Mr. Speaker, all Canadians should have affordable access to prescription drugs. It is a key component of health care. Income and ability to pay should not stop people from having access to life-saving treatments.
I do want to thank my colleague from New Westminster—Burnaby for bringing forward a suggestion on how we can help people like his friends Jennifer and Jim. For us to evaluate whether his potential approach is the best one or would actually work, we must begin with a review of the current state. There are three points to consider.
First, how many Canadians have drug coverage at present and how many do not? At present, most recent estimates suggest that between 90% and 98% of Canadians have some form of prescription drug coverage, whether through private insurance or a public plan. While a smaller percentage of Canadians do not have coverage, many Canadians already do. We should be targeting our intervention to Canadians without adequate coverage and clearly defining what that means.
Second, the gaps in coverage are not just for those who cannot afford to pay for prescription drugs. There are also gaps in coverage when drugs are available elsewhere in the world, but not in Canada. One example is the life-saving drug for cystic fibrosis patients called Trikafta.
Third, health care delivery has a large jurisdictional responsibility within the provinces. While I believe federal and provincial governments should work together to address issues like this, we also need to ensure that any potential solution respects jurisdiction and the unique regional challenges of our Confederation.
In the context of these three points, I will evaluate whether the proposal of this bill is the best option to address this issue.
First, let us start with what this bill does. To re-emphasize, many Canadians already have some form of drug coverage, but the coverage these plans do provide is provided by employers and insurers, not taxpayers. This bill proposes that the best way to provide coverage to the smaller percentage of Canadians who do not have adequate coverage is to eliminate access to private plans for those who currently have them and replace them with plans provided by a government agency and the taxpayer with varying degrees of coverage that might be less than their current level of coverage and likely with a tax increase to cover the significant associated cost. This is what is commonly referred to as pharmacare in Canadian politics.
Many people do not understand that what proponents of pharmacare mean to do is eliminate the coverage many Canadians already have, replace everything with state-run coverage that might not be as good as their current coverage and likely significantly increase taxes to do so. I believe that instead of this approach, it would be better to focus on targeting support to those who do not have it, rather than entirely scrapping a system that works for a majority of others.
Second, this bill does not address the potentially unintended negative impact it might have on patient care. We do not know the level of coverage this proposal would provide and whether it would be a lower standard than what many Canadians already have in their current plans. This needs to be clarified.
A good example of this is what happened with the OHIP+ program under the Ontario Liberals. OHIP+ was supposed to fix access to drug coverage for people under 25 by providing public coverage. However, Ontarian Jackie Bain had to start paying out of pocket for her son's ADHD medication because her private insurance was no longer recognized. Many Ontarians face similar issues with access to other prescription drugs for epilepsy and rheumatoid arthritis.
OHIP+ transferred 2.1 million Ontarians who already had private plans to a public plan that provided worse coverage than what they had before and at a higher cost. In other words, the government's attempt to increase drug coverage by fully eliminating private plans removed more people from drug coverage than it added. The vagueness of this bill gives rise to this possibility, but on a national scale.
Third, this bill needs to clarify the potential impact of nationalizing access to pharmaceuticals on workers in pharmacies across this country. Would their jobs and businesses and ability to provide expert advice to Canadians be affected? This impact needs to be addressed.
Fourth, there is no consensus on whether this bill's approach would actually provide savings. For example, the Neighbourhood Pharmacy Association of Canada estimates a single-payer, pharmacare plan would cost between $10 billion and $14 billion, which is different from what this bill's sponsor has suggested. That cost estimate is on top of other issues it would produce in terms of dismantling existing private coverage and replacing it with government bureaucracy, for which detailed publicly available costing is not available.
On the issue of bulk purchasing, nationalization is not needed for provinces and territories to buy drugs in bulk.
Fifth, this bill does not address the issue of lack of access to life-saving drugs in Canada. There is no doubt that we need a strong drug and therapeutic safety review process, but as we have seen with the Liberals' slow and backward approach to reviewing COVID rapid tests, this system could use improvement.
Drug access for Canadians has arguably been threatened by the government's changes to what are called the PMPRB regulations. We have seen how this regulatory uncertainty has deterred some life-saving drugs from entering the Canadian market. These changes could dramatically alter pharmacists' abilities to run patient-support programs. While the new guidelines may lower some drug prices, they might also harm our ability to get access to certain new therapeutics, and this needs to be addressed.
Sixth, the bill does not adequately address other issues related to drug supply. Our drug supply has been in jeopardy since the start of the COVID pandemic because of disruptions to supply chains. Canadian pharmacists have been ringing alarm bells for months, but the government has not done anything. Given that government usually does not do anything particularly well, in this regard I worry about what would happen if the government took total control of access to prescription drugs, as the bill may propose.
Seventh, I am worried that the member has not addressed jurisdictional issues raised by members during debate today.
In short, I believe the bill will not provide access to pharmaceuticals to vulnerable Canadians who need them the most and could have significant negative unintended consequences that could actually make drug access worse for some Canadians and add another tax burden to already heavily taxed working Canadians. However, I do agree with the bill's sponsor that we need to help vulnerable Canadians who do not have access to prescription drug coverage, like his friends Jennifer and Jim.
This is what I suggest.
We should encourage the government to finally come up with a fully costed plan in coordination with the provinces to provide support for those without prescription drug coverage within the system that already provides significant coverage to millions of Canadians. That plan should be compassionate and first aimed to help those who are in critical need of access to life-saving drugs.
It should reduce bureaucracy rather than create it, as the bill proposes; sustain access to coverage for those who already have it; and protect jobs and businesses rather than looking to replace them with unnecessary government bureaucracy.
It should respect provincial jurisdiction while taking a leadership role to help those in need. It should also work with the provinces on creative ways to enable bulk purchases within existing regulatory structures.
It should look at innovative ways to reduce costs for these products within the existing system, such as looking at policy options like classifying common drugs that are classified as over the counter in allied countries like the U.S. and the U.K. as over the counter here. Some estimates suggest that if we did that for just three drugs, we could ensure Canadians save $1 billion a year on spending on drugs.
This plan should also bolster Canada's capacity to domestically manufacture critical drugs. It should ensure strong safety reviews for therapeutics and devices, while eliminating the pedantic, slow and innovation-killing systems that prevented Canadians from getting COVID rapid tests and Trikafta. It should correct policies that prevent Canadian medical innovations from being commercialized in Canada, as many of our innovations are currently licensed out of the country instead of being retained here.
I strongly believe that we have a duty to provide support to people who do not have access to pharmaceuticals in Canada. I think it is long overdue, and it is something federal Liberal governments have been talking about since the 1970s. However, I do not think the bill gets it right. I think we should be looking at a hybrid system that takes into consideration the points I have made and allows Canadians to have adequate coverage. We should then build on that rather than just seeking to nationalize it. I think we should also be questioning what the role of government is in this regard, and we should be targeting our plan to the people the member for New Westminster—Burnaby talked about in his speech, rather than trying to eliminate coverage for people who already have it.
I certainly want to emphasize that the Conservatives will continue to support government action that makes prescription drugs more accessible and affordable for Canadians. We will hold governments to account, especially the current Liberal government, which has not addressed issues like access to novel therapeutics like Trikafta. However, we do not think we need to nationalize the entire system to do this, and we are concerned about examples like OHIP+, which really failed a large portion of people who enrolled in it.
I look forward to working with my colleague in a non-partisan way on this approach, but I think his bill needs a lot of improvement.