Debates of Oct. 5th, 2017

Opposition Motion—Pharmacare

[Anne Minh-Thu Quach, NDP, Salaberry—Suroît, QC]

Mr. Speaker, I cannot believe that the Conservative member thinks that the 20% of Canadians who do not have access to medications because they cannot pay for them represent a small percentage.

One in five people cannot meet their own health needs. That is serious and the result of the federal government's inability to establish a universal pharmacare program. It is the parliamentary budget officer, not I, who said that it will result in savings of $4 billion.

Another statistic is that, over the past 12 years, Canadian spending on prescription drugs has surpassed that of all other comparable countries, including the United States. The cost of medications has increased by 184%. A Conservative government was in power over the past 12 years. The Liberals are now in power, but so were the Conservatives. Why was nothing done?

The Conservatives often speak of the economy, which is of the utmost importance to them. We know we would be saving a minimum of $4 billion a year. Some say that the savings could range from $4 billion to $11 billion. If Conservatives consider themselves good money managers, why did they not find a solution that would keep the prescription drug costs down, to the benefit of all Canadians? It seems to me that Canadians' health should be paramount.

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Mr. Speaker, I appreciate the comments by my colleague on this issue, and each and every one of us in the house knows how important it is. Quite often we hear about our seniors, those who suffer with various disabilities, and especially those dealing with cancer care, who struggle to keep up with some of the high costs.

All of us are very committed to finding solutions. The government has certainly made some significant progress with the pan-Canadian group and, together with the provinces, is moving forward on answers. There is no simple way to do this. It takes a lot of negotiations with a lot of the provinces. The official opposition was not able to do it. However, on this side of the House, we certainly have made significant progress since coming into office. I wonder if the member would appreciate that and have a little more patience.

I applaud the members for raising the profile of this issue, because the only way change is going to happen is when it continues to get raised. That said, is the hon. member is having significant difficulties with this issue in her own riding with her community members? Would she like to comment on that?

[Anne Minh-Thu Quach, NDP, Salaberry—Suroît, QC]

Mr. Speaker, since taking office, the Liberals have met with the first ministers four times in two years. I commend them for that, and I encourage them to keep it up. What we are asking is that they continue to negotiate with the provinces. I think that would be good for everyone.

Right now, one in five people cannot afford to pay for their own medication. That has to be weighing on our conscience. We should be able to ensure that all Canadians can buy the medication they need.

The Canada Health Act should require the implementation of a health care system that is fair for everyone. It would save us at least $4 billion. Making sure that everyone is in good health and that everyone is treated fairly are Canadian values. The Liberals are saying that they need more time. However, the motion gives them until October 1, 2018. They still have a year. It is time to take action. Young people and seniors are unable to pay for their medication.

Right now, the government is taking indigenous youth to court over a health care matter. That is unacceptable. That needs to stop, and the government needs to start walking the talk. The time is now.

[Ginette Petitpas Taylor, Liberal, Minister of Health]

Mr. Speaker, I rise today to debate the opposition motion calling on the government to commence negotiations with the provinces to implement a national pharmacare program.

Our government is committed to protecting and promoting the health and safety of all Canadians. We are also committed to improving the affordability, accessibility, and appropriate use of prescription drugs within our country.

As the member is likely aware, the Standing Committee on Health, better known as HESA, is studying the development of a national pharmacare program as an insured service under the Canada Health Act. As part of the study, the committee asked the parliamentary budget officer to prepare an estimate of the cost of a universal federal pharmacare program. The results of the study were published on September 28 of this year. Based on it, the member has called on the government to begin negotiations with the provinces and territories no later than October 1, 2018, in order to implement a universal pharmacare program.

Mr. Speaker, our government is well aware that we need to improve access to necessary prescription drugs and make them more affordable for all Canadians.

We need to make the current prescription drug system more effective and flexible before we begin discussions on the national medicare program. Our government is taking bold action to improve the system in order to reduce the cost of prescription drugs and better manage their use. I would also like to remind members of our government's approach to strengthening the way our health care system deals with prescription drugs.

Prescription medicines contribute directly to the health of Canadians. We all know that. They can help prevent, control, and cure diseases. Health care professionals and providers in hospitals and community settings turn to prescription drugs to help them manage patients' symptoms, improve their well-being, and also to save lives.

New research and discoveries continue to expand the range of conditions and the number of people who could benefit from drug treatment in our country. As such, the use of prescription drugs in evolving. The statistics are very compelling. Health Canada approves about 200 new drugs for the Canadian market every year.

We are seeing a correlation between the aging population, and the increase in chronic conditions and prescription drug use. Nearly 40% of Canadians take at least one prescription drug on a regular basis. That percentage increases to 80% for Canadians 65 and older.

Nearly one in three seniors take at least five different drugs every day. Though that may be of some benefit in some cases, in others we have reason to be concerned about the number of prescription drugs that seniors are taking. At the same time, we are seeing more expensive niche buster drugs designed to treat illnesses that affect smaller populations coming from all over the world. In fact, the number of drugs that cost more than $10,000 per patient, per year, has doubled over the past five years. The number of drugs that cost more than $50,000 per patient, per year, has increased by 50%.

While some of these drugs offer real breakthroughs in patient care, others do little to improve health outcomes. Therefore, stronger management of our use of pharmaceuticals is essential, and the cost demonstrates this. Every year across the system pharmaceuticals account for an ever greater share of health spending in the country. In 2014, drug spending reached $29 billion. That represented about 16% of our health spending. When we add up drug spending for 2016, we expect that amount to grow to about $36 billion a year. That is a significant number.

Clearly, pharmaceuticals play an increasingly important part in Canada's health care system. Unfortunately, even as public and private payers wrestle with the growing costs, Canadians are not getting all of the benefits that this level of investment should provide to them. A key reason for this is that Canadian prices for both patented and generic drugs are high by international standards.

Our patented drug prices are exceeded only by the U.S. and Germany, and we are well above the average for the 35 countries of the OECD. According to the most recent data available, in 2015, OECD generic drug prices were, on average, 28% lower than those in Canada.

There are some other factors that feed the challenges we face in managing the use of pharmaceuticals within this country. For example, Canada's drug review and approval system, which includes federal regulatory review for quality, safety, and efficiencies to determine if a drug should be authorized for sale in Canada, followed by a review of cost-effectiveness by the Canadian Agency for Drugs and Technologies in Health, is cumbersome and needs to be revised.

This system lacks the flexibility to meet patients' needs in a timely manner. These concerns need to be addressed before we can start to consider any expansion to the pharmacare program. That is why our government is tackling these challenges by taking action to improve the affordability, accessibility and appropriate use of prescription drugs for Canadians.

The last federal budget, which was tabled in 2017, supported these actions with an investment of $140 million over 5 years, followed by $18.2 million per year on an ongoing basis. This funding supports the work of Health Canada, the Patented Medicine Prices Review Board, and the Canadian Agency for Drugs and Technologies in Health. In collaboration with pan-Canadian health organizations and our provincial and territorial counterparts, we will work to lower the cost of prescription drugs, provide faster access to new drugs that Canadians need, and improve patient care through more appropriate prescribing practices.

To better protect Canadian consumers and public and private drug plans from excessive patented drug prices, our government is modernizing the way prices are regulated. For the first time in more than 20 years, the Minister of Health will update the patented medicine regulations, which, together with relevant provisions of the Patent Act, provide the PMPRB with the tools and information it needs to monitor and regulate prices in today's pharmaceutical environment.

At the end of June, Health Canada held its first round of public consultations on potential changes. Stakeholders and all interested Canadians will have another opportunity to comment once the regulatory changes are published in Part I of the Canada Gazette later this year. The Government of Canada is also working closely with the provinces and territories to reduce the country's drug costs.

In addition, the Government of Canada is working closely with the provinces and territories to reduce drug costs. As a member of the pan-Canadian Pharmaceutical Alliance, established by the provinces in 2010, we are combining the collective purchasing power of all public drug plans in Canada to make prescription drug prices more affordable and to lower generic prices for all payers.

This initiative has been extraordinarily successful. As of March 2017, the work of the alliance has resulted in annual savings of almost $1.3 billion.

Our government also recognizes the importance of supporting breakthrough innovation and giving Canadians quicker access to the new medications they need while continuing to ensure the quality and effectiveness of those drugs. That is why Health Canada launched a new five-year initiative to make the minister a more modern, flexible, and responsive regulator. Under this initiative, the government will harmonize federal medical review procedures with those of its health care partners, such as CADTH. Jointly implementing these programs will speed up decisions about adding new drugs to the list of insured drugs, which means that useful new treatments will be available to Canadians sooner.

In addition, Health Canada will expand its priority review policy and establish new regulatory pathways to expedite the consideration of new drugs that have the potential to meet the pressing needs of patients in the health care system.

The initiative will also see the expanded use of real-world evidence about new drugs after they enter the market. This will ensure that they are as safe and effective as expected and will allow the government to take action if a problem is identified.

Finally, our government will work collaboratively with health system partners to improve the quality and efficiency of patient care through more appropriate prescribing practices. With enhanced federal support, CADTH will develop improved prescribing tools and provide health care practitioners with guidance on the optimal use of drugs and drug products.

All these measures combined will have major repercussions and will make drugs more affordable and more accessible while ensuring the appropriate use of prescription drugs. They will help advance the common interests of the federal, provincial, and territorial governments by improving Canada’s pharmaceuticals management system to ensure that it is sustainable and meets the needs of Canadians.

I wish to add that the federal, provincial, and territorial governments committed to making prescription medication more affordable and our health care more innovative as part of recent discussions on health care funding.

To improve access to prescription medications and lower drug prices, budget 2017 invested over $140 million over five years. As I noted earlier, this will support work by Health Canada and by groups like the PMPRB and CADTH.

To expand e-prescribing, virtual care initiatives, and the adoption and use of electronic medical records, we will invest over $300 million over five years to help support the Canada Health Infoway.

Canada Health Infoway is developing a national secure electronic prescription system, which will contribute to reducing prescription errors, advising pharmacists of potentially harmful drug interactions, and helping patients take their drugs as prescribed.

We are also investing $51 million over three years into the Canadian Foundation for Healthcare Improvement to make our health care system more responsive and innovative.

As well, we plan to invest $53 million over five years for the Canadian Institute for Health Information to improve decision-making and to strengthen the reporting of health-related polices and outcomes.

I appreciate this opportunity to provide the House with this overview of the significant actions this government is taking in this important area that concerns us all. I would like to underscore the important role research plays in providing the kinds of evidence that will support our progress going forward.

As I said earlier, our government understands that, in order to meet the health needs of all Canadians, before anything else, it needs to make Canada's current prescription drug system more efficient and flexible.

We are also confident that the measures we are taking to improve the system will help lower the price of prescription drugs and better manage their use.

Our government is determined to strengthen Canada's health care system by making drugs more affordable and more accessible, while ensuring that prescription drugs are used appropriately.

We look forward to reviewing the parliamentary budget officer's analysis of the costs of a universal national pharmacare program. However, the actions proposed by the member for Vancouver Kingsway, while well-intentioned, would be premature if we have not first achieved the related goals we are pursuing, goals such as bringing down prescription drug prices and improving the management of how these drugs are used in our health care system.

Prescription drugs are an important part of Canada's health care system. They help Canadians by preventing, treating, and healing illness.

That is why making drugs more affordable and accessible has been established as a top shared priority for federal, provincial, and territorial health ministers, while also ensuring the appropriate use of prescription drugs.

As I mentioned, for the first time in more than 20 years, the government is proposing substantial—yes, substantial—amendments to the patented medicine regulations.

As I have noted, for the first time in more than 20 years, the government is proposing major updates to the Patented Medicines Regulations. That is significant. Put simply, we need to make Canada's existing prescription system more efficient and more responsive before we can begin to discuss a national pharmacare program.

In light of all these initiatives and others I have outlined today, I would argue that the government is making progress on a number of these issues and that members of the House should vote against the opposition motion.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, here is what is concretely established by every single researcher and health care professional in the country who has studied this issue: seven million Canadians have no pharmaceutical coverage whatsoever today. That means that there is someone waking up in this country right now who needs medicine and cannot get it.

Second, we know from a source as credible as the parliamentary budget officer, who used extremely conservative assumptions, who did not even account for all the cost-saving measures, and who used the Quebec formulary, the broadest formulary in this country, that if we had a national pharmacare system, we would save billions of dollars. That is not surprising. It is consistent with every single peer-reviewed academic study. We know that with universal pharmacare, we could cover every Canadian and save billions of dollars.

I would ask the Minister of Health, as someone charged with the responsibility of making sure that Canadians in this country are healthy, what possible reason there could be to not agree with the NDP motion to at least start a discussion with the provinces in the next year to begin the process of implementing universal pharmacare. Is she opposed to universal pharmacare, or is she simply opposed to action?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, I would like to thank the member for Vancouver Kingsway for his continued work and also for his great work on the health committee.

We certainly recognize that Canadians are paying too much for drugs. I think we all agree on both sides of this House that this is certainly a priority we need to address. What we also need to address is access to drugs within this country. Our government is taking that work very seriously.

Yesterday I received my mandate letter from our Prime Minister. I want to read a quote from part of the mandate letter I received that specifically speaks to this.

Work with provinces and territories to:

advance pan-Canadian collaboration on health innovation to encourage the adoption of digital health technology to improve access, increase efficiency, and improve outcomes for patients;

improve access to necessary prescription medications. This will include joining with provincial and territorial governments to negotiate common drug prices, reducing the cost Canadian governments pay for these drugs, making them more affordable for Canadians, and exploring the need for a national formulary;

I will continue, as health minister, to work very hard to ensure that we address these needs.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Mr. Speaker, we have a mixed system in Quebec that ensures that everyone is covered. Despite that, and although Quebec is very protective of its jurisdiction over health care, Minister Barrette has expressed an interest in talking about universal pharmacare, because he knows that it can save money.

I am wondering how my colleague can question the urgency of raising this issue, when the most advanced province in terms of universal pharmacare believes that universal pharmacare would lead to cost savings and promote the appropriate use of medication.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, again, I thank my colleague for her question.

Let me be perfectly clear. We know Canadians pay too much for prescription drugs. That is one of the reasons why our government is working in partnership with the provinces and territories to combine our buying power and generate major savings. I have received data showing that last year, the provinces and territories saved $1.3 billion by buying their drugs together. We want to tackle this issue in order to lower drug prices. This is one of the actions we are taking.

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

Mr. Speaker, I truly appreciate the fine work by the Minister of Health on a number of files. When I think of the pharmacare file, obviously all of our constituents are concerned about the cost of pharmaceuticals and getting the medicines they require. The work the government has done in getting the different provinces and territories to work together in a pan-Canada approach has been somewhat successful, from what I understand.

How important is it that we work with the different provinces and stakeholders? As much as Canada, as a national government, can play a strong leadership role, we also have a responsibility to work with the different stakeholders to do the best we can for Canadians on the cost of medicines.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, all Canadians and both sides of the House recognize that the price of drugs is extremely high in this country. Therefore, we have to work collaboratively to ensure that we can get those prices down. Working with the provinces and territories has been crucial to reducing the cost of drugs. Since 2016, we have joined with the provinces and territories to ensure that we have more bulk buying power. As a result, we have seen significant savings in drug costs. We have been advised that we have saved over $1.3 billion since 2016 through the bulk purchasing program. That is a significant saving to our health care system, and monies that we can invest in other areas where it is very much needed.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, it feels like 1966 again, when the New Democrats were trying to explain to the Liberal government why universal coverage was better for the health of Canadians and would save money. The Liberals had to be dragged kicking and screaming in that regard. It is the exact same reasoning for why our public universal health care system covers all Canadians and is cheaper than the private systems in the U.S. That applies equally to prescription drugs. I have heard no cogent answer from the minister to explain why the Liberals would not understand that.

The issue here is not only that Canadians are paying too much for pharmaceuticals, but that millions of Canadians do not have coverage at all at any cost. Therefore, I would like the minister to answer this. She claims she is making progress. Have drug prices in Canada come down for Canadians, and if so by how much?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Mr. Speaker, I reiterate that our priority is to ensure that our system is efficient and responsive to the needs of Canadians. This government has made significant investments in moving forward toward that. We recognize that the price of drugs in this country is too high. However, in moving forward we certainly have to take some steps to deal with the situation properly.

I have already listed a few examples of the things we have done, including working diligently with the provinces and territories. Moreover, there are other initiatives and investments that we have made. In budget 2017, we invested over $140 million over five years to really look at these issues. We have made significant investments in the Canada Health Infoway, a pan-Canadian organization that has done some very innovative work when it comes to pharmaceuticals. It is looking into a digital system to ensure that when doctors are prescribing drugs, the prescriptions will go specifically and directly to a pharmacy. As a result of that, we will have better data and services for our patients. It will also be more effective. We will have better data to analyze, and better decisions can be made moving forward.

I would also like to talk about other investments we have made. We have made significant investments in the Canadian Foundation for Healthcare Improvement. I can speak personally with respect to my province of New Brunswick. A pilot project was undertaken to look at the overuse of antipsychotic drugs in long-term care facilities. From the work done on that, we could see if there was a proper use of medication. In looking at specific cases, we could see that people were being over-prescribed medications.

We are making different investments in different parts of the system, because we want to make sure that we are getting this right.

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

Mr. Speaker, today I will be splitting my time with my colleague from Chatham-Kent—Leamington.

As deputy health critic for the official opposition, I am happy to speak today to the motion by the member for Vancouver Kingsway. In summary, his motion relies heavily on the results of the recent report prepared by the parliamentary budget officer on the costs of a national pharmacare program in Canada. The motion calls for the government to start negotiations with the provinces next year to implement a universal program.

As we consider this motion, we should be aware that the principal role of the federal government in pharmaceuticals, according to the parliamentary budget officer's report, is to regulate market access, thereby ensuring the efficacy, quality, and safety of drugs; to provide financial support to the provinces through the Canada health transfer, as required by the Canada Health Act; to deliver pharmaceuticals to particular populations; and to regulate the price of new and innovative drugs.

The Standing Committee on Health is currently studying the possibility of a national pharmacare system. In fact, it was that committee that requested a report by the parliamentary budget officer on the potential costs involved. The completed study was provided to the committee just last week. Given this, I would suggest that the opposition day motion is a bit poorly timed. Does it not make sense for the committee to now have time to examine the report, consider its findings, and then report back to the House? I would ask the member for Vancouver Kingsway, the vice-chair of the health committee, to provide his committee colleagues the time they need to do their job.

The Conservative Party of Canada wants to ensure that Canadians are receiving the best health care possible and that even the most vulnerable have access to the latest in pharmaceutical care. As we know, the Canada Health Act provides universal drug coverage for prescription drugs administered in a hospital setting. In addition, the federal, provincial and territorial governments all offer drug insurance plans, providing some coverage to approximately 53% of the Canadian population. If we are to consider an additional level of coverage, we need to bear in mind that private drug insurance programs provide coverage to 24 million Canadians in total.

I think we should focus on the result of a 2002 study by the Fraser Group that estimated that 11% of Canadians faced the risk of high prescription drug costs because they either had no coverage at all, or were significantly under-insured. These are the Canadians who need this type of program. Therefore, I would suggest that a more targeted approach would be to begin with the health committee's study on a national pharmacare program.

Let us look at the costs, the logistics, and the overall effect of a program focused on Canadians currently without any existing coverage at all. This would include seniors, those with low fixed incomes, people with uncertain work or low wage jobs without benefits, the disabled and others in need. Should the committee and the House agree to examine a plan like this, we could receive feedback from the provinces, stakeholders and, indeed, from Canadians themselves on whether it would indeed provide quality health care to those in need of it. Additionally, the information obtained on the actual versus estimated costs would be invaluable for future discussions of a possible and potentially expanded program.

This brings me to the fact that my Conservative colleagues and I are concerned about the lack of data and the high initial cost of implementing a national pharmacare program here in Canada, considering the growing deficits that Canadians are facing as a result of the irresponsible government. This motion unfortunately reflects what I would describe as typical NDP thinking. The members somehow believe that there is an unending supply of tax dollars that can be accessed into infinity.

The PBO has evaluated what it would cost to provide a national pharmacare program to all Canadians, even those with an existing plan, to be approximately $22.6 billion dollars annually. The PBO indicated that its initial study shows that a national program would grow by 11% in just five years, from $19.3 billion to $22.6 billion in 2020. It also clarified that this number could be off quite substantially, as overall consumption of prescription medication could very well increase under a national pharmacare plan. The cost of prescription medications is the largest factor causing patients not to follow their prescribed treatments, and with the sudden implementation of a universal pharmacare program, individuals with newfound access could end up flooding the system. These costs are unpredictable.

Although the parliamentary budget officer provided a budget based on the drugs list in Quebec, the drugs on that list are quite different from other provinces', which is another factor making the true costs unknown. The health needs of each province's population, prescribing habits of physicians, generic drug pricing, and price negotiations vary. This creates differences in the consumption by and even coverage of various drugs for specific populations. To seriously consider pharmacare, we must determine the potential source of the funds, particularly as the current government has well exceeded its proposed deficit targets, leaving us with little room to consider this plan.

The Conservative Party of Canada supports a high-quality, sustainable health care system that would ensure that Canadians get the best possible care. As previously mentioned, approximately 12% of Canadians are under-insured or not covered by a plan already. Due to the fact that the majority of people are already covered, we should be targeting our limited resources at a more efficient way of covering individuals who do not presently have coverage. This would involve focusing on individuals such as seniors, those with low fixed incomes, people with uncertain work or low-wage jobs without benefits, the disabled, and others in need.

The fact is that there are alternatives to reduce the costs for Canadians, especially those without drug coverage, as I discussed recently with regard to Motion No. 132. Costs can be lowered through volume leveraging and generic-versus-brand purchases without the scope of a program, as costed by the parliamentary budget officer. The resulting savings could be upwards of $7 billion.

Again, I would remind the House that the framework of the parliamentary budget officer's report on funding health care is based on Quebec's inclusive list of drugs, eligibility requirements, copayment levels, and eligibility requirements for copayment exemptions. It is important to note, however, that Quebec runs a hybrid system that is close to universal pharmacare by requiring that residents have drug coverage either through a private plan sponsored by their employer, a professional association, or through the government-run public plan. Even in that province, 7.2% still do not adhere to prescribed treatment due to the cost.

I would suggest that the health committee look at how my home province of Alberta is handling this issue. Alberta works hard at providing publicly funded drugs to those who need them the most, such as seniors. It provides public drug coverage plans for individuals who have no other type of coverage and who are not necessarily experiencing high drug costs relative to their income. There, the the number of people who do not adhere to their drug treatment plans due to the cost is only 0.4% higher than in Quebec. However, the key point is that with similar results to Quebec, Alberta is able to do so at $209 billion lower cost.

In summary, while no Canadian should be without necessary pharmaceuticals, we must consider the most efficient and cost-effective way to achieve this. I would ask the member to allow the health committee to finish its work so that we may go forward with complete information as we consider the best way to achieve universal drug coverage for Canadians.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, it is interesting that during testimony at the health committee's study of pharmacare, a study that the New Democrats prompted by moving a motion, members heard from a number of employer groups who said uniformly they wanted a universal pharmacare system. The reason is that employers across this country who provide extended health plans for their employees are finding it increasingly expensive. It is a cost of business for them to provide those benefits to their employees, and since pharmaceuticals are among the fastest-rising costs in the health care system, they are finding it very expensive to provide these plans to employees and increasingly are abandoning these plans and leaving their employees without any coverage. That is not good for them, as the number of sick days is increasing and their employees are not as healthy as before. Quite surprisingly, they say as a result that they want a universal pharmacare system to cover everyone and save money.

Would my hon. colleague comment on that? Would the businesses in her community share that perspective articulated at the health committee?

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

Mr. Speaker, that is exactly what I am suggesting. We need complete and comprehensive information before we go ahead with such an expensive and costly plan. I would like to see all Canadians have access to drugs, which are so important for well-being and for life. However, it is very important that we have all the information before we decide on the approach of how to proceed with this.

While the information from the hon. member for Vancouver Kingsway is very valuable, it indicates there are many parts that we must consider to have better, more, and complete information before we commit to such an extensive and broad plan.

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

Mr. Speaker, for a number of years I was the health care critic in the Province of Manitoba. There was a great debate even at that time on how to address the ever-increasing cost of pharmaceuticals. One of the discussions we had was on the fact that we had two tertiary hospitals, we had community hospitals, and we had general hospitals throughout the province. The idea was to try to get our regional health care authorities to work closer together to get better prices on drugs. Within the two years, our national government will be getting together with provinces and territories to look at ways to deal with prices on drugs.

Would my colleague agree that Ottawa cannot do this alone? Ottawa needs to work with the many different stakeholders, in particular our provinces. Therefore, there is a lot of goodwill on the part of the government to address this issue, because it is an issue of great concern to Canadians, but it is not quite as simple as the New Democrats try to portray it. In the federation, there is a responsibility to work with the provinces. Would the member across the way not agree with that concept?

[Stephanie Kusie, Conservative, Calgary Midnapore, AB]

Mr. Speaker, I certainly would agree that provinces should also be involved in the consultation on the consideration of the national pharmacare plan. They are indeed stakeholders that should be considered as we move forward.

However, as I indicated, it is very difficult at this time because of the horrific deficit we have found ourselves in over the last two years as a result of the government's spending. While there is a will, there must always be a way. This way is absolutely being impeded by the difficult position we are being put in at present.

While I would agree that we all share the objective of universal pharmaceutical coverage in one capacity or another, when it comes to spending, I and the Conservative Party of Canada, my respectful colleagues, disagree on how this is to be achieved. However, I will agree with my colleague that we must include the provinces, as stakeholders, as part of the solution for drug coverage.

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Mr. Speaker, today we will be discussing the motion by the NDP for a universal drug plan. The Office of the Parliamentary Budget Officer released a report entitled, “Federal Cost of a National Pharmacare Program”. This 88-page report sets out to give Canadians an overview of its findings. It concludes that a universal pharmacare program would cost $22.6 billion.

There was a time in the House when governments would explain how they would pay for new programs. I understand the NDP is not the current government, but there is a responsibility that falls on all of us in the House to save for the future and take responsibility.

I want to tell a great story, one I heard from the former Speaker Mr. Milliken. We would sometimes have the privilege of entering his chambers in the back and he would point to this wonderful chandelier. There was a great story attached to that.

He told us that there was a former Speaker who felt that because important dignitaries and people would be invited to the office, a proper light was needed instead of the plain looking light that was there. He went out and bought himself a beautiful chandelier. Later on, he was called into the office of then prime minister John Diefenbaker. John threw him the invoice, wanting to know what it was for. The Speaker explained that it was for the new chandelier in his office. John looked at him and said that they did not pay for light fixtures, and the Speaker wound up paying for that bill. I love that story, and I tell it to people.

The real story behind that was that John Diefenbaker knew what was being spent in the House. I wonder how many of us today know exactly what is being spent in our office, let alone in the House. It teaches us something. It teaches us that we are responsible for the public purse. I want to talk about that a bit today. I will talk about other things too, but I want to talk about the Liberals and what they seem to have done.

The Liberals have this new approach to governance, as witnessed by their reckless spending in the past budget. There will be a $30 billion deficit, with no sign of changing that trajectory in the foreseeable future. Now, they adopted a budget that was balanced, yet they set out to indebt future generations, our children and grandkids. They will saddle them with that debt. They had a great explanation that they had a wonderful program. I have kids with kids, and they receive this monthly cheque for child care. It is nice to receive, but they recognize, as do most Canadians, that somebody has to pay for this.

In all fairness, and I want to be fair with my colleagues on the other side, they have been telling Canadians how they are going to pay for this and how they are going to handle their reckless spending. It is through higher taxes. We just had a series of debates and pleadings with the Liberals, putting pressure on them to please stop what they were doing. They are going to put a tax on businesses and start taking away some of the benefits from businesses, farmers, and ordinary Canadians in order to try to balance their books. They want to take this money to pay for their reckless spending.

The Conservative Party knows that businesses hire people. In fact, SMEs, the small and medium-sized businesses, account for most of the hiring in the private sector today. Make no mistake about it. All of us get really excited when we hear about a big corporate organization or company moving into our riding, and those are great things when they happen.

However, the vast majority of jobs in our country are created by small and medium-sized businesses. They account for the wealth that is generated. They fill the coffers of the government, through taxes, so we can give back to the people what they expect to receive. They expect to receive good health care. They expect to receive education. They expect to be defended by our military. The list goes on and on. All in all, we have done an admirable job of doing that as a society. However, there is a troubling trend. We have forgotten that we have to pay for what we want.

The Conservatives, because we understand markets, opened markets for our businesses, our farmers, and our resources. I served on the trade committee as well as the finance committee. It always surprises me when I see the number of free trade agreements for which the Conservatives were responsible, countries like Colombia, Honduras, Peru, Panama, Jordan. One might think these are small countries, but there is bigger stuff, such as Israel and South Korea. For the Ukraine agreement, the work was done by the Conservatives when we were in government. The Liberal government, to its credit, has finalized that. A Canada European free trade agreement was made before the famous CETA one. I will talk about that in a second. There were a number of small countries in Europe that were not part of CETA. Then of course, there is CETA, the largest trading agreement that has ever been entered by two groups. There are 500 million people in Europe, and the possibilities are vast and endless. That is the sort of thing we need to do if we want to grow the economy so we can afford to do the very things the NDP has proposed.

In all fairness, the Liberals are pushing through a new drug bill. I sit on the health committee. We went through clause-by-clause. That bill will be enacted in July of next year. It will give everyone over the age of 18 the ability to smoke marijuana legally. There are a number of added parts to it that, which people really have to get a grip on and understand. We will have an opportunity to talk about that later. The NDP supports the bill. In fact, the party's new leader supports legalizing all drugs.

I am a dad. A lot of members know I have a lot of kids and grandkids. I love to give my kids gifts and good things. That is why the Conservatives, when in power, fought for lower taxes. We knew that if we wanted to give those things to our constituents, the people of Canada, we had to pay for them. We recognized that we had to get our goods to market. Therefore, we began the process, right to the door of the completion of the Gordie Howe bridge, so we would have access to our largest trading partner at the busiest port.

I say these things because we have to pay for what we do in this place. It is our duty as legislators, as representatives of our constituents, to ensure we do not saddle our children and grandchildren with the debt now. We can do a number of great things in the area of drugs. There are things that are possible for us to do, but the proposal by the NDP is not sustainable. As such, I will not be supporting the motion.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, before I get to my question, I want to point out that the comments of the hon. member for Winnipeg North suggested that it is important to work with the provinces on national pharmacare, which is actually the very core of the motion before us. The motion calls on the federal government to sit down with the provinces and territories and negotiate a national pharmacare system.

More to the point of my hon. colleague, with whom I have the pleasure of sitting on the health committee, I just want to clarify one thing. The leader of the NDP has called for the decriminalization of drugs and not for legalization of drugs. Of course, it is a very important distinction: decriminalization and regulation as opposed to legalization.

My question is this. I know that the member wants to save money. In fact, he opened up his speech with a story about Mr. Diefenbaker and the importance of frugality. Well, one of the core rationales behind the motion of the NDP today is that we can extend coverage to all Canadians and save $4.2 billion a year nationally. Therefore, as a Conservative, as someone who claims that we, as parliamentarians, should work to reduce costs for our citizens, can he tell us why he is going to vote against a motion that would bring in a system that would actually reduce the costs of pharmaceuticals for every single Canadian in this country? Why does he want to saddle them with higher pharmaceutical costs?

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Mr. Speaker, I want to thank my hon. colleague, and I do enjoy the time we spend together on the health committee. We are good friends. We disagree on a lot of things, but we certainly want to do the best for all our constituents.

I want to correct the record. The member is absolutely correct that the new NDP leader is proposing the decriminalization of all drugs, which is an important clarification to make.

As I said earlier, we disagree on some things, and I do not see this issue that way, unless the NDP can show us on paper. I am still involved with a dealership, and I used to have a mentor who was one of the finest actuaries I have ever known, and he would say “It's in the numbers, Dave”. We often hear, when there is a new project being proposed, that it would save us money.

I have trod the soil a little longer than most. I am going to be 62 this week. I find that with all of the promises I hear, the opposite becomes true, and things cost us more money.

We want to do the right thing. We want to do what is good, but we have to pay for what we plan to do, and I cannot say that enough.

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

Mr. Speaker, it has been an interesting discussion. When we talk about the cost of pharmaceuticals, the NDP says it is a $20 billion cost commitment, and I wonder if we could discuss that $20 billion. Currently on health care, the provinces contribute toward the financing of it, and Ottawa contributes towards it in terms of financing. I wonder if my colleague across the way, in giving the issue due diligence, thinks we should be talking about some of these cost factors.

It is not good enough to say that we are going to save hundreds of millions of dollars. I know that provincial jurisdictions, and even with the pan-Canada approach, would be saving millions of dollars, combined. However, there is a significant issue dealing with costs. Would the member across the way agree that any sort of pharmacare program going forward would have to have some sort of a joint sharing of costs?

[Dave Van Kesteren, Conservative, Chatham-Kent—Leamington, ON]

Mr. Speaker, I am beginning to think my hon. colleague is seeing the light.

The member is absolutely right. We have to make sure that we understand the costs and that, if we are going to get to that objective, we are going to get there in a reasonable fashion and not saddle ourselves with more debt. I cannot repeat that enough. I agree, that must be the way we move forward.

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

Mr. Speaker, today I will be splitting my time with the member for Abitibi—Témiscamingue.

As the seniors critic for the NDP, I am sadly too familiar with the cost barriers of medications in our country for the most vulnerable of us. I am pleased that the House of Commons is taking the time to discuss the implementation of a universal pharmacare program. Without the hard work and dedication of our health critic, the member for Vancouver Kingsway, I am not sure we would be in this position today to address it in such a credible fashion.

I have consulted with seniors across my riding and heard from many across Canada. I hear too many disheartening stories, and too many of them are focused on the high cost of prescription drugs.

Too many senior Canadians are sharing the reality that they are facing with increasing poverty. Affording the essential medication they need as they age is a barrier that is only increasing. I have heard from seniors who are taking their medication every second day to make it last, and from health care professionals who are desperately working to find the most affordable medication, because too many of their patients are not able to afford the costs and therefore not taking what they need to support their health.

Sadly, Canada is the only country with a universal health care system that does not have universal coverage of prescription drugs. I think it is time to change that.

Seniors 65 and older are the heaviest users of prescription drugs in this country. The majority of seniors are using multiple drugs. In fact, 62% of seniors on public drug programs are using five or more drug classes. This gets very expensive, very fast.

There is a reason I believe we need a universal pharmacare program. The statistics paint a crying need for federal leadership. Here are a few examples. British Columbia shows the highest levels of access to medication problems, at 29%. One in five Canadians report that either they or a family member neglects to fill prescriptions due to cost. In fact, we heard evidence of this reality this week at HUMA committee, where we are studying a national seniors strategy, from Ms. Wanda Morris at CARP who confirmed this very clearly.

Canada currently has the second highest rate among comparable countries of skipped prescriptions due to cost. This ends up costing our health care system much more in the long run, as untreated conditions get worse, resulting in preventable hospital stays and doctor visits.

The Canadian Centre for Policy Alternatives estimates that between 5.4% and 6.5% of hospital admissions are the result of non-adherence, resulting in costs as high as $1.63 billion. In a country like Canada, this is a horrifying statistic.

Spending is also increasing. Public drug spending on seniors increased from $603 million in 2002 to $1 billion in 2008. By 2036, the number of seniors will double. How many more billions are we going to spend before we actually take action and do something?

In September 2016, the House of Commons Standing Committee on Health asked the parliamentary budget officer to provide a cost estimate of implementing a national pharmacare program. The committee provided the program's framework, including the inclusive list of drugs to be covered by pharmacare.

The PBO costing found out that, in 2015-16, Canadians spent $28.5 billion on pharmaceuticals. Of this, $24.6 billion would have been eligible for coverage under a national pharmacare plan. Accounting for pricing and consumption changes, the PBO estimates that Canada would have only spent $20.4 billion in 2015-16 under a national pharmacare program. The reality is that this place would have saved $4.2 billion in 2016, if action were actually taken.

The PBO is not the only credible source to suggest a universal pharmacare program is sound economic policy.

In 2015, a report authored by Canada's leading health policy experts was published, entitled “Pharmacare 2020: The future of drug coverage in Canada”. This study estimates that universal pharmacare would result in public and private savings of between $4 billion and $11 billion per year under reasonable assumptions.

Pharmacare would yield significant savings for Canadians, principally because of the increased spending power it would bring. During price negotiations drug companies often inflate the price of their drugs and provide confidential rebates based on the bargaining power of each purchaser. Universality would further increase Canada's bargaining power by extending coverage to every single Canadian.

All Canadians understand the real reason we need to be having this conversation.

The most common drug class used by seniors is to lower cholesterol levels. Is it normal that a year's supply of a widely used cholesterol drug costs about $143 in Canada but only $27 in the United Kingdom and Sweden and under $15 in New Zealand?

Canadians pay among the highest prescription drug costs in the industrialized world, second only to the United States.

The administration costs of for-profit private plans are also enormous, around 15%, while administration costs for public plans are less than 2%. This is just good fiscal policy. Replacing private plans by a universal public plan would not only reduce wasteful spending, but it would save Canadians an additional $1.3 billion a year in administrative costs.

An overwhelming majority of Canadians, 91% in fact, expressed support for the concept of a national pharmacare program that would provide universal access to prescription drugs. That is not a surprise, when millions of Canadians cannot access the essential medication they need when they need it. That is simply not right.

Tommy Douglas, the father of medicare, never intended to create such an odd gap in Canadian health care coverage. Prescription drugs and other services were always meant to be integrated into a system of comprehensive public coverage along with hospital and physician services.

Today I stand before the House, as New Democrats have for over half a century, to proudly proclaim our belief that health care in Canada must be a right and not a privilege.

With the recent release of the PBO's report, it is clearer than ever that a national pharmacare program is not only good for the health of all Canadians but also sound economic policy for all Canadians, especially our seniors.

Our motion today calls on the government to commence negotiations with the provinces no later than October 1, 2018, in order to implement a universal pharmacare program. With a little political will we can finally make this happen for all Canadians.

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

Mr. Speaker, Health Canada has been a fairly effective department over the last year and a half.

When in opposition, my party objected to the fact that the Stephen Harper government chose not to renew the health care accord. What we have seen lately is a proactive government trying to deal with and deliver on health care. Our government achieved a new health care accord. My province was the last of the provinces and territories to sign on to that particular agreement. Our national government, through the Department of Health, has assisted in providing that pan-Canadian agreement working on pharmaceuticals.

We have been in government for close to two years. The NDP is trying to give the impression that this pharmacare plan could be put in immediately. Does the member believe we have a responsibility to negotiate and have discussions with the provinces? What percentage of the financing of a pharmacare program does the NDP think Ottawa should foot the bill for? Are those members suggesting that it should be 20%, 50%, 100%? Have they even thought through their own policy on this idea?

It was not Tommy Douglas who brought in a national health care program. It was a Liberal government.

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

Mr. Speaker, my only response would be that I encourage the hon. member to actually read the motion that has been put forward.