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

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, the member did mention rare diseases, and I cannot pass up the opportunity to clarify a couple of things.

It is only mentioned once, in clause 5 of the legislation. To all my constituents back home, and all the rare disease organizations and patients across the country, not a single person will have their rare disease drugs paid for by this legislation, not a single one. It is not in the legislation. The 2023 announcement that the government just made is a reannouncement of its 2019 announcement.

[Some hon. members]

Oh, oh!

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, the NDP caucus is heckling me once again. I know the New Democrats get really upset when I raise this. The government is the one that actually cancelled the original rare disease strategy in 2016, and at the time, the head of the organization called it “the kiss of death” for rare disease patients. Does that member agree?

[Julie Dzerowicz, Liberal, Davenport, ON]

Mr. Speaker, Bill C-64 would establish the framework of a national universal pharmacare program here in Canada. It is phase one of the proposed program, which would include prescription drugs and free coverage for contraceptives and diabetes medication, and we are hoping to expand the program.

As well, there are additional elements that would complement the national pharmacare program, which is our national strategy for drugs for rare diseases. Again, it is starting with a $1.5-billion investment over three years. I believe our intention is that we will be expanding it in the years to come.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Mr. Speaker, my question is simple, but at the same time I think it is rather complex because I have never gotten a clear answer from the federal government.

Why does the government think that it is better placed to understand the needs of Quebeckers than the Government of Quebec, which administers a pharmacare program that has been around for many years?

[Julie Dzerowicz, Liberal, Davenport, ON]

Mr. Speaker, this is a national pharmacare program. We know that there are a number of provinces that offer different levels of pharmacare support right now, but what we are trying to do is provide a national pharmacare program based on the four principles that we have been consistently talking about, which are accessibility, affordability, appropriate use and universality. We are trying move beyond the provinces of B.C., Quebec and P.E.I. to make sure that there is accessibility, affordability, appropriate use and universality for all Canadians.

[Gord Johns, NDP, Courtenay—Alberni, BC]

Mr. Speaker, I find it pretty rich when Conservatives start talking about expanding pharmacare when they are doing everything they can to block it. Three years ago, they voted against pharmacare. They could have brought forward amendments to expand it to cover people with rare diseases. They did not do that. In fact, they are saying that people are already covered.

Becky in my riding writes, “Our out-of-pocket costs for my son's insulin and devices come to just over $11,000 per year. It is so expensive sometimes that the pharmacy calls me to give me a heads-up about how much an order will be, as if we have an option. Without it, he will die. Something like national pharmacare would be a game-changer for us.”

Maybe my colleague can talk about if she would would be willing to work with the NDP and the Conservatives, with everybody coming together, to include rare diseases. She knows that there is a willing partner right here.

[Julie Dzerowicz, Liberal, Davenport, ON]

Mr. Speaker, I want to thank the hon. member for his commitment and passion to the national pharmacare program.

In my riding of Davenport, having a national pharmacare program is very popular. Constituents are very excited about phase one with the introduction of diabetes medication being covered, as well as contraceptives. I know that they are looking for an expansion of this program, which is something I am very interested in as well.

[Yasir Naqvi, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I know that the member for Davenport has been a long-time supporter of pharmacare, and just like me, she has campaigned on this. Can she tell me the impact that this legislation would have on her community?

[Julie Dzerowicz, Liberal, Davenport, ON]

Mr. Speaker, I want to thank the hon. member for his leadership on the pharmacare act.

I will say that the impact of this legislation on my community would be huge. It is particularly very popular within the senior population, but I know that it is something that would be very helpful.

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Mr. Speaker, I am pleased to have another opportunity to address Bill C-64, an act respecting pharmacare. It is an act with respect to pharmacare, and yet it would cover only diabetes and contraception. As a member of the Standing Committee on Health, I can say that the bill, which is really more of a pamphlet than a real piece of legislation, has been the main focus of committee for the last month or so, about as long as it took for the government to draft the legislation.

It is important to make sure that Canadians know what the pamphlet really is and, more importantly, what it is not, since many people are under the impression that Bill C-64 would mean free medications for all Canadians. This is absolutely not the case. Despite what the NDP-Liberal coalition is claiming, the pamphlet would do very little to improve the lives of the majority of Canadians, and overall it could have more negative impacts than positive.

One huge issue that I have with Bill C-64 is the way that it was rammed through Parliament so quickly. Typically when legislation comes to committee, we are given ample time to hear from witnesses and to read all the briefs, submissions and recommendations from stakeholders on the legislation. This is extremely important, as there are many groups that have valuable insight and input on issues as major as pharmacare. We on this side of the House believe that they all deserve to be heard and considered, yet due to closure on what Canadians think should be a piece of legislation intervening in provincial domains, it was rushed through.

When it comes to matters that would potentially affect a huge portion of the population, due consideration must be given to the opinions of experts. This is not an issue that should be handled by “Ottawa knows best”, which the Liberal-NDP coalition so often does. The Liberals think they know better than the professionals who are said to be the most impacted by the pharmacare pamphlet, so they are fine with pushing the weak legislation through. Why is that? It is because they want to be able to tell Canadians that they gave them universal pharmacare, even though that is blatant misinformation because what the bill would provide is anything but universal.

There were 10 hours of committee time to hear from witnesses with respect to Bill C-64, which was not nearly enough time to cover all the industries, organizations and individuals who would be affected by the poor piece of legislation before us. My inbox was inundated with emails from groups that were pleading with the government to have a chance to give their input at committee. However, because the NDP-Liberals were so desperate to ram Bill C-64 through Parliament, their voices were not heard.

It astounds me that the costly coalition is trying to tout the pamphlet as being historic and groundbreaking, when the Liberals neglected to listen to the very people who would be most impacted by the shoddy work of the file. Many groups who were fortunate enough to appear at committee said they were not consulted by the NDP-Liberals before or during the development of the pharmacare pamphlet. In what world is this acceptable?

It is not just the medical field that the NDP-Liberal coalition failed to consult in advance. One of the biggest industries that would have to deal with all of the changes caused by Bill C-64 is the insurance industry. We were fortunate to be able to hear from some industry representatives on the matter at committee. Mr. Stephen Frank, president and chief executive officer of the Canadian Life and Health Insurance Association, made some important observations.

Mr Frank said, “The Minister of Health has stated that people who have an existing drug plan are going to continue to enjoy the access they have to their drugs. If that's the minister's intent it's not...clear from this bill. As many of the questions reinforced today, its text is ambiguous, it repeatedly calls for universal, single-payer, pharmacare in Canada with no mention of workplace benefit plans. Read in its entirety the bill could result in practical, and even legal, barriers to our ability to provide Canadians with the drug benefits that they currently have.

“For the majority of Canadians, therefore, this plan, as it's currently written, risks disrupting existing prescription drug coverage paid for by employers, limiting choice, and using scarce federal resources to simply replace existing coverage while leaving a huge gap for uninsured Canadians who rely on other medications beyond diabetic drugs and contraceptives.”

There are a number of different drug insurance plans out there: government-sponsored plans, employer-sponsored plans, association-sponsored plans and private plans. The Conference Board of Canada found that 36.8 million Canadians, or 97.2%, are eligible for some form of prescription drug coverage. The Canadian Chamber of Commerce indicates that the uninsured population is 1.1 million, or 2.8%, and 3.8 million are eligible but not enrolled. That is basically 4.9 million, a little over roughly 10% of the population, yet Statistics Canada in 2019 indicated that 86.2% of Canadians are covered by at least one type of drug insurance.

When an issue as important as access to medications and prescriptions comes up, it is the minister's job to ensure that all policies are clear and comprehensive and that all possible implications have been considered. Obviously, this is not being done with Bill C-64.

Another witness who appeared at committee and had concerns about the clarity of this bill was Carolyne Eagan, the principal representative for the Smart Health Benefits Coalition. She stated, “thousands of our advisers have received thousands of phone calls and engaged discussion with the misperception that people can go ahead and cancel their plan and essentially replace it by the free plan, not knowing what is on that list of coverage and who it's intended for.

“My own mother, who's turning 80 this year, got her letter. She was completely confused and figured she would cancel her plan and have free coverage with everything included. Luckily, I'm in the business and could explain it to her.

“It is a risk and there's a great risk of employers and Canadians thinking they would lose access to a longer list of medications where their health is stable on the treatment plan that they have been prescribed. Losing that access puts everything at risk. It puts the sustainability and health of Canadians and families, and our workforce and productivity, at great risk.”

This is alarming to say the very least. How many seniors in this country are going to lose their private insurance plan because the NDP-Liberal coalition failed to be clear about what the pamphlet would actually do and cover? How many seniors might have already cancelled their plan? What will stop employers from cancelling the benefit plan they offer and telling their employees to use universal pharmacare, which covers medication for only two things?

These are the questions that were asked at committee, yet the minister was unable to answer. Even more alarming is that only 44% of new drugs launched globally are distributed in Canada, and only 20% of them are covered by public plans. According to a study by Innovative Medicines Canada, which, by the way, asked to present at committee and was denied.

The fact of the matter is that the minister came to committee and gave blatant misinformation to Canadians, telling them that everything is going to be okay and that they must just trust him. After nine years of the Prime Minister's ruining our country, it is absurd that he is expecting public trust. The NDP-Liberal coalition has broken promise after promise, and somehow the minister thinks that he deserves or is entitled to something as sacred as the trust of Canadians.

One of the briefs that was received at committee was sent by Chris MacLeod, a 54-year-old lawyer who has cystic fibrosis. This disease is one that hits home very personally, and I am grateful to Mr. MacLeod for sharing his experiences with public drug plans in this country. He stated that unfortunately Bill C-64 looks like it could be another major barrier to access for patients, especially those with rare diseases, and that notably, the federal government's attempt to force substandard public formulary coverage on everyone across the country could prove to be a disaster, with potentially deadly consequences.

People who live with diseases like cystic fibrosis do not deserve to have their life made even more difficult because of incompetence with respect to the bill. The bottom line is that most Canadians already have solid drug plans that they are happy with and they do not want to have them replaced.

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

Mr. Speaker, for a four-page pamphlet, the member is having a difficult time going through it and recognizing that this four-page pamphlet is going to benefit millions of Canadians who have diabetes and assist millions of Canadians who want to have contraceptives. At the end of the day, I believe there are a number of Conservatives who feel ashamed about what the House leadership has told them that they are going to be doing. They are voting against this so-called pamphlet.

Does the member have any remorse about his vote on this legislation because he is being forced to vote a certain way by his leader?

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Mr. Speaker, I find that question extremely interesting from the member, who is being compelled to vote for this piece of legislation as he speaks. If the member was to read this piece of legislation, in four pages, the member would also understand that he is misleading Canadians by saying that this would cover every piece of diabetic medication out there. That is not going to happen. In fact, it would to cover less. As a single payer, when that system is put in place, people who have health care plans that cover multiple programs would lose that ability because they would be forced to go on that single-payer plan.

[Nathalie Sinclair-Desgagné, Bloc, Terrebonne, QC]

Mr. Speaker, in his speech, my hon. colleague talked a lot about inefficiency, for example, in the way this program was communicated. Could he also tell us how little confidence he has in this federal program in general, particularly with respect to how it is organized and how it is being rolled out?

Why does the federal government believe that it can run a pharmacare program when it cannot even issue passports?

[Robert Gordon Kitchen, Conservative, Souris—Moose Mountain, SK]

Mr. Speaker, one thing I learned through her colleagues who were at committee was about the importance placed on the great health care program the Province of Quebec provides. It is a tremendous program and is one of the best in the country. It is a plan and a program available because the province provides it. Health care is a provincial issue, and every province is in a position to provide health care. Instead of the government putting the $1.5 billion in the budget toward this, it should put that money toward those who are uninsured and help those who are uninsured.