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Pharmacare Act

An Act respecting pharmacare

This bill is from the 44th Parliament, 1st session, which ended in January 2025.

Sponsor

Mark Holland  Liberal

Status

This bill has received Royal Assent and is now law.

Summary

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.

Similar bills

Elsewhere

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:

C-64 (2017) Law Wrecked, Abandoned or Hazardous Vessels Act
C-64 (2015) Law Georges Bank Protection Act
C-64 (2013) Law Appropriation Act No. 3, 2013-14
C-64 (2009) Law Appropriation Act No. 4, 2009-2010

Votes

June 3, 2024 Passed 3rd reading and adoption of Bill C-64, An Act respecting pharmacare
May 30, 2024 Passed Concurrence at report stage of Bill C-64, An Act respecting pharmacare
May 30, 2024 Failed Bill C-64, An Act respecting pharmacare (report stage amendment)
May 7, 2024 Passed 2nd reading of Bill C-64, An Act respecting pharmacare
May 7, 2024 Failed 2nd reading of Bill C-64, An Act respecting pharmacare (reasoned amendment)
May 6, 2024 Passed Time allocation for Bill C-64, An Act respecting pharmacare

Debate Summary

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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, also known as the Pharmacare Act, proposes a framework for a national universal pharmacare program in Canada, starting with coverage for contraception and diabetes medications. The bill aims to improve accessibility, affordability, and equity in prescription drug coverage while also establishing the Canadian Drug Agency to oversee a national formulary and bulk purchasing strategy. However, some argue that the bill infringes on provincial jurisdiction, duplicates existing programs, and does not address the root causes of affordability issues.

Liberal

  • Support for universal pharmacare: The Liberal party supports Bill C-64 as a step towards national universal pharmacare. They believe that access to medication is a key component of healthcare and should be based on need, not ability to pay.
  • Focus on affordability: The Liberals aim to reduce the financial burden on Canadians, particularly those with chronic illnesses like diabetes. They highlight that many Canadians are struggling to afford essential medicines, leading to negative health outcomes and increased healthcare costs.
  • Emphasis on prevention: The party emphasizes the importance of prevention, particularly regarding universal access to contraception. They believe it saves money in the long run by preventing unwanted pregnancies and improving women's reproductive health and autonomy.
  • Collaboration with provinces: Liberals see collaboration with provinces and territories as essential for successful implementation. They want to reduce jurisdictional barriers and ensure all Canadians have equal access to necessary medications, while respecting provincial healthcare administration.

Conservative

  • Provincial jurisdiction infringed: Multiple members stated that pharmacare falls under provincial jurisdiction. They criticized the federal government for interfering in provincial affairs and not adequately consulting with provinces and territories before introducing the bill.
  • Inadequate existing plans: Some Conservative members noted that a high percentage of Canadians already have some form of drug coverage, suggesting the bill addresses a limited need. They questioned whether the proposed plan would be as comprehensive or beneficial as existing private plans.
  • Just a Liberal-NDP deal: Several members asserted the bill is primarily a political maneuver to maintain the NDP-Liberal coalition, rather than a genuine effort to improve healthcare. They accused the NDP of compromising its principles for a superficial achievement.
  • Fiscal irresponsibility: Conservatives raised concerns about the cost of the bill, estimating that it would create a new government agency costing millions to establish and operate. They criticized the government's overall fiscal management and questioned whether the program is sustainable given the country's debt.
  • Implementation failures foreseen: Referencing the dental care program, members expressed skepticism about the government's ability to implement the pharmacare plan effectively. They cited low enrollment rates among dentists and lack of consultation with relevant stakeholders as reasons for concern.
  • Amendment proposed: Stephen Ellis put forward an amendment to decline the bill, asserting it does nothing to address the healthcare 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.

NDP

  • Strong support for bill C-64: The NDP strongly supports Bill C-64, viewing it as a significant step towards universal pharmacare and a victory for their advocacy. They emphasize that the bill addresses critical healthcare gaps, particularly for diabetes medication and contraception, and will improve the lives of many Canadians.
  • Criticism of Conservative opposition: The NDP criticizes the Conservative party for opposing the bill, accusing them of being out of touch with the needs of their constituents and of prioritizing the interests of big pharma over the health of Canadians. They highlight the Conservatives' attempts to block the bill and suggest this stems from ideological extremism and a lack of consultation with those who would benefit from it.
  • Focus on women's health: The NDP emphasizes the importance of the bill in promoting women's health and reproductive rights by providing access to affordable contraception. They condemn efforts to control women's bodies and highlight the need for gender equity in healthcare, accusing the Conservatives of endangering women's rights.
  • Economic benefits of pharmacare: The NDP underscores the economic benefits of universal pharmacare, citing potential savings to the healthcare system and individual Canadians through bulk purchasing and reduced emergency care. They argue that investing in preventative care through pharmacare is financially sound and will lead to a healthier population.

Bloc

  • Quebec's jurisdiction: The Bloc Québécois staunchly defends Quebec's exclusive jurisdiction over health matters and its existing prescription drug insurance plan. They insist that Quebec should not be forced to adhere to a pan-Canadian pharmacare plan.
  • Full compensation: The party demands full financial compensation from the federal government if a pan-Canadian pharmacare plan is implemented. The compensation should be without conditions.
  • Against federal interference: The Bloc views the federal government's approach as heavy-handed and disrespectful, criticizing the lack of consultation and the potential duplication of existing structures in Quebec. They believe the federal government should focus on managing its own jurisdictions competently before interfering in provincial matters.
  • Opt-out right: The Bloc Québécois is not opposed to pharmacare in principle, as it already exists in Quebec, but insists on Quebec's right to opt out of the federal plan with full compensation, ensuring that Quebec's system is not dismantled or its coverage reduced.
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Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6 p.m.

NDP

Taylor Bachrach NDP Skeena—Bulkley Valley, BC

Madam Speaker, I will be splitting my time with the wonderful member for Port Moody—Coquitlam.

In this debate this evening, we can lose a bit of the context, and that context is the historic nature of the legislation before us. I am so proud to rise on behalf of the people of Skeena—Bulkley Valley and speak to Bill C-64, an act that will lay the groundwork for Canada's first national single-payer universal pharmacare system, a system that is going to help millions of Canadians, including many people in northwest British Columbia. The case for this bill is—

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:05 p.m.

Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Madam Speaker, I rise on a point of order. I believe, if you seek it, you will find unanimous consent to table this document showing the total number of dentists in Toronto alone, which is well over 500, who are under the current program, despite what the member for Souris—Moose Mountain said.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:05 p.m.

The Assistant Deputy Speaker Carol Hughes

Is there consent?

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:05 p.m.

Some hon. members

No.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:05 p.m.

NDP

Peter Julian NDP New Westminster—Burnaby, BC

Madam Speaker, on a point of order, we generally do not interrupt speeches, so I would hope that the member for Skeena—Bulkley Valley could start from the top.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:05 p.m.

The Assistant Deputy Speaker Carol Hughes

This is not the first time that an individual has been stopped during a speech. The hon. member still has nine minutes and 16 seconds to continue.

The hon. member for Skeena—Bulkley Valley.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:05 p.m.

NDP

Taylor Bachrach NDP Skeena—Bulkley Valley, BC

Madam Speaker, I thank my colleague for his timely intervention.

This is a proud and historic moment because Canada stands alone in the world as the only country with universal health care that does not have some form of universal coverage for prescription medication, and the case for this bill and the case for pharmacare are exceedingly strong.

One in five people in this country have zero or poor medication coverage. Nearly a million people cut their spending on things like groceries and heat so that they can afford medication, and one in five households have a member who did not take the medication they were prescribed because of the cost of that medication. This is something that profoundly affects the lives of the people we represent, and I am surprised, to be frank, that there is not unanimity in the House to try to expand our health care system in this way and to get people the help they so desperately need.

I will tell a really brief story. I held a meeting on pharmacare, which had attendance by nurses and health care folks in northwest B.C. and concerned citizens. One of the nurses told this story about patients she sees come into the hospital for a very routine procedure, a colonoscopy, which is something that many of us will be getting in order to detect what can be really life-threatening illnesses. I have not had one of these procedures yet, but I very much look forward to it.

In preparation for this procedure, people have to take a medication in advance that allows this procedure to take place. That medication, at the time, cost about $40. For many of us, the cost of a $40 prescription to get ready for an important procedure is something that is affordable. However, the nurse said she was surprised by the number of patients who came in for this scheduled procedure, went home with the prescription and never came back for the actual colonoscopy because they could not afford the $40 for the medication.

That is what we are talking about. What happens to those people? They are not getting a diagnostic procedure that could save their lives, and some of them, a percentage of them, are getting sick and ending up back in our hospitals and in our emergency rooms. They are having to have surgery and some of them are losing their lives all because they could not afford medication that was not covered under our health care system. That is shameful and it is something that we in the House can change. We can change it today by voting for Bill C-64.

Why would anyone oppose the bill before us? We have heard some of the arguments and, frankly, it is somewhat surprising. I was listening to the member for Red Deer—Lacombe extolling what he sees as all of the various problems with it. Then he got to the fact that it would cover diabetes medication and devices, and he said something like, “on the surface of it, that is a good thing”.

This bill would be incredibly positive for a lot of people, yet we see opposition. We also see a cynical critique of the legislation, and that critique goes like this: The Conservatives say that the NDP and the Liberals call this a pharmacare bill, but it is nothing of the sort. They say that it does not go nearly far enough, and Canadians who are expecting this wonderful vision of pharmacare are going to be disappointed.

When Canadians hear that, they are going to think that the Conservatives want something even better, that they want coverage that goes even further and that would help more people, but no. What the Conservatives are proposing is to get rid of this legislation altogether and not to improve it one iota. The Conservatives have brought forward an amendment to kill it outright. That is not contributing to the conversation. It is not going to make people's lives better in this country. With all due respect, it is a cynical critique of the bill before us.

It is also incredible that in the Conservatives' opposition to pharmacare, they are parroting many of the same lines coming from big pharma. We have heard that most people will be worse off under the pharmacare program. We heard from the Conservative leader that most people already have coverage through their employer, and we heard that this law is somehow going to prevent people from getting their own private insurance. It is incredible that Conservatives and big pharma are sort of harmonizing in the same beautiful key of total nonsense. It is incredibly frustrating because none of this, of course, is true. This is a program that is going to help millions of Canadians.

We hear that health care is a provincial jurisdiction, yet nothing could be further from the truth because it is shared jurisdiction. If we look at the Canada Health Act on the federal government's own website, it clearly lays out that, while the provinces are responsible for health care delivery, the federal government is responsible for setting national standards and, of course, for funding health care, in part, through federal transfers. Therefore, this is very much in the federal government's wheelhouse and something I believe the federal government has a moral and a practical responsibility to fulfill.

However, despite all of this opposition from Conservatives to pharmacare, we are here on this historic day to move this bill through the legislative process and make it a reality. This is a bill that, among other things, enshrines the step-by-step implementation of single-payer universal pharmacare in our country, for the very first time, in accordance with the principles of the Canada Health Act. It is a bill that forces the government to develop a list of essential medications within a year of this bill's passing into law. It is a bill that establishes an expert committee that is going to guide the implementation and the financing of pharmacare right across the country.

I am very pleased that not only will this bill lay the groundwork, the foundation, for universal pharmacare that covers a wide range of prescription medications, but it is starting in its first phase with two major classes of medications that are going to help a lot of folks who are struggling with the costs. People in the House know what those two classes of medications are.

First is contraception, which can cost people upwards of $200 a month, and disproportionately that cost is borne by women in our country. When it is not affordable for people, they are forced to make other choices, but sometimes they do not have choices. Ensuring that people have affordable contraception is going to improve the lives of so many people.

The other class of medications is diabetes medications and devices. Anyone who knows someone who lives with diabetes knows the incredible out-of-pocket costs that can come with managing the condition. Diabetes Canada approximates that the cost of type 1 diabetes is upwards of $18,000 a year, out of pocket, and for type 2 diabetes it is upwards of $10,000 per year, out of pocket. These are the out-of-pocket expenses that our constituents are paying. With the bill before us, as soon as agreements are struck with the provinces, this program is going to cover those costs for Canadians, and I could not be prouder for having been part of the process of making that a reality here in Canada.

I am going to leave it at that. I know that the constituents I represent want this bill. I know the health care professionals who work in our health care system recognize the importance and significance of this bill. I hope everyone in the House of Commons votes for this bill and passes it unanimously into law as quickly as possible.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:15 p.m.

Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Madam Speaker, one of the things I find most perplexing about this entire debate is that not only are Conservatives against this bill, but it is as though they are actively rooting for its policy failure. It is like they are downplaying how many dentists have signed up. They are downplaying the impact this would have on Canadians. They keep saying that only one out of every five Canadians wants this, as though it is not a good thing to do something when one out of five Canadians wants it.

I wonder if the member can make sense of all this, the fact that Conservatives are not just against the bill but are actively rooting for the failure of this program.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:15 p.m.

NDP

Taylor Bachrach NDP Skeena—Bulkley Valley, BC

Madam Speaker, in many ways they are rooting for big pharma, whose incredible profits are threatened by the idea of the bulk purchasing that would be enabled under a universal pharmacare plan. The hon. member across the way's question made me think about what it would be like to be debating the Canada Health Act in the House of Commons in 2024, and what arguments Conservatives would bring forward against the idea of every Canadian having the dignity of basic access to health care. I think we are very fortunate that the act got passed all those years ago, in the late 1960s, before I was born, maybe before he was born—

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:15 p.m.

Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Yes.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:15 p.m.

NDP

Taylor Bachrach NDP Skeena—Bulkley Valley, BC

Yes, we are the same age, Mark.

Now we have a chance to expand it to include pharmacare, and I think this is a wonderful opportunity.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:15 p.m.

The Assistant Deputy Speaker Carol Hughes

I want to remind the hon. member that he is not to call a member by his first name or his last name; however, “hon. member” is fine.

Questions and comments, the hon. member for Port Moody—Coquitlam.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:15 p.m.

NDP

Bonita Zarrillo NDP Port Moody—Coquitlam, BC

Madam Speaker, I was struck by the member's comments about someone needing to go for a colonoscopy and not being able to afford the prep. I have heard this in my riding as well. I have heard it in regards to dental care also, that they are not being able to pay the $5 or $10 to go to dental care.

I would just ask the member if he could share how important it is that people have basic access to medication to stay proactively healthy.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:15 p.m.

NDP

Taylor Bachrach NDP Skeena—Bulkley Valley, BC

Madam Speaker, this is something I did not have time in my speech to get to, but the reality is that when people are able to take the medication that their doctors prescribe, they are often able to get better. When they get better, that means they are not showing up at the doors of the emergency room. They are not ending up in hospital beds for long hospital stays. We know that it costs $1,000 a day to have someone in our hospitals, and these are all costs that are borne by our system.

The bill before us is about making people's lives better, first and foremost, but also, when we look down the road at public pharmacare, universal pharmacare, we see that it is going to save our society, as a whole, billions of dollars through bulk purchasing and through allowing people to lead healthier lives. I think that is a huge, positive move in the right direction.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 6:15 p.m.

Conservative

Michelle Ferreri Conservative Peterborough—Kawartha, ON

Madam Speaker, those at home watching this may be wondering who does not want this. This is child care 2.0. However, the reality, as we know, is that, like this morning, there was a British Columbia mother who was saying that she was going to be homeless because she cannot find child care.

I just had a text from a dentist. I asked them what they thought of the dental program. The reply was that it is an absolutely amazing election slogan. That is exactly what has happened here.

My question to the member opposite, who props up the Liberals continuously, is this: Why does he think the Liberals will actually deliver this? It is almost abusive to watch what they do to the NDP because they will not deliver what they said they would. My question is this: Is he okay with that?