House of Commons Hansard #213 of the 42nd Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was drug.

Topics

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

12:45 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

I want to again remind the member that he might not want to use the word “you”. That would stop me from getting up and asking him to please address his questions through the Chair.

Questions and comments, the hon. member for Hochelaga.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

12:45 p.m.

NDP

Marjolaine Boutin-Sweet NDP Hochelaga, QC

Madam Speaker, the argument the Liberals and Conservatives regularly put forward, which we heard again just now, is that the opposition motion is premature.

Has my colleague not considered that starting a discussion right away with the provinces on the subject of a universal pharmacare program might bring to light information that has not yet come up in committee or that could be useful if and when such a program is implemented?

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

12:50 p.m.

NDP

Wayne Stetski NDP Kootenay—Columbia, BC

Madam Speaker, I will again bring attention to what the opposition day motion actually says:

That, given that millions of Canadians lack prescription drug coverage, and given that overwhelming evidence, including from the Parliamentary Budget Officer, has concluded that every Canadian could be covered by a universal pharmacare program while saving billions of dollars every year, the House call on the government to commence negotiations with the provinces no later than October 1, 2018, in order to implement a universal pharmacare program.

Nobody would disagree with the fact that millions of Canadians lack prescription drug coverage. We have heard a lot of interesting facts presented in the chamber over the course of the last couple of years. I would like to think the PBO is about as good as it is going to get for reliable information.

Earlier we heard questions about the federal government negotiating with the provinces. October 1, 2018, is a very generous date for the government to implement a universal pharmacare program. I think everybody is on board; they just do not realize it.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

12:50 p.m.

NDP

Richard Cannings NDP South Okanagan—West Kootenay, BC

Madam Speaker, I am happy and proud, as a New Democrat, to speak today to our motion on the need and the great opportunity for a national pharmacare program that would provide free access to prescription drugs for every Canadian. Just as I am proud to stand for that belief, Canadians are proud of their health care system. It defines us as Canadians. We do not think health care should only be available to those who can afford it.

When Tommy Douglas brought the concept of universal health care to Canada, it was always intended to include the cost of necessary medicines. Unfortunately, this was not implemented when universal health care came into effect in Canada. Now Canada is the only country in the world with a universal health care plan that does not include the cost of drugs in its coverage. How can we consider our system to be universal if it excludes the very drugs that bring us back to health and indeed save our lives?

We have the nonsensical situation where I can go to my doctor to get my cut foot stitched up at no cost, but then I have to pay for the antibiotics necessary in that situation. If I cannot afford to pay for that prescription, I may well end up at the emergency room, needing the free medications I can get in the hospital. It does not make any sense.

That added pressure on our health care system adds costs to all levels of government. The Canadian Centre for Policy Alternatives estimated that about 6% of hospital admissions were the result of people not filling their prescriptions, not taking their medicine. That results in an annual cost as high as $1.63 billion across the country, to say nothing of the loss of quality of life for those people who try to get by without proper medication and end up housebound or bedridden because of that inaction. This is a clear case of how unfair our present system is. Why should people with the financial means to buy their medications be afforded better health care than those who cannot afford them?

In the debate today, I have heard several members ask where we will get the $20 billion to fund pharmacare in Canada and who will pay for those medications. We will all pay, just as we do now. The good news is that if we had universal pharmacare plan, we would be paying at least $4 billion less than we do now, according to the report produced by the parliamentary budget officer last week. That is a highly conservative estimate. The savings could be as much as $11.5 billion, as reported by other very credible studies. We could have a universal pharmacare plan in Canada where everybody is covered, everybody gets free medications, and we end up paying billions and billions of dollars less every year.

Getting back to the question of who pays for our present system, the answer is individuals, businesses, and government. The Conservatives are always talking about the effects of payroll taxes on small businesses across the country. Extended health benefits that include prescription payments are one of those payroll taxes, one of the most expensive ones, and the costs are rising steadily for Canadian businesses because of that.

It is perhaps just a little hypocritical of members here to denounce a national pharmacare plan when their own medications are already paid for by the people of Canada. Like many Canadians with good jobs, we in the House of Commons have most of our drug costs covered by private insurance paid for by our employer. I was covered by a similar plan under my previous employer before I was elected, but millions of Canadians lack that coverage.

Also like many Canadians, I take cholesterol-reducing medication to reduce the chance that I will have a serious heart attack or stroke. If I had to pay for that medicine myself, it would cost me well over $100 a year. If I were still self-employed, I would probably choose not to take that drug, putting myself at risk, risking higher costs for our health care system. One of the interesting facts about the medication I take is that Canadians pay an extraordinarily high price for it. Elsewhere in the world, in countries that have universal pharmacare and the strength of negotiating fair prices with pharmaceutical companies, that drug is much cheaper.

People in New Zealand only pay one-tenth the amount we pay in Canada for that cholesterol-reducing drug. This is true across the board for most medicines we use in Canada. We pay more for drugs in Canada than almost every country of the world. That could be fixed through a national pharmacare system, with central purchasing for a powerful negotiating position with drug companies.

Today we have heard many examples of Canadians who cannot afford to pay for their medicines, the negative effect that has them, and the costs incurred by the health care system across the country.

I will mention just one more example. One of my constituents is a veteran. He uses medical cannabis to treat his severe PTSD. Veterans Affairs has covered the cost of that prescription, which has allowed him to have a relatively normal life for the past few years. This coverage has helped hundreds of other vets across the country, keeping them off dangerous opioids and away from the destructive use of alcohol.

Recently Veterans Affairs cut back on that coverage. This has forced my constituent, and many like him, to endure the painful effects of PTSD once again. Some repeatedly end up in the emergency rooms of hospitals. The costs of those visits, especially when compared to the small savings from the cutbacks in coverage, are astronomical.

The report of the parliamentary budget officer is clear. Our present system that separates the cost of prescription medicines from other health costs does not make any sense. It does not make sense from the perspective of keeping Canadians healthy and it does not make sense in terms of how much money we spend on our health care. Universal pharmacare is sound, economic policy.

If members do not believe the PBO, they can listen to what the Heart and Stroke Foundation of Canada says:

It's time for Canada to fill a gap in our health care system and truly provide universal health care for all. The Heart and Stroke Foundation believes in the values of universality, equity, and equality in our health care system. All people living in Canada should have equitable and timely access to necessary prescription medications based on the best possible health outcomes rather than their ability to pay.

The Canadian Diabetes Association believes that “universal access to necessary drugs is critical to the health of all Canadians and a sustainable health-care system in Canada.”

Universal pharmacare will save Canadians billions of dollars. Everyone in the House should be happy to hear that. It will save individual Canadians money, and it will mean significant savings for business owners across the country. It will also relieve pressure on our health care system, saving billions of dollars there as well. It would keep us all healthier.

The motion simply asks the government to begin talks with the provinces about how a universal pharmacare program could be structured in Canada. It gives the government a whole year to organize those talks.

Now the government side has said that the time is not right for this. Well, we have all heard the saying that the best time to plant a tree was 50 years ago and that the second-best time is today. We should have included pharmacare in our health care system 50 years ago, but we have the opportunity to make that bold step today.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1 p.m.

Scarborough Southwest Ontario

Liberal

Bill Blair LiberalParliamentary Secretary to the Minister of Justice and Attorney General of Canada

Madam Speaker, as a point of clarification, the member has said that he has heard members of the House denounce a national pharmacare system. I want to have a better understanding of how he came to that conclusion, because that is not at all what I have heard today.

What I have heard today is an all-party commitment for our health committee to examine this issue and to inform the government of its examination. I have heard about the remarkable amount of work and the number of witnesses the committee has called. In fact, it was the health committee that asked the parliamentary budget officer to report back to it.

It seems to me that the health committee has identified this as an issue worthy of examination, that it has taken extraordinary steps to hear from witnesses and to gather information so it might complete a report.

What the member has heard from our government is a tireless effort from the outset of our mandate to reduce the costs and to increase the accessibility of pharmaceuticals for all of our citizens, and of our work with the provinces and territories to try to come to better agreements and to bring efficiency, affordability, and accessibility to the pharmacare system.

The member said that he heard somebody in this room denouncing this notion. Frankly, I have not heard that. Perhaps the member could clarify his remark.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1 p.m.

NDP

Richard Cannings NDP South Okanagan—West Kootenay, BC

Madam Speaker, I was perhaps speaking of comments I heard from members on the Conservative side here, who were saying that we cannot afford this, where would the money come from, we cannot afford more taxes, etc., whereas the parliamentary budget officer's report clearly says that this would actually save us money.

I am very happy that the health committee is studying this issue. I think that was the result of the NDP member for Vancouver Kingsway initiating those studies. I am proud that he took that action and I am glad that members are studying it. However, the point of the motion is to move from talk to action. We want to set a date. We give a full year to begin negotiations with the provinces to see how we can get this pharmacare system up and running in Canada. It is long past due.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1 p.m.

Liberal

John Oliver Liberal Oakville, ON

Madam Speaker, I heard the hon. member make a very strong case for national pharmacare, which I fully support. He spoke about the need and about the affordability.

However, as a member of the health committee, I can say that affordability is a critical piece of it, but it is not enough. There is complexity, and we have heard from many witnesses that there is great complexity. Will there be provincial or national formularies? Who will decide the drugs that will go on those formularies? As we heard from so many constitutional, science, and consumer groups—evidence-based groups—it is not just about affordability; it is about how to do it right. How do we make sure, if we launch this final very important step, that all Canadians are covered for pharmaceutical prescriptions?

Why would we not wait? Let the committee address those complexities. It will have recommendations and thoughts on this issue. Let the full report come to the committee, and let the committee finish its work with the PBO. No one has actually examined the PBO yet on this report. To go ahead would be premature.

How would you address these complexities?

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

Well, I am not going to tell the member how I am going to address those complexities. I would just remind the member that he is to address the question to the Chair.

The hon. member for South Okanagan—West Kootenay.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1 p.m.

NDP

Richard Cannings NDP South Okanagan—West Kootenay, BC

Madam Speaker, I would say to the member across the floor that no one said that this was not going to be complex. Our health care system is complex in Canada. The provinces are all involved and the federal government is involved, and I know the health committee is meeting on this matter.

The thing is, we can get a start on this. It will involve all the questions the member asked and involve negotiations with the provinces. Let us get going on that. The health committee will do its deliberations, and we will question the PBO on the details.

The PBO has a very detailed report. It is all on paper. Someone asked when we were going to get something on paper. Hey, it is on paper, if one prints it out, but we do get it online.

Let us get started on this. We have a year, and we should move ahead with it. While the health committee is talking, let us organize a meeting to negotiate and start talks with the provinces on how this will happen.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:05 p.m.

Liberal

John Oliver Liberal Oakville, ON

Madam Speaker, I will be sharing my time with the member for Winnipeg North.

Thank you for the opportunity to speak to the motion of the member for Vancouver Kingsway on national pharmacare.

For me, it is pretty simple. Any Canadian who needs treatment should be able to meet with their family doctor, or equivalent; receive a prescription for a drug, if it is required; proceed to their local pharmacy, and have that prescription filled at no cost, or at very low cost.

Today approximately 10% of Canadians cannot afford to have that prescription filled. Further, one in four Canadians report they cannot afford either to fill their prescriptions or complete their prescriptions. Traditionally, this under-treatment burden has fallen most heavily on our more disadvantaged populations, particularly those who are working in low-paying jobs, which often have no benefits. Often these are temporary jobs, and the people who hold them face periods of unemployment.

I believe Canadians would not want to hear that a temporarily unemployed mother with two children cannot afford to provide basic drug treatment when needed because it is unaffordable to her, yet that is the case in Canada today. Increasingly, even with full-time jobs, many of us are experiencing difficulty affording prescriptions as employers reduce their percentage coverage to lower levels, increasing the self-pay burden.

New treatments for rare and uncommon diseases are emerging, but they are very expensive. One of our most famous Canadians, Paul Henderson, who in the 1972 Russia summit series scored the winning goal, was diagnosed later in life with chronic lymphocytic leukemia. I understand the cost of the life-saving drugs to treat his condition is over $50,000 a year, and that could last for the rest of his life. Who among us can afford this life-saving pharmaceutical intervention without all of us sharing in the cost? All of us and our families face the risk of not being able to access essential medicines because we cannot afford them. We need to work together, pool risk, and support each other, as we have in other important health services.

Our government is already working to improve the affordability of prescription drugs and our access to them. Our current focus is on reducing the price of drugs, which will help improve access to necessary medications. We join provinces and territories as a member of the pan-Canadian Pharmaceutical Alliance, which negotiates lower drug prices on behalf of public drug plans. In the year and a half since joining, we have been able to use this bulk buying power to negotiate 60 agreements that are already saving Canadians money. We continue working collaboratively with the provinces and territories on other ways to make prescription drugs more affordable and accessible for Canadians.

Through the Patented Medicine Prices Review Board, the Government of Canada regulates the maximum allowable prices of patented drugs. The board recently completed the first phase of a consultation with Canadians on changes to its guidelines that would enable it to better protect consumers from excessive patented drug prices.

While much has been done to make pharmaceuticals more affordable for Canadians, I believe more can be done. I do not believe that lowering the cost of drugs would make them any more affordable for that single, temporarily unemployed mother of two. The problem is that prescription drugs outside of hospital care are not covered by the Canada Health Act.

As Canadians, we are proud of our national health care program. Today our national program covers doctor care, most diagnostic services, hospital stays, and prescription drugs while in hospital. It does not cover the $28.5 billion that was spent on pharmacy-filled prescription drugs in 2015.

The Standing Committee on Health, of which I am a member, began a study of the development of a national pharmacare program in 2016. We have heard from dozens of witnesses, including patient advocates. We have heard from experts in medicine, social policy, constitutional law, and pharmaceutical manufacturing, as well as pharmacists and the insurance industry.

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. We included the inclusive list of drugs to be covered by pharmacare, based on Quebec's gold standard formulary; eligibility requirements; copayment levels; and eligibility requirements for copayment exemptions.

The committee received the report, which is a public document, on September 28, a short week ago. The paper estimates the cost to the federal government of implementing this particular framework for pharmacare. It incorporates assumptions of the potential savings resulting from a stronger position for drug price negotiations, consumption or behavioural responses of providing universal coverage, and potential changes in the composition of the drug market.

After accounting for pricing and consumption changes, the PBO estimates that total drug spending under a national pharmacare program would have amounted to $20.4 billion if the program had been implemented in 2015-16. This would have represented savings of roughly $4.2 billion on the actual expenditures, which I believe is a conservative estimate.

In 2015-16, $13.1 billion was paid by public insurance plans for prescriptions, while private insurance plans, mostly through private employers, covered $10.7 billion. These two existing coverage streams would cover the entire population of Canada with a national pharmacare program and yield savings back to the employers. This is a win-win scenario.

I agree fully with my NDP colleague that Canada needs to adopt a national pharmacare program. As a caring society, I believe all of us are interested in ensuring that no one in Canada has to go without essential prescription drugs. Why, then, as caring Canadians, would we not move immediately to adopt a national pharmacare program, as proposed in this motion?

As I mentioned earlier, the Standing Committee on Health has heard from many witnesses on this topic. We have heard that affordability is not the only challenge. There are other complexities that need to be considered. Should there be a formulary to decide what drugs are insured? Should the formulary be set nationally or set by each province and territory? How do we ensure that research and development continues in Canada and provide patent rights while ensuring that we can all access generic drugs to make the program affordable? Should there be a single-payer model, or would we continue with the multiple private insurance system? How would our model of federalism be applied?

There are many complexities around this issue. For example, the U.K. has created the National Institute for Health and Care Excellence, whose role is to improve outcomes for people using the national health system and other public health and social care services. It produces evidence-based guidance and advice for health, public health, and social care practitioners, but, most importantly, it advises on the use of new and existing medicines, treatments, and procedures within the national health system. If we are to proceed with a national pharmacare model, we would need a corresponding scientific and evidence-based body to advise on what drugs should be in the insured plan.

The Standing Committee on Health is currently engaged in the final stages of its study of a national universal pharmacare system. We can bring recommendations on all of these complexities and on the cost model. The committee asked the PBO to prepare a report, given certain parameters, to guide the committee in its evaluation of policy options, and we are looking at options.

We have not even had the chance to meet with the PBO, examine his PBO's work, and ask about the assumptions and procedures used to produce the report. As a committee, we have not finished that work on this report. I strongly feel that it is premature for Parliament to call upon the government to act when the committee has not even drafted, let alone tabled, its report. I am disappointed that a valued member of the standing committee would rush to the House to table a motion asking Parliament to direct the government ahead of his own committee's report. Therefore, I say to my fellow committee member from Vancouver Kingsway that we should let the committee finish its work.

I also believe we need strong federal leadership to drive this change, starting with amendments to the Canada Health Act, and not just by initiating conversations with the provinces and territories, as is proposed in this motion. We need federal leadership on this issue.

For these reasons, I will be voting against the motion, but I want to be very clear on this issue to the residents of Oakville, my colleagues in the House, and those across Canada who are championing a push for national pharmacare: I fully support this initiative. One of the primary reasons I entered politics was to do my best to see that all Canadians are entitled to receive prescription drugs.

As I said earlier, all of us and our families face the risk of not being able to access essential medicines because we cannot afford them. We need to work together, pool risk, and support each other, as we have on other important health services.

I support national pharmacare, but it must be implemented appropriately and with thoughtfulness to ensure that Canadians receive the excellence in care that they deserve.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:15 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Madam Speaker, I appreciate my hon. colleague's thoughtful remarks. For a second there, I thought he was a New Democrat.

What an apology for inaction we just heard. It is a classic Liberal position to say that they believe completely in universal pharmacare, but just not yet. There were a number of errors in the member's statement. For instance, he commented that the motion calls on the government to move immediately or thoughtlessly. It does no such thing. For any Canadian watching, the motion calls on the government to commence negotiations with the provinces within one year. That is to start discussions within a year with a view to implementing national pharmacare. That is not irresponsible. In fact, I drafted this motion specifically to give the government enough time.

By that time, the report of the committee will have been issued. In fact, it will be out in a month or two. However, we already know two basic facts. We know that millions of Canadians are not covered and we know that pharmacare would save billions of dollars. My friend refers to the details, including working out what is covered in the formulary, whether it will be a single-payer system or a stand-alone federal system, and what the federal-provincial cost sharing details will be. He is absolutely right that those details need to be worked out. How do those details get worked out, except at a federal-provincial table?

This really amounts to another statement by the current government to the effect that it has convinced Canadians it is progressive by talking a good line, but never actually doing anything. We are not going to get pharmacare in this country unless the federal government shows leadership and calls on the provinces to sit down and roll up their sleeves and start talking about it.

While the government dithers and delays because it is a little complex, what does my hon. colleague say to those Canadians right now whose lives are being shortened in some cases and who are dying because they do not get access to pharmaceuticals because they cannot afford them?

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:15 p.m.

Liberal

John Oliver Liberal Oakville, ON

Madam Speaker, I take some offence at his accusing the government of dithering. It is the committee that is doing the work right now. It is the committee that is working on this report. If the member is suggesting that the committee is dithering, then he should look at his own comments on health at that committee to make sure that we move faster on this.

However, I come back to the point that it is premature to be bringing this motion to the House and asking members of Parliament to pass a motion when they have not seen the full report of the committee and the committee has not even challenged the PBO on those cost estimates the member is quite happy to recite. We should take the time and let the committee finish its work and bring a fulsome report back to the House for a full discussion.

I say again that I share the same agenda and objectives of the member. I think the committee's report needs to be tabled and that we need to give it our full consideration and thought before we think about giving direction as a House to the Government of Canada.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:15 p.m.

Conservative

Colin Carrie Conservative Oshawa, ON

Madam Speaker, I had the honour and pleasure of sitting on the health committee with my colleague, where we did start this report, which I think everyone in the House would like to encourage the health committee to continue.

However, one of the challenges of government is that it has to be responsible. Everyone likes to have positive social programs like these, but it is important to have ways of paying for them. I wonder if my colleague could comment on the NDP's policies, including ones that would increase taxes on Canadians. It has policies against our energy resources sector; in other words, it is against things like the northern gateway pipeline. We have the energy east project. These things put money into the system, but the New Democrats and Liberals seem to be against them.

Could my colleague comment on how important it is that the current government gets its fiscal house in order so that Canadians can afford and take advantage of some of these programs? Does the government have any plan to balance the budget and bring in more income so that Canadians can afford these types of programs?

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:15 p.m.

Liberal

John Oliver Liberal Oakville, ON

Madam Speaker, the hon. member raises a good question about how there is a $20.5 billion cost to national pharmacare. However, as I said in my remarks, taxpayers are already paying for $13.1 billion in public insurance, to public companies, public businesses, hospitals, schools, municipalities, and even the House of Commons. They are already paying for $13 billion of it, so there is a $7 billion shortfall not yet in the system. Private insurance plans are covering $10.7 billion already, so people are already paying for a private insurance plan. We could actually implement this with those two streams and return a lot of savings back to small businesses and the private employers who are covering insurance for their employees at this point in time, and we could cover all—

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:20 p.m.

NDP

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:20 p.m.

Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the Leader of the Government in the House of Commons

Madam Speaker, there is so much that could be said about the issue of pharmacare and how important it is in the whole health care field. Over the years, I have had many opportunities to discuss it, and I have enjoyed every one of these discussions. The issue we have before us today is not quite as simple as the NDP try to portray it.

I believe that we have a government that has been very progressive in moving forward on the health care file. Maybe that is a good way to start my remarks. When I was sitting in opposition, for years I challenged the government, as many others did, to deal with the health care accord. I remember the ministers of Stephen Harper standing up and saying that they were contributing more money to health care transfers, which were at record highs, and all of that kind of stuff. In reality, it was a health care accord by Paul Martin that had increases embedded in it.

Liberal governments in the past and today understand just how important health care is to each and every Canadian, no matter what region, province, or territory they live in. It is a top priority for this government. In fact, within a year and a half, our Minister of Health was able to get together with the different provinces and territories on a one-to-basis to put in place a new health care accord.

When we talk about health care, we also talk about pharmacare. We should also be talking about issues like home care services and hospice care. There are so many aspects to health care that are so critically important to all Canadians.

I was a bit disappointed at one of the questions to my colleague from Brampton. Whether it is my colleague from Brampton or Oakville, or other members of the standing committee, they have recognized the true value of pharmacare and what Canadians' expectations are. They were part of the standing committee. When the steering committee asked what they would like to study and talk about as a standing committee, those two members participated and said they wanted to talk about pharmacare, as did members of other political parties. They understand and appreciate how important it is. That is a very obvious thing to give consideration to at the Standing Committee on Health.

I was very proud of our standing committee in recognizing and coming to an agreement that it was something they needed to work on. I applaud the efforts they have put into it to date. The study has not concluded yet. They have held many meetings and heard from many stakeholders and witnesses on the pros and the cons of a universal pharmacare program, and about many of the problems that exist. I know there are a lot of problems, because I used to be a health care critic in the province of Manitoba.

There are serious issues and problems in health care, and pharmacare is something that consistently came up. We would like to think that an individual who leaves a tertiary hospital, community facility, or access facility would be in a position to take the medications necessary. The concerns I have are reflective of the concerns of the constituents I represent, and I know full well what Canadians would like to see the government deal with. That is why I applaud the efforts of the standing committee.

It was the standing committee that requested the parliamentary budget officer to look into and report back to the committee on this very issue. Yes, there was a report that just came out. The standing committee wanted it, but now one member of the committee is trying to say this is an NDP idea.

This has nothing to do with an NDP idea. I know they are very few and far between, but this is not an NDP idea. This is being driven by Canadians. It is their interest in this very topic that ultimately led to this being discussed by the Standing Committee on Health. It was the committee that asked the parliamentary budget officer to conduct a study and report back to the committee. The committee has not even heard the report yet. I believe it will happen in the coming days, possibly within a week, when it will get the report. It is absolutely critical information that needs to be shared, discussed, and debated as part of the committee's own report before the committee can be in a position to come back to the House.

I understand full well the importance of the issue. I cannot tell members the number of times I have talked to constituents, particularly seniors in my community. We talk a great deal about the cost of medicine. However, we have to understand that Ottawa cannot just dictate to the provinces and other stakeholders the way it will be.

A Liberal administration decades ago brought into force the Canada Health Act. If members check with Canadians today, they will tell them that it is part of our heritage, our Canadian identity. We believe in our health care system. However, that was not achieved by one, two, or three individuals. There was a consensus achieved among the public and parliamentarians at different levels. It was not just Ottawa that turned it into a reality.

We have a government that understands the issue, which is why members will find government members who are exceptionally supportive of the idea of moving forward on this file. We do not need to be reminded or told something by the New Democrats. We consult with our constituents. We understand what is important. However, we also have a a responsibility.

I am looking forward to hearing from the standing committee and ultimately seeing its report. At the end of the day, when I look at the provincial side of it, there have to be negotiations. There will be very delicate discussions in the years ahead on how to deal with the cost of pharmaceuticals.

When I was first elected back in 1988, I believe our health care expenditures were roughly $1.5 billion. That is my best guesstimate. However, if we look at them today, they are is well over $6 billion. Some may find that a laughing matter across the way, but I can tell members that from a provincial perspective, it consumes over 40% of provinces' budgets.

Before opposition members, particularly New Democrats, start jumping up to say they want a national pharmacare program, they better understand how that program would be financed, unless, of course, they are advocating that the national government pay for 100% of it. However, coming from a party that vowed it would not have a debt, those members do not understand the concept.

There is a responsibility to work with the provinces. I cannot recall offhand from my just under 20 years at the Manitoba legislature, most of them under an NDP administrations, when there was a push to resolve that issue.

Now, within 18 months of coming into government, we have this wonderful initiative by the Minister of Health, the pan-Canadian Pharmaceutical Alliance, which negotiates lower drug prices on behalf of public drug plans. This is our Minister of Health working with the provinces and stakeholders to come up with a better way to keep those drug plans' costs lower.

The point is that we have members who understand the importance of what our constituents are telling us, and we have a government that is acting on the important issue of health care. We have seen that not only with that one measure I just made reference to but also in terms of the renewal of the health care accord—

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:30 p.m.

NDP

The Assistant Deputy Speaker NDP Carol Hughes

The member's time is up. Before I go to questions and comments, during the parliamentary secretary's speech, a few members on the New Democratic side were speaking over the parliamentary secretary. I am not going to point out those members, but I want to remind members that I am sure they appreciate respect when they are speaking and will refrain from yelling out their comments. Questions and comments.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:30 p.m.

NDP

Daniel Blaikie NDP Elmwood—Transcona, MB

Madam Speaker, I want to thank the member for exemplifying how Liberals managed to take 13 years and waste it without getting anything done on this file.

A national pharmacare program was a 1993 commitment of the then Liberal government. It had all sorts of platitudes about it, not just in the election but in subsequent Parliaments. It never got it done. The member did a very good job of showing how the Liberals can keep running out the clock on an issue as important as pharmacare without actually getting anything done.

The member rightly says that we need to negotiate with the provinces. It is in the motion to negotiate with the provinces. The motion simply calls for the federal government to organize a meeting of the provinces within 12 months to discuss the implementation of a pharmacare program and to get to all the various details that he and other Liberal colleagues have rightly pointed out.

Our point is that we have seen Liberal governments rag the puck on this issue before, until they are no longer in power. It could be over a decade that they do it. What we are saying is that we want the government to commit to action. We want it to call the meeting and start doing the work that has to be done to prepare for that meeting. That is what we are asking for.

They are right. This is not an NDP issue. It is driven by Canadians. They have been driving it for decades, and Liberal governments have not been doing anything about it. We are asking it to be different, support the motion, and get ready for that meeting.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:30 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, back in October 2015, Canadians voted for real change. That is in fact what has been taking place. All one needs to do is look at what we have been able to accomplish in less than two years. There is a litany of issues I could go through. The highlight for me, personally, on the issue of health, is the renegotiation of a health care accord. That was a significant accomplishment within two years, not to mention what we have already done in regard to trying to keep the cost of pharmaceuticals down, not to mention issues in regard to assisted dying. There are many aspects the government has been able to do in two years that governments have not been able to do in more than 10 years.

We have a standing committee that is actually doing the work Canadians want us to do on pharmacare, and we have a New Democratic member jumping the gun on the issue. Let us allow the standing committee to continue to do the fine work it is doing, and I suspect we would have some very positive results.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:30 p.m.

Conservative

Colin Carrie Conservative Oshawa, ON

Madam Speaker, the parliamentary secretary does speak quite loudly, so I did not even notice the heckling.

I want to point out that it was the Liberal government that cut $25 billion from transfers. My NDP colleague pointed out that the Liberals made a promise back in 1993 to start addressing this issue. Mr. Martin did call something a health accord, and if members remember, he promised to fix health care for a generation. By the end of it, people basically called it a health accord with no teeth. It was a blank cheque, and there was nothing there.

My colleague said that what he is proudest of in health care is the new health accord. We saw the minister get in the room with the provinces, and she was bullying them. She used divide and conquer. I have never seen worse interprovincial relationships.

Could the hon. parliamentary secretary please table the health accord? If they have negotiated this thing he is so proud of, could he table it in the House so Canadians can have a look at it? Could he tell us today where in the health accord it actually addresses the issue of prescription drug availability for Canadians? If that is such a big priority, should it not be in the health accord?

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:35 p.m.

Liberal

Kevin Lamoureux Liberal Winnipeg North, MB

Madam Speaker, with such limited time to respond, I would suggest that the member take a look at the Health Canada website, where he might be able to find many of the answers.

The member referenced the cutbacks during the nineties. I would like to remind members that it was the Brian Mulroney government that shifted from cash to tax transfers. It would have taken Ottawa out of health care expenditures. It was Jean Chrétien who guaranteed that there would always be health care transfers to provinces. He made that commitment.

We have a progressive government today that wants to meet the needs in health care not only today but well into the future, which includes pharmacare and home care.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:35 p.m.

NDP

Daniel Blaikie NDP Elmwood—Transcona, MB

Madam Speaker, it is a pleasure to speak to what is a very timely motion on pharmacare. For the benefit of those listening who have not already heard what the motion reads, it is worth reading it into the record again:

That, given that millions of Canadians lack prescription drug coverage, and given that overwhelming evidence, including from the Parliamentary Budget Officer, has concluded that every Canadian could be covered by a universal pharmacare program while saving billions of dollars every year, the House call on the government to commence negotiations with the provinces no later than October 1, 2018, in order to implement a universal pharmacare program.

These kinds of common-sense initiatives are the reason I got into politics. It is about trying to help ordinary people in their day-to-day struggles with affordability, and it is good public policy. It is good public policy because it would deliver help to those who need it in a more effective way. It is be good public policy because it would also help save money.

I will be splitting my time with the member for Essex, who will have more to say on this, I am sure.

This is exactly the kind of public policy initiative the government should be looking to take, regardless of where it stands on the ideological spectrum. Nobody should be ideologically opposed to helping people out with the things they need to live a healthy life. I do not think anyone is ideologically opposed to doing that for less money.

The parliamentary budget officer's report is the most recent of a series of reports that have been published over the years. I am more familiar with the ones published in the last three years or so, but reports on pharmacare go back decades.

I hear the Liberals pretending that this is a new issue and that they need to know what is in the parliamentary committee's report to pass the motion. The motion only talks about beginning conversations with the provinces. The motion would not prejudge or preclude action on any of the recommendations in the report. It would simply signal a commitment by the government to actually do something about pharmacare instead of just talking about it in the House. I cannot really understand how the Liberals can get up in this place and make that argument and look at themselves in the mirror.

The need for pharmacare has been long-standing. I invite Liberal members to come to my riding and talk to seniors and young people who need medication to go about their day-to-day lives and who are struggling to afford that medication. They can tell them that it is too soon for a national pharmacare program, and it is too soon to start a dialogue with the provinces about how it would be paid for and what the details would be. Those are important, but the bottom line is that whichever governments end up paying for it, they are funded by the same people. They are funded by Canadian taxpayers. They are funded by the people who have to pay for those drugs.

We hear from the parliamentary budget officer that right now Canadians are paying around $24 billion a year for prescription drugs. By having a different level of government pay so that it is more coordinated, those same Canadians could be paying $20 billion instead. For those who struggle with the math, that is $4 billion less per year spent by Canadians on prescription drugs. I am baffled that the motion does not enjoy the support of the whole House, but particularly of a government that styles itself as progressive and as wanting to help people and help the middle class.

I want to raise a particular example of a young women from my riding named Kerri, who is part of the Faces of Pharmacare campaign. I would encourage people listening at home and members here to check out Faces of Pharmacare. They can Google it. It is stories of Canadians across the country who are struggling with prescription drug costs and are calling for a national pharmacare plan. Kerri says:

The four asthma medications I take keep me relatively healthy, and being diagnosed with severe ADHD in my early twenties, ADHD medication has been positively life-altering for me. My ADHD medication is not fully covered by [the Manitoba pharmacare program], but with assistance from other programs I am able to cover the full cost of the name brand medication as my doctor has prescribed.... This adaptation allows me to feel and function at my best, both in traditional employment scenarios as well as in self-employment. Without Manitoba Pharmacare, my prescriptions would have cost 24% of my income—nearly a quarter of an income which a totally “healthy” person would not have to pay!

A national pharmacare program could do more to assist Kerri and people like her who are struggling to afford the medications they need, as she rightly points out, to participate in the labour market. We are talking about reducing the sticker price of drugs, but there are other costs we are incurring economically, in terms of lost productivity, that are not measured by the PBO report but are very real when people cannot afford the prescription drugs that keep them going.

I have talked to a lot of seniors in Elmwood—Transcona as well. It is clear that seniors on fixed incomes who are just receiving CPP and are relying on the GIS are not able to afford their prescription drugs. Having a national pharmacare plan would make those drugs affordable for them and would take away one of the many pressures people who do not have enough income face. They face those pressures when it comes to housing. They face those pressure when it comes to food. One way we could help that is concrete and makes sense is to establish a national plan so that by virtue of coordinating our purchases in a different way, the money we are already spending on drugs would be less, which would mean more money for other things.

To the extent that a lot of the people who would benefit from a pharmacare program are those who do not have high incomes, that money would go back into their pockets, whether it was refunded by the federal government, provincial governments, or municipal governments, or there was a lower cost at the drug store for certain other drugs. However the money would go back to Canadians, we understand that at least $4 billion a year, and some studies say as much as $7 billion or $11 billion a year, would end up back in the pockets of Canadians. When we put money back in the pockets of low-income Canadians, it is money that is spent in the community. It is not money that goes off into a tax haven somewhere. It is not money that would not be captured because there is a CEO stock option loophole being taken advantage of. It is money that would go back into Canadians' pockets, and it would be spent at local grocery stores. It would be put back into the public transit service of the municipality they are in. Those are the kinds of things people are struggling to afford in Canada, and those are exactly the people that a national pharmacare program would help.

What are the arguments we are hearing against it from the other side? It sounds to me like the government has agreed that people are struggling with the cost of prescription drugs. It does not seem to deny it, although there was an allusion to the idea that maybe the PBO report is not authoritative or that they need to examine the study themselves and then pronounce on whether the parliamentary budget officer did a good job. Maybe he is off by $4 billion, in which case there is a net zero effect. I do not know. Liberal backbenchers would like to redo the work of the PBO. I do not know what kind of resources they have in their offices, but I am willing to take the parliamentary budget officer at his word.

Liberals say it is too fast. The Liberals were calling for this in 1993, and the NDP much longer. Canadians who are struggling with the cost of prescription drugs have been calling for this much longer. There is no way to implement a pharmacare program today, tomorrow, or a year from now that would be too soon. We are way past doing this too soon.

New Democrats want the government to support this motion. That is why the motion simply calls on it to convene a meeting of the provinces and the federal government within a year. That would give them a lot of time to prepare for that meeting and to get into all the details.

The Liberals are right. There are details to work out about this, but there are details to work out with respect to the legalization of marijuana as well. That is a complicated issue. That involves Canada's commitment under international treaties. That involves discussions with the provinces. That involves discussions about how much to tax it, where the revenue is going to go, and to whom, and how old people will have to be to smoke it in their provinces. That is something the Liberals said, in light of others who said it was too complicated and they were moving too quickly, was a question of political will, and they were going to get it done.

On an issue that has been decades in the making and that hurts seniors and others who are struggling to afford prescription drugs, I do not understand why the Liberals do not have the political will to start this discussion as soon as possible. They should bring the provinces around the table and get it done. They are doing it on other issues, and they ought to be doing it on this one.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:45 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Madam Speaker, the member for Elmwood—Transcona gave an outstanding speech, and he made several powerful arguments and comments.

The amount of deflecting and excuse-making I have heard from the government side of the House today is almost unprecedented, but I have not heard a single Liberal disagree with the two fundamental realities in Canada right now: millions of Canadians cannot get pharmaceutical coverage, and a universal pharmacare system would save billions of dollars.

My hon. colleague pointed out that in terms of working out the details, of course we would have to sit down with the provinces and work out what kind of formulary we would have and how the costs would be shared. The bottom line is that whoever pays for pharmaceuticals now would still be paying for them after universal pharmacare, but they would be paying at least $4 billion less.

Since I cannot get the Liberals to explain the problem with that, would my hon. colleague explain any public policy arguments he sees against that proposition?

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:45 p.m.

NDP

Daniel Blaikie NDP Elmwood—Transcona, MB

Madam Speaker, what is shocking is that there is no argument against it. Saving $4 billion a year is a good idea. That money would go back into the pockets of Canadians, and it is money that right now is going into the pockets of big drug companies. Those are not the people we are here to defend. I do not know why the Liberals see it as being their role to defend those guys through inaction, if not in words, and I want to speak briefly to the comments my colleague made about what we are hearing from the other side.

If we had no sense of history in this place, we might say we should give the Liberals the benefit of the doubt. They say they are working on it. Okay, let us give them time to work on it. Even the motion does give them time to work on it, so nobody is being unreasonable on this side of the House.

However, when we look at the Liberals historically in terms of their commitments in 1993 for a national pharmacare program, we see that they had 13 years to do it and did not even try, and then on other commitments, such as electoral reform, the current government members strung the House along until ultimately they said they were never committed to it in the first place, so there is no reason to take them at their word when they say this is something that they are going to get around to.

Opposition Motion—PharmacareBusiness of SupplyGovernment Orders

1:45 p.m.

Liberal

John Oliver Liberal Oakville, ON

Madam Speaker, I am a new politician, and I feel it is unfortunate that on this issue that is so important to so many Canadians, there is such politicization across the ranks. If ever there is a time for parties to pull together and work together for Canadians, it is on an issue like a national pharmacare program.

That said, one of the complexities we were dealing with at the committee was whether there should be a national formulary or provincial and territorial formularies. That is a very important discussion, because provinces and territories may have very different decisions and thoughts on what they would include in their formulary.

I notice in the motion, which the member took great care to read into the record, that they have decided not to include the territories in these discussions. If the decision is made by the provinces that there should be provincially unique formularies, I am not sure the territories are sufficiently ready to deal with formulary development. I am wondering why New Democrats chose to exclude territories from the motion.