Bill C-64 (Historical)

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.

Second reading

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, I, of course, come from the province of British Columbia, where contraceptives are already provided by the provincial government. To ensure equality for women, how much money would the Province of British Columbia receive from this NDP bill because we already have contraceptives? For equality's sake, what is the number B.C. would get?

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, I would also like to apologize for my misreading when I was reading the article. I do apologize. I was not trying to be cheeky, but I was reading directly from an article.

We know that certain provinces, provinces his colleague called “communist”, are providing free contraception care—

[The Deputy Speaker, Chris d'Entremont]

There is a point of order from the hon. member for Mission—Matsqui—Fraser Canyon.

[Brad Vis, Conservative, Mission—Matsqui—Fraser Canyon, BC]

Mr. Speaker, I would just like the record to state I never said “communist.” I only came into the debate—

[An hon. member]

No, you did not.

[The Deputy Speaker, Chris d'Entremont]

We are getting into debate.

The hon. member for Winnipeg Centre has the floor.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, I certainly was not saying that he called provinces communist. I said that some of his colleagues have called them communist.

Certainly, provinces do not act alone in health care. The federal government works with provinces to provide services. We have pushed the federal government to ensure provinces have what they need to provide, as a starting point, free diabetes medication and also contraception.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Mr. Speaker, one issue seems fundamental to me in this context. The Government of Canada and the rest of Canada want pharmacare. That is fine for them, but it goes against the spirit of the Constitution.

I would be curious to hear my colleague's thoughts. Quebec already has a pharmacare system. Would she agree that Quebec should have the right to opt out with full compensation?

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, the federal government is responsible and obliged to uphold national standards. We know that Quebec is ahead of the game on a number of issues. I will give the hon. member a couple of examples. On child care, Quebec is decades ahead, as well as on social programs, certainly.

Absolutely, when we are talking about provinces, the federal government is obliged to provide provinces with what they need to be able to offer these services.

I would, however, give a caveat to New Brunswick. In New Brunswick, currently, women cannot access an abortion. There need to be guidelines, in terms of public health transfers, if provinces are not upholding what the Liberal government has called the human right to access safe, trauma-informed abortion care.

[Brenda Shanahan, Liberal, Châteauguay—Lacolle, QC]

Mr. Speaker, I have greatly appreciated the comments of my colleague from the NDP. It has been a very spirited debate here. We are talking about the provinces, the jurisdictions, and also about equality of care across the country. I think that is where the federal government comes in. That is where legislation like Bill C-64 comes in to ensure that there is equality of access to pharmacare, specifically in the areas of contraceptive care and diabetes.

I would like to hear my colleague's comments on that issue.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Mr. Speaker, that is exactly it. If one looks at access to reproductive rights, they vary throughout the country. We need to change that to ensure that if this country is actually doing what it says, which is protecting the reproductive rights of those people who can get pregnant, then they need to start doing that. That means access to safe, trauma-informed abortion care or access to contraception.

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

Mr. Speaker, I am thankful for the opportunity to speak about Bill C-64 and about how this represents a historic milestone in the evolution of the Canadian health care system.

This bill and other investments made by our government will help millions of Canadians who are struggling to pay for their medication.

I was very thrilled when the Minister of Health, and many other incredible Canadians who have been advocating for a pharmacare program in Canada, joined in my community of Ottawa Centre, at the Centretown Community Health Centre, where, toward the end of February, we made the announcement on Bill C-64, on covering diabetes and contraception medication. One could see the excitement among people when that announcement was made in my community.

In fact, I have been working on this issue for over a decade now, during my time as a member of provincial Parliament in Ontario. I was part of a Liberal government that brought something that we called OHIP+. That “plus” covered medications for young people, and then, we were moving on to cover medications for seniors. It was really unfortunate that the Conservative government under Doug Ford cancelled that incredible program because it allowed for care for so many Ontarians.

However, I am thrilled that we are taking this important step here at the federal level.

In 2021, Statistics Canada found that one in five adults in Canada did not have the insurance they needed to cover their medication costs. This means that over 20% of adults in Canada face out-of-pocket drug costs that create a financial burden. This can lead to people sacrificing their basic needs, such as buying groceries or heating one's home, in order to afford their medications. It can also lead people to ration their medications, causing them worse health outcomes. This is not acceptable and I do not think that this is the kind of country any of us want to have.

Choices like whether to fill a prescription have serious consequences. Whether skipping meals or skipping doses, the decision to go without can create a cascade of negative impacts on a person's health and can increase the burden on our health and our social safety nets.

We can and we must do better. That is why we introduced Bill C‑64 and proposed this first step toward universal pharmacare.

Our commitment to address the accessibility and affordability of medication can be seen with the various initiatives we have implemented with respect to national pharmacare. In addition to the introduction of the pharmacare act, which includes a commitment to work with provinces and territories to ensure universal access to contraception and diabetes medications, we also established a partnership with P.E.I. to improve the affordability of prescription medications, implemented the first-ever national strategy for drugs for rare diseases and established a Canadian drug agency.

Let me start with the pharmacare act, which outlines a way forward toward national universal pharmacare in Canada. Bill C-64 recognizes the critical importance of working with the provinces and territories, which are responsible for the administration of health care. It also outlines our intent to work with these partners to provide universal, single-payer coverage for a number of contraception and diabetes medications.

This bill is an important step toward improving health equity, affordability and outcomes, and could help reduce health care system costs over the long term.

Coverage for contraceptives would mean that nine million Canadians of reproductive age would have better access to contraception, reducing the risk of unintended pregnancies and improving their ability to plan for the future. We are a government that has always and will always recognize that autonomy over one's body and the ability to control one's own sexual health is a matter of fundamental justice.

Contraception is a key component of individual autonomy. It is an essential component of reproductive health and contributes to advancing gender equality.

Cost has consistently been identified as the single most important barrier to accessing contraception and the cost is unevenly borne by women, people with low incomes and young people, all of whom are more likely to work in part-time or contract positions and often lack access to private coverage. Studies have demonstrated that publicly funded, no-cost universal access to contraception can lead to public cost savings. The University of British Columbia estimates that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. Having safe, reliable birth control represents freedom and safety. However, these costs continue to be a barrier. With Bill C-64, we are taking action to remove the barrier.

The same cost reduction principle applies to diabetes medication. Diabetes is a complex disease that can be treated and managed with safe, effective medication.

However, one in four Canadians with diabetes have reported not following their treatment plan due to cost. Improving access to diabetes medications will help improve the health of 3.7 million Canadians living with diabetes and reduce the risk of serious, life-changing health complications, such as blindness or amputations.

Beyond helping people with managing their diabetes and living healthier lives, if left untreated or poorly managed, diabetes can lead to high and unnecessary costs to the health care system due to diabetes and its complications, including heart attack, stroke and kidney failure. The full cost of diabetes to the health care system could exceed almost $40 billion by 2028.

Independent of the legislation, we have announced that we will work with provinces and territories on a diabetes devices fund. This fund would ensure that people with diabetes have access to the medical devices and supplies they need, such as syringes, test strips, glucose monitoring devices and insulin pumps. This, combined with the framework outlined in Bill C-64 for universal single-payer coverage for first-line diabetes medications, will help ensure that no person with diabetes in Canada is forced to ration their medication or compromise their treatment.

I previously mentioned our excellent work with P.E.I. and how this $35-million investment is focused on improving affordable access to prescription drugs while at the same time informing the advancement of a national universal pharmacare. The work accomplished by Prince Edward Island has been outstanding. Since last year, P.E.I. has expanded access to over 100 medications to treat a variety of conditions, including heart disease, pulmonary arterial hypertension, multiple sclerosis and cancer, and is saving millions of dollars in out-of-pocket costs for P.E.I. residents.

On a national level, we launched the first-ever national strategy for drugs for rare diseases in March 2023, with an investment of up to $1.5 billion over three years.

As part of the overall investment of $1.5 billion, we are making up to $1.4 billion available to the provinces and territories over three years through bilateral agreements.

This funding will help to improve access to new and emerging drugs for Canadians with rare diseases as well as support enhanced access to existing drugs, early diagnosis and screening for rare diseases. This will help ensure patients with rare diseases have access to treatment as early as possible for a better quality of life.

I want to quickly mention that, in December of last year, we announced the creation of the Canadian drug agency, which will provide the dedicated leadership and coordination needed to help make Canada's drug system more sustainable and better prepared for the future.

This is an incredible opportunity for Canadians coast to coast to coast, working alongside provinces and territories, to allow for pharmacare, especially when it comes to contraception and diabetes. This is the beginning of building a more robust health care system that will work for all Canadians. I am excited to support this bill, and I encourage all my colleagues to do the same.

[Mike Lake, Conservative, Edmonton—Wetaskiwin, AB]

Mr. Speaker, I want to ask a question about incompetent Trudeau government overspending. Of course, it raises the ire of members on the other side sometimes when I talk about the Trudeau government of the 1970s and 1980s and the devastating cuts that resulted in the mid-1990s of 32% over two years from 1995 to 1997 for spending on health care, social services and education.

I am wondering if the hon. member shares the same concern about the incompetent Trudeau government overspending of the 1970s and 1980s and also of his own Liberal government as it relates to our ability to fund important social programs in the future.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Mr. Speaker, I would suggest to the member that it would be incompetent for any government not to invest in health care for Canadians.

I would ask the member, if he thinks that this is wasteful spending, if he would cut the spending. Would he not provide pharmacare for Canadians? What else would he cut? Would he cut the Canadian dental care plan, which is now helping millions of seniors, just starting a few days ago, and has the incredible potential of improving people's lives? Is he going to cut $10-a-day child care, which is helping so many families? I would suggest to the member that it would be incompetent for any government not to invest in the important needs of Canadians by making their lives more affordable.

[Yves Perron, Bloc, Berthier—Maskinongé, QC]

Mr. Speaker, my question is simple. Does my colleague think that the pharmacare system they want to put in place will be ineffective if the government gives Quebec the right to opt out with full compensation?

What is that going to change given group purchasing is already happening? The group purchasing argument no longer holds water. There is no other argument.

Why not respect Quebec's will? The member does not live that far away. He must have some understanding of Quebeckers. I would like to have a nice honest answer to that.