Health Committee on May 23rd, 2024

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

Minister, I don't think that was my question, sir.

[Mark Holland, Liberal, Ajax, ON]

I would ask you this: What is your plan, sir, if not this plan? There are 1.1 million uninsured Canadians.

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

Excuse me, sir, I believe it's my question to—

[Mark Holland, Liberal, Ajax, ON]

Could you tell us what your plan is to insure those folks and make sure that people who don't have medication have medication? What is your plan, sir?

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

Do you know what, Minister? You'll have your chance to ask me questions at some point when you're sitting in the opposition.

Can you tell all Canadians the number of days from global first launch to public reimbursement in Canada?

[Mark Holland, Liberal, Ajax, ON]

Again, it depends on the medication and the jurisdiction.

I would put it back to you. If you are going to vote against something, my proposition would be that you have to explain what you're going to do in its place. If you have all of these folks who have no insurance or medication, it's a pretty simple question to ask back: What are you going to do in its place? If you say you have no answer, I would ask you why you are voting against this.

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

No, I didn't say I didn't have an answer. You're the person who has given me.... I have asked you two questions now on simple numbers, questions to which you do not know the answer, nor do your officials.

Here's a third question, a simple number. Let's try another one. It's on the percentage of new medications available by OECD country.

There were 460 new medicines launched from 2012 to the end of 2021. How many are approved in Canada? What is the percentage? Just give the percentage.

[Mark Holland, Liberal, Ajax, ON]

I will be straight with you: What is your purpose? What are you trying to ask?

I understand you're trying to play a “gotcha” game here, instead of.... I'm trying to talk about people who don't have medicine, and you seem to be lost in some kind of weird partisan thing you're doing.

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

Oh, no, no. Let's—

[Mark Holland, Liberal, Ajax, ON]

Do you have a plan for people to get medicine, or do you not? Is this an attempt to obfuscate the point that you don't have a plan?

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

If you want to talk about the wacko things you're trying to do, we can talk about those. What I'm asking are simple questions on behalf of Canadians.

[Mark Holland, Liberal, Ajax, ON]

I'm curious. What's your point? Do you have a point?

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

I have lots of points.

Let's start with the first point: You have no idea what you're talking about.

The second point is this: Canadians wait the longest time in OECD countries for approval of medications, which you clearly have no clue about. We're back to that again, sadly. The last time you were here, you had no clue and you remain clueless, obviously.

The percentage of new medications available in Canada is 44% of 460 medications. What that means is this: Despite the fact that you want to go out and announce things that are untrue and not even happening, the system you have—the regulatory system that you, sir, have control over—is failing Canadians. You had an opportunity to change that. You have chosen not to. You have chosen to attempt to keep yourself in power with your costly NDP coalition partners by creating something that already exists at provincial levels—

[The Chair, Liberal, Sean Casey]

That's your time. If you want an answer—

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

Thank you very much, Chair. I think we have already provided the answer.

[The Chair, Liberal, Sean Casey]

Hopefully, somebody else will allot you some of their time to respond. I think that would be the fair thing to do.

Mr. Naqvi, go ahead for six minutes, please.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Thank you, Chair.

Welcome, Minister.

I think the behaviour we just saw from Mr. Ellis is shameful. We're really trying to have a thoughtful conversation about a very important piece of legislation that is going to make an incredible impact on the lives of Canadians. You don't have to agree with everything. The idea behind a committee meeting is to have an analytical discussion as to how we can improve a piece of legislation, not get into the political, rhetorical diatribes that we saw.

I'm personally very excited to see this piece of legislation. I spent time working at the provincial level in the parliament in Ontario, where we brought in pharmacare legislation, a program called OHIP+. I was very disappointed when I saw the Conservative government of Doug Ford gut that legislation, denying so many Ontarians access to important life-saving medication, so I'm thrilled that at the federal level we are coming in with the national pharmacare plan.

I'm interested, Minister, in learning about the details. I know that this is a thoughtful piece of legislation. Can you share with us, if this legislation passes, the next steps in terms of engaging the provinces, the territories and indigenous peoples in rolling out this particular program? Also, I'm interested in the work that you are doing pursuant to this legislation, if passed, to ensure that all Canadians get access to diabetes medication and contraceptives.

[Mark Holland, Liberal, Ajax, ON]

I think, in the first order—and this is why I was pushing back—that we have a very serious problem, and that problem is that a huge number of Canadians don't have drug coverage.

If we're discussing how we address that problem, I'm totally open to different ideas. I think this process is indicative of that. We had two different parties with two different ideas try to come together and find common ground. If other parties have other ideas, then I think it's important to talk about them.

Frankly, if they have no idea and they just think people should continue to be uninsured, then yes, I'm going to point that out. I think that's important to highlight, and I don't think it is appropriate to try to obfuscate behind some kind of weird strategy.

What I will say in terms of the next steps, because this is critically important, is that we've already started those steps. There have been very productive conversations with every province and every territory. They have really set aside partisanship to ask, in each province and each jurisdiction, how we can work with that jurisdiction of authority to augment and make better what they have.

We have provinces that are leaders, so let's acknowledge Quebec, B.C., Nova Scotia, and Manitoba particularly, which are really taking leadership in this area. We want to see that go even further to be able to work with leaders and to be able to expand our circle of action.

What's exciting about that is that it's an example of governments of all political stripes recognizing that diabetes and contraceptives are not something that we should be crossing swords over or trying to score political points on, that it's really how we get the medicine to people who need it and how we talk about solutions. It could be quite frustrating when I'm talking to provinces about solutions to be curtailed from that.

Then I would add an additional measure. Obviously, to really finalize those conversations, we need the House to adopt this so that we can finish those conversations, but then I would turn to the non-insured health benefit. You were asking, very importantly, about indigenous peoples, and I think that this is an important opportunity, in conjunction with what we're doing with the non-insured health benefit, to consider its efficacy and make sure that everybody has access to the medicine that they need. That's an iterative process, and it has to be taken a step at a time.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

In terms of next steps, you are working toward what you foresee as bilateral agreements, and I'm assuming that they would provide for the delivery and payment of those medications.

For example, if I'm a Canadian who's uninsured and I don't have access to these medications, can I walk up to my local pharmacy and use my provincial health card to get access to, let's say, diabetes medication, if I need it?

[Mark Holland, Liberal, Ajax, ON]

I think that's a fair characterization. We have to work it out for each province, but the idea is that you would have choice.

Somebody who has existing coverage can continue to use that coverage. For somebody who doesn't have coverage or is under-insured, this would give them a path towards coverage.

There are a lot of folks who are under-insured. Somebody may only have 70% coverage for their medicine, as an example, and can't afford the 30% copayment. That means they're not getting the medicine they need, which means they don't adhere to a regime of taking that medication, which means they wind up with a chronic disease, which means they end up in our hospital system, which costs us an enormous amount of money.

It's more than social justice. It's critical that those people have access to a choice. That is what this measure is going to do. It's going to open up a choice about whether you want to use your existing insurance or go with the single-payer universal system.

[Yasir Naqvi, Liberal, Ottawa Centre, ON]

Talk to me a bit about choice. It's important, because there are a few out there who are trying to relay the point that somehow this is going to get rid of the private insurance someone may have and that this will be the only option to get their diabetes medication or their contraceptives.

Can you assure Canadians about what that choice looks like and how, if they choose to maintain their private insurance, they can do so?

[Mark Holland, Liberal, Ajax, ON]

Yes, that's 100% right.

It's incredibly important that we don't allow misinformation to fill this space. This is about adding folks, expanding coverage and making sure that folks who are under-insured or who need access to insurance can get it and get the medication they need. It can be delivered through a single-payer model.

[The Chair, Liberal, Sean Casey]

Thank you, Minister.

Mr. Blanchette‑Joncas now has the floor, for six minutes.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Thank you very much, Mr. Chair.

I'd like to welcome the minister, who has joined us today.

Minister, the Bloc Québécois is in favour of the principle of helping sick people and the most vulnerable among us to obtain health care and benefit from a pharmacare program. Of course, you know the Bloc Québécois' position and that of the Quebec government, which are similar.

Minister, here is my first question: Have you had a discussion with the Quebec Minister of Health, Christian Dubé? If so, what did he tell you, in concrete terms?

[Mark Holland, Liberal, Ajax, ON]

You're absolutely right, it is essential that we work in co‑operation with the Government of Quebec. It has accomplished a great deal in the area of access to medicines for all Quebeckers. Our intention is to work directly with the Government of Quebec to increase what the provincial system provides. We don't intend to create another system; the idea is really to increase what the current system offers.