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.

The House proceeded to the consideration of Bill C-64, An Act respecting pharmacare, as reported (with amendments) from the committee.

Speaker's Ruling

[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.

Motions in Amendment

[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.

[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?

[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?

[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.

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

Madam Speaker, I am thankful for the opportunity to speak to a very important piece of legislation, Bill C-64, which deals with pharmacare and develops a framework for it. This bill, along with other investments made by our government, would help millions of Canadians who are struggling to pay for their prescription drugs. We had a very healthy process at HESA, the Standing Committee on Health. I want to thank all witnesses who appeared before the committee and those who sent written testimony because it really helped us understand the positive impact of this legislation.

This bill is a priority for our government. It establishes the fundamental principles for implementing a national pharmacare program in Canada. It also sets out our plan to work with the provinces and territories who so desire to propose universal single-payer coverage for a certain number of contraceptives and diabetes medications.

Since this bill was introduced, we have heard many facts about access to and affordability of prescription drugs within Canada. Statistics Canada's data from 2021 indicates that one in five Canadians has reported not having enough insurance to cover the cost of prescription medication in the previous 12 months. We know that having no prescription insurance coverage is associated with higher non-adherence to prescriptions because of cost. We also know that this results in some Canadians having to choose between paying for these medications and paying for other basic necessities, like food and housing.

This is why our government has consistently made commitments toward national pharmacare. Bill C-64 recognizes the critical importance of working with 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 legislation is an important step forward to improve health equity, affordability and outcomes and has the potential of long-term savings for the health care system. In budget 2024, we announced $1.5 billion over five years to support the launch of national pharmacare and coverage for contraception and diabetes medications. I would like to highlight the potential impact that these two drug classes, for which we are seeking to provide coverage under this legislation, would have on Canadians.

We have heard stories of people, or know someone, in our constituencies struggling to access diabetes medication or supplies due to a lack of insurance coverage through their work, or of an individual who has limited insurance coverage so they cannot choose the form of contraception that is best suited for them. For example, for a part-time uninsured worker who has type 1 diabetes and is also of reproductive age to manage her diabetes, it would cost up to $18,000 per year, leaving her unable to afford the $500 upfront cost of her preferred method of contraception, a hormonal IUD. With the introduction of this legislation, this individual would save money on costs associated with managing her diabetes and would be able to access a hormonal IUD at no cost, with no out-of-pocket expenses, once the legislation is implemented in her province.

Studies have demonstrated that publicly funded, no-cost universal contraception can result in public cost savings. Evidence from the University of British Columbia has estimated that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. Since April 1, 2023, British Columbia is the only province in Canada to provide universal free contraceptives to all residents under the B.C. pharmacare program. In the first eight months of this program, more than 188,000 people received free contraceptives.

The same cost-cutting principle applies to diabetes medication.

Diabetes is one of the most widespread chronic diseases in Canada. Although there is no cure for diabetes, there are treatments to manage the disease.

One in four Canadians with diabetes has reported not following a treatment plan due to cost. Improving access to diabetes medications would help improve the health of some of the 3.7 million Canadians living with diabetes and would reduce the risk of serious life-changing health complications such as blindness and 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 on the health care system due to its complications, including heart attacks, strokes and kidney failure. The full cost of diabetes to the health care system could exceed almost $40 billion by 2028, as estimated by Diabetes Canada.

The bill demonstrates the Government of Canada's commitment to consulting widely on the way forward and working with provinces, territories, indigenous peoples and other partners and stakeholders, including other political parties, to improve the accessibility, affordability and appropriate use of pharmaceutical products by reducing financial barriers and contributing to physical and mental health and well-being.

Beyond our recent work on Bill C-64, I would like to highlight some of the ongoing initiatives that this government has put in place to support our efforts toward national pharmacare.

On a national level, our government 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 $1.5-billion investment, our government will make available up to $1.4 billion over three years to willing provinces and territories through bilateral agreements.

The strategy marks the beginning of a national approach to meeting the need for drugs used to treat rare diseases.

This funding would help provinces and territories improve access to new and emerging drugs for Canadians with rare diseases and would support enhanced access to existing drugs, early diagnosis and screening for rare diseases.

I would also like to highlight another initiative under way, which involves the excellent work by Prince Edward Island through a $35-million federal investment. Under this initiative, P.E.I. is working to improve affordable access to prescription drugs, while at the same time informing the advancement of national universal pharmacare. The work accomplished by P.E.I. has been remarkable. Since December of 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, psoriasis and cancer. In addition, effective June 1, 2023, P.E.I. reduced copays to five dollars for almost 60% of medications regularly used by island residents. I am pleased to share that through this initiative, P.E.I. residents have saved over $2.8 million in out-of-pocket costs as of March of this year.

Finally, on December 18, 2023, the Government of Canada announced the creation of Canada's drug agency, the CDA, with an investment of over $89.5 million over five years, starting in 2024-25. The CDA will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future, helping Canadians achieve better health outcomes. I am pleased to share that as of May 1, Canada's drug agency has officially launched.

In closing, members can see the extraordinary amount of hard work that has been dedicated to national pharmacare.

Bill C‑64 is a major step forward in our commitment to guaranteeing affordable, quality drugs for all Canadians. Our universal coverage plan for contraceptives and diabetes drugs will change the lives of individuals, families, society and our health care system.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, it is hard to know where to begin with the speech the parliamentary secretary just gave. I have heard some of this before at rare diseases conferences. I just want people at home to know that not a single rare disease drug would be paid for through this legislation. That is for starters. It is only mentioned once in this entire piece of legislation. Second of all, the Canadian drug agency is not created. CADTH is being repurposed and renamed into the CDA.

My question, though, is specifically on rare diseases because the parliamentary secretary mentioned them. Of the $1.5 billion announced all the way back in 2019, $1.4 billion is still left unspent. Could the member tell me which rare disease drugs were covered between 2019 and today, which patients received the drugs and for what conditions?

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Madam Speaker, I want to thank the hon. member opposite for his advocacy on rare diseases and drug coverage. I have heard him speak before quite convincingly, and I thank him for the hard work he is doing.

The member is absolutely right. We have allocated $1.5 billion over three years, but that delivery will come through provinces and territories. We are doing the hard work to engage in bilateral agreements with provinces and territories so that we can flow that money through provinces and cover the cost of medication through bilateral agreements for rare diseases. That work is ongoing.

The work that we are doing through Bill C-64 on pharmacare is an add-on to that work. It complements the work that we are doing on rare diseases, and I look forward to continuing to work with the member opposite on this very important issue.

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

Madam Speaker, the Conservatives were fighting tooth and nail to stop the dental care program. More than two million seniors across this country have signed up for dental care already. In the first three weeks of the dental care program, 120,000 have had access to dental care, often for the first time in their lives. Conservatives fought like hell to stop that program from coming into being and helping their constituents.

Now the Conservatives are wasting $400,000 in taxpayers' money in a debate that is about deleting all the clauses of the bill, a meaningless, ridiculous, disrespectful debate that will cost Canadians $400,000 by the time it ends this evening to try to block pharmacare, which will help, on average, 18,000 Conservative constituents with diabetes medication and 25,000 Conservative constituents in every riding in the country in terms of contraceptives.

Why are the Conservatives so afraid of the benefits that the NDP has forced the government to provide that will actually make a difference and help their constituents' lives?

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Madam Speaker, the truth is that the Conservatives do not support a pharmacare program. They do not support a Canadian dental care plan. They are throwing up all kinds of obstacles and denying the existence even of a Canadian dental care plan because they do not support that kind of really important help.

In fact, ideologically, they are motivated by private health care. If they have their way, that is what they will be championing, but on this side of the House, in this government, we strongly believe in a universal, single-payer system of health care and making sure that the most vulnerable in our communities get the care they need. That is why the Canadian dental care plan is such a success just in three weeks. The numbers cited by the member opposite are absolutely correct, and we will see more seniors and young people getting that health care because oral health is health.

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

Madam Speaker, I am wondering if my colleague can provide his thoughts with regard to how the Government of Canada works with other jurisdictions, in particular, the provinces, to look at ways that we can support Canadians in terms of medications.

I see this as a good, solid first step for pharmacare. I would ask him to add some comments with respect to that.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Madam Speaker, the member and I share an experience. We have both served in the provincial legislatures in our respective provinces, Manitoba for him and Ontario for me. We know that one of the biggest responsibilities provinces have is the delivery of health care. That is why it is imperative that the federal government work with provinces and territories in delivering these programs. That is what this pharmacare framework legislation is all about. I am very much looking forward to entering into those bilateral agreements with provinces and territories once this bill is passed into law.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, I would like to commend the members who may have the courage to sit late with us this evening.

Today we are debating Bill C‑64 to supposedly institute a national pharmacare program. I say supposedly because that is not what the bill does. Let us speak the truth. It is a bill mainly designed to playing politics, to the benefit of who knows who because by all accounts, the NDP is dropping in the polls.

What we are seeing today is a partial implementation of this system. The Liberal government, together with the NDP, is focusing on diabetes medication and contraceptives. What we are seeing today is a bit what the Conservatives have also been trying to do for a while now in this Parliament, to introduce American-style politics here in Canada's Parliament. We know that in the United States, in some states, the right-wing parties, the right-wing Republicans are attacking a woman's right to bodily autonomy. The Liberals are very afraid of the Conservatives, often with reason, because we know that there are a lot of people in the Conservative caucus who think that women do not have the right to control their own bodies. Essentially, the pharmacare plan is being used to Americanize Canadian politics.

Now, what this bill does is say that a national pharmacare program is needed. I want to point out that we are talking here about a federal national program, because we know that Quebec is a nation. The government is imposing a format. It is called first-dollar coverage, which means that an individual must be insured and must have access to medication without having to spend a single penny. I understand that it would be ideal if many insurance plans, depending on the nature of the risk, were to say that, when a person is sick, they are not responsible for their situation. They did not do anything in particular to get sick, they are just unlucky and they should be insured and not have to spend a single penny. Society will be responsible for providing full insurance coverage.

However, Quebec already has an insurance program, a mixed insurance system. It is true that people have to pay a little. For example, for the public plan, when a person does not have a workplace plan or a private plan, they pay from $0 to $700 and change per year per person, depending on income. The contribution is geared to income. Most people have a plan through their employer that is negotiated as part of their collective agreement, so it is true that, in some cases, people pay a deductible for medication. They pay a certain amount, which is often very low, but everyone in Quebec is insured and the system already exists.

The money that is going to be used to meddle in Quebec's affairs in an area where the federal government is notoriously incompetent, namely health care, should be paid out to Quebec so that we can improve the system that already exists and help it evolve. There is a list of 8,000 drugs that are covered in Quebec. That seems to have piqued people's interest. The federal government knows it is going to be very expensive, so it is buying time. The Liberals know very well that this completely universal plan, where everything is covered, will never come to fruition before the Conservatives come to power. This plan deals with two health conditions. Do people realize how huge a gap there is between reality and rhetoric and how we could have taken this money and sent it to Quebec so that these funds could be managed based on Quebec's priorities?

Some of the debates we had were disgusting in many ways. We, in the Bloc, were told that by opposing Bill C‑64, we were opposing the well-being of the people in our own ridings, and that the only possible way to show concern for people's health, supposedly, was to support a bill that will not properly establish a universal pharmacare system for Quebeckers. That is going to be addressed through questions, if the Liberals ask any. They will tell us that we are against this or that, that we are against people's health, but that is absolutely untrue. We are in favour of insurance, but Quebec is ahead of the game, and we cannot totally upend the Quebec system just because at some point, 25 years down the road, the federal government and the NDP decided to wake up one Tuesday morning. We cannot do that.

One of the reasons the NDP included this kind of program in its coalition agreement with the Liberals, and one of the reasons the only NDP member from Quebec, the member for Rosemont—La Petite-Patrie, is fighting tooth and nail for Bill C‑64, is supposedly because the major unions support it. It is a delicate situation.

It is true that the cost of drugs has increased, as has the cost of health care services in general, as well as all health technologies. As a result, the cost of private group insurance has gone up. In many workplaces, employer and employee contributions have increased over the past few years. This can put pressure on people's ability to pay. This can put pressure on collective bargaining to get higher wages to deal with the cost of living. We recognize that. We know that is important.

The reason the unions might be united in supporting this federal legislation is not because Ottawa is capable, it is not because Ottawa is good, it is not because Ottawa is competent, it is because the money is in Ottawa; it is because there is a fundamental fiscal imbalance; it is because there are more revenues in Ottawa than the weight of responsibility on the federal government; it is because the provinces need money. The federal government is so determined not to transfer money unconditionally to the provinces that many people have at some point lost confidence in one day having a federal government that will act responsibly and transfer money unconditionally. At some point, the unions decided that they will support the minimum. They will support what they think is feasible in a context where the federal government's lack of respect for provincial jurisdictions and its contempt for Quebec have been institutionalized for decades. That is what is happening.

The member for Rosemont—La Petite-Patrie is grandstanding and saying that he has the support of the unions. The message that he should be sending to the unions is this. He should tell the unions that, with Ottawa running this program, they will get less value for their money. There will be fewer drugs and less coverage. The system will not be as effective. The government will be creating a redundant system. In the end, the workers are the ones who will pay. This measure is extremely anti-union.

The member for Rosemont—La Petite-Patrie should have acted more responsibly. He should have explained to the unions that we need to stand together and look to Quebec to get the transfers with no strings attached because Quebec is prepared to improve its system. That is what should be done.

I served on the Standing Committee on Health for several months. The ability to spend, the ability to put a knife to the provinces' throats, to make them accept conditions in exchange for money is in the NDP's DNA. I spent enough time in committee to know that.

The Bloc Québécois proposed a completely reasonable amendment. It asked for the right for Quebec to opt out with full compensation because Quebec already has all the necessary infrastructure. Quebec already has a system. Quebec is prepared to improve its system. It needs that money to continue this social development, which, as with day cares, means that, today, Quebec has a social policy—

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, I apologize to our hon. colleague.

I rise on a point of order. In a debate such as this, there seems to be, according to our constitutional requirements, a lack of quorum.

[The Assistant Deputy Speaker, Carol Hughes]

I am sorry, but quorum cannot be called during this debate.

The hon. member for Mirabel.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, indeed, the absence of Liberal colleagues in the House should not be mentioned.

We have tabled an amendment—

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I rise on a point of order. Just to be very clear, there are members inside and outside the chamber, from all political parties, who listen—

[The Assistant Deputy Speaker, Carol Hughes]

I am sorry. Someone was speaking while you were speaking initially and I did not quite get what the hon. member said.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, it was just in reference to quorum. It should be noted that members cannot call quorum, as you have pointed out, but there are members, both—

[The Assistant Deputy Speaker, Carol Hughes]

Yes. Thank you very much. I think all members know very well what the rules are because of the fact we have been doing this over and again for quite some time. There is no quorum call during these debates.

The hon. member for Mirabel.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, that adds a bit of spice to our evening, obviously.

As I was saying, we asked for the right to opt out with full financial compensation. That should have been granted, in the interests of patients, those who are ill and workers. However, it was denied by the Speaker on the pretext that it requires royal recommendation, when the only thing Quebec wants is to have its share of the funds that are already allocated within this bill.

This shows just how institutionalized and deep-seated Ottawa's desire is to crush Quebec, to crush Quebec's desire to act in its own areas of jurisdiction and to exercise authority within its own areas of jurisdiction based on its preferences, particularly when it comes to pharmacare. It is in the genes of Ottawa's politicians, in their DNA. What is happening here today is so unfortunate.

It is unfortunate because the interests of patients and Quebeckers are coming second. We should be greatly saddened to see that people's health is being politicized for electoral purposes. That should never be commended.

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

Madam Speaker, I am truly surprised that the Bloc Québécois refuses to listen to what Quebeckers are saying.

A large coalition, the largest in Quebec, made up of two million Quebeckers, major unions and community groups, said that Quebeckers applauded the federal government's Bill C‑64.

They said the following:

Never before have we come so close to implementing a real public, universal pharmacare program. The hybrid public-private system in place in Quebec creates a two-tiered system that is unsustainable and needs to be fixed.

While criticizing the system, they also said this:

We are asking the federal government not to give in to the provinces and territories, which are asking for an unconditional right to opt out with full financial compensation.

That is the message that Quebeckers are sending to the Bloc Québécois. It is a bit like dental care, where the largest percentage of people advocating for dental care are Quebeckers.

Why does the Bloc Québécois refuse to listen to Quebeckers?

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, there are dissenting voices in every society. There are debates in every society. However, Quebec's voice is heard in the Quebec National Assembly, which is made up of 125 members who are elected by the people.

My NDP colleague's leader had the nerve to send a letter to Quebec's health minister. He literally told the health minister that he wanted a meeting with him, that he wanted to educate him and teach him how pharmacare works.

Do members know how Quebec's democracy responded? First, he was told to take a hike, because it was deeply disrespectful and ridiculous. Then, Quebec's democracy unanimously passed a motion in the National Assembly denouncing this kind of paternalistic attitude, which is, and always will be, unacceptable.

[Colin Carrie, Conservative, Oshawa, ON]

Madam Speaker, I want to thank my colleague from Mirabel for a very well-thought-out speech.

I come from Ontario, and the Conservative Government of Ontario has something called the Ontario drug benefit program. The member is aware of, and quite rightly pointed out, the jurisdiction of the provinces.

The pharmacare program that the government is bringing forward is not really a pharmacare program. It is like an announcement. It does not cover most of the drugs that the provincial plans cover. No Canadian, no Ontarian, wants a worse plan that would cover less. Perhaps the federal government would only cover certain medications.

Could the member explain to the Liberals and the NDP a little more about the jurisdictional issues that they are dealing with, and what people on the ground in his community are really asking for?

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, that is an interesting question.

One thing is for certain: If the federal government has money for the provinces to cover more drugs, then perhaps even more drugs could be covered if the money is sent to the provinces and they are given the right to opt out with full compensation so that they can expand programs with existing infrastructure.

However, Ottawa has this bad habit of creating structures, bureaucracy and new layers of all sorts of things that cost a lot of money. Then we end up with dental care plans like the Liberal plan that ultimately involves the private sector, which runs counter to the very principle of the Canada Health Act if it were subject to it. That is what we end up with. These are failures after failures.

What is the point of all this? It is about campaigning for the Liberals and the NDP.

[Soraya Martinez Ferrada, Liberal, Minister of Tourism and Minister responsible for the Economic Development Agency of Canada for the Regions of Quebec]

Madam Speaker, I am also from Quebec and I fully respect Quebec's jurisdictions.

I have a question for my colleague. Does he not know that, right now in Quebec, IUD fittings, for example, are not covered by insurance? Women have to pay every month for their method of contraception, which costs between $20 and $30. Many women choose not to take contraceptives.

Why not simply join a program that will give all women free access to their choice of contraception?

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, my best regards to the minister. I thank her for her very good question.

I will use the same wording to answer. Does she not know that Quebec is asking for health transfers? Does she not know that Quebec needs unconditional transfers? Does she not know about the health care funding deficit? Does she not know that if Ottawa stopped saying no to health transfers, we might not be where we are today?

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

Madam Speaker, I would like to start off by just taking a moment to congratulate the citizens of the United States of America and the rule of law that has prevailed this evening. Donald J. Trump has been convicted of 34 felony counts. Justice will be done in the United States, and a serial criminal, who has committed many crimes but never had to pay the price, will finally be behind bars in a matter of a few months.

I send my regards to the citizens of the United States. Tonight, the verdict is in, and Donald Trump has been found guilty on 34 counts. Finally, we see justice being served in the United States.

There are Conservatives who admire this convicted criminal. I think it is important and very relevant to the debate tonight that Conservatives have imposed five hours of debate, at a cost to Canadians of $400,000. This is being spent on a debate that Conservatives have put forward—

[Some hon. members]

Oh, oh!

[The Assistant Deputy Speaker, Carol Hughes]

I just want to remind members that if they have questions or comments, or if they are not interested in listening to the debate, they should ensure that they hold off until it is the appropriate time or step out of the chamber and come back when they are interested in listening to the debate.

The hon. member for New Westminster—Burnaby.

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

Madam Speaker, I would also suggest to Conservative members that they should not be drinking and coming into the House. It is not a good combination, and it does not look good on them. The reality is—

[The Assistant Deputy Speaker, Carol Hughes]

The hon. member for Cariboo—Prince George is rising on a point of order.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Madam Speaker, my hon. colleague has been in this chamber for a very long time and knows that we cannot do indirectly what we cannot do directly. To assert that Conservative members are drinking and coming into the chamber intoxicated is incredibly unparliamentary. I would ask that he withdraw those comments.

[The Assistant Deputy Speaker, Carol Hughes]

I am not sure exactly what is being done. If the hon. members could stick to the subject matter that is before the House, the House will run much more smoothly. I do not think that putting accusations forward is proper.

I would just ask the member to withdraw so that we can continue.

The hon. member for New Westminster—Burnaby.

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

Madam Speaker, it was not an allegation, but advice, and that is quite a different matter.

[An hon. member]

Oh, oh!

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

However, Madam Speaker, I will withdraw it if that advice was misconstrued by any member, including the member who seems to be shouting very belligerently.

This debate tonight is going to cost us $400,000, which is a lot of money. Even Conservative MPs, I think, would agree to that. However, what they have proposed in this debate tonight on pharmacare is a Conservative series of motions to delete the entire bill. That is why we are spending $400,000 of taxpayers' money. That is it. That is what they have to offer tonight, which is certainly in keeping with what they have been doing since February 29. They have been trying to block, by all means possible, the passage of pharmacare.

Why would they do that? Why would they waste $400,000 of taxpayers' money? Conservatives love spending money. We saw this under the Harper regime, with $30 billion given each year to overseas tax havens, tens of billions of dollars given to corporate CEOs in the oil and gas sector and $116 billion, including from the CMHC, given to banks to prop up their profits. I mean, there were unbelievable amounts of cash showered on lobbyists, on corporate CEOs and on banks. Conservatives love to spend money on anything but what actually helps people.

Conservatives have raised the question today, curiously, and are spending $400,000 of taxpayers' money on a useless debate where all they are offering, in terms of motions, is deleting every single clause in the bill. There is absolutely nothing respectful of Parliament to try to put forward such a motion. They are ready to spend $400,000 to basically waste a whole evening on a useless debate about deleting the bill rather than just voting against it, which is what normal people would do. However, they are unwilling to spend a penny to help people such as Amber.

Amber pays $1,000 a month for her diabetes medication. She lives in Burnaby, B.C. She has to scrimp and save; she finds it difficult to keep a roof over her head and to put food on the table. However, the member for Carleton and his entire caucus are suggesting that it is okay to burn $400,000 tonight on a useless, meaningless debate in which they are simply trying to delete every single clause of the bill. For them, it is okay to give $116 billion, including from a housing fund, for bank profits. It is okay to give tens of billions of dollars to corporate CEOs in the oil and gas sector. It is okay to put in place the infamous Harper tax haven treaties, for a loss of $30 billion each and every year over the course of the dismal Harper regime; that is nearly $300 billion that they just burned. However, when it comes to helping Amber or their own constituents with paying for diabetes medication, which can sometimes cost as much as $1,500 a month, Conservatives draw the line. They say, “No, hey, we give money to banks. We give money to oil and gas CEOs. We give money to big people. We give money to the rich. That is where we love to spend our money.” The member for Carleton, the lobbyist-in-chief of the Conservative Party, believes that this is where Canadian taxpayers' money should go, not on pharmacare and certainly not on dental care.

Now, on the dental care front, Canadians have said overwhelmingly to Conservatives that they are wrong. There were 120,000 seniors getting dental services in the first three weeks. What Conservative MP, over the course of their career, can ever point to having helped people? On the NDP side of the House, we can point to 120,000 seniors, including many in Conservative ridings, who have been helped immediately by the work of the member from Burnaby South and the entire NDP caucus. The NDP forced dental care through the House of Commons even though it was voted against four years ago by both Conservatives and Liberals. We certainly proved our worth to Canadians, and we have come back on pharmacare. However, Conservatives say the same thing: “We do not want to see our constituents helped.” There are 18,000 people in each Conservative riding in the country who would benefit from having diabetes medication paid for. Amber is just an example of what millions of Canadians are living with.

Canadians are looking for contraception. Women are looking for their reproductive rights and freedoms. There are 25,000 on average in each and every Conservative riding in the country, and the Conservatives say, “No, we do not want to give them that money. We want to burn $400,000 on an all-evening debate about motions that would simply delete every single clause of the bill.” That is the one contribution that Conservatives have been making to the debate since February 29.

On this side of the House, we actually believe in helping people, unlike the member for Carleton. He has never really held a job in his life. He worked for Dairy Queen for a few weeks, and that is it. Everything else has been given to him by the Conservative Party. In my background, I had to work as a manual labourer. I had to work in the service industries. I had to work my way through school as a teacher. I worked in a brewery. I worked in an oil refinery. I have working experience. The member for Carleton has not a whit, and maybe that is why, because every single member of the NDP caucus can point to that real-life, real-world work experience, we understand that when people are struggling to make ends meet, they actually need us to help them.

Conservatives will say they want to take a few cents off a litre of gas on the price on carbon. They are going to eliminate the price on pollution, as if somehow that would help Canadians, and we know full well that already the cost of the climate crisis goes far beyond the price that it has put on pollution.

The Conservatives, despite the fact that now the member for Carleton has been leader for a couple of years, have not been able to offer a single solitary thing to Canadians who are struggling to make ends meet and put food on the table. One could ask, if the Conservatives are bad, what about the Liberals? The reality is that the biggest fault of the Liberal government has been that it continued all the Harper practices. We still have the infamous Harper tax haven treaties still costing us $30 billion a year, according to the PBO. The government also coughed up money to the banks over COVID and was willing to spend money from the CMHC. Instead of that going to affordable housing, it went to prop up the banks, and the government has continued the oil and gas subsidies.

The biggest thing that I can reproach the Liberals on is the fact that they have acted like the Conservatives, with some exceptions, and that is because the NDP has stepped up to force them to get dental care into place. That has been an undeniable success. It is the best new support for Canadians that we have seen in decades. Now with pharmacare, people like Amber can know in the next few months, once we pass this bill, that they will actually get supports, and Amber will not have to struggle to find $1,000 each month to pay for her diabetes medication.

That is why I am supporting the bill, and that is why I find it ridiculous that the Conservatives are forcing, at a cost of $400,000, this ridiculous debate to delete all clauses in the bill tonight.

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

Madam Speaker, one thing that amazes me is the degree to which the Conservatives are so insensitive to their own constituents. One of the biggest beneficiaries of passing this legislation would be people with diabetes. Every member of Parliament has literally hundreds, if not thousands, of constituents with diabetes, and this bill is long overdue. I would like to to see it passed, and the Conservatives do not seem to want to recognize the important impact this is going to have on Canadians with diabetes.

Could the member provide his thoughts on that aspect, please?

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

Madam Speaker, the question is a very relevant one. On average, 18,000 people in each and every Conservative riding in the country, whether it is Cariboo—Prince George or Cumberland—Colchester, could benefit from the pharmacare provisions that the NDP have pushed the government to put into place, yet those members of Parliament, instead of helping their constituents, are siding with big pharma.

Who are they benefiting by, for the last few months, fighting to stop this bill from helping their constituents who pay $1,000, sometimes $1,500, a month for medication? I think they need some reflection, because Conservatives are not doing anything to help their constituents at all.

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

Madam Speaker, it is absolutely fascinating, because when we look at the statistics, about a million people really do suffer from a lack of coverage. That is just the fact, in spite of the conflated numbers that the member from NDP wishes to state.

Maybe the member could do his math again on behalf of all Canadians and let Canadians know how many diabetics really need this program. There are some, admittedly, who really need it, whereas many others have fantastic coverage. His foolish plan would actually take away their coverage, leaving them with less ability to choose the insulin that works well for them or the other medications that are important to their own health, and the freedom of choice that they now have.

Perhaps the member could swallow his pride and get his numbers straight on behalf of Canadians.

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

Madam Speaker, I like the member.

We have had a breakthrough. One Conservative has finally admitted that people actually need pharmacare. One Conservative said, “Oh gosh, yes”. His numbers are wrong, but he is right in saying that people actually need pharmacare.

Why have the Conservatives been fighting tooth and nail to block this bill since February 29? Why have they been trying to stop their constituents, 18,000 of them, who he has just admitted actually need the program, from getting the program they need?

There is a breakthrough tonight. Maybe this is a use for some of that $400,000 that the Conservatives are burning. If some Conservatives had the penny drop and finally realize that they are doing the wrong thing, they may start to do the right thing. That would be a benefit to all Canadians.

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

Madam Speaker, the member was starting to hit the nail on the head here, when he made reference to the fact that there might be some benefit in terms of late-night sitting tonight, if somehow we can get the Conservatives to flip-flop on this particular issue.

It is encouraging, and the first step is to recognize not only people with diabetes, but also the millions of Canadians who would directly benefit because of contraceptive coverage. I believe it is somewhere around nine million women who would, potentially, directly benefit from this aspect of the program.

Can the member comment?

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

Madam Speaker, that is very important, too.

There are 25,000 people in each and every Conservative riding in the country who would benefit from the provisions around contraception. Conservatives should be embracing that. On the issues of family planning, women's bodily autonomy, reproductive rights and freedoms, if Conservatives actually believe in freedoms, they should be supporting this bill.

I am hoping, perhaps, there may be some usefulness for the $400,000 that the Conservatives are spending tonight to try to delete all sections of the bill. If one, or maybe two or three Conservative MPs wake up and actually vote in favour of the bill, maybe it will be worth it.

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

Madam Speaker, it is a pleasure to be able to rise and speak to this legislation today.

There are some aspects of public policy that I have had a great deal of interest in over the years, not only here in Ottawa, but also during the days I spent in the Manitoba legislature. Canadians have a justified expectation that provincial and federal governments will work together on the important issue of health care. It is part of our Canadian identity. In many ways, it is one of the biggest treasures we have as Canadians.

At the end of the day, when I look at this legislation, Bill C-64, I see it as a significant step forward in recognizing just how important it is, when we talk about health care, that medications need to be incorporated in a very real and tangible way into the discussions. I think of the number of people over the years who have ended up going to emergency services, had a premature death or were in situations where there were additional costs for health care. Imagine the number of different pharmacare programs that are scattered throughout the provinces. Even within a province, there are multiple different forms of pharmacare programs being provided. However, even with all of those hundred-plus national or provincial insurance programs that are out there, there are still many Canadians, hundreds of thousands, who have absolutely no insurance for prescribed medicines.

This policy that is sound and makes sense. Therefore, I am bewildered as to why, yet again, we see the official Reform Party across the way saying no to Canadians on what I believe is a significant step forward toward a national pharmacare program. It would start off with two medications, in two areas. I believe Canadians would overwhelmingly be in support of this. Whether it is people in Quebec, Manitoba, B.C. or Atlantic Canada, we will find resounding support for this initiative, and I would like to think that Conservatives, at some point in time, will open their eyes and have a better appreciation for the true benefits of this program.

This is not new for me. I have been talking about it in this House for many years. For the last half-dozen or so years, I have raised the issue. I have presented petitions on the issue. Whenever I had the opportunity to highlight the importance of pharmacare, I would often make reference to the importance of the federal government working with provincial governments across the country to encourage more participation in a truly national program. Interprovincial migration happens all the time. I have family members who live in different provinces. In fact, I have a brother who lives in B.C. and a sister who lives in Newfoundland and Labrador. The types of coverage vary. We all have opinions. Because this includes medication for people with diabetes and contraceptives for women, we would all benefit directly because we all have family members or know people who would benefit from that. I would personally love to see an add-on to it with respect to shingles.

I understand that in some provinces there is better coverage than in other provinces. That is one reason I would argue, as my daughter has in Manitoba, that we need to get provinces to come to the table in such a way that we could recognize the best pharmacare program that we could have, while expanding it to what it ideally could and should be into the future, with a higher sense of co-operation. I believe that is the answer. I think it was back in 2016 or 2017, I recall being on Keewatin Street in the north end of Winnipeg, asking people to sign a petition on the importance of national health care and on a national pharmacare program.

The NDP House leader made reference to a Quebec union and its thoughts about ensuring not only that this program sees the light of the day, but also that all politicians get behind it. There is a saying from the national nurses union that health care workers understand and they appreciate. If one goes into a hospital, one will find, at least in Manitoba, that one's medications are covered. When one leaves the hospital, depending on their situation and what kind of a plan they might have, they will get their medication. Many may not have a plan, so they will not get the medications, and often, the person returns to a hospital situation. I have talked to individuals, particularly seniors, who talk about medications versus food. That is a real discussion that takes place, sadly. From a personal point of view, the pharmacare program has been more important to me than the dental care program, and we have seen the success of the dental care program.

As a government, with the Prime Minister, we have seen how much Liberals value our health care system, our Canadian identity, virtually from the get-go with the buying of prescription medications to be circulated in order to support provinces, until not that long ago when we made a contribution of $198 billion over the next 10 years to support our health care system so that we can enhance programs such as staffing requirements, long-term care and mental health. Those are expectations our constituents have. That is the type of thing that we are delivering because we have seen agreement after agreement with provinces and Ottawa dealing with health care, and we recognize just how important the issue is. We continue to be able to work with the different jurisdictions.

I believe that when we think about issues like mental health, dental services, pharmaceuticals and long-term care, they are all things that I believe, through the Canada Health Act, we have a responsibility to show leadership for. I like to think that whether it is a territory or a province, there is a some semblance of what we could expect and that it would be of a similar nature. That is why we have transfer payments, equalization payments and so much more. That is why we have a government that not only understands it, but it brings in budgetary measures to support it and legislative measures like we are debating today on Bill C-64. The Conservative Party needs to wake up and understand what Canadians want. That is better quality health care, and Bill C-64 delivers just that. Conservatives should be voting in favour of it, not filibustering.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, I do not get to say this very often, almost never, in the House, but that speech by the member was so much better than the previous drivel that we heard from the member for New Westminster—Burnaby. It was not good, but better than what the NDP House leader from B.C. had said, which was incoherent babble.

I do have a question for the member, which I asked the previous health minister and the current health minister at committee: How many provincial health ministers at FPT meetings asked for a pharmacare program? I have talked to the health minister in Saskatchewan, and this was never on the agenda at any FPT meeting. How many provincial health ministers asked the NDP-Liberal government to bring in this program?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, I will do better than that because I have been talking about this and campaigning on this type of issue for many years, and a vast majority of the constituents, the people whom I represent, want to see this. They want to see strong national leadership, and we are getting that through the Prime Minister, through the current government and the collection of Liberal MPs, and we are grateful for the support we get from the NDP. Because of that, we are going to see it happen, and as a direct result, millions of Canadians could realize the benefits. Our health care system is being improved upon, and believe it or not, that is something that the member who posed the question would also like to see.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, I will actually ask the member a question about the legislation. In Bill C-64, clause 6, “Payments”, it says very specifically that it is supposed “to provide universal, single-payer, first-dollar coverage”.

First-dollar coverage means that if a private insurance company today covers diabetic medication, it will not be able to do so if this legislation comes into force. In fact, it would be a crime. It would be illegal to do that, which means that there is a great potential for Canadians who are currently insured for their diabetes medication with a private insurer to lose it. They are actually the majority in this country.

How many Canadians would lose the coverage that they currently have because of this first-dollar coverage found in clause 6 of Bill C-64?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, let me answer the member by asking this: How many of his constituents are not going to have the types of benefits this legislation would provide if the Conservatives prevail and this legislation were to die? We are talking about hundreds, if not thousands, of his constituents who would not be able to have the medications they require at the cost we are suggesting, which is zero. The member needs to reflect on that. He is denying his constituents the opportunity to receive those types of benefits. We are not talking about a few thousand constituents; we are talking about millions, nationwide.

[Colin Carrie, Conservative, Oshawa, ON]

Mr. Speaker, I want to ask my Liberal friend a question. I come from Ontario, and the Conservative government has something called the Ontario drug benefit plan. It already covers diabetes and reproductive medications. To compare it to what my colleague was asking, there are a lot of people with private insurance, and they have this coverage. However, this plan may only cover certain medications that are not really specific to an individual who can tolerate different types of medications.

Can the member please confirm for Canadians that nobody would lose the medication that they are used to utilizing and that they stay healthy on because of this new program?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, I can tell the constituents whom he represents that what he just said is not accurate. He tried to give the impression that the people of Ontario do not have to pay anything for diabetes medications.

There are things such as deductions and a whole spectrum of ways in which there are direct and indirect charges for people who need insulin. I think the member does a disservice in trying to discredit the legislation, when I am sure he knows better, as the Conservative leader ought to know, that millions of Canadians would in fact benefit by the passage of this legislation. The Conservatives really need to ask themselves, collectively, in front of a mirror, “Why are we trying to deny Canadians these benefits?”

[Jacques Gourde, Conservative, Lévis—Lotbinière, QC]

Mr. Speaker, it is a privilege to speak to Bill C-64, an act respecting pharmacare, which seeks to support the implementation of a national, universal pharmacare program.

I am always ready to champion a federalism that meets the needs of all Canadians, but there are a number of things that bother me about Bill C-64. Apart from the fact that it interferes in provincial jurisdictions, it was born of the Liberals' need to keep a minority government alive. That is why we are debating this bill tonight. Another thing that bothers me about Bill C-64 is that the Liberals are using the NDP like a lapdog, keeping it warm and cozy, only too happy to give in to the NDP's costly demands, while keeping it on a tight leash in a minority government that is on life support until the fall of 2025.

Since this bill does not respect provincial jurisdictions, it is obviously not legitimate. I have a hard time sorting out the reasons for this interference in provincial jurisdictions, which has become chronic over time, since the arrival of this Liberal government. I am even beginning to wonder whether the Bloc Québécois is not starting to rub off on the Liberal-NDP government in the House on other subjects.

One things is certain. Canadians are finding it increasingly difficult to identify with those who have become spokespeople for every issue instead of minding their own business. The Bloc Québécois is another example. On many issues, they are undermining the real well-being of Canadians, and especially Quebeckers, by playing provincial politics in the federal arena. They are confusing everyone.

In its current form, Bill C-64 would replace the private insurance system with a single insurance system. It would be a federal monopoly administered by a centralizing and incompetent Liberal government that has trouble managing its own departments and portfolios. For example, I am thinking about this government's inability to issue passports on time, which we experienced two years ago. I am not even sure what to say about the government's financial management, when it keeps spending borrowed money on the backs of future generations and dragging us towards a chronic and structural deficit. It is distressing to see a Liberal government that is incompetent across the board being supported by the NDP and, unfortunately, all too often by the Bloc Québécois as well.

Canadians are increasingly vulnerable, not because they lack access to medication in the provinces, but because they can no longer make ends meet. They have to make difficult choices between food and housing. Bill C-64 is just another idea where the expense is not worth the cost. Even more of taxpayers' money is being wasted in the expansion of the federal government, which is becoming increasingly intrusive and costly. Bill C-64 was born of noble intentions, but implementing it would create yet another inefficient and costly bureaucracy on top of the one that has been far too intrusive since 2015.

Currently, according to the brief submitted by Innovative Medicines Canada to the Standing Committee on Health, 97.2% of Canada's population benefits from access to prescription drug coverage through a public or private pharmacare plan. However, one in 10 Canadians is not enrolled in a government program that would cover the costs, even though they are entitled to it.

If we want to improve coverage, then we need to better inform Canadians. We do not need to destroy what is already in place to rebuild on a new foundation that has not been proven. The precursor pharmacare system in the province of Quebec, which was implemented 28 years ago, has been proven. The system is already practically universal. Common sense tells us that to improve coverage and access we just need to have targeted policies for the populations that do not have access. It is unnecessary to demolish what is already working, contrary to what the Liberals are currently proposing.

Monopolies of any kind have rarely served the interests of citizens. Replacing all the private drug plans entails major risks, including a reduction in the quality of service. As a result of competition, approximately twice as many new drugs are made available to patients on the private market in half the time.

Canadians appreciate this efficient system. Because it is a high-quality system, hospitals are less crowded, which in turn means lower costs. As I was saying earlier, this is yet another attempt by the Liberal government to interfere in provincial jurisdictions without consultation.

The health minister suggested that it would be absolutely out of the question for Quebec to give Ottawa free rein to create a pharmacare program in the province, unless it gives Quebec the right to opt out with full financial compensation, which the Prime Minister has no intention of doing. The same goes for Alberta.

The real reason behind this bill is that the Liberals have no choice but to bring forward this proposal because it is a condition of the NDP's support for the Liberal government and its survival, which has been at risk since its re-election. They outright ignore all the misgivings about the need for the bill and especially the costs associated with implementing it, as the Parliamentary Budget Officer told us. The survival of the costly coalition is at stake. They are trying once again to establish an even more centralist government, forgetting the country's federative nature and attempting to make it a unitary state.

The government should be more pragmatic and less ideological about this bill, otherwise all its efforts will be counterproductive. Instead of thinking about kickbacks to stay in power, the Liberal government should recognize the following facts. This is not a pharmacare plan. It is an empty promise that will not cover the vast majority of drugs used by Canadians.

After nine years of Liberal governance, the current Prime Minister has made a lot of promises. He promised affordable housing, and then he doubled the cost of housing. He promised that the carbon tax would cost nothing, and now we learn that 60% of families are paying more because of the carbon tax. He promised that taxes would be lowered but they went up. He promised safe streets, but ushered in crime, chaos, drugs and disorder.

This Liberal-NDP government cannot be trusted to deliver anything worthwhile to Canadians. In fact, the people have been betrayed, along with the working class too, to keep the Prime Minister in power while he doubles the cost of housing and quadruples the carbon tax.

Most Canadians already have prescription drug coverage. Many worry about losing the coverage they already have, coverage that works for them. There are also serious concerns about the cost of this proposal. The Parliamentary Budget Officer has said that it could cost tens of billions of dollars. Canadians cannot afford it at a time when they cannot even afford to pay their bills because of this Prime Minister. No Canadian wants a system that performs less well, offers less coverage, costs more and creates a massive new bureaucracy in Ottawa.

In closing, I want to reassure concerned voters who are not buying it. The common-sense Conservatives are going to abolish the carbon tax and bring down the prices of the basic goods that Canadians need. Canadians do not need legislation like this in these difficult times. What they need is an election as soon as possible to axe the tax, build the homes, fix the budget and stop the crime.

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

Madam Speaker, we are talking about pharmacare and the member is talking about cutting the carbon tax.

Let me read a quote from Linda Silas: “Every day, nurses witness the profound impact of poor access to medications on their patients’ health.” She has addressed this to all members of Parliament. Further down she says, “Get it done for the sake of our patients, for the future of our health care system and for the well-being of our country. VOTE “YES” ON BILL C-64.” Linda happens to be the president of the Canadian Federation of Nurses Unions.

Could the member provide his thoughts on why the Conservative Party is going against our professional health care providers, who really want to see this legislation pass because they understand it?

[Jacques Gourde, Conservative, Lévis—Lotbinière, QC]

Mr. Speaker, I would love to hear what Canadians think about this during an election, which may even come this summer. That would be for the greater good of all Canadians.

If this government has the courage to find out what the people want, it should call an election. Otherwise, let it continue to follow the NDP's lead.

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

Mr. Speaker, I am well aware that the member has had a long career and that he lived through the Harper regime, the most expensive regime in Canadian history. Some $116 billion was given to the big banks to increase their profits. According to the Parliamentary Budget Office, $30 billion a year went to tax havens thanks to Mr. Harper and his team. Of course, there was also all the money given to CEOs in the oil patch.

The costly Conservatives spent a lot of money on the rich and affluent. However, now we are talking about pharmacare, which will help people in his riding. It will help 18,000 people with diabetes who are struggling every month to pay sometimes up to $1,000 for their medication.

The question I want to ask my friend is very simple. Why are the Conservatives so keen on spending money on billionaires, CEOs and banks, but do not want to give a penny to people struggling to pay for their medication, such as diabetes medication?

[Jacques Gourde, Conservative, Lévis—Lotbinière, QC]

Mr. Speaker, I would like to remind my colleague, who was here when I was part of an excellent Conservative government, that the national debt was around $500 billion. It is now over $1.25 trillion. That alone is costing Canadians an enormous amount. Right now, the Liberals are spending more on debt interest than on health transfers. We are paying a huge amount of interest. The 7% that we pay on goods and services goes toward paying the debt instead of toward health care.

That is because the NDP is forcing the Liberals to overspend.

[Joanne Thompson, Liberal, St. John's East, NL]

Mr. Speaker, I am very interested in getting my colleague's response to the reality. As a community health nurse many years ago and someone who led, for a number of years, a multidisciplinary team at a community health centre that was very much about vulnerability, I saw time and time again the chronic illness implications of diabetics who did not have access to appropriate treatment. I saw repeatedly and was able to demonstrate through our data systems the cost to our health care system when someone with a chronic illness continued to move to the more severe aspects of their disease process because they did not have access to care.

I hear time and time again at committee and in the House that my colleagues are very interested in cost savings. Could the member please explain to me why he is reluctant to move this legislation forward in light of the very well demonstrated implications of cost savings in our health system?

[Jacques Gourde, Conservative, Lévis—Lotbinière, QC]

Madam Speaker, my colleague asked a very interesting question. I talked about that in my speech. It would have been better to target people who do not have access or who need a lot of prescription medication that they cannot afford. If the government had done that, then it would have to cover only about 1% to 2% of the Canadian population, and we might have supported the measure. However, it bothers us that that the government wants to scrap everything that currently exists in the public and private sector to implement an extremely onerous system with a lot of red tape.

[Ben Carr, Liberal, Winnipeg South Centre, MB]

Mr. Speaker, is it always an honour to rise in this House.

I want to start on a personal level. I was always so proud to grow up with my mother as a family physician, who continues to practice medicine in Winnipeg. In the past number of years, she has moved into working with people battling addictions. Much of my understanding of the health care system and how we care for people in our society has come through the compassion, expertise and professionalism that I have seen on my mother's part, so it is with her in mind that I rise today to speak about pharmacare.

Like so many of our colleagues in the House, I have heard from constituents who are eager for the government to move in a direction that will allow for a universal pharmacare plan. There are a variety of reasons for this, which I will get to later in my remarks. However, what I have heard primarily from seniors, whether it is on the government's plan for dental care, the proposed piece of legislation we are talking about today or investments in aging in place with dignity, is that they are extremely enthusiastic about the direction the government is headed in relation to a variety of different health care policies.

As members know, recently there was an election in my home province of Manitoba. We have been working collaboratively with the new government, and I was very proud to join other colleagues, as well as the premier and the Manitoba health minister, not too long ago to announce a $630-million health care deal with the Province of Manitoba. It is going to see us invest directly in a variety of areas that are going to make a difference in the lives of my constituents, and Winnipeggers and Manitobans broadly speaking. They include things like a reduction in wait times, investments in mental health and addiction and ensuring that we have greater efficiency in our health care system.

I have talked often in this chamber about my experience as a teacher, as a principal and as a coach, having worked for many years with young people, and I am proud of the investments we are making in youth mental health. I would also note that many of the students I have worked with in the northwest part of the city of Winnipeg are unfortunately, and in many instances disproportionately, impacted by type 2 diabetes. It is indigenous communities in particular that are facing those challenges. I come to this debate with some first-hand experience, having seen how difficult it can be to operate without coverage.

Our government promised to bring in a national, universal pharmacare plan so that all Canadians can have access to the prescription drugs that they need.

Our government worked on developing a solid foundation for building a national, universal pharmacare program. This work includes investments in the national strategy for drugs for rare diseases to help Canadians with rare diseases access the drugs they need. It also includes the announcement of the creation of a Canadian drug agency in December 2023.

With the help of the Canadian Agency for Drugs and Technologies in Health, we have also completed preliminary work toward a national formulary. This work included the establishment of a multidisciplinary advisory panel with a recommended framework and process for the development of a national formulary.

In Canada, the roles and responsibilities for health care services are shared between provincial and territorial governments and the federal government, as we know.

The provincial and territorial governments are responsible for the management, organization and delivery of health care services for their residents, which includes determining which drugs are reimbursed, and under what conditions, for their eligible populations.

We look forward to continuing to collaborate with our provincial and territorial partners to improve the accessibility to and affordability of prescription drugs for Canadians. The bill would do just that, starting with contraception and diabetes products.

By continuing our work together and making wise investments, we can ensure that the health care system is there for us when we need it, both now and in years to come.

I said at the outset of my remarks that I spent a number of years as an educator, and it was during that time that I got to know kids and their families on very personal levels. I did not just get to understand them as students, but I got to understand them as people, including all the challenges that come along with daily life. Some of those challenges included access to health care.

I cannot tell members how many times, for example, I would have a first nations single mother with a child in crisis in my office, and she was not sure how to advocate well for her child, because they had had so many challenges over the years in interacting with the health care system. I remember one particular instance where a child was having some significant mental health issues, and I said that I thought we really needed to call the son's doctor and get an appointment for him. The mother picked up the phone and called the doctor, and the receptionist at the office answered the phone and said that, unfortunately, they did not have a spot for the next four months. This was a young person who was contemplating taking their own life at the time.

I was fortunate enough to be able to help that family in that particular instance. This was by virtue of something I mentioned at the beginning of my remarks, and that is having seen my mother's ability to operate in and navigate the system. However, this is not uncommon, particularly for marginalized communities. In Manitoba more specifically, there are indigenous communities, whether first nations, Métis or Inuit, as well as newcomers, who have difficulty accessing our health care system for a variety of different reasons.

In addition, in many of these families, there were single mothers or single fathers working multiple jobs. They had to go long ways across the city in order to make ends meet and to provide for their families, and they did not have access to plans. They did not have access to medications that would allow them to live healthier and more prosperous lives.

I have those families and those kids in mind when I think about what the bill would mean for them and their future. I am proud to have the opportunity to rise today to talk about what we can accomplish through this historic piece of legislation.

I know that my time is running short, so with that, I will gladly take my seat for a moment and welcome questions from my colleagues across the way.

[Branden Leslie, Conservative, Portage—Lisgar, MB]

Mr. Speaker, I congratulate my hon. colleague across the way for a very impassioned speech, based on real lived experiences, that was not intentionally partisan. It was actually about reality. The class of by-elections of 2023, I think, includes some of the best around this place.

I will respond in kind with a bit of a personal reality. My beautiful wife, Cailey, was diagnosed with type 1 diabetes at age one, which I think was the earliest in the country at that point. Prior to meeting her, I did not know a lot about diabetes, so I personally had to learn a lot of the challenges of living with diabetes and what it entails, and I certainly can recognize the costs.

I am going to do a quick shout-out, while I have the opportunity, to wish Cailey a happy birthday tomorrow. I look forward to spending the day with her.

Cailey is on an insurance plan, as are many other Canadians, and a real concern is that the options available for specific products and insulin are adequately covered for the majority of people right now. Why the need to aim for universality when we could be more targeted and use taxpayer dollars more efficiently to still try to seek the same results? Obviously the expectation is to expand this to other products. We need to be smart with taxpayers' money while still trying to seek the results the member wants to achieve.

[Ben Carr, Liberal, Winnipeg South Centre, MB]

Mr. Speaker, as a fellow Manitoban, it would be impolite of me to not also wish Cailey a happy birthday. To my hon. colleague's wife, I hope it is a fun day together tomorrow.

There are tens of thousands, hundreds of thousands of Canadians across the country who do not have access to the medication they need. I appreciate that, in some instances, there are provincial health plans or private plans that cover certain medications, but the reality is that this is simply not enough.

I would respond to my colleague by referencing something my colleague from St. John's East, who happens to be in close proximity to me at the moment, mentioned earlier: We are being smart with taxpayer dollars, and this is an investment in taxpayers. It is an investment in their health and in their future. The more we can get ahead of proactively addressing health care challenges people are facing, the healthier people are going to be down the line. That, in and of itself, is smart tax policy.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, early in my career as a politician, I was in a meeting with two young people who had type 1 diabetes. They came from two different provinces, so it was very interesting to hear the story of those young people and their parents. What stuck with me was that one young person lived in one province and had an important, often life-saving device, and the other young person from a different province did not have it. The reason they did not have it is that it was costing them a significant amount of money every month. The dad had been hurt on the job; he was now living on very minimal income, and they had to take the device away from their child. Could the member talk about how this would really create that important factor of universality so that all young people who have type 1 diabetes get exactly the same appropriate care across Canada?

[Ben Carr, Liberal, Winnipeg South Centre, MB]

Mr. Speaker, that is exactly the point. When we use the word “universal”, it is to ensure we do not have this kind of hodgepodge patchwork health care system across provinces, but that any Canadian, wherever they live in the country, is able to access these medicines when they need it.

I mentioned in my remarks that I worked with a lot of first nations kids in northern Manitoba in particular. Because there is so much migration within the province through to the city of Winnipeg, as a result of historical harms and all the reasons we know indigenous people are disadvantaged in this country, they are disproportionately susceptible to many of the challenges that come along with diabetes and other poor health outcomes. For first nations kids, in particular, and indigenous kids as a whole, as well as people such as the constituents she was talking about, the legislation would allow for us to fill some of the gaps that exist and make sure they get the type of health services that they need in this country. I am proud to work alongside her and other members across the way who support this legislation.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, it is an honour to stand here and talk about what is being billed as universal pharmacare but what we know is not universal pharmacare.

Before I go down the path of our debate tonight, it is about 5:18 p.m. back home in British Columbia, which would mean that my granddaughter Ren is being picked up from our house. She watches every time I am on, and she always talks to the screen. I am going to say hi to my granddaughter Ren and tell her that papa loves her and will be home soon.

We are talking about Bill C-64 tonight. We are talking about a bill that is literally, for Canadians who are watching, four pages long. That is it. It is being billed as universal pharmacare. We have those who are in the audience to listen to this speech tonight at 8:19 p.m; it is a packed house in the gallery. Canadians at home are watching this important debate.

It is an important debate. There are over 27 million Canadians who are insured and have private plans. There are approximately 1.1 million Canadians who are under-insured or do not have plans. This has been said before by my esteemed colleague from Cumberland—Colchester, a former physician. He and I sit on the health committee. We work together in the best interests of Canadians and the constituents we represent.

When the government forced closure on Bill C-64 and started to ram it through the House, we rolled up our sleeves in good faith and submitted in excess of 43 amendments. These are amendments that the Conservatives and the other opposition parties were asked to submit without the opportunity to hear from the witnesses. Witnesses gave 10 hours of testimony. Surprisingly enough, the two most prominent experts in Canada with respect to pharmacare were not invited. We did not get a chance to hear from them.

There were 43 amendments that we tried to introduce in good faith. The government always says, with its NDP coalition partners, to trust it. We should just get the bill to committee, and we will do great work there. We will work collaboratively with all parties to make reasonable, needed amendments to these watered-down pieces of legislation. It does not work that way.

For five and a half hours, the member for New Westminster—Burnaby filibustered each and every one of the amendments. He says that it was Conservatives who had been blocking the bill the whole way.

[An hon. member]

Oh, oh!

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

The member heckles me and laughs at me right now from down at the far end.

Mr. Speaker, I have a great deal of respect for my colleague from New Westminster—Burnaby, and he is a fellow British Columbian. We have worked collaboratively before.

At every step of the way, we introduced common-sense amendments. If I may, I will read into the record snippets of a few: “universal, in respect of pharmacare, means providing uniform coverage to all residents of all provinces and territories, including Indigenous peoples.” That was one that was voted down by the Liberal-NDP coalition.

Another amendment was this: “payments to the province or territory in order to provide, to Canadians without access to any other prescription drug coverage plan, public pharmacare coverage for or to increase any existing public pharmacare coverage for and to provide universal, single-payer, first-dollar coverage for”. Does that sound like Conservatives are trying to block this piece of legislation? It does not. How about this? This one is very straightforward: “make progress on providing universal coverage of pharmaceutical”.

I offer that to the House because, at every step of the way and throughout the next couple of hours of this debate, we will hear interventions from our Liberal colleagues and our NDP colleagues that will say that Conservatives tried to block this piece of legislation every step of the way.

Those of us who have been tasked, on this side of the House, to work collaboratively with the other side in the health committee worked diligently to try to come up with an actual piece of legislation that was accurate and that provided the necessary tools and meat for such an important topic. We were shut down at every step of the way, primarily by our colleague from New Westminster—Burnaby, who was doing yeoman service for his Liberal coalition on the other side, as most of them sat silent.

I want to remind the House as well that all provinces have their own type of pharmacare and that 97.2% of Canadians have some form of coverage. This is a $2-billion cost, a program cost. Surely, for the one million or 1.1 million Canadians who are without coverage, we could have found a different way of doing this, a better way of doing this, that would not have put in jeopardy the plans that 27 million other Canadians have. We have spoken with insurers. We have spoken with businesses that offer private insurance to their employees, and they have questions: Who is going to pay? What happens to their employees? What happens to those who are insured by them? Insurers have concerns. Canadians have concerns.

Moreover, I will offer this. In last night's committee of the whole debate, a lot was said about this plan being universal pharmacare. We know that we have constituents who are phoning and saying that they are going to the pharmacy today and asking if they can get their medications paid for. The reality is this: No, they cannot.

This was confirmed by the Minister of Health last night when I asked him if Bill C-64 provides any government funding for those struggling or inflicted with cardiac issues. The answer was no. Does Bill C-64 provide any funding for those with ALS? The answer was no. Does Bill C-64 provide any government funding for those who are struggling with asthma? It does not. Does Bill C-64 provide any funding for any medications other than contraception or diabetes? His answer was no, that it does not.

This is not universal pharmacare. It provides the necessary and very important medications for those struggling or living with diabetes and it provides contraception. It does not offer what it is being billed as. That is exactly what we are telling the government.

Tell Canadians exactly what it is. Let us be honest with Canadians. This is not universal pharmacare. That is where we have problems with this bill.

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

Mr. Speaker, that is not true. That is not the reason why the members of the Conservative Party have difficulty with this bill. The reality is that when it comes to diabetes and contraceptives, millions of Canadians will actually have benefits that many of them would never have had without the passage of this legislation. The member might be sympathetic as an individual member, but let there be no doubt that the Conservative Party of Canada, under the current far-right leadership of the leader today, does not support national pharmacare in any fashion whatsoever.

The member should not be trying to confuse the debate on this issue, to try to imply that it is some bogus reason as to why they are not supporting it. He might support it individually, but the party, the official opposition, does not.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, at every step of the way, we asked for clarification from the minister and his charges for definitions and terms that were contained within this four-page document. The member would like to stand up, wildly move his hands, speak very loudly and conflate the issues. This is not universal pharmacare. The Liberals are billing it as some “be-all and end-all”, which it is not. The member knows better and he needs to be honest with Canadians.

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

Mr. Speaker, I always enjoy speeches from my friend, and I like working with him, but they must be kidding. We see tonight what Conservatives have done in terms of the bill. They had an opportunity to put forward report stage amendments that actually, in their minds at least, would improve the bill; instead, they decided to waste $400,000 of taxpayer money by deleting every single clause of the bill. It is just a complete waste of time at committee. The Conservatives know that many of their amendments were not even in order, and they withdrew a number of them as well. Therefore, I find a bit rich the idea that Conservatives were working in good faith at committee.

I know the member understands his riding. In Quesnel, Williams Lake and Prince George, those folks have been signing up for dental care. Many of them need access to pharmacare. In some cases, the member has constituents who are paying $1,000 a month for diabetes medication, and he is standing in the way of their getting the supports they need. Therefore, will he stand up for his constituents and will he actually say to his Conservative colleagues, “Let us support the bill. Let us get this done so that people with diabetes and people who need contraception can actually have that paid for”?

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, that is a little rich from a member who has supported he most costly government in the history of our country at every step of the way. He approved the $61-billion budget that the government announced just recently. At every step of the way, the member has done the bidding of his Liberal coalition. He has covered up scandal after scandal. The member also knows that I stand up for my riding of Cariboo—Prince George and I stand up for British Columbians each and every day because, God only knows, the British Columbians from the NDP do not.

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

Mr. Speaker, I will come back on that. Of course, the NDP members got dental care for British Columbians. They are getting pharmacare for British Columbians, affordable housing and anti-scab legislation, all of the things that the Conservative caucus had been unable to do.

The reality is that Conservative MPs just have not worked very hard. We are not asking that member, who I know is devoted to public service, and the rest of his colleagues to actually lift a finger to deliver pharmacare for their constituents. All we are asking them is to stop standing in the way, stop forcing these meaningless debates like tonight's, with deleting all clauses of the bill, and let the NDP work on behalf of their constituents, so that all British Columbians and all Canadians—

[The Deputy Speaker, Chris d'Entremont]

I will interrupt the member, just so we have time for the hon. member for Cariboo—Prince George.

[Todd Doherty, Conservative, Cariboo—Prince George, BC]

Mr. Speaker, there were 43 amendments. Only an NDP member would say that they worked hard for two years and came up with a four-page document. We had 43 amendments, and for five and a half hours we had to listen to a filibuster, as we are tonight.

[Angelo Iacono, Liberal, Alfred-Pellan, QC]

Mr. Speaker, I am pleased to rise today to participate in this important debate. The legislation before us contains the four principles of accessibility, affordability, appropriateness and universality.

Today, I will speak to the principle of appropriateness, which relates to the appropriate prescribing and use of medicines. I will outline the importance of achieving a pan-Canadian strategy on the appropriate use of drugs, which is a key feature of this legislation. Notably, the World Health Organization defines “appropriate use” as follows: “patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community.”

Prescription drugs play a critical role in the day-to-day for Canadians. Every year, over 750 million prescriptions are filled by 18 million people in Canada. It is estimated that in any given month, 55% of adults and 23% of children and youth will take at least one prescription medication. Getting the right medication at the right time can be life-changing. Whether it is receiving a prescription for an inhaler to help an asthmatic patient breathe better or anti-hypertensive medication to bring down blood pressure and decrease the risk of heart attack or stroke, medications have the power to restore health and improve a person's quality of life. However, getting the wrong medication at the wrong time can cause significant unintended harms. In fact, adverse drug events are a leading cause of unplanned hospital visits, contributing to over two million emergency department visits and 700,000 hospital admissions in Canada every year.

Examples of appropriate use and action include an informed conversation between a patient and their health care provider on the best treatment to improve their health, opting to stop a medication that was once helpful and is now causing more harm than good, or a public awareness campaign on how to use antibiotics wisely. Unfortunately, a growing body of evidence suggests that inappropriate prescribing and use happen more often than they should. Consider that 21% of adults in Canada between the ages of 40 and 79 are currently taking more than five prescription medications at a time. This is called polypharmacy and it can increase a person's risk of falls by 75%, among other impacts.

Consider the story heard from a clinician about a patient who was taking over 25 different medications, the combined effects of which were taking a serious toll on their health and quality of life. This clinician stressed to us the significant time and effort required to support the patient and caregiver to slowly discontinue the inappropriate medications. A striking takeaway from this conversation was that this case was far from an anomaly in their practice.

Inappropriate prescribing can threaten patient safety and lead to negative health, social and financial impacts. Other significant examples, such as increased antibiotic resistance due to overuse that threatens patient safety, the risks of addiction and overdose from opioid misuse, and many problems and injuries related to the long-term use of sleeping pills, show this issue is widespread.

It is estimated that approximately 1.9 million Canadian seniors regularly use at least one inappropriate medication, which can lead to dizziness, memory problems, hospitalization and even death. The cost of these inappropriate prescriptions is over $419 million per year, and it rises to over $1.4 billion if the costs of hospital visits and the impacts of other harms are included.

Appropriate use was established as a shared priority among federal, provincial and territorial governments. Jurisdictions, health organizations and even local providers have implemented a variety of initiatives and programs to address the issue at hand. There is good work happening across the country, but those doing this important work have called for a unified approach so we can increase its impact and reach.

While there are several pockets of excellence addressing appropriate use, persistent gaps and challenges exist. Inconsistent reach, overlapping efforts and even duplication have limited the scale-up and spread of promising approaches across the health care system, which limits our ability to make these benefits available to people across the country. Without a devoted strategy to better connect our siloed work and improve collaboration, we risk stretching our already limited health system resources, and we will miss an opportunity to serve patients with the highest quality of care.

Other countries around the world have shown us that addressing appropriate use works and makes a difference in the health and safety of their citizens. Countries such as Australia, the U.K. and the Netherlands have developed a coordinated solution that addresses appropriate use at multiple levels and works to ensure that everyone, including patients, prescribers and the public, is motivated to make the necessary changes. In doing so, they have managed to improve prescribing and use behaviours while reducing the harms and health system costs of inappropriate care. Developing and implementing a pan-Canadian strategy that builds on this learning would help expand the impact and reach of successful appropriate use programs to better serve prescribers, patients, and diverse communities across the country.

To date, efforts to improve appropriate use, detect and respond to patient safety issues as they arise have been hampered by the uneven ability of prescribing data. This has significantly limited the supports available to patients and prescribers to make the best decisions regarding their care. Support to enhance the collection of and access to prescribing data will need to underpin any strategy. Addressing appropriate use of prescription drugs also presents a unique opportunity to tackle some of the most topical challenges facing our health system, such as appropriate therapies for mental health; access to safe, long-term care; and optimizing primary care.

The prescribing of antipsychotics in long-term care is a prime example where, at any given time, it is estimated that nearly one in four long-term care residents was receiving an antipsychotic drug while having no clinical reason for its use. These medications put patients at increased risk of falls, fractures and even strokes. Ultimately, healthier patients and fewer adverse drug events puts less stress on our health professionals and health care system.

Patients, health care providers and partners all agree that now is the time to act, and a pan-Canadian appropriate use strategy would bring the vision into reality. This means directing efforts towards implementing widespread programs and initiatives, collaborating closely to make meaningful change, ensuring that health policy promotes positive actions and bolstering evaluation of programs so we can scale and spread those programs that we know would make a difference.

We are already getting started. Last spring, the Canadian drug agency transition office established an appropriate use advisory committee, comprising organizations, prescribers, patients, insurers and health system partners, to provide guidance and advice for the development of a pan-Canadian appropriate use strategy. The committee will soon issue its final report. It is also working closely with key partners, including Choosing Wisely Canada and the Canadian Medication Appropriateness and Deprescribing Network to better coordinate existing efforts to further enhance its impact.

New health challenges continue to emerge, and the need for a coordinated appropriate use strategy to enhance quality of care, improve patient health and promote the judicious and equitable use of health care resources has become even more critical. Members can see that this strategy, guided by the CDA, would be an important element of moving forward with national pharmacare. Addressing appropriate use on a national scale would confront these challenges, knitting together our existing patchwork of programs to provide much-needed support for patients and prescribers while improving safety and outcomes, ultimately reducing the cost of burdens caused by inappropriate care.

We look forward to working closely with patients, prescribers, health partners and jurisdictions in making the program a reality.

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

Mr. Speaker, with respect to all Canadians such as physicians, nurse practitioners and pharmacists who are listening and who are out there prescribing medications this evening, I find it fascinating that the member would be suggesting that their appropriateness is actually inappropriate and that we need the government now to tell physicians what to prescribe.

Think about someone with hypertension, sitting in their family doctor's office if they are fortunate enough not to be one of the seven million people without a family doctor. What is the family doctor going to do? Are they going to call the “1-800-who-cares” phone number provided by the people who cannot even get them a passport, and wait on hold while they say which medication should be prescribed? I find that to be an absolutely terrifying prospect for Canada's incredibly well-trained frontline prescribers in this country who have the independent ability to make those decisions, the best decisions on behalf of the patients, many of whom they have known for an incredibly long time.

Maybe the member could answer this: Would they now be setting up a 1-800 number for doctors to ask which medication should be prescribed? Perhaps, as I mentioned, they could call it “1-800-who-cares”.

[Angelo Iacono, Liberal, Alfred-Pellan, QC]

Mr. Speaker, I would like to start off by first saying hello to my 10-year-old boy, who is watching. I know it is past his bedtime, but his mommy has given him an opportunity to hear daddy speak.

Second, I would like to say that is not what I said in my speech. Maybe the member should consult a hearing doctor. Why am I not surprised by the question from my Conservative colleague? Pharmacare, for example, is about access to contraceptives for women, which is clearly not within the priorities of the opposition party. My colleague opposite and his party have shown every woman in Canada that when it comes to contraception, they are on their own.

Canadians are listening, and by now they know that when it comes to health care, they cannot trust the Conservatives, just like when the member said, making fun of the 1-800 number, “Who cares?”

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, it has been disappointing to listen to the debate and how partisan it has been. I wonder whether the member can remind us of what the bill would do. As this is just the beginning of getting universal pharmacare started, what would the legislation do to ensure that more work is done to improve on it as time goes on?

[Angelo Iacono, Liberal, Alfred-Pellan, QC]

Mr. Speaker, we know very well where the members of the official opposition stands on the bill. Obviously they are against it. They do not care, and it is very easy for them to be critical about it.

I thank my colleague for the tremendous work they did in shaping the bill with the government. We both understand how important it is. For example, contraceptive drugs were chosen as part of the next step in universal pharmacare specifically because contraception improves the equality of all women when they are able to receive proper care for their needs. It reduces the risk of unintended pregnancies and improves reproductive rights. Also, the bill would help all diabetic patients access proper care and be well treated.

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

Mr. Speaker, I think throughout the debate on Bill C-64, whether at second reading stage or at committee, we have seen nothing but fearmongering on the part of the Conservatives, for a simple reason: They do not support the bill. They do not want Canadians to have pharmacare. In fact, they support a private health care system. That is why they have chosen every which way to put up blockades against the bill by inventing stuff. We heard the member opposite, the health critic for the official opposition, throughout the committee process make things up while witnesses kept telling him that was not the case. He is still repeating the same mistruths.

I want to ask the member, who gave an excellent speech, this: How does he feel the legislation, if passed by Parliament, would help his constituents get the medications they so deserve and need?

[Angelo Iacono, Liberal, Alfred-Pellan, QC]

Mr. Speaker, through our bilateral health agreements with the provinces and territories for the Canadian dental care plan and now pharmacare, we are delivering on the promise that every Canadian deserves better health care.

Thanks to this plan, nine million women and gender-diverse Canadians across the country will be able to access the contraception and reproductive autonomy they deserve.

In addition, it will help 3.7 million Canadians living with diabetes get the medication and resources they need. Canadians should never have to choose between their health and their—

[The Deputy Speaker, Chris d'Entremont]

Give a foot; take a mile. I should know better. I wish your son good night. I am sure he was happy to see his dad working tonight.

Resuming debate, the hon. member for Edmonton Manning.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Speaker, I am proud to stand on behalf of the people of Edmonton Manning tonight.

When a bill is brought before committee, I expect that during the study done there committee members would be able to make amendments that would improve the legislation. Sadly, that has not happened with Bill C-64, the pharmacare act, which is probably because the legislation is so flawed that nothing can fix it. The only proper fix is to bury it.

I wish that tonight we were debating the merits of a proposed national pharmacare program. Many Canadians would like to see such a thing, although they might not be so enthusiastic once they saw the price tag. The only resemblance the bill before us has to pharmacare is in the name. If we had asked Canadians what they expected to receive from the NDP-Liberal coalition besides ever-increasing taxes, high inflation, sky-high crime rates and housing shortages, they would probably have said, “Well, at least they have promised pharmacare.”

If we had asked what that meant, they would have said, “free prescription drugs for everyone: drugs to treat heart disease or cancer, life-saving drugs and maybe penicillin to treat any number of less serious illnesses”. Instead, what the government is offering is a pledge to consider funding contraceptives and diabetes drugs. It is not a pharmacare plan; it is an empty promise. It is not what anyone was expecting, but it is no surprise. It is not as if the Liberals really want a national pharmacare program. If they did, they would not have needed the NDP to push them into creating the bill before us.

The Liberals' plan is empty and it is pretty simple. They want to delay as much as possible to convince the NDP that a plan is coming and that therefore the incompetent government must be propped up. I have to give the Liberals credit for their political skill in this matter. They have the NDP so completely fooled that the government faces no chance of defeat no matter the scandals and no matter how much Liberal polices are hurting Canadians. The NDP is blindly accepting a Liberal promise, apparently unwilling to admit that they have been fooled.

I think it is safe to predict that when Canadians go to the polls, whether it is in October 2025 or earlier, the NDP will not be able to point to a functioning pharmacare program, not even the limited one that the bill calls for. However, the promise will have accomplished its purpose: keeping an undeserving government in power. It is the Canadian electorate that will hold both the NDP and the Liberals accountable for their actions. It is the Canadian people who will elect a Conservative government that actually cares about serving them and does not just care about political power.

The bill is being shoved through in haste by a government that is so desperate for approval. The Minister of Health is assuring Canadians that the pharmacare plan should not jeopardize the drug coverage that millions of Canadians have through private insurers. I am sure he is well-intentioned when he makes that statement; he may even believe his words, but good intentions are not reality.

The CEO of the Canadian Life and Health Insurance Association says that the bill could indeed cause disruption for those who have existing drug plans. Either he is right or the minister is right; it cannot be both. Given the Liberal track record, I suspect the minister is indulging in some wishful thinking, which is not surprising from a government that thinks budgets magically balance themselves, something that has not happened under the current Prime Minister.

By using time allocation, the government is rushing the bill through the House without opportunity for proper scrutiny, which is no surprise. Despite having had two years to figure out how they were going to implement their deal with the NDP, the Liberals put together the legislation at the last minute.

It is window dressing, designed not to define pharmacare, but to keep the government in office for a few more months to deny Canadians what they want most, which is an end to Liberal overspending and incompetence.

The proposed bill is a promise, and Canadians know what happens when Liberals make promises. They have made promises in the past nine years. The reality is that, when the Liberals make a promise, things always seem to get worse. They promised affordable housing, and housing costs have doubled under their watch. They promised that the carbon tax would not cost us anything, and we find now that 60% of families are paying more than they collect. The Liberals promised that taxes would go down, and taxes have gone up. They promised safe streets, and then delivered crime, chaos, drugs and disorder. It is no wonder Canadians are afraid things will get worse when the Liberals promise pharmacare.

If the government were serious about helping Canadians, it would have gone about things differently. It would have consulted with the insurance industry, found out what the private insurance sector was offering and what the non-profit sector was providing, examined existing provincial coverage, and discovered if there were gaps that needed to be addressed. Instead, the Liberals decided to rush blindly ahead.

Canadians know the government is not worth the cost. That has been proven time and time again over the past nine years. Is this pharmacare program worth the cost? An honest answer is that nobody knows because the minister cannot tell us how much it will cost. Any numbers he tosses around are more wishful thinking than reality.

Canadians are struggling and looking to the federal government for help. Inflation eats away at their paycheques. Every trip to the grocery store, it seems the prices are going up. Liberals' catch-and-release bail policies are turning violent offenders loose to commit yet more crimes. Despite an ever-increasing carbon tax, the government has no plan to balance its books.

The Liberals apparently have no desire to fix the problems created by their wasteful spending. They believe that water runs downhill but never reaches the bottom. They know they will not be in government when the bill for this mismanagement comes due. Food Banks Canada's 2024 poverty report card shows that almost 50% of Canadians feel financially worse off compared to last year, while 25% of Canadians are experiencing food insecurity.

The cost of living has become so high that food banks have seen a 50% increase in visits since 2021. As a direct consequence of the government's inflationary spending and taxes, millions of Canadians are struggling to keep their heads above water, yet the Liberals ask us to take on faith that they know how to set up and run a pharmacare program without turning it into a disaster.

This is the government that spent more than $50 million on an app that was supposed to cost $80,000, and it cannot tell us how or when that cost overrun happened, or who is responsible. Why should Canadians trust it to run anything?

The good news is that this is not a serious piece of legislation. As I said, the Liberals have no idea what they are doing and no real intention to institute a pharmacare program. Bill C-64 is a public relations exercise with which they hope to fool the NDP and Canadians into thinking they are doing something to help people. Given the Liberals' track record, I doubt many Canadians will be fooled.

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

Mr. Speaker, I respect the member opposite a lot. I listened to his speech quite diligently, and I am a bit perplexed because, on one hand, he spoke about and advocated for private health care insurance. He talked about how Canadians should just get private insurance for medicine if they do not have any, but then he went on to talk about affordability and the high use of food banks.

I hope the member can explain to all of us how he wants to ensure affordable fees against a pharmacare system that is going to save hundreds of dollars for Canadians who do not have private health care insurance so that they can afford to buy good, nutritious food for themselves. I would love to hear that explanation.

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Speaker, with respect to the hon. member, who I do respect a lot, I did not suggest what he just said.

What I was saying is, if there is a gap in the system, the gaps can be filled in many different ways, and we need to solve the problem rather than giving a big promise that we know is not going to be delivered upon. That is the fundamental issue. There is no way I can speak in the House and not mention the difficulties Canadians are going through these days. There are the increased use of food banks, higher mortgage payments, high taxes and all the inflation issues Canadians have to deal with. It is a stop at the perfect time and position to be able to address that and remind ourselves about the disaster the Liberal government and the Liberal-NDP coalition have put Canadians through.

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

Mr. Speaker, Conservatives, in a bizarre way, seem obsessed with the size of the bill. It is just a few pages, they say.

There is another bill that Canadians hold dear, and it is called the Canada Health Act. It is just a few pages, but it puts in place our universal health care that, in poll after poll, 80% of Canadians see as our most cherished institution.

The dental care plan the NDP pushed out, which Conservatives refused to support and in fact tried to block at every turn, has now helped hundreds of seniors in the member's riding.

Now we have pharmacare, which would help about 18,000 people in this riding with diabetes and 25,000 who are looking for contraception. The reality is that the next election will be a health care election. Conservatives are very badly placed because all they have done is obstruct and block rather than offering anything at all.

Why is my colleague blocking legislation that would help 18,000 of his constituents who have diabetes, and who are sometimes paying up to $1,000 a month, and 25,000 people who are looking for support for contraception?

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Speaker, with the thinking mode the NDP member is in this evening, there is no way we can have a reasonable conversation. As well, his suggestion about the 18,000 people in my riding is as if I do not know my riding or the people who live in Edmonton Manning. The member chose to be fooled by the Liberals, but we are not fooled, and Canadians will not be.

[Colin Carrie, Conservative, Oshawa, ON]

Mr. Speaker, I cannot believe how easy it is to fool the NDP. We heard the NDP member stand up to talk about universal pharmacare. We have this bill in front of us, and it is covering two important things, which are contraception and medication for diabetes, but it is being promoted as universal pharmacare.

What does my colleague from Edmonton think Canadians are going to think about this? Again, this is another promise that is not being fulfilled, but the way it is being presented is really deceptive. What does he think Canadians are going to think about that?

[Ziad Aboultaif, Conservative, Edmonton Manning, AB]

Mr. Speaker, unfortunately, the NDP is gathering, as a price for this, a one-week extension of the election so its leader can collect his full pension. That is what they are getting in return, and it does not matter what Canadians get, as long as the NDP leader—

[The Deputy Speaker, Chris d'Entremont]

There is a point of order from the hon. member for New Westminster—Burnaby.

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

Mr. Speaker, the member is absolutely misleading the House. He forgets, of course, the member for Burnaby South was not elected in the last—

[The Deputy Speaker, Chris d'Entremont]

That is not a point of order. We should not be saying that members are intentionally misleading the House.

We are going to move on to the next speaker, the hon. member for St. John's East.

[Joanne Thompson, Liberal, St. John's East, NL]

Mr. Speaker, I am rising in the House today to speak to what our government is doing, and plans to do, to help millions of Canadians who are struggling to pay for their prescription drugs.

Statistics Canada has indicated that one in five Canadians reported not having insurance to cover the cost of prescription medications in the previous 12 months. We have heard, time and time again, that Canadians who do not have drug insurance coverage struggle to afford medications and are left to make extremely difficult decisions to choose between paying for these medications or other basic necessities of life, such as food and housing.

No Canadian should have to make this type of a decision. This is why we introduced Bill C-64, the pharmacare bill, and continue to work with all parliamentarians and colleagues to ensure its speedy adoption.

This bill is needed for so many reasons. It proposes the foundational principles for the first phase of national pharmacare in Canada. These principles of access, affordability and appropriate use and universality have guided, and will continue to guide, our government's efforts in moving towards national, universal pharmacare.

We have seen these principles reflected in the work that is already under way, including launching the national strategy for drugs for rare diseases and improving affordable access to prescription drugs, which is the initiative with Prince Edward Island. I would like to take a moment to highlight the impact that both of these initiatives would have on national pharmacare.

In March last year, the Government of Canada launched the first-ever national strategy for drugs for rare diseases with an investment of up to $1.5 billion over three years. As part of the overall $1.5 billion investment, the federal government will make available up to $1.4 billion over three years to provinces and territories through bilateral agreements.

This funding would help provinces and territories 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 would help ensure patients with rare diseases, including children, would have access to treatments as early as possible for a better quality of life.

With respect to Prince Edward Island, the Government of Canada established an agreement with P.E.I., in August 2021, to improve the affordable access to prescription drugs and inform the advancement of national universal pharmacare. The $35-million investment has allowed for P.E.I. to add new drugs to its provincial formulary and lower out-of-pocket costs for drugs covered under existing public plans for island residents.

As of March of this year, P.E.I. has expanded access to over 100 new medications to treat a variety of conditions, including heart disease, pulmonary artery hypertension, multiple sclerosis, psoriasis and cancer. In addition, effective June 1, 2023, P.E.I. reduced copays to $5 for almost 60% of medications regularly used by island residents. I am pleased to share that, through this initiative, within the first nine months alone, P.E.I. residents have saved over $2.8 million in out-of-pocket costs on more than 300,000 prescriptions.

These two initiatives highlight how the principles of access, affordability, appropriate use and universality are reflected in our government's work, but they also underscore the importance of working with provinces and territories. Provinces and territories are, and will continue to be, a key partner in ensuring that Canadians get the health care they need. Our government will continue to work with provinces and territories to help ensure that this goal is met.

Finally, I would like to highlight another key component of Bill C-64, and that is the Government of Canada's intent to work with provinces and territories to provide universal, single-payer coverage for a number of contraceptives, as well as diabetes medications and supports. Similar to other initiatives that we have put in place, our work to provide contraception and diabetes medications would be guided by the principles I mentioned earlier and will involve working closely with our provincial and territorial partners. The importance of this provision within the bill cannot be overstated.

We have likely heard over the past few weeks, since the introduction of Bill C-64, Canadians sharing their stories of how this bill would help them, how they are currently suffering from diabetes and do not have the insurance coverage, so they have to pay for their insulin, syringes and test strips out of pocket. Similarly, we are hearing stories of young women who do not have the drug coverage needed to pay for contraception or are limited in the choice available to them because more effective contraception is financially out of reach.

We have been receiving, and I certainly have received, numerous letters from Canadians across the country expressing their full support for Bill C-64 and asking the same question of when these drugs would be available to them. There is definitely a need for both of these sets of essential drugs, and I applaud the work of my parliamentary colleagues in getting the bill one step closer to a reality for Canadians.

Bill C-64 would allow for nine million Canadians of reproductive age to have better access to contraception and reproductive autonomy. This will help reduce the risk of unintended pregnancies and improve an individual's ability to plan for the future. As I mentioned, cost is the single most important barrier to access to these medications. Bill C-64 would ensure that Canadians will have access to a comprehensive suite of contraceptive drugs and the devices that they need. Similarly, we know that there is no cure for diabetes, but it can be treated with safe and effective medications.

Due to cost, 25% of Canadians with diabetes have reported not following their treatment plan. Improving access to diabetes medication, as outlined in Bill C-64, will help improve the health of almost four million Canadians living with diabetes and reduce the risk of serious life-changing health complications, which can include amputations or blindness. That is what Bill C-64 would do. It would give Canadians access to medications to maintain their health and give them a choice to determine which medication is best for them. In addition, these efforts will help avoid additional costs to the health care system.

In closing, our government will continue to work toward a national pharmacare plan that focuses on the principles of accessibility, affordability, appropriate use and universality. We will do so in partnership with provinces and territories, and we will do so knowing that Canadians need this immediately to help them access the drugs they need to live a healthy life.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, for constituents at home and Canadians wondering whether any rare disease drugs will be covered by anything, as the member mentioned rare diseases, not a single medication will be covered. In fact, the government's own 2019 budget announcement of $1.5 billion for rare diseases has not covered a single medication for any patient in Canada.

I would ask the member the same question I asked the parliamentary secretary. How many medications has the 2019 budget announcement covered? It has been five years. How many Canadians with a rare disease obtained their medication that was covered by the government's announcement of the $1.5 billion for rare disease patients?

[Joanne Thompson, Liberal, St. John's East, NL]

Mr. Speaker, I guess my colleague did not hear the earlier part of my speech when I spoke about the project in P.E.I., which certainly did take into account a very successful pilot on the impact of government coverage for rare diseases.

It is really important to understand that with dental care and child care, the government has demonstrated time and time again the ability to work with provinces and territories to allow programs to roll out from the federal government into the province and territory that are able to meet the specific needs of that province. In Newfoundland and Labrador, the reality of our health care system, while there are similarities, is different from what we see in Ontario or on the west coast.

We need to be really careful to understand that what we are introducing in this bill is a starting point. It is two significant parts of pharmaceutical needs for Canadians. We know it is very much an upstream process and, in very short order, which we hear all the time from key witnesses, we will see the benefits to our health care system.

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

Mr. Speaker, I have a lot of admiration for the member for St. John's East. I always listen quite attentively when she is speaking because she brings a wealth of knowledge and experience as a registered nurse, and now in her role as the chair of the national seniors caucus.

I know she spends a lot of time talking to seniors. I would like to know what she is hearing from seniors across our country around the Canadian dental care plan, as it has helped over 120,000 seniors in just three weeks. What is she hearing from seniors in terms of pharmacare, like access to diabetes medications at no cost?

[Joanne Thompson, Liberal, St. John's East, NL]

Mr. Speaker, I thank my colleague for his question. It highlights some very important aspects of this bill and why I am so pleased to speak about it this evening. As chair of the national seniors caucus, I meet with seniors across the country from coast to coast to coast, and they talk about the need for pharmacare.

I think what we are missing in many of our conversations today is how difficult it is for many people in the country to manage the cost of daily living, housing and medication. They pick and choose what medications they take based on affordability. It impacts their health outcomes.

It is clearly demonstrated that they enter the health care system in points of crisis. It costs our government and our systems disproportionate amounts of money. Preventative care is essential for us to be able to manage our health care system.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, I wonder if the member can share how much of this bill would go toward supporting care for indigenous peoples. If there is not enough support, how does this bill need to change? We all know that the health conditions for indigenous peoples are some of the worst compared to other Canadians.

What do we need to do to make sure that indigenous peoples are getting the pharmacare that they need too?

[Joanne Thompson, Liberal, St. John's East, NL]

Mr. Speaker, I worked for many years in a community outreach centre where we saw a disproportionate number of indigenous people who were outside of the supports they needed. Health care and pharmaceuticals for chronic disease management were very much part of that.

I think the agreements between the provinces and the territories, which are clearly laid out in this bill, are going to be important to ensure that every Canadian has access to diabetes medications and contraceptives.

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

Mr. Speaker, we are here to debate Bill C-64 at third reading. It will come as no surprise to anyone when I say that the Bloc Québécois will be voting against this bill. I am the last person from the Bloc Québécois who will be rising today to speak to this bill on pharmacare. We will soon be voting on it and we will see whether it passes.

What we have been saying repeatedly in the House is simple. What the Bloc Québécois wants is for the federal government to stop interfering in provincial jurisdictions. We want the money to be transferred to Quebec with no strings attached and we want full financial compensation. We want health transfers. That is what we want, and that is what we will continue to hammer home. I feel like I have to keep repeating myself in the House and that is not right. All the Bloc Québécois wants is to defend Quebeckers' rights and to simply get the money we send to the federal level back so that we can improve the pharmacare program that we already have in Quebec.

When this bill was being studied in committee, the Bloc Québécois proposed an important amendment. It read as follows:

(4) Despite subsections (1) and (2), a province or territory may elect not to participate in national universal pharmacare, in which case that province or territory remains unconditionally entitled to receive payments in order to maintain the accessibility and affordability of the prescription drugs and related products already covered by its public pharmacare.

I do not think this amendment was unreasonable. Its purpose was simply to uphold respect for jurisdictions. The committee chair rejected the amendment on the grounds that it was out of order. The reason will come as a surprise to many. The chair ruled that our amendment was out of order because, in his opinion, it would have required royal recommendation, which we obviously challenged. In committee, however, we can challenge a decision, but unfortunately, we cannot debate it. The committee therefore voted to uphold the chair's ruling.

I was rather shocked that the committee ruled our amendment inadmissible. The purpose of the amendment was simply to ensure that jurisdictions are respected and that Quebec be given the money that has already been budgeted and set out in the bill. Quebec is simply asking that its share be set aside and that the money be transferred to Quebec so that it can improve the system that already exists in Quebec. It is unbelievable that that was rejected. It makes no sense.

I think the opposite is what should require a royal recommendation. Anything that goes against the Canadian Constitution should require a royal recommendation. That is not the case here. Unfortunately, this bill goes against the very foundations of the Canadian Constitution. Let me explain.

It is rather ironic that it still takes a member of the separatist party to remind the House how the Canadian Constitution works, when the government never misses an opportunity to point out that the Constitution is untouchable and that all the issues related to it are not important to Canadians and Quebeckers or that Quebeckers do not care about jurisdictions. However, as surely as I stand in the House today, based on the polls we are seeing, I can say that Quebeckers want jurisdictions to be respected. Whenever Quebeckers are asked who they would prefer to manage services like education or health care, the vast majority of the time, the answer is the same: Quebec.

It is all the more ironic given that the Constitution I am talking about is the one that was imposed in secret by the father of the current Prime Minister, during the night of the long knives in 1982. That was a little refresher. Since then, the Liberal Party's tendency has grown stronger. Increasingly, English-speaking Canada wants Ottawa to be its real government, the one that manages the bulk of public services. Conversely, Quebec has made a different choice. Quebec wants to manage its own jurisdictions, its own health care system, its own education system, its own day cares and so on. That is the choice that Quebeckers are making and that is the clear choice that the Quebec National Assembly made when its members unanimously reiterated that jurisdictions must be respected.

Of course, pharmacare has a noble objective, that of giving every individual, every person who needs medical services or prescription drugs the ability to get those drugs for little or no cost. It is so noble that Quebec has already done it. Quebec already has its own pharmacare program. Taking care of people affected by the difficult economic conditions we are experiencing is very noble. The problem is that these measures are ill-suited to the different realities of Quebec and Canada's provinces.

Even with all the good faith in the world, this was inevitable. Health and housing are not federal matters. The House of Commons has no business getting involved in those areas. That is because Quebeckers believe that their real government is in Quebec City. As long as that is the case, the concept of fiscal imbalance will exist. My colleague from Mirabel is very familiar with the concept of fiscal imbalance. We will not stop talking about it in the House. By fiscal imbalance, I mean the fact that the provinces have insufficient financial resources in relation to their own powers, while the federal government normally has surpluses. It is hard to understand why it has these deficits given all the money it collects. Yes, it has services it is supposed to deliver, but they are not exactly high-quality services.

The responsibilities that fall under federal or provincial jurisdictions must be respected. More simply, as Bernard Landry used to say, “the needs are in the provinces but the means are in Ottawa”. Even if the federal government tries hard to deny its existence, the fiscal imbalance is a major problem that has been recognized for many years. As the population ages, the cost of Quebec's social programs is rising rapidly. The cost of pharmacare is obviously rising rapidly. It is up to the Quebec government, and the Quebec government alone, to determine where the funds for these programs should go and how to improve the pharmacare program that already exists.

Since Quebec is chronically underfunded, we might wonder, as we often do, if a Quebecker is worth less than a Canadian. The Government of Quebec is shouting itself hoarse asking for health transfers. What does the federal government have to say in response? It responds with even more intrusions into Quebec's jurisdiction. That is what we are seeing again today with pharmacare. Unfortunately, the reason Quebeckers prefer to have pharmacare and every area of Quebec's jurisdiction run by Quebec City, is that everything the federal government touches results in failure. Federal equals failure.

I have talked about ArriveCAN several times in the House. I have a question: How much does Tylenol cost when it is 7,500% higher than its cost, like the ArriveCAN app was? It is going to be expensive. That is what is happening with pharmacare. The pharmacare that the federal government is going to create is going to cost us a lot more because the only thing the federal government does is mismanage its programs, run them completely inefficiently, like it did with ArriveCAN.

Quebec's system may be imperfect, but it does not need interference or duplication of costs. It needs more money. That money is in the hands of the federal government. It is a mixed system, a system that works well between a “forgiver” and company contributions and individual payroll contributions. It is not perfect, but it works. It is based on an existing model in France. The federal government is modelling its plan after it. However, instead of simply saying that Quebec has the expertise and skills to run its own pharmacare, the federal government wants to duplicate it and make it less efficient. It is crazy and that is why the Bloc Québécois is against this type of bill and the pharmacare program proposed by the federal government.

I keep hearing my NDP colleagues remind us that the major unions, including the Fédération des travailleurs et travailleuses du Québec, have come out in favour of moving forward with pharmacare. Of course, they had their reasons, as I will explain today. The reason is noble, the objective is noble. Improving medical coverage and offering pharmacare to people with diabetes or people who use contraception is noble, but it is not a federal jurisdiction. It is up to Quebec to decide how to do that. It would cost Quebec less to improve its own pharmacare program than to have it managed by the federal government. A ton of evidence shows that the federal government has no idea how to manage its own programs. Does anyone need to be reminded about passports or ArriveCAN? No, I will not go there. It is too late, and if the truth be told, I am a little too tired for that.

In conclusion, once we recognize, first of all, the fiscal imbalance problem, which will continue for as long as Canada is governed by the current Canadian Constitution, and secondly, the need to take steps to help our fellow citizens, the House will have to ask itself some hard questions. When the federal system was set up, important needs came under federal jurisdiction, like participating in imperialist wars. Today, the real needs are in the provinces.

Let us be honest. Instead of voting on pharmacare tonight, why not vote to reopen the Canadian Constitution and finally put an end to this farce of separate jurisdictions?

Let us ask Quebeckers to vote again, put an end to jurisdictions, and declare Quebec's independence.

[Soraya Martinez Ferrada, Liberal, Minister of Tourism and Minister responsible for the Economic Development Agency of Canada for the Regions of Quebec]

Mr. Speaker, according to the Fédération du Québec pour le planning des naissances, every dollar invested in contraception saves the Quebec government $90 in health care costs.

Not all forms of contraception are available at this time. For example, IUDs are not covered by pharmacare. I would like to ask my esteemed colleague what she thinks about increasing access.

It is not a matter of jurisdiction, but rather it is about saying that we will work with Quebec. We want to ensure that all women in Quebec do not have to choose between paying for contraception and paying for groceries. They do not have to choose.

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

Mr. Speaker, I do not think that any Quebecker is really trying to decide between filling their fridge or paying for an IUD.

It would be good if every contraceptive method was covered. Obviously, we are in favour of contraceptives being covered, but it is up to Quebec alone to decide whether or not they will be covered. The only role the federal government has in this is to send Quebec the money that it collects from Quebeckers and Quebec taxpayers, so that the province of Quebec, the nation of Quebec or the future country of Quebec can run its own pharmacare system.

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

Mr. Speaker, I always like listening to my colleague.

It seems to me that Bloc Québécois MPs should at least listen to Quebeckers. There are at least two million of them united in the largest coalition in Quebec. They are specifically asking that Bill C‑64 be passed by the federal government. They are very critical of the current pharmacare situation in Quebec. They talk about co-payments. They talk about all the problems that exist in Quebec. All the community and union organizations are asking the federal government not to give in to the provinces and territories that are asking for an unconditional right to opt out with full financial compensation. They are saying that because they want Bill C‑64 to pass.

Why is the Bloc Québécois not listening to Quebeckers?

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

Mr. Speaker, I will simply answer with a piece of advice. Why does the member not just go talk to the National Assembly and explain to its members how pharmacare would work for Quebec?

I am sorry, I forgot, they already offered. How did the National Assembly respond? It told the NDP to mind its own business. The health care system is Quebec's responsibility. The NDP has nothing to teach the Quebec health care system about how to operate.

[Dave Epp, Conservative, Chatham-Kent—Leamington, ON]

Mr. Speaker, I want to congratulate my colleague from the Bloc for a very well-prepared and articulated speech, with its constitutional elements. Obviously, this bill is another example of federal intrusion into provincial jurisdiction, and I agree with her on the points in her speech.

Does she find the federal intrusion into provincial jurisdiction a unifying factor in this country? I hear that it is not. Does she find that taking the money would unify our country more? Is she in favour of more unification through the federal granting of funds to the provinces?

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

Mr. Speaker, I thank my hon. colleague for his wonderful and inspiring question. Respect for jurisdictions is important, of course.

Unfortunately, I would still like to remind the House that when we moved a motion to respect jurisdictions, his party voted against it. I find that really unfortunate. We used to have a Conservative Party that respected jurisdictions. However, all we see in the Conservative Party now is a willingness to interfere in Quebec's policies. That is really unfortunate.

[Colin Carrie, Conservative, Oshawa, ON]

Mr. Speaker, I am wondering if the member could comment on the fact that Ontario, where I come from, does have a program. Quebec has a great program. Will the program presented by the federal government cover more or fewer medications for Quebeckers?

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

Mr. Speaker, I really liked the premise of my colleague's question. I noticed that he said that Ontario has a program and that Quebec has a great program. I would like to congratulate him on recognizing the quality of Quebec's program.

If the Ontario program is meant to be the same, then members from Ontario should vote in favour of respecting jurisdictions next time.

[Laurel Collins, NDP, Victoria, BC]

Mr. Speaker, it is a historic day: We are going to be voting on the first steps toward universal pharmacare. The Liberals have been promising pharmacare to Canadians since 1997, and for decades Canadians have been waiting to have access to essential medication.

I want to start off by sharing a story. In 2021, I was out door-knocking in a subsidized housing complex. When I knocked on one of the doors, the first person to come to the door was a little girl. She was holding two mermaid dolls and she was adorable. She might have been three or four years old, and she smiled up at me. Then her siblings came running out, and they called for their mom. When I talked to her mother, she had these bright eyes, and she was listening and staring up at us. Her mom said she had not a chance to think about policies or what needs to happen because she was so stressed about how much the devices for her little girl's diabetes cost and how much the medication costs.

This family had been struggling to afford essential medications, and the costs were so high that this mother was wondering how she was going to care for her little girl. I do not know how anyone could look that little girl in the eye and say that she does not deserve access to life-saving medication. I promised that mom that I would come here to Ottawa and fight for universal pharmacare so that her little girl would have her medication covered. I am so proud to be part of a team that is delivering on that promise.

For that family and their struggle, and for families across Canada that are in the same position, it is not inevitable. They are working hard. They are doing everything right. They are trying their best to provide a good life for their kids. However, with the choices of Liberal and Conservative governments for decades, they have decided to side with the biggest pharmaceutical companies instead of everyday Canadians, instead of that little girl.

Liberals have promised this for decades, but it is only now that New Democrats are in a position of power and are able to force the government to deliver on pharmacare. While the Conservatives try to do whatever they possibly can to stop people from getting access to life-saving medication, we are going to keep fighting to deliver on the promise to that mom, to that family and to families across Canada who deserve pharmacare.

I once shared a bit of that story and then asked the Leader of the Opposition how he could look that little girl in the eye and say that she does not deserve access to diabetes medication, that she does not deserve access to life-saving devices. His answer was to spew misinformation. He said that pharmacare will “roll back the rights that unions have fought so hard and so long to secure. Our labour movement fought too hard to secure private drug plans, and we will never let a big, centralizing, bureaucratic government in Ottawa take those rights away from workers.”

However, the major unions in Canada are calling for universal single-payer pharmacare: the United Steelworkers, CUPE, the Canadian Federation of Nurses Unions and Unifor. I could go on. Many of these unions have specific campaigns advocating for single-payer universal pharmacare. Unions across Canada came out celebrating the fact that the NDP was able to force the government to first provide contraception and diabetes medications and diabetes devices, but also to lay the legislative framework for universal pharmacare.

This is a huge step, and I think about some of those huge steps. Tommy Douglas had a vision of universal health care. It was New Democrats who fought alongside Tommy Douglas to get our country to a place where if a person broke their leg, they were not going to be turned away because they could not afford to fix it. I think about young kids, and we know that dental surgery is the most common surgery at pediatric hospitals. If people have essential dental costs or if they have tooth pain, then for the first time in our country's history, there would be people accessing dental care who could not afford it. We would have people like that family I talked about accessing diabetes medication and not worrying about whether they could afford it. They would not have to choose between putting food on the table or paying the rent and could access life-saving medication. This is a historic, huge step forward for our country. I am so proud to be part of the team that is making this happen.

I want to also take a moment to talk about providing contraception across Canada and what that means for women and for gender-diverse people. It is huge. I want to give a special shout-out to Devon Black and Teale Phelps Bondaroff, who are the co-founders of AccessBC, and who fought, pushed and advocated, and were successful in bringing this issue to the attention of the provincial government. I am proud that the B.C. NDP has already paved the way, offering British Columbians access to free contraception. We know that countries around the world have been doing this for decades, and finally, the federal government acknowledges that contraception is health care.

It is not surprising that the Conservatives are fighting tooth and nail to stop women from having control over their reproductive health. We know that their MPs have brought forward legislation that is trying to bring back the debate around a woman's right to choose or a woman's control over her own body. A Conservative MP went out and spoke at the rally that was calling to end abortion access in Canada. I would hope that we were past a point in Canada when a major political party is accepting of its members of Parliament calling to end abortion access. Abortion is health care. Contraception is health care.

Now, in Canada, we could start expanding our universal coverage to essential medication and to dental care. I would like to see it also expanded to mental health care. We could have a system in Canada that, if a person is sick and they need health care, they could access it.

I want to end by calling on all MPs in the House to take a moment and to think about the historic steps that we are taking. This would make a tangible difference in the lives of Canadians from coast to coast to coast. I think about that family, that little girl and what this would mean to her. I am so proud to be voting in favour of pharmacare tonight. I am grateful to be able to work alongside 24 other New Democrat MPs who have fought tooth and nail to get this piece of legislation to this point. We are going to take it over the finish line to ensure that every Canadian would be able to access the medication they need.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Mr. Speaker, I appreciate the passionate speech by the member from the NDP. I agree that this is really a milestone. There are medications for rare diseases, which are very expensive. There are medications for cancer treatment, which are very effective but cost hundreds of thousands of dollars a year. How would this national pharmacare program help to ensure that these medications are affordable to our society? I would give a hint: It is probably because it actually looks like a national pharmacare system would end up saving health care dollars rather than costing.

[Laurel Collins, NDP, Victoria, BC]

Mr. Speaker, the member stole my thunder a little.

We are talking about a universal, single-payer pharmacare program. The reason it is so effective, the reason experts and labour unions have been calling for this, and the reason civil society has been calling for it is that it would save Canadians money, and it would give access to essential drugs. It would also mean that when we buy as a single payer, we would get to negotiate prices as a single payer. It would mean that we would have so much more negotiating power.

That is why pharmaceutical companies are so opposed to it. They do not want to lower our drug costs and make less money. By ensuring that we have a single-payer system, it means those kinds of drugs are going to be more accessible to Canadians. It means that Canadians would be paying less, and it would save money over time.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, I listened to the hon. member's comments around the young lady and the child who did not have diabetes coverage. That is actually the reason I got into politics and fought with the Saskatchewan Party in 2011 to increase coverage for diabetes, and then again in 2016 to yet again increase the coverage for everyone in Saskatchewan who has diabetes.

Could the hon. member please tell me this: Does she know what age complete coverage for diabetes goes up to in Saskatchewan? Will the member's plan, this fake health pharmacare plan, cover it as well as it is covered in Saskatchewan? Just give the age number, please.

[Laurel Collins, NDP, Victoria, BC]

Mr. Speaker, I am a member of Parliament from British Columbia, so I am not familiar with the Saskatchewan program.

However, it is written into the legislation that the federal government is going to work with provinces. Provinces are going to get on board because this is funding, transferring money, to ensure that people have access. We also know there are different age cut-offs in different provinces, and that is not acceptable. We do not want to have someone in one province be able to access medication and another person in another province not be able to access it. We want to be able to deliver health care. Everyone should have access to the medication they need with their health card, not their credit card.

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

Mr. Speaker, just like the hon. member, I also ran on pharmacare, both when I was a provincial member in Ontario and federally.

I am really excited to see that our government party is working closely with the NDP to make this a reality for millions of Canadians. During this process, especially through the committee, we heard a lot of fearmongering from the Conservatives, especially when it comes to private health care, that somehow this pharmacare would take away primary health care. That was not the case in the Ontario experience.

Could the member for Victoria respond to the fearmongering that the Conservatives have been raising about the state of people's private health care when we pass pharmacare through this legislation?

[Laurel Collins, NDP, Victoria, BC]

Mr. Speaker, Canadians know that they cannot trust the Conservatives when it comes to health care.

The Conservative team is full of corporate insiders and lobbyists, including their deputy leader, who is a former lobbyist for big pharma. In fact, the Conservatives' national governing body is made up of 50% lobbyists. It is not a surprise that the Conservatives are fighting tooth and nail to keep money in the pockets of big pharma at the expense of Canadians who are paying out of pocket for essential medication.

The House resumed consideration of Bill C-64, An Act respecting pharmacare, as reported (with amendments) from the committee, and of the motions in Group No. 1.

Pharmacare Act

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, after the NDP House leader, let us get this back on track and talk about the pharmacare bill, Bill C-64. I am pretty happy to take to my feet. I did have the opportunity to sit in committee for five hours a couple days ago and listen to some of the witnesses and some of the comments and concerns around the pharmacare bill, Bill C-64. I want to put some of my concerns on the record. I see the former health minister and I am looking forward to hearing him talk about it, if he is going to get to his feet.

A year ago, I asked the former health minister how many provincial health ministers at an FPT meeting had asked to bring forward a pharmacare bill. Was it on the top of their priority list? At that time, the minister did not have an answer for me. In committee, a couple of days ago, I had the opportunity to ask the current health minister that exact same question. I do believe that health is a provincial jurisdiction.

My question was whether they were able to name any health ministers who proactively came to the federal government to ask for this bill to be brought forward or whether there were other requests.

I know, in Saskatchewan, that we have a shortage of nurses. We have a shortage of doctors. There are a lot of issues, and I think many provinces do have concerns around doctor and nurse shortages. I think we are short 30,000 doctors right now in Canada. That is a pretty big deal. I think around seven million Canadians do not have access to a family physician.

I think that is something that health ministers probably brought forward at the FPT meetings. I believe that is something that we do need to look at: how we can support our provincial partners and have that conversation.

Once again, the current health minister did not answer my question about whether this was a priority at FPT meetings. Tonight, I was able to ask that question again to the member from Winnipeg North. I asked if he could name a health minister who brought this pharmacare bill forward as a priority for the provinces. I have never seen him play hockey but he was pretty good at skating around that question. He went full circle, but he never really came to the crux of my question as to whether a health minister had asked for this.

This is not partisan rhetoric. This is a legitimate question around public policy and the priorities of provincial governments. I heard from my colleague from Victoria. She talked about a child who needed diabetes care. I listened to her speech and when I asked her if she could tell me the age of full coverage in Saskatchewan, she could not. That is a very real concern of mine, the fact that they are bringing forward this legislation and that people voting for this bill do not know what the different coverages are out there in different provinces.

That is a legitimate problem. We should know where the coverages are across the provinces. In my home province of Saskatchewan, I have been texting with our health minister, I asked him if this was one of the things he brought forward and he said no, that they just came to them and said they were going to do this, take it or leave it. Then they asked for details. The minister said that they never gave them any details because they did not have any yet. It is surprising for a provincial health minister to not have any details on a pharmacare bill. A pamphlet, in my opinion, is not a bill, as it is four pages long. It covers diabetes and contraceptives, but there is little detail given to our provincial partners and that is a legitimate concern that we have to discuss.

They rammed this through. They bring in time allocation and then they just expect everything to be okay. We all know that this is just what the NDP asked for to keep the government in power for a little bit more time. This is part of the supply and confidence deal. They continue to tell falsehoods to Canadians. It is not coverage; two things are being covered.

For NDP members to bring up Tommy Douglas in the House is laughable. He would be embarrassed by the NDP and the situation it is in right now. He would probably be a Conservative right now. He would be completely embarrassed by what the NDP, the rump of the NDP, has become: a bunch of activists. I think it is very funny whenever they bring forward the name of Tommy Douglas, because he probably rolls over in his grave when that happens.

Being from Saskatchewan, I also had a time to be in government, with the Saskatchewan Party and former premier Wall, which takes me to another point. The NDP-Liberal government continues to bring in bills and then it says it is going to do consultation. I think that is a little bit backward. I remember being in Saskatchewan, and I was a member of the all-party traffic safety committee. We travelled around Saskatchewan for a couple weeks, in all corners, and took feedback from all of the stakeholders.

We consulted. We gathered feedback. Then we made legislation. Is that not a novel idea? Talk to people, ask what is going on, ask what works and what does not work, and then put forward legislation, instead of bringing forward legislation and then asking if it can work. Sometimes, I just find that some of the things the government does are quite backwards. The same thing happened with nuclear consultations. We started nuclear consultations in Saskatchewan in the first term of 2007 and continued to talk to people and consult before we even got to the point of even the discussion of small nuclear reactors. That was how long we actually consulted with the people of Saskatchewan. Can members imagine having that approach here in this House, to continue to talk to people, instead of ramming things through based on political ideology and what people think they need to stay in power?

Getting back to my point about diabetes, I have a cousin who plays for Regina Thunder. He was diagnosed with type 1 diabetes when he was two. That is why I am such a champion of diabetes care. His mother and father had to wake him up at night and prick his finger when he was a baby and when he was two or three years old. Then he would get insulin pills. Now he has tracking on his arm. He has a pump that is covered by the province of Saskatchewan. That is progress. That is how to listen to people and get things done. I think that is what we should take forward.

The NDP have talked about compassion. Where is their compassion for the 27 million Canadians who have insurance, but who are scared right now that they are going to have less coverage? I know 1.1 million Canadians are under-insured. We can take care of them.

Just imagine if one of the health ministers of the NDP-Liberal government went to a provincial-territorial meeting and asked how to get people insured under their provincial programs. What is the need out there? The Liberal government of the day wants to take credit for everything. There did not have to be a national program. Imagine if it had worked with its provincial partners and then supplemented their programs. Maybe the provinces would have needed extra money. I guarantee that it would not have cost $1 billion or $2 billion. This program is going to cost $2 billion.

There are several public policy reasons why this bill should not go forward in the form it is in. We should continue to work with our provincial partners. I would love for one of these ministers of health to answer how many provincial health ministers asked for this program to come forward. The same could be said for the dental plan.

Today is a pretty special day in my life. On May 30, 1944, my father, Ron Steinley, was born. I am not able to be home with him, but I want to wish him a very happy 80th birthday. He is in Swift Current, Saskatchewan. I am going to try and rip out there, maybe this week or next week, so we can take him out for supper. Happy birthday to my dad and all the best.

[The Speaker, Greg Fergus]

Not only do I thank the hon. member for Regina—Lewvan for his intervention, but I would like to congratulate him for two things, one, to wish his father a very happy birthday and, second, how his father's birthday has united this House. Great job to Mr. Steinley, Sr. I hope you have an opportunity to see him soon.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, I have to start by saying remembering our humanity in this place is really important. I, too, wish a very happy birthday to the member's father. I think it is a beautiful thing to have these opportunities. We are away from them far too long.

Through you, Mr. Speaker, I just want to remind everybody in this House that, in fact, Tommy Douglas was very clear. His first step was going to be medicare, and the second step of his vision was pharmacare. I stand here as a proud New Democrat, feeling that I am carrying a legacy forward in a profound way. I will always be proud of that.

I do not know if the member knows this, but, in my province, the B.C. NDP are making sure that all contraceptives will be covered, knowing that is an important right. When this program is in place, it will actually free up resources so that the province can reallocate funds to a different place. I just hope the member understands that and is looking forward to what his province will receive based on this allocation.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, I thank the member very much for wishing my father a happy birthday.

The New Democrats talk about Tommy Douglas a lot. I actually had the time in the Saskatchewan legislature to read his master's thesis, which was on eugenics. Is that the third step, then? If they are going to talk about Tommy Douglas, they should talk about all the things he thought health care needed. They never talk about that, which is interesting.

I believe the provinces really do need to work together with the federal government. The fact it is trying to ram this down the provinces' throat is actually quite funny. I can text the health minister right now, who will say that, because he has no idea what is in this plan, he does not know how the province is going to be prepared for it or how much it is going to spend because it has no idea what it actually entails.

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

Mr. Speaker, my question is rather simple. If the member believes in respecting jurisdictions and can talk about the pharmacare that exists in several provinces of Canada, then why did his party vote against the Bloc Québécois' proposed amendment to the budget? That amendment sought to require the government to respect jurisdictions in its budget, including Quebec's jurisdictions. Why did his party vote against that amendment?

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, we are talking about Bill C-64. I think the provincial government has jurisdiction over health care and the federal government should butt out.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Mr. Speaker, I would like to congratulate his father on behalf of the Liberal Party. We will share a beer in his honour tonight.

The member at least implied in his speech that he took part in ensuring that young diabetics in Saskatchewan have the cost of their medication paid for. Maybe he could speak a little more about that.

I would also say, is that not what we are trying to do with our bill here? Would it not be a good thing if the health minister did this in Saskatchewan? If he did, great.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, in Saskatchewan, in 2011, the Saskatchewan Party made a commitment to campaign on providing coverage for diabetics up to the age 18. Then, in 2016, we campaigned to move that to age 25. That is exactly what we did: We provided coverage for diabetics until the age of 25. The theory behind that was, after the age of 25, a lot of people had their own coverage when they were gainfully employed and had private insurance. There are still other programs to cover people who are less insured.

The problem I have with this is that we do not know what the coverage is going to be. Not all diabetics take the same medicine either, so we do not know which medicines would be covered in this program, as it is not going to be all of them, which goes to my point that consultations should be done before bringing in legislation so we know what works and what does not.

[Colin Carrie, Conservative, Oshawa, ON]

Mr. Speaker, my colleague mentioned two important points that are missing here. One is that it was a top-down approach and there was a lack of consultation. The other is how many provincial ministers actually asked about it.

One of the things the member touched on that I thought was really important is that many people in his province have very good coverage already. My question for the member is this: If it becomes a top-down approach, why does he fear the federal government would make it worse for the people who are doing good on their medication?

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, the Liberals always talk about providing coverage for the 1.1 million people, which is important, but they would take away some of the better coverage that 27 million people have. That is fake compassion and the lie of the left.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Mr. Speaker, I am pleased to rise to speak to this issue and this bill, finally.

As others have already pointed out, Canada is the only country with a universal health care system that does not provide some sort of universal drug coverage. Under the British, Australian, New Zealand, French and Belgian systems, basically to some degree or another, people's medications are paid for by the government and they do not have to pay for them. Having said that, admittedly, in some countries there is copay.

This is an important bill. It is the first step in creating a national pharmacare system, and this I truly support. However, I did not always feel this way. As somebody who has long practised in the health care system, I was a bit worried, because with the health care system as it presently is, we are struggling to pay for it. It occurred to me that what the government ought to be doing in health care is making sure that this sucker stays on the road. Certainly, I had a bit of trepidation with the idea that we were going to add another cost like pharmacare. However, having thought about it and having sat through committee meetings where we talked to experts, I have changed my mind because I think that a national pharmacare system would save the health care system money, not increase costs.

The current system, as we have it, which is a patchwork of private and public plans, is really inefficient. Multiple studies and recommendations since the 1960s have all basically said that. In fact, one study from the Canadian Medical Association Journal in 2017 concluded that we in Canada pay 50% more for our drugs than people do in 10 other wealthy countries that have national pharmacare programs. In addition, the inefficiency of our pharmaceutical system is demonstrated by the fact that we in Canada pay the second most for drugs of any people in the world. The Americans pay more, but other than that, we pay more for drugs than anyone else.

The inefficiency of our system comes from the fact that we provide pharmacare in Canada like the United States does. We, like the United States, have a patchwork system of private and public providers, and the private providers are often set up through employers. At times, these are non-profits, but for the most part they are for-profit companies. Similarly, there are public systems and public plans, and there are multiple public plans. For example, in Ontario, there is the Ontario drug benefit plan for those over 65, there is a Trillium plan for higher-cost medications and there is OHIP+.

Basically, we pay for our medications in Canada like Americans pay for all parts of their health care system, but our system for paying for medications, like the U.S. health care system, is really inefficient. Americans pay twice as much for health care as Canadians do. On average, Americans pay $12,000 per person for health care, and in Canada we pay $6,000 for health care per person, and they have worse outcomes than we do. For example, they have a lower life expectancy than we do in Canada.

I studied health law and policy both in Boston and at Georgetown University in Washington, D.C., and learned a bit about the health care system. I was certainly impressed by the inefficiency of the American health care system. They have private hospitals, private health care providers and private insurance companies, and each of these organizations has administrators who basically spend half of their time scheming on how they can decrease costs and increase profits. They have to pay for these administrators. Similarly, they have to pay the CEOs and the higher-up executives, who all bring in the big bucks, for working in those positions. On top of that, and most of all, a lot of money goes to the shareholders of corporations, which are legally obliged to financially benefit shareholders. All this money comes out of the health care system, money that ought to be going toward trying to improve the health care of Americans.

Similarly, in Canada, we currently have 1,100 private and public plans according to a Lancet 2024 study, although according to the Hoskins report, we have 100,000 private plans. If instead of having all these plans, we just had one plan, then surely there would be tremendous savings coming from economies of scale. We would not need 1,100 organizations with 1,100 sets of administrators administering their own plans. We would not need hundreds of CEOs siphoning money that would otherwise go to health care, and there would be no profits going to shareholders rather than going to health care.

There would be all sorts of savings from economies of scale and increased bargaining power. For example, if someone went to a provider or manufacturer of drugs and bought 10 million pills rather than 10,000 pills, I am sure they would get those pills at a cheaper cost, so there are savings there. Also, shipping costs are lower when buying in bulk, and there are fewer inspections needed.

When we add up all these savings, how much do they add up to? Well, according to the 2019 Hoskins report, with national pharmacare by 2027, which is when it would come into effect, total spending on prescription drugs would be $5 billion lower than it would be without national pharmacare. That is money we could use in the health care system for other things. That means more money to afford expensive cancer therapies, more money to address the long waiting times for either surgeries or diagnostic tests and more money to do research and try to find new cures for things like cancer, ALS, etc.

However, it is not just about saving money in the system. It is also about helping Canadians who struggle to meet the high costs of medications. According to the Hoskins report, between 5% and 20% of Canadians are either uninsured or under-insured, which amounts to two million to eight million people. Furthermore, one in five households reported that a family member in the past year had not taken a prescribed medicine due to its high costs, another three million Canadians said they were not able to afford one or more of their prescription drugs in the past year and almost one million Canadians borrowed money in order to pay for prescription drugs.

For all these reasons, I support this legislation and moving to the next step toward a national pharmacare system. I also welcome that we will be able to provide diabetic medications and contraception to people as one of the next steps in getting to a national pharmacare system.

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

Mr. Speaker, my colleague from Thunder Bay—Rainy River is always thoughtful here and mindful of the shortfalls of things the government puts forward. There are a couple of things, though, to think about. At the health committee, we had two of Canada's experts, Drs. Morgan and Gagnon, and as the member well knows, they had no input into but much criticism about this bill. It related to the fact that it would not create a national, universal, single-payer, first-dollar pharmacare system. I heard them say that and I know the member across heard them say that as well.

The other criticism we heard clearly is that the newly formed Canadian drug agency will have absolutely no oversight, especially from the point of view of an Auditor General's audit, with respect to its activities. We know on behalf of Canadians that at the current time, the time from application to approval for a drug in Canada is one of the longest among the OECD countries.

I would appreciate my hon. colleague's comments with respect to those two things.

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Mr. Speaker, this is a step toward universal health care. Yes, it does not bring us to that point yet, but it is a step.

With respect to the committee that is going to be involved in this, I thought the member was going to ask me about the fact that those two people were not consulted in the process. That is too bad. However, I agree with the member that how we do this is really important. If we have an efficient system and an efficient bureaucracy, this can save Canadians money. If we create a gigantic bureaucracy that costs a whole ton of money, more than the private system, then it will not end up benefiting Canadians. It is really crucial who we put on that committee and the steps we take in subsequent days, weeks and years.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Mr. Speaker, I have worked with the member very closely on a number of files, and I know him to be a very honourable member of this place.

He referenced the Hoskins report many times, and of course this is the report that was commissioned by the government to look at this. It found that $5 billion of savings would be available if we were to put in a national pharmacare program. Like the member, I recognize that this is not a full pharmacare program. This is a framework on which we could build a pharmacare program.

Could the member comment on the medications or drugs that he thinks should be next in the pharmacare program now that we have dedicated this particular step to diabetes medication and devices and to contraceptives?

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Mr. Speaker, the member's question is very pertinent. I have some background in this. Once upon a time, years ago, I worked in a tiny country in the South Pacific, Vanuatu, on its essential drug list, which was its first essential drug list. The WHO is trying to do this with a lot of countries.

Similarly in Canada, this act calls for the creation of an essential drug list. On that essential drug list, we would have the input of physicians and other specialists from across Canada to determine what the priority drugs are that a government finance system ought to supply its citizenry.

That is an important question, and it is one of the next steps. I, like her, realize that this does not bring us to a national pharmacare system, but it is an important step on the way to that.

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

Mr. Speaker, I appreciate being recognized again.

It is a great honour for me to work with the hon. member for Thunder Bay—Rainy River on the HESA committee. Given his medical and legal background, I find him quite beneficial to me for my understanding of a lot of health care issues.

One of the things we heard a lot about at committee is the impact of this framework legislation on private health insurance. There was a lot of fearmongering on the Conservatives' part that somehow it would disappear.

Could the hon. member for Thunder Bay—Rainy River comment and give us his views on what impact this bill would have on private health insurance?

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

Mr. Speaker, I welcome the very perceptive question by the member from Ottawa.

This is a very important point. We heard from a lot of people, and there was a lot of concern about having a basic system. What if we needed more expensive medications for certain things? Would we be getting rid of private drug plans? That is not necessarily the case. There will be a public plan, but I think there would still be the option, if people wanted, to pay additional money for a private plan that would cover all the things that are not currently insured, as there is for other kinds of health care at the moment.

[The Speaker, Greg Fergus]

Before I go to the member for Nunavut, who will be joining us virtually, I want to let members know that I have tried to provide members with about 40 seconds to ask and answer questions so that we can do the full rotation. It is really important that we all try to keep to that so that everybody can participate. I am also providing some flexibility, because questions are interesting and I want to hear as complete an answer as possible, as I am certain a person who asks a question would like that.

The hon. member for Nunavut.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, before I begin my speech, I will take this opportunity to congratulate Sharon DeSousa, who just became the first racialized national president at the Public Service Alliance of Canada. I first met her when the Iqaluit Housing Authority Inuit workers had their 136 days of striking to advance the rights of workers, not just for Iqalummiut, but also abroad. I am excited about Sharon's election.

I will get to my speech. As the member of Parliament for Nunavut, Bill C-64, an act respecting pharmacare, put me in a bit of a personal dilemma. I wondered if I should support a bill that would do too little for the majority of my constituents. Through my speech this evening, I will share how I came to support the importance of this bill.

As an Inuk from Nunavut, I continue to see the impacts of what happens when the federal government purposefully underinvests in indigenous peoples. The lack of investing in housing means that people live in overcrowded housing conditions. Many live in mouldy homes. These conditions create poorer health outcomes and deep-rooted social issues, such as increased violence, substance abuse and the continuation of intergenerational trauma being passed on to our children and our grandchildren.

Having lived through these hurdles, I am always analyzing bills and debates with sensitivity to how all too common my experience is for indigenous peoples in Canada. I know all too well what it means to suffer. I hope that when Canadians hear me, they do their part to act on reconciliation with indigenous peoples.

When I became the member of Parliament for Nunavut, I learned to act on solidarity. Before I was an MP, it was just a word. I wholeheartedly thank my colleague and friend, the member of Parliament for Hamilton Centre. This is what I am doing in supporting this bill. I am compelled to act knowing that this bill, when it is passed, will help so many Canadians. It will help women and gender-diverse people access contraceptives. It will help many Canadians pay for diabetes medication.

On another note, I must express my view regarding the Bloc's position on this bill. Its main concern seems to be that of jurisdiction and telling the government to stay out of its jurisdiction. I do hope its members reconsider their position because, regardless of jurisdiction, this bill can help more Canadians. This bill sets a foundation to create a universal single-payer system across Canada.

This reminds me of Jordan's principle. I take this opportunity to honour the family of Jordan River Anderson, after whom this program is importantly named. Jordan died a preventable death. He died while different jurisdictions were fighting over not having jurisdiction to cover his expenses and care. Because of Jordan's principle, care for first nations and Inuit has improved.

While the Liberal government's responses take too long and it allows funding to lapse, Jordan's principle has made significant impacts for Inuit and first nations. Bill C-64 is an opportunity to model Jordan's principle so women and gender-diverse people have immediate access to contraceptives and people with diabetes can stop stressing about their finances knowing they can rely on this program for diabetes medication.

I must share my criticism of the bill. I am dismayed to see that, once again, when it comes to indigenous peoples, we are forced to wait. While I appreciate that Bill C-64 would require the Minister of Health to initiate discussions based on essential medicines lists with provinces, territories and indigenous peoples, this work must start immediately.

While first nations and Inuit have the non-insured health benefits program to have services such as dental care, eye care and mental health services paid for, much of the investments in Nunavut go toward medical travel because of the lack of health care in Nunavut. Children are flown thousands of kilometres to access basic care and dental care. This program funds millions of dollars to the airline industry. Ensuring pharmacare improves on the NIHB program will be very important in making sure that Nunavummiut, northerners and indigenous peoples see better care closer to home.

The pharmacare bill must avoid the pitfalls that we have seen in NIHB. I remember, for example, my colleague and friend, the MP for Algoma—Manitoulin—Kapuskasing, bringing to me a witness when the indigenous and northern affairs committee studied the non-insured health benefits program. She brought forward a pharmacist, Rudy Malak, who struggled to get paid for providing eligible people the drugs covered under the non-insured health benefits program. The proposed act must ensure that pharmacists would be paid immediately without worrying about closing their doors because the federal government may take too long to pay its bills.

I conclude by reminding everyone that, when it comes to helping Canadians, we must do so with a foundation of removing barriers for people. As much as I am conflicted about the bill, I must practise what the MP for Hamilton Centre taught me about acting in solidarity, knowing that the passage of the bill will help so many Canadians.

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

Mr. Speaker, I appreciate the member's general attitude in recognizing the importance of the legislation to the degree in which it would assist millions of Canadians in all regions of the country. I am wondering if she could expand on why it is so important that Liberals, New Democrats, Bloc members and Conservatives should be behind this bill to help so many of our constituents.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, as I said earlier, having empathy is really important, but acting on that empathy is even more important. When I hear about so many Canadians possibly having amputations because they cannot afford diabetes medication, I feel we all have to do our part to make sure that we act when we can, and it is our duty as parliamentarians to make sure that all Canadians get the drugs and the care that they need, so we can keep making sure that Canada is a better place to live in.

[Rachel Blaney, NDP, North Island—Powell River, BC]

Mr. Speaker, when we are in this place, we have to wrestle with really hard pieces of legislation that benefit some but not all, and I am afraid that in this place, historically, up until today, indigenous people are left out of so much decision-making, and their needs are extensively not met, again and again.

I am just wondering if the member could talk about what she sees as being needed right now to start including indigenous people in a more meaningful way so that we can start to repair the harm that has been done, specifically in this place.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, that is such an important question. One of the answers is what indigenous peoples have been saying all along, and we hear it in some responses, such as co-development, but we have to really make sure that when it comes to laws, program development policies and decisions regarding lands and the health and education of indigenous peoples, we have to be at the table helping to make those decisions, not just because of a legal duty to consult, but demanding it because of reconciliation. We have to make sure that we have more indigenous people become parliamentarians, and we have to make sure that there is more participation that does not prevent us from helping to make decisions on these matters.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Mr. Speaker, my hon. colleague talked about Jordan's principle, and I would really love for her to expand on the importance of that within her own community and on the dangers that we see with the government stepping back from the commitment to ensure that the needs of first nations, Inuit and Métis are placed in priority over money and squabbling between jurisdictions.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, Jordan's principle is such an important story to always remember because the implementation of it allows payments to be made up front and for the jurisdictions to discuss who ends up paying for it in the end. We have an opportunity with the pharmacare act for women and gender-diverse people to get their contraceptives immediately, without having to worry about whether it is going to be the provinces or the federal government who pays for it, as well as for people to get their diabetes medication.

I know this kind of system can work because we see it in Jordan's principle, especially when we have discovered, through that program, the atrocities indigenous children are forced to experience and that treatment will happen immediately. We need that same kind of foundation through this pharmacare program.

[Julie Dzerowicz, Liberal, Davenport, ON]

Mr. Speaker, it is a real pleasure for me to stand once again today to speak to this very important bill. Bill C-64 is an act respecting pharmacare.

The bill contains three key sections. One, it would establish a framework toward a national universal pharmacare in Canada for certain prescription drugs and related products. Two, it provides that the Canadian drug agency work toward the development of a national formulary to develop a national bulk-purchasing strategy and support the publication of a pan-Canadian strategy regarding the appropriate use of prescription medications. The third section is that, within 30 days of hopefully this bill receiving royal assent, the minister would establish a committee of experts to make recommendations regarding the operation and financing of national, universal, single-payer pharmacare.

The bill, along with other investments made by our government, would help millions of Canadians who are struggling to pay for their prescription drugs. Since this bill was introduced, we have heard many facts about access and affordability of prescription drugs within Canada. We know that Statistics Canada data from 2021 has indicated that one in five Canadians reported not having enough insurance to cover the cost of prescription medication in the previous 12 months.

We know that having no prescription insurance coverage was associated with higher out-of-pocket spending and higher non-adherence to prescriptions because of cost. We know that this results in some Canadians having to choose between paying for these medications or for other basic necessities, like food and housing. This is why we have consistently made commitments toward national pharmacare and have focused efforts on the key areas of accessibility, affordability and appropriate use of medications.

Let me start with the pharmacare act, which references the foundational principles of access, affordability, appropriate use and universality. We have heard a lot about these four principles this evening, but it is important to continue this conversation. Bill C-64 recognizes the critical importance of working with 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 legislation is an important step forward to improve health equity, affordability and outcomes, and has the potential of long-term savings to the health care system. In our most recent budget, budget 2024, we announced $1.5 billion over seven years to support the launch of national pharmacare and coverage for contraception and diabetes medications. I would like to highlight the potential impact the two drug classes for which we are seeking to provide coverage under this legislation would have on Canadians.

We have heard of stories or know of someone in our constituency who is struggling to access diabetes medications or supplies due to lack of insurance coverage through their work, or of an individual who has limited insurance coverage so they cannot choose the form of contraception that is better suited for her.

For example, let us talk about a part-time, uninsured worker who has type 1 diabetes and is also of reproductive age. For this individual to manage her diabetes, it would cost her up to $18,000 every year, leaving her potentially unable to afford the $500 upfront cost of her preferred method of contraception, a hormonal IUD. With the introduction of this legislation, this individual would save money on costs associated with managing her diabetes and would be able to access a hormonal IUD at no cost, with no out-of-pocket expenses, once the legislation is implemented in her province.

Studies have demonstrated that publicly funded, no-cost universal contraception can result in public cost savings. Evidence from the University of British Columbia estimated that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. Since April 1, 2023, B.C. is the only province in Canada to provide universal free contraceptives to all residents under the B.C. pharmacare program. In the first eight months of this program, more than 188,000 people received free contraceptives. That is wonderful.

With respect to diabetes, it is a complex disease that can be treated with safe and effective medications. One in four Canadians with diabetes has reported not following their treatment plan due to costs. Improving access to diabetes medications would help improve the health of some of the 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, we also know that, if left untreated or poorly managed, diabetes can lead to high and unnecessary costs on 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, as estimated by Diabetes Canada.

The bill demonstrates the Government of Canada's commitment to consulting widely on the way forward and working with provinces, territories, indigenous peoples, and other partners and stakeholders to improve the accessibility, affordability and appropriate use of pharmaceutical products by reducing financial barriers and contributing to physical and mental health and well-being.

Beyond our recent work under Bill C-64, I would like to highlight one or two initiatives, depending on my time, that the government has also put in place to support our efforts towards national pharmacare.

On a national level, our government has 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 $1.5-billion investment, our government will make available up to $1.4 billion over three years to willing provinces and territories through bilateral agreements. This funding would help provinces and territories 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.

I would also like to highlight another initiative under way, which involves the excellent work by P.E.I. through a $35-million federal investment. Under this initiative, P.E.I. is working to improve the affordable access of prescription drugs, while at the same time informing the advancement of national universal pharmacare.

The work accomplished by P.E.I. has been remarkable. Since December of 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, psoriasis and cancer. In addition, effective June 1, 2023, P.E.I. reduced copays to $5 for almost 60% of medications regularly used by island residents. I am pleased to share that through this initiative, P.E.I. residents have saved over $2.8 million in out-of-pocket expenses as of March of this year.

Finally, on December 18, 2023, the Government of Canada announced the creation of Canada's drug agency, with an investment of $89.5 million over five years, beginning this year. Built from the existing Canadian Agency for Drugs and Technologies in Health, and in partnership with provinces and territories, the CDA will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future, helping Canadians achieve better health outcomes. I am pleased to share that as of May 1, CADTH has been officially launched as Canada's drug agency.

In closing, we can see the extraordinary amount of work that has been and will continue to be dedicated to our commitments related to national pharmacare that focuses on accessibility, affordability and appropriate use of medications.

Bill C-64 represents the next phase of helping Canadians receive the medications they need, and we look forward to working with all parliamentarians to ensure its successful passing.

[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 were 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 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 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.

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

Mr. Speaker, I will talk about someone who is insured. Sheila wrote to me and said that with two type 1s in the family, with one suffering from multiple complications from 50 years with the disease, their out-of-pocket medical expenses are about $18,000 a year, and that is with extended medical. Otherwise, it would be about $30,000. That is one paycheque just to keep everyone alive and well. Maybe my colleague can say a few words to Sheila on why he is blocking getting her the help she deserves and needs.

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

Mr. Speaker, I applaud the member for Courtenay—Alberni, with whom I have worked on health care many times over the last nine years, for his passion and care for his constituents and for his desire to do the best that he believes he can to help. I do believe he is doing what he can to help. Ultimately, though, this piece of legislation is about diabetes coverage. It is not about rare diseases. It is about diabetes coverage, and that diabetes coverage would actually be less than what is available in other programs.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Mr. Speaker, we have lived through the NDPs in Saskatchewan. When they were in power the last time, they closed 52 hospitals, closed 1,000 care beds and fired 1,000 nurses. They were an unmitigated disaster, and that is why they will never govern in Saskatchewan again.

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

Mr. Speaker, my colleague from Regina—Lewvan is so right. In Saskatchewan, we saw the total destruction of the system under the NDP government. Today, we see the building of beds to be provided for drug addicts and meth addicts. They are being provided by the provincial government because it is the provincial government's responsibility to provide that coverage.

[Patrick Weiler, Liberal, West Vancouver—Sunshine Coast—Sea to Sky Country, BC]

Mr. Speaker, I am very pleased to rise in the House to speak to Bill C‑64.

It is a great pleasure to join the debate today about the pharmacare legislation that is going to bring in the first steps of pharmacare in Canada, as well as to be the last person to give a speech before we actually vote on this important piece of legislation.

Quality health care, including access to prescription drugs, is vital to protecting and promoting the health and well-being of Canadians. Prescription medicines allow millions of Canadians to prevent and fight disease, manage chronic illness, ease pain and breathe better; in other words, they allow Canadians to live healthier and more productive lives. I must say, there are few issues that I hear more about than health care as a priority for my constituents.

With rising costs, some Canadians are facing difficult choices between paying for their prescriptions and covering essentials, such as food and heat. Nobody should be put in that circumstance. We need to ensure that prescription drugs are more accessible and affordable for Canadians, including those facing the greatest financial barriers to accessing medications. That is why our government has introduced the pharmacare act. The bill proposes foundational principles for national universal pharmacare and describes the government's intent to work with provinces and territories to provide Canadians with universal, single-payer, first-dollar coverage for a range of contraceptive and diabetes products.

When medicare was introduced in Canada in the 1960s, prescription drugs played a relatively limited role in health care. Most drugs outside of a hospital were inexpensive medicines for common conditions. However, in the intervening decades, the development of drugs has surged as pharmaceutical companies have pushed the science further in search of new treatments and cures. Prescription medicines are now an essential part of health care. As a share of overall health care costs, spending on prescribed drugs has risen from six per cent in 1975 to nearly 14% in 2022. This makes prescription drugs the second-largest area of health care spending in Canada, after hospital services.

Today, the landscape of prescription drugs available in Canada is robust and complex, with pharmaceutical companies launching dozens of new products every year. To support effective management, in government-run, public drug plans in Canada, as well as some privately run plans, a formulary is developed, which is a list of drugs and related products that are eligible for coverage under the drug plan. To develop the formularies, public plans consider both how well a drug works and whether these products offer good value for money relative to other treatment options. While there are over a hundred public plans in Canada, there is generally good alignment with regard to the list of drugs that are eligible for coverage across provinces and territories.

Many Canadians are only eligible for public drug coverage with high deductibles or premiums that provide little relief for more routine drug expenses, such as for prescribed contraception and diabetes medications. A national formulary would outline the scope of prescription drugs and related products that all Canadians should have affordable access to under national universal pharmacare.

In 2019, the advisory council on the implementation of national pharmacare, chaired by Dr. Eric Hoskins, recommended a national formulary service, one of the standards for national universal pharmacare. He proposed pharmacare coverage to be phased in, starting with a short list of essential medicines. In budget 2019, the government announced funding for a number of foundational steps towards national pharmacare, including the development of a national formulary. Back in 2022, the government announced continued progress towards this by introducing a pharmacare act and tasking the drug agency to develop a national formulary of essential medicines and a bulk purchasing plan. Preliminary work has already been completed, and a framework and process for developing a future national formulary was recommended.

The panel released its final report in 2022, including giving guiding principles for the formulary and a process for bringing it into place, as well as a sample list of commonly prescribed drugs and related products for three therapeutic areas with a high volume of drug use in Canada. These are cardiovascular disease, diabetes and mental illness. This list has been expanded by looking at equity-seeking groups to make sure that we are closing the gaps in access between different communities in Canada.

Actually, this foundational work is already having real-world impacts. In 2021, our government announced that it would work with the Province of Prince Edward Island on the improving affordable access to prescription drugs initiative. Under this initiative, P.E.I. is receiving funding to add new drugs to its list of publicly covered drugs and to lower the out-of-pocket costs for island residents.

I just want to say that, with the legislation, P.E.I. residents have already saved $2 million in out-of-pocket costs on more than 230,000 prescriptions, and the savings continue. Our government remains firmly committed to taking the next steps in pharmacare, and the legislation today is going to help us do that by providing coverage for contraception and diabetes medicine. This is part of our overall approach to support the provinces to improve health care in Canada, including with a new deal we signed with all the provinces last year to provide better care, as well as making it easier to get access to such things as a medical practitioner in rural areas, including where I live, by providing student loan forgiveness for people to operate there.

[The Speaker, Greg Fergus]

It being 11:26 p.m., pursuant to order made on Wednesday, May 22, it is my duty to interrupt the proceedings and put forthwith every question necessary to dispose of the report stage of the bill now before the House.

The question is on Motion No. 1. A vote on this motion also applies to Motions Nos. 2 to 6 and 8 to 12.

If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

[Rick Perkins, Conservative, South Shore—St. Margarets, NS]

Mr. Speaker, I would request a recorded division, please.

[The Speaker, Greg Fergus]

Call in the members.

(The House divided on Motion No. 1, which was negatived on the following division:)

Vote #791

[The Speaker, Greg Fergus]

I declare Motion No. 1 defeated. I therefore declare Motions Nos. 2 to 6 and 8 to 12 defeated.

[Dan Vandal, Liberal, Saint Boniface—Saint Vital, MB]

moved that Bill C-64, An Act respecting pharmacare, as amended, be concurred in at report stage.

[The Speaker, Greg Fergus]

The question is on the motion.

If a member participating in person wishes that the motion be carried or carried on division, or if a member of a recognized party participating in person wishes to request a recorded division, I would invite them to rise and indicate it to the Chair.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, we request a recorded vote, please.

(The House divided on the motion, which was agreed to on the following division:)

Vote #792

[The Speaker, Greg Fergus]

I declare the motion carried.