NDP-Liberal coalition.

It is also odd that the government posted on its Canada.ca website a list of drugs, diabetic drugs and contraceptives that may or may not represent what would actually be on the formulary in the future because we know it would be the responsibility of the Canadian drug agency, in consultation with provinces and other stakeholders, to create a formulary to be used.

I think it is also important to point out that, if we are to have any faith whatsoever, which I personally do not, in the formulary that has been put out thus far, much to the chagrin of Canadians, it is rife with older medications, with no fees for pharmacists or the primary care provided by pharmacists to many Canadians because of the sad reduction in the number of family physicians. It is also worth noting, very specifically, that the blockbuster drug in treatment of diabetes in a generation, namely Ozempic, is not included. There is no surprise there.

As I was saying, after the creation of the Canadian drug agency and a formulary, and after holding these consultations, the only consultations that have happened thus far, of course, are with the NDP costly coalition partners, which should not give Canadians any warming in their hearts.

When we look at the other issues that are clearly brewing in Canada at the current time, Canadians know that the state of our beloved health care system has been under siege by the inept management of the NDP-Liberal coalition. We know that wait times have surged beyond what they have ever been in history. For instance, the wait time from seeing a family physician to a specialist to obtaining specialist-based treatment has increased 195% to a 27-week wait time. This is the longest it has been in three decades. Is this a system that Canadians should be proud of?

The other disturbing statistic is that 6.5 million Canadians are without access to primary care. As time will march forward, as it always does, by 2030, in Ontario alone, the 2.3 million Ontarians currently without access will surge to four million Ontarians without access to primary care. It is very clear, even if this were a good pharmacare plan, which it clearly is not, that without access to primary care, there is really no way to get medications. I would suggest that there is a bit of a misguided nature here.

The other difficulty that Canadians are also very aware of is that the newest medications, a class of medications called “biologics”, which account for 2% of claims, are now accounting for 30% of spending. Of course, none of these biologics are included on any of the proposed fantasyland formularies from the NDP-Liberal coalition.

The other problem we have in our health care system is wait times from application to approval of medications to be on the formulary to the actual acceptance on 50% of public formularies, and we have the longest wait times in the world at 25 months for new life-saving therapies. A government should be seized with policy changes to improve the lack of bureaucratic control and the ability to change things that would be cost effective for Canadians, and indeed changes like this to make a government work more efficiently, which would actually not cost the government anything, it would cost Canadians nothing. However, what is the government doing? As I said previously, it is interfering with clear provincial jurisdiction and adding federated programs that in no way, shape or form could possibly reduce the cost for medications.

The other reason, of course, is that the cost of these medications are already in a forum which allows all of the public plans to come together under a program called the “pCPA”, which already allows all public plans to negotiate for low prices for those medications. For the federal Minister of Health to suggest that this new plan would suddenly allow prices to drop precipitously is absolutely and categorically untrue.

The other major issue is related to finances and the cost of living. When Canadians were asked what the major cause of their inability to afford their medications was, and I suspect my colleagues know very well what the answer to that question is, it was inflation. Yes, inflation is cited as the major cause of Canadians' inability to afford their prescription medications.

Why do we have 40-year high inflation? Well, of course, it is because of the costly coalition of the NDP and Liberals. We know that the chance of a young Canadian now owning their own home is almost zero. It is a dream that is almost dead because of the NDP-Liberal coalition's incompetence. We also know that, more than ever, Canadians are turning to food banks to enable themselves to feed their families. Two million Canadians a month, very sadly, are having to go to food banks, and what do we see?

We are seeing more large federal government spending in what David Dodge called last evening “likely to be the worst budget” announcement in the history of this country. We are waiting for more of these terrible budget announcements today, in which we will see another estimated $40 billion of deficit spending.

On top of that, we know that the $1.2-trillion debt that the NDP-Liberal coalition has coffered together, more than all Canadian governments in history combined, is costing more now to service than we are spending on health care. That is an incredibly sad state of affairs. I would suggest that it is one that Canadians are paying very close attention to.

We also know that simply saving for a down payment for a house is now taking 25 years, when the Canadian dream would be that those 25 years would allow us to pay a mortgage, not simply to save for the down payment.

Canadians are suffering more and more with their mental health. We also know that the Liberal government had committed $4.5 billion to the Canada mental health transfer, and not one penny of that has been transferred. That is a very sad state of affairs, when one-quarter to one-third of all Canadians are currently suffering with mental health issues, and it is believed that 50% of those are suffering with inadequate treatment. The $4.5 billion could go a long way to help treat the mental health of Canadians.

This NDP-Liberal coalition has had a multitude of failures, and they are worth pointing out simply because we question why Canadians would believe that another large federal program would ever come to fruition. What we know is that these programs are great announcements. The next prime minister of Canada has spoken about how people cannot eat the papers the announcements are printed on. They are incredible photo ops, when ministers go out to say that they might be capable of doing things, but Canadians know they are absolutely unable to do so.

I had asked a question of the Minister of Health, which he, sadly, once again, failed to provide an answer to, but now I am quite happy to provide that answer on the Canadian dental care program. Last week I had the opportunity to speak to every dental association in this country, save the Yukon, simply because of time. That being said, I have a sample of the number of dentists who have signed up for this widely touted program.

In my home province of Nova Scotia, four, not 400 or 14, but four dentists out of 400 have signed up for this program. It is shameful. In Prince Edward Island, it is even easier. The number is zero. There is no debating zero, it is none, zilch, nada. In New Brunswick, once again, to be clear, four out of 370 dentists have signed up. The most we were able to find was in speaking with the British Columbia Dental Association, and it had 400 out of 4,000, which is still a mere 10% of dentists.

This is a program that has been created without any consultation with respect to dentists. It has been creating an incredible administrative burden on dentists. It has also created a conflict where dentists have to sign a contract with a provider, namely the federal government, as opposed to having a relationship with the patient, which is how health care has historically been delivered in this country.

Dentists will continue to ask questions about this program. Why would they sign up for a program when they have distrust in this NDP-Liberal coalition?

Let us talk a bit about affordable housing, which was another failure. It was promised by the government in 2015. It would have to build 9.6 million homes over the next 10 years. We also know they are now building less than this country was building 50, and not 15, but 50 years ago. Fewer houses are being built now because of the terrible policies of the NDP-Liberal coalition.

We also know that the Prime Minister sat here in the House of Commons and promised 7,500 new doctors, nurses and nurse practitioners, and as I mentioned previously, 6.5 million Canadians now do not have access to primary care. We also know that the government continues to spend money, which could be easily used to generate these spots for Canadians, on its consultants. The government is quite happy to line the pockets of its friends.

The Liberals also said they would reduce Canada's federal debt-to-GDP ratio every year, which sadly has not happened. We know that they can barely even deliver passports, which is actually one thing that is in the purview of the federal government. It is now announcing things that certainly delve into provincial jurisdiction, yet it cannot do things it should be able to do that are the purview of the federal government. As we begin to look at these things, we know that the NDP-Liberal coalition is an abject failure.

People will often say that I have a lot of negative things to say. Why do I not give Canadians hope? Let us focus on that for a few minutes.

The blue seal program we have announced, as Canada's Conservatives, would allow those who have trained internationally to quickly and safely have their credentials recognized here in Canada. That is a program that we would create because, as we go around this country, what we hear from new Canadians who have trained in other countries is that now they are driving taxicabs. I heard a story from one trained physician who is not allowed to work in this country. He was very sad because his young child asked him why, if he was a physician, he went to work dressed as a security guard every day. It does not get any worse for new Canadians than that.

As we look at that, we know that Canada's Conservatives have been working hard to create policies that, when we form the next government, would easily allow new Canadians to have their credentials recognized here in Canada, so they can support Canada's health care system and work in a manner that is attuned to the training they have undertaken in their home countries.

We have, again, a photo op. We have papers. We have announcements. We do not have a plan that has been put forward by the NDP-Liberal coalition, in any way, shape or form. We have more announcements. We have no actions, and we have continued interference in provincial jurisdictional matters. As I said, I have gone around the country speaking to provincial ministers of health. The last thing they want is another federal program dropped in the laps of the provinces, which they have to pay for because of the ineptitude of the NDP-Liberal coalition.

We await the time when the Conservatives will form the next government of this country. We would have a new prime minister and new hope for Canadians, as they would be able to afford their lives, and the inflationary pressures and inflationary spending that continues to be put forth by the NDP-Liberal coalition would end. Canadians could then not be priced out of their lives.

We would axe the tax, build the houses, fix the budget and stop the crime.

I would like to put forward an amendment.

I move:

That the motion be amended by deleting all the words after the word “That” and substituting the following:

“The House decline to give second reading to Bill C-64, An Act respecting pharmacare, since the Bill does nothing to address the health care crisis and will instead offer Canadians an inferior pharmacare plan that covers less, costs more and builds up a massive new bureaucracy that Canadians can't afford.”

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, it is really important to look at the contrast between what the Government of Canada, the Liberal Party, and the Conservative Party are espousing. We are the only party that is espousing the national health care system that Canadians have grown to love for generations now. What we are talking about is expanding it and looking at ways we can complement the national health care system by bringing in a pharmacare program or at least taking a good step forward. That is what we are proposing.

The Conservatives, on the other hand, are proposing to kill it. They are proposing that the federal government should not play a role in many aspects of health care. I believe that the Conservative Party is doing a great disservice to Canadians. Can the member give a clear indication as to why the Conservative Party does not believe pharmaceutical care has the role to play in Canadian health care that Canadians want it to play?

[Stephen Ellis, Conservative, Cumberland—Colchester, NS]

Madam Speaker, what this member says is categorically untrue. What we have pointed out with the eloquent speech that I just gave is that 6.5 million Canadians do not have access to health care. We know that the wait times are the longest that they have ever been in the history of this country. With the booing and guffawing behind me, they know it is all true that the difficulty that exists inside the current health care program is the inability of Canadians to access the program.

Why would we continue to put lipstick on a pig when the Liberals' inaction has allowed the system to deteriorate to the point where many Canadians say that the system is failing them, as indeed it is? When 17,000 to 30,000 men and women a year in this country are dying on a waiting list, that is a failing system.