Evidence of meeting #117 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was coverage.
A video is available from Parliament.
Public Health Agency of Canada Chair, Family Planning Research, Action Canada for Sexual Health and Rights
I provided evidence. I wasn't part of their internal process to develop the bill.
Conservative
Anna Roberts Conservative King—Vaughan, ON
Okay. We have experts here who were eliminated from that. I'm a little confused about it.
Dr. Morgan, with this patchwork system that you mentioned earlier, how is it that this pharmacare plan will benefit Canadians?
Professor, School of Population and Public Health, University of British Columbia, As an Individual
One of the things is that if we move to a system that is truly national, universal and single-payer, Canadians will have increased access to medicines from coast to coast. We can use national procurement contracts to get better prices for medicines. We can use those same contracts to make sure manufacturers guarantee the supply of medicines when Canadians need them and when we know shortages are all too common internationally.
It's true that if the federal government were to fund these first stages of contraception and diabetes treatments and leverage the purchasing power nationally to get the average price we find in comparative countries, that system might actually cost more than the PBO has estimated, but it would deliver savings to the provinces and territories on the order of about $1.3 billion per year—
Professor, School of Population and Public Health, University of British Columbia, As an Individual
—and it would deliver savings to the private sector of $1.7 billion per year and net savings to the country of $700 million.
Conservative
Anna Roberts Conservative King—Vaughan, ON
I'm sorry to cut you off, but I do have limited time.
My concern is that Bill C-64, in its current state, does not give specific enough information to ensure that this plan will benefit Canadians. Unless I misunderstood you, that's what I took from your statement.
Professor, School of Population and Public Health, University of British Columbia, As an Individual
This plan will provide some new coverage, but it will cost significantly more than it should and will continue to impose inequitable financial burdens on individual households and employers.
Conservative
Anna Roberts Conservative King—Vaughan, ON
Would you agree that individuals with private health care and private plans are better off than they would be with the current plan the government is offering?
Professor, School of Population and Public Health, University of British Columbia, As an Individual
They're not better. There's no change. That's what the minister basically said yesterday in testimony. They'll just have the same coverage through their private insurance under this new plan.
What we want to see is a change where they can actually see their medicines being procured nationally through a public program that takes the financial burden off their households and their employers.
Professor, School of Population and Public Health, University of British Columbia, As an Individual
That's not what this bill will achieve.
Liberal
The Chair Liberal Sean Casey
Thank you, Dr. Morgan.
Thank you, Mrs. Roberts.
The last round of questions for our examination of Bill C-64 will come from Mr. Jowhari for the next five minutes.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
Thank you, Mr. Chair.
I thank all the witnesses for joining us today.
We're well into Friday afternoon. I know that it's past four o'clock, and most of the amendments have probably already been written down and passed on, but I want to emphasize the fact that this bill will go through clause-by-clause on Monday. It will be sent back to the House. We will have the opportunity to debate it, and then it will go to the Senate. That will present more opportunities for us to highlight areas where we could strengthen it.
I'm going to focus most of my questions on Dr. Morgan. I noticed that you were patiently waiting and that a number of times, you wanted to intervene. You were not given the opportunity, so I'm going to dedicate all my five minutes to you.
You were very complimentary about the Hoskins report. You also said that if certain elements are considered in the design, then this bill, Bill C-64, would be a good starting base for us to introduce pharmacare.
If I get up next week in the House and debate those areas on third reading, using Hoskins as a base and saying, “Hey, look, this is the reality of Bill C-64; this is the base in Hoskins, and these are the three areas I want to focus on to make sure this bill is strong”, what would those three areas be?
You have all the time you want before the chair stops you.
Professor, School of Population and Public Health, University of British Columbia, As an Individual
Yes, I'll be quick.
There are minor amendments to clauses 4 and 6 of Bill C-64 that would probably suffice to make sure that even though this is just like baby steps, the pilot project for implementing Hoskins' recommendations, if you make a couple of key amendments, you can genuinely say that this legislation is actually going to do what Hoskins said.
For instance, clause 4 of Bill C-64 reads, “The Minister is to consider the following principles”. I think the Conservative members of this committee pointed out that this is unusual language. It should say, “The Minister shall apply the following principles”. That's important language.
In proposed paragraph 4(d), it reads, “provide universal coverage of pharmaceutical”, but the Hoskins council was very clear that it should be universal single-payer, first-dollar public coverage. There's language there that could be improved and clarified.
As was discussed yesterday at this committee, this bill should define what is meant by “single-payer”, “first-dollar” and “public coverage”. Those are terms that are very clearly defined in the Canada Health Act, which would be the analogous act to Bill C-64 in terms of establishing principles that all provinces and territories should aspire to in delivering these things. There are a few changes there.
Similarly, in clause 6, where it talks about the kind of coverage that should be implemented, it should be very clear what we're talking about. As the Hoskins council recommended and as many other commissions have recommended, the program should be universal, single-payer, first-dollar and public. That word needs to be there.
Liberal
Majid Jowhari Liberal Richmond Hill, ON
Thank you.
I want to go back to another topic, and I want your input. As it relates to, let's say, diabetes, and as it relates to the different types of diabetes medications, the minister has said that this is basically our floor. We will negotiate with different jurisdictions, provinces, territories, indigenous groups and others. We'll look at their needs, and then we'll expand that.
What are your thoughts on that?
Professor, School of Population and Public Health, University of British Columbia, As an Individual
If I were to design a program like this, I would start with the most compelling evidence-based basket of medicines that should be provided.
You've heard witnesses testify that some of those compelling medicines, including GLP-1 drugs, such as Ozempic, are outside of the current proposed basket, so you might go back and think carefully about what would be included.
I want to be clear that if you do this as a truly universal plan, as a truly single-payer plan, buying medicines on behalf of 40 million Canadians, you would have such purchasing power that you could include a comprehensive basket of treatments for contraception and diabetes and save considerable funding while doing so. It can be done in a very prudent way, and it should be evidence-based but also sufficiently well funded so that it does meet the needs Canadians have.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Jowhari.
Thank you to all of our witnesses. This was an absolutely fascinating panel and a really good one for us to finish on.
We are coming up to the time that has been designated by the House for adjournment. Before we adjourn, separate and apart from thanking the panel, we've been very well supported by the clerks, the analysts, the technology people, the IT folks and the interpreters throughout this process. On behalf of the committee, I express my gratitude to them.
Is it the will of the committee to adjourn the meeting?