The House proceeded to the consideration of Bill C-64, An Act respecting pharmacare, as reported (with amendments) from the committee.
Mark Holland Liberal
This bill has received Royal Assent and is, or will soon become, law.
This is from the published bill. The Library of Parliament has also written a full legislative summary of the bill.
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.
All sorts of information on this bill is available at LEGISinfo, an excellent resource from Parliament. You can also read the full text of the bill.
Bill numbers are reused for different bills each new session. Perhaps you were looking for one of these other C-64s:
This is a computer-generated summary of the speeches below. Usually it’s accurate, but every now and then it’ll contain inaccuracies or total fabrications.
Bill C-64 aims to establish a framework for a national pharmacare program in Canada, beginning with universal, single-payer coverage for certain contraceptives and diabetes medications, with the goal of improving access, affordability, and health outcomes. The bill also calls for the creation of a national formulary and bulk purchasing strategy, while emphasizing the need to collaborate with provinces and territories for the administration of healthcare. The legislation has sparked debate over its potential impact on existing private insurance plans, its limited scope of coverage, and the extent of provincial consultation.
Liberal
Conservative
NDP
Bloc
The House proceeded to the consideration of Bill C-64, An Act respecting pharmacare, as reported (with amendments) from the committee.
Speaker's RulingPharmacare ActGovernment Orders
The Assistant Deputy Speaker Carol Hughes
There are 13 motions in amendment standing on the Notice Paper for the report stage of Bill C-64.
Motion No. 7 will not be selected by the Chair as it requires a royal recommendation. Motion No. 13 will not be selected by the Chair as it could have been presented in committee.
All remaining motions have been examined, and the Chair is satisfied that they meet the guidelines expressed in the note to Standing Order 76.1(5) regarding the selection of motions in amendment at the report stage.
Motions Nos. 1 to 6 and 8 to 12 will be grouped for debate and voted upon according to the voting pattern available at the table.
I will now put Motions Nos. 1 to 6 and 8 to 12 to the House.
Stephen Ellis Conservative Cumberland—Colchester, NS
moved:
Motion No. 1
That Bill C-64 be amended by deleting the short title
Motion No. 2
That Bill C-64 be amended by deleting Clause 2.
Motion No. 3
That Bill C-64 be amended by deleting Clause 3.
Motion No. 4
That Bill C-64 be amended by deleting Clause 4.
Motion No. 5
That Bill C-64 be amended by deleting Clause 5.
Motion No. 6
That Bill C-64 be amended by deleting Clause 6.
Motion No. 8
That Bill C-64 be amended by deleting Clause 7.
Motion No. 9
That Bill C-64 be amended by deleting Clause 8.
Motion No. 10
That Bill C-64 be amended by deleting Clause 9.
Motion No. 11
That Bill C-64 be amended by deleting Clause 10.
Motion No. 12
That Bill C-64 be amended by deleting Clause 11.
Motions in AmendmentPharmacare ActGovernment Orders
The Assistant Deputy Speaker Carol Hughes
The hon. member for New Westminster—Burnaby is rising on a point of order.
Peter Julian NDP New Westminster—Burnaby, BC
Madam Speaker, could you clarify that the result of these Conservative motions would be to delete the entire bill at a cost of voting of about a quarter of a million dollars?
Motions in AmendmentPharmacare ActGovernment Orders
The Assistant Deputy Speaker Carol Hughes
I am sorry but that is not a point of order. The hon. member can ask that question during questions and comments.
The hon. member for New Westminster—Burnaby is rising on another point of order.
Peter Julian NDP New Westminster—Burnaby, BC
Madam Speaker, could you clarify whether the Conservatives could simply vote against the bill and have the same effect?
Motions in AmendmentPharmacare ActGovernment Orders
The Assistant Deputy Speaker Carol Hughes
Again, that is a point of debate. I would just ask the hon. member to maybe keep those questions and comments for the appropriate time.
Resuming debate, the hon. member for Cumberland—Colchester.
Stephen Ellis Conservative Cumberland—Colchester, NS
Madam Speaker, it is interesting here in the House, the whole idea, whether the NDP-Liberal costly coalition likes it or not, of actually having a robust debate, especially when there are significant differences of opinion. Of course, that is why we are here tonight. We on this side of the House believe that legislation should be debated, and debated robustly, in spite of the fact of the trickery and antics used by the costly coalition to move closure on the bill.
On behalf of Canadians, I say that it has become fascinating to me that the notion that the House is spending other people's money has been lost, and this is a $2-billion bill where we would spend the money of taxpayers. I think we should do it with great caution. We should be prudent when we are doing it, and we should be doing things that we hear from taxpayers are important to them.
When we look across the country and hear about the things that are mentioned in the bill, we know that that is not happening. Therefore, when the hon. NDP member who is standing behind me says that what we are talking about is this or that, or some other foolish intervention, then what we end up with is just wasting more time. He has been here long enough to know the rules, or he should know the rules.
We know that when the bill was introduced there were only 10 hours of witness testimony and five hours of debate on clause-by-clause on it. Why is this important? When we begin to look at the pharmacare bill, we see that some of the amendments that were introduced originally were related to having Canadians understand that the bill really relates to only two classes of medications: contraception and medications and products for diabetes. That does not mean that those two classes are not important; they are. They involve important health states that often need the intervention of a prescription, but it means that the bill is no more than that at the current time.
It is interesting that the government, on canada.ca, puts out a list of medications that may or may not be covered by the bill, which creates hope for Canadians. Canadians will say, “Well, these are the medications that are going to be covered.” Many different groups come forward and ask, “Well, why not this and why not that?” Probably one of the most influential medications in the history of diabetes treatment besides insulin is Ozempic, but it is not on the list. People will say, “Well, why is it not on the list?” Then, of course, the government talks about the bill and says, “Well, that is not really the list; that is just a list. It is any old list.” Why did it publish it on its website, on canada.ca? Are those things important? Absolutely, they are.
When we talk about definitions, folks listening in at home will say that some of them are self-evident. They are not self-evident when we are dealing with $2 billion. For example, what is the definition of “universal”, “single-payer” and “first dollar”? Those definitions are incredibly important, so that the 70% to 80% or so of Canadians who have private insurance can be at least somewhat reassured that they would not lose private coverage.
That is the largest, most expansive and most distressing concern that we on this side of the House have. I would suggest that reassurances from the Minister of Health are just not enough for Canadians. To say, “Oh, trust me” is kind of akin to that old saying, “I'm from the government and I'm here to help”, which we all know is a difficult pill to swallow.
There was another interesting thing that, in our limited time, we did learn in committee. There were two experts. One was actually there in person and one was on Zoom, and they were both touted as Canada's experts on pharmacare. I was glad they were not in the same room, as we never know what might have happened, but that being said, the most fascinating thing was that, even though both of them are experts on pharmacare, neither one of them was actually consulted on the bill. They did not give any input whatsoever on how the bill should come to be, what should be in it or what should not be in it, and for me that is somewhat distressing.
Another somewhat distressing thing that is referenced in the bill is the committee of experts, the group that would be put forward to decide exactly which medications and which devices would be covered. Again, there are several amendments related to that. Things such as regional representation and professional representation were once again simply dismissed by the NDP-Liberal costly coalition. That creates significant problems for us on this side of the House, and it is exactly why we believe we need to be here this evening. When we know it is not a plan, not a blueprint, but is a plan perhaps to create a plan, that again creates distress on behalf of Canadians.
We know that people value the private coverage they are fortunate enough to have at this time, and we know that employers are happy to offer those benefits to their employees as a condition of their employment. Sadly, about a million people do not have coverage for medications. We on this side of the House believe there could be better ways to give them that than offering the pharmacare idea.
When we begin to look at the state of health care in this country at the current time, we know there are problems with the system we have. When one cannot access primary care, it is incredibly difficult to have a lab test done, to see a specialist or to have a diagnostic imaging test done. I say it is difficult because what happens is that people end up going to emergency rooms and urgent care centres to have some routine things done or even to have their prescriptions refilled. When we begin to look at that, in the words of former Canadian Medical Association president Dr. Katharine Smart a couple of years ago, the system is actually on the brink of collapse.
If anything, in the last couple of years we know that things have become even worse. There are now approximately seven million Canadians who do not have access to primary care, which means, as I mentioned, that they have to go to urgent care centres or emergency rooms, or go without care, which is the worst state of affairs.
Some of the other estimates would say we are 30,000 physicians short in this country. When we graduate about 3,200 every year, it seems almost an impossibility to make up the shortage. I always to try to help Canadians understand it. It is kind of like having a car that does not have any wheels on it, but wanting a new stereo in it, which is not terribly helpful. It is perhaps not a great analogy but it is something to try to help Canadians understand what is going on.
The other part is that we know that wait times in the system, if one is so fortunate enough to be able to access it, are the longest they have been in 30 years, three decades. If one is fortunate enough to have a family physician, the wait time for having specialist care is over 27 weeks, six months. We know that people on waiting lists are dying. Somewhere between 17,000 and 30,000 people are dying every year waiting for treatment in this country. The system itself is in absolutely poor shape and falling apart.
The difficulty we also see, again, is government members' being champions of photo ops. They talk about their dental program, which has significantly disappointed many Canadians. We now know that provincial dental associations are taking out ads warning people about the extra costs and the lack of ability to find a dentist.
Liberals promised a $4.5-billion Canada mental health transfer, which has never come to fruition at all. They promised affordable housing, and we know they are building less housing than before. They promised $10-a-day day care, and of course one cannot access it.
What we have is a government that is great at announcements and very bad at actually making anything happen. We know, on this side of the House, that Bill C-64 needs significant amendments and significant debate. On behalf of Canadians, we need to be incredibly cautious with how we are spending other people's money.
Marcus Powlowski Liberal Thunder Bay—Rainy River, ON
Madam Speaker, under the statute, there would be a requirement for the government to come up with an essential drug list within a year of its getting royal assent. It would seem to me this would be a difficult process. I am sure all kinds of doctors are going to want different things to be part of the essential drug list. What does the member think about our ability to do that and to do it within one year?
Stephen Ellis Conservative Cumberland—Colchester, NS
Madam Speaker, sometimes people liken getting a group of doctors angry to getting a bunch of bees angry, in the sense that if we make one mad, they all want to sting us. That interesting image would hold true in this case.
How do we decide things when a group of experts get in a room? First of all, we need to pick a group of experts, which we had some ideas on at committee. They were rejected by the costly coalition. The other part of it is asking, what is the best insulin? What is the best medication, the pills, available to treat diabetes? Why is Ozempic not here? How do we make those pharmacoeconomic decisions when we know that some medications are incredibly cheap but not as effective as the more expensive medications? Who is going to be the final arbiter of that decision-making?
I thank my hon. colleague for the question, because I think it is a very important one. Canadians need to understand that the lists published on Canada.ca are simply lists and are not worth the paper they are printed on.
Jean-Denis Garon Bloc Mirabel, QC
Madam Speaker, we have a problem here in Ottawa. Governments, particularly Liberal governments, think they know more than the provinces in fields where they are completely incompetent.
However, the NDP is breaking records. It is even worse. Not so long ago, the leader of the NPD wrote to Quebec's health minister asking for a meeting so he could teach him about the benefits of a pharmacare system. He did that even though Quebec has a system where everyone has been insured since 1996.
I would like my colleague to tell us what he thinks of this kind of attitude in Ottawa. How does the NDP's centralizing and equally incompetent attitude compound the already deep wrongs of Liberal governments?
Stephen Ellis Conservative Cumberland—Colchester, NS
Madam Speaker, it is very important to respect provincial jurisdictions.
Everyone in the House knows that the province of Quebec has a drug coverage program. It is a very extensive program, but it costs too much.
We need to sit down together, talk about the problems and find solutions, especially in a case like this, where drug coverage is really a provincial responsibility.
Peter Julian NDP New Westminster—Burnaby, BC
Madam Speaker, Conservatives say they want to save money, but they are spending $400,000 on this debate tonight, which is about meaningless motions that basically delete the entire bill. There is not a single contribution the Conservative Party and Conservative MPs have made to pharmacare.
We know the Conservatives were wrong on dental care. Some 120,000 seniors, in the first three weeks, benefited from dental care across the country. Two million seniors have signed up, with tens of thousands more each and every week. Pharmacare would help six million Canadians with diabetes and nine million Canadians who buy contraceptives.
Is that not why Conservatives are wasting this debate and $400,000 of taxpayers' money tonight? Is it not because they fear the supports the NDP is providing for the Conservatives' constituents across the country?
Stephen Ellis Conservative Cumberland—Colchester, NS
Madam Speaker, let us be clear. I do not fear anything the NDP members have to say or think. I think that is important. They fear spending money on anything except democracy. All they want to do is ram legislation through, in their costly coalition partnership, with respect to things they sadly do not understand. The only other thing the NDP members want to spend money on is delaying the date of the election by one week so that many of them can access their pensions, which is money spent on behalf of Canadians.
When we look at those kinds of things, those words do not ring true with any of us in the House.