Debates of March 12th, 2020

Opposition Motion—Pharmacare

[Stéphane Lauzon, Liberal, Parliamentary Secretary to the Minister of Seniors]

Mr. Speaker, I would like to thank my colleague from Cumberland—Colchester for sharing her time with me.

Our government is committed to providing the first nations and Inuit access to the health services they need, including the necessary medical benefits coverage provided by the non-insured health benefits program, the NIHB.

The NIHB program delivered by Indigenous Services Canada is one of the largest supplemental health benefits programs in the country. This program is national in scope and provides the necessary health benefits to roughly 868,000 eligible first nations and Inuit clients, both on and off reserve. Last year, the NIHB program spent more than $1 billion on providing access to these medically necessary health benefits and services.

The NIHB program provides significant coverage in different insurance zones that is complementary to the insurance already provided by the provinces, territories and private insurers. This includes prescription drugs, non-prescription drugs, medical supplies and equipment, mental health counselling, dental care, vision care, and medical transportation where health services are not available in the community.

Access to affordable medication is not just a provincial responsibility. The federal government administers five separate drug plans for first nations and Inuit peoples, for offenders in federal correctional institutions, for members of the military, for members of the RCMP and for veterans.

The NIHB program gives eligible first nations and Inuit peoples coverage for the prescription medications and over-the-counter drugs included in the NIHB drug benefit list when they are prescribed by a health care professional. The NIHB drug benefit list currently includes about 900 chemical entities, or about 8,500 separate drug identification numbers, known as DINs.

I should also note that coverage for certain drugs not included in the drug benefits list may be approved under exceptional circumstances. Unlike many other programs, the NIHB does not require eligible clients to pay a co-pay or deductible, and health care providers are encouraged to bill the program directly so that clients do not incur any additional fees. Federal drug plans have adopted an approach focused on assessing health technologies, to ensure that pharmaceutical products are accessible, affordable and appropriate for clients.

Once a drug is approved for sale in Canada, our country's public drug plans, including the NIHB program, must decide whether the drug will be eligible for public reimbursement. To facilitate this decision-making process, Indigenous Services Canada, along with the other administrators of federal drug plans, fully participates in the common drug review and the pan-Canadian oncology drug review, which are managed by the Canadian Agency for Drugs and Technologies in Health, or CADTH.

As part of its reviews, CADTH conducts objective evaluations of the clinical, economic and patient evidence on drugs and uses this evaluation to provide reimbursement recommendations and advice to Canada's federal, provincial and territorial public drug plans. Public drug plans, including the NIHB program, make their final decisions on whether to reimburse or cover drugs based on the recommendations of CADTH and on other factors, such as the plan's mandate, jurisdictional priorities and budgetary implications.

If necessary, price negotiations will take place to improve cost effectiveness.

Last year, a single drug class, biologic anti-inflammatory drugs used to treat certain autoimmune diseases such as rheumatoid arthritis, accounted for 10% of the pharmaceutical market, with sales totalling over $2 billion in Canada. That is a lot of money.

It is worth mentioning that we pay approximately 25% more to treat arthritis than other countries with similar markets. For example, in Ontario, the top selling arthritis drug costs nearly $30,000 per year. In France, that same drug costs about $22,000 per year. If Canada paid the same price as France, we would have saved $220 million a year last year on that drug alone. Any failure to get the best price for a drug is a missed opportunity to do more for Canadians.

We can do better. The work has already begun. The federal, provincial and territorial governments came together to create the pan-Canadian pharmaceutical alliance, or pCPA. The pCPA negotiates drug prices on behalf of public drug plans. By harnessing the collective purchasing power of governments to negotiate the best price, we will save more and more money. We will continue to work to that same end as new drugs are added.

Treatment for hepatitis C is a good example. Hepatitis C can be debilitating and fatal. If left untreated, it can lead to liver failure and cancer. New hepatitis C treatments are effective for many patients, but they cost between $45,000 and $100,000 per patient.

In February 2017, the pCPA succeeded in lowering the cost of hepatitis C drugs. For public drug plans, lower prices mean more patients can get better treatment sooner. That is proof that working together makes the provinces and the country stronger and better able to make good decisions and work on reducing drug costs.

As a full member of the pCPA, the non-insured health benefits program, the NIHB, is implementing new agreements negotiated by the pCPA, which is making new drugs more affordable and more accessible for members of first nations and Inuit communities.

We recognize that there are serious problems related to substance use disorders across Canada, including in indigenous communities. The government takes the issue of client safety very seriously. The NIHB program is recognized as a national leader when it comes to efforts to address substance use disorders and protect client safety. It has implemented a broad range of measures over the past decade to ensure that clients receive the medication they need without putting them in danger.

Here are some examples of such measures: using warning and reject messages in real time to alert pharmacists of potentially worrisome situations regarding safety; introducing dosage and quantity limits, thereby limiting the quantity of drugs a client can receive; and imposing access restrictions on drugs when there is a safety risk or risk of diversion.

To detect high-risk drug tendencies, potentially inappropriate licensing and other safety problems, the NIHB program has a formal monitoring program, which directly implicates prescribers and providers when concerning trends are detected. Clients whose drug utilization patterns indicate an increased risk are entered into the client safety program.

Furthermore, the NIHB is guided by the Drugs and Therapeutics Advisory Committee, known as DTAC, which makes recommendations with respect to drug policies and the drug formulary. The DTAC is an advisory body of highly qualified health professionals who bring impartial and practical expert medical and pharmaceutical advice to the NIHB program to promote improvement in the health outcomes of first nations.

The approach is evidence-based and the advice reflects medical and scientific knowledge, current utilization trends, current clinical practice, health care delivery and specific departmental client health care needs.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, there has been a lot of talk today about the proper relationship between the federal government and the provinces. Health care is a shared jurisdiction and in this country we have made it work with medicare, with the federal government providing transfer payments to provinces, which then are responsible for delivering those services to their citizens. It is a cost-share and nothing obligates a province to participate. Provinces could pull out of medicare tomorrow if they wanted. Why do they do it? Because they want the federal contributions, they want good health for their citizens and they agree to abide by the principles of the Canada Health Act.

The New Democrat proposal and the Hoskins proposal is to do that very same thing with pharmacare. The federal government would provide transfer funds to the provinces, they would negotiate a shared formulary and the provinces, if they wish to participate, would provide drugs at no cost, respecting the principles of the Canada Health Act, and receive money in exchange.

Does my hon. colleague agree with the NDP that it is a viable way of delivering pharmacare into the public system, just like we deliver all other covered health services under the Canada Health Act?

[Stéphane Lauzon, Liberal, Argenteuil—La Petite-Nation, QC]

Mr. Speaker, I would like to thank my colleague for his question and participation from the start of the debate.

Personally, my wife, my daughter and I have used Quebec's pharmacare plan. We are diabetic and require fairly expensive medications.

I am thinking of a colleague from the west or elsewhere in Canada who may not have access to these medications. Even though Quebec has pharmacare, I believe that the collaboration of the provinces and territories is the key to success. That is what we have been saying from the beginning, ever since I was elected in 2015. We have never prevented a province from moving forward.

I am proud that Quebec serves as a model. In Quebec, we are proud to work with the provinces to show the rest of Canada that we can always do better.

[Denis Trudel, Bloc, Longueuil—Saint-Hubert, QC]

Mr. Speaker, I thank the member from Quebec for his valuable contribution to the debate, but he is not answering the fundamental question.

Earlier, my Liberal colleague talked about Quebec and Canada collaborating. I asked him the same question. There is no collaboration. Quebec's National Assembly is unanimous about that. Coalition Avenir Québec, Québec solidaire, the Liberal Party and the Parti Québécois all agree that the federal government should mind its own business.

Ever since the Constitution, health has been under provincial jurisdiction. If my colleagues want to change the Constitution, that would be fine by us. The Bloc Québécois has a number of demands relating to the Constitution. If MPs want to reopen the Constitution, we would be happy to. We could have a lot of conversations about that.

The National Assembly said no to collaboration. What we want is the money. We know what to do. We already know how to manage hospitals and doctors. As my colleague said, Quebec has had pharmacare for 20 years. It is not perfect, but it works pretty well. We want health transfers.

What does my colleague have to say to that?

[Stéphane Lauzon, Liberal, Argenteuil—La Petite-Nation, QC]

Mr. Speaker, I want to thank my colleague opposite for his question and his participation. He has asked many questions in the House. They often come back to the same thing, but I will be pleased to answer them.

First of all, I am very happy to represent Quebec. In Quebec, I benefited from a system that was very good to me. However, in the House, I have decided to represent Canada. I was elected to the Parliament of Canada to represent Canadians, and my role is to represent the entire country, not just one province.

I will use my province, which is a model when it comes to drug insurance, to spread the good news to all my colleagues in Canada. I never feel like I need to protect just one province, like my colleague across the way does. He speaks only on behalf of Quebec. He has no concern for other people in Canada who need medication.

[The Deputy Speaker, Conservative, Bruce Stanton]

Before we resume debate, it is my duty pursuant to Standing Order 38 to inform the House that the questions to be raised tonight at the time of adjournment are as follows: the hon. member for Edmonton Strathcona, International Development; the hon. member for Bow River, Health; the hon. member for Louis-Saint-Laurent, Natural Resources.

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

Mr. Speaker, today I will be splitting my time with the member for Esquimalt—Saanich—Sooke.

I am really happy to be here today in the House talking about something that is so important to so many Canadians across this beautiful country. I am going to ask lenience from the Chair to wish my grandson a happy fifth birthday. Today, Shoshonne will be five. I was there when he came into the world and every birthday that I am not with him I am always a little sad. I want him to know that his Chi-chia loves him very much and wishes so much that I was with him today.

One of my mentors was the late Maya Angelou and she said, “When we know better, we do better.” When I think about the discussion we are having today on a national universal pharmacare program, I cannot help but think that we have known better for a very long time in this country and it is rather devastating that we are still having this conversation. In fact, we are the only country with a universal health care program that does not have the partnership with the universal pharmacare program and that is very concerning for myself and for many of the people that I represent in North Island—Powell River.

When I look at the history of this place, universal public drug coverage has been recommended by commissions, committees and advisory councils dating as far back as the 1940s and here we are in 2020 still having this debate when people are struggling every day in this country to afford medication that they need to survive. We know that in our country, one of the wealthiest countries in the world, people are dying because they cannot afford their medication. That is the type of isolation and pain that a family has to face that I cannot imagine. I am really shocked that we are still here having this debate like it is something we should be discussing instead of something we should simply be acting on.

The Hoskins report, which the Liberal government sponsored, was very clear. I do not know what else is really needed here, but here we are having this discussion again. The Hoskins report said a universal, comprehensive, public pharmacare program would reduce annual system-wide spending on prescription drugs. It would lower drug costs. It is something that is so important. I think of the many constituents who have come to me and talked about their personal reality. When we have an opportunity to do better for Canadians, I hope that everyone in the House will support this motion so that we can take that action.

In my opinion, pharmacare should follow the same basic principles that are the bedrock of our public health care system: universality, comprehensiveness, accessibility, portability and public administration. It just makes sense.

Once implemented, a pharmacare plan would make medication free for Canadians and there are a lot of constituents who cannot imagine a world without that financial burden, without the constant stress of worrying about how they are going to pay for their loved one's medications. I talked to family groups that are collaboratively coming together every month to put down the little that they have to buy medication for somebody in their family who is struggling with health concerns.

When we look at the system, we also know that it will have an impact on our emergency wait times because people will actually be taking the medication they need so that they do not have to go to the emergency wait lines all the time. It would free up more hospital beds for those who need them. People who need medications and cannot afford them should not have to be in those beds. They should be given the medication they need and not have to access the service. They deserve a better life than that.

We also know it would save governments more than $4 billion a year. Basically, after what the Hoskins report clearly stated, this is really a choice for the government to choose a system that will put Canadians first and will make sure that the health care and the well-being of Canadians is top of front and centre, or we will continue to have a system that largely benefits big pharma and the insurance industry.

In my riding of North Island—Powell River, we have a lot of rural and remote communities and a lot of people with differing experiences. The stories that I hear from each corner of the riding always make me concerned and I carry those stories with me.

I remember one woman who talked about her health care issue. She told me her family worked together so that she could buy a van. She needed the van because she could not afford rent. Her plan was to live in the van and then she would be able to afford her medication on her very limited income. She was worried about what it would be like in the winter. She had been living in her van for months, but it was the warmer months and she did not know what would happen when it got really cold.

This is Canada and this is a decision one of the people who lives in this country has to make.

I talked to a senior woman in my riding who lives in one of the northern parts, so it is a little bit more chilly during the winter. She talked about how every January and February she turns down the heat and has to wear extra sweaters and gloves in her house because she simply cannot afford the higher cost of heat, as well as her medication at the same time.

When I think of the people who built our country, the seniors of this country, asking them to do this just does not seem right to me.

I also have a constituent in the riding who has a very serious health issue that requires him to wear compression socks and he needs medication to keep him alive. The medication costs $70 per month and at this time he is only able to afford the medication, so he cannot afford to buy the compression stockings as well. This has gone on for several months. The family is really worried that he is going to end up in a hospital. Their frustration is that for the price of some compression socks why it is that he has to potentially spend time in the hospital? Where is the help? Where is the support?

Another woman named Ann in my riding spoke to us and said that she is a diabetic. Every month, the cost for her is $174 for the medication that she requires simply to stay alive. She will be 60 years old in June and she has no plans to retire because she cannot figure out any other way to afford her medication. It concerns her that it is different in every province. When she lived in Alberta, this expense was covered, but now that she is in B.C., it is not. I have heard this from young people as well with diabetes, who talk about the different services that they get in each part of this country.

We need to start looking at this because if we are going to have a universal health care system, as well as, hopefully soon, a universal pharmacare program, it really is devastating to think that some people get treated in some provinces and territories and they do not in others. That does not seem right to me if we want a universal system.

One in five Canadian households have reported a family member who, in the past year, has not taken prescribed medication due to cost. We know that after continuous cuts by the Liberal and Conservative governments, we have seen that less and less money going to the provinces for health care. All of these things are adding up, making it harder and harder for families every single day.

Nearly three million Canadians per year are unable to afford one or more of their prescription drugs. These stats are important because we know that people are not able to afford what is going to keep them well. Think about some of the challenges. I have talked to families who have children with serious health issues. I remember one in particular whose daughter had diabetes and had a scanner in her arm, but it cost a certain amount of money. When the father of the family was hurt at work and was on a disability pension, they could not afford that anymore and they had to get it removed from her arm. I cannot imagine families having to make these kinds of decisions.

There are some fundamental issues we need to deal with in this country. We know of the three million Canadians who cannot afford their medications, with 38% having private insurance and 21% having public insurance, which does not cover enough of their costs. Almost one million Canadians per year cut back on food or heating, like the senior in my riding, in order to pay for their medication and almost one million Canadians every year are borrowing money to pay for their medication.

I am a great admirer of the greatest Canadian in our country, and that is Tommy Douglas. He had a vision. I am hoping that today we will all be brave enough to step up to support this and move farther toward that dream and that vision, because this is really a way of making sure that everybody gets the treatment that they deserve in our country. It is about looking at how to spend money more effectively. I certainly would love to see money going into somebody's medication instead of it going into a hospital bed. We do not want people who are not well to be in a hospital bed when medication would make their lives that much better. Hopefully, we will see a positive result of this.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, I have raised the issue repeatedly about access for rare disease patients. That is what I want to talk about some more. One of the ways the national pharmacare would work is this. The current architecture for drug approvals in Canada goes through CADTH first for a health technology assessment, or HTA. Then pCPA is the negotiating body on behalf of the provinces.

I know there are some Liberal members who have said the Canadian drug agency would basically do this now, but in the current architecture what is going to happen is that a drug will get approval and then not be reimbursed by the public insurers. It is happening and is going to happen in the national pharmacare system. I have examples from my riding and all across Canada of where this happens. In some cases, people are even prohibited from using a special access program, because they are told it is a drug approved in Canada, but it is not publicly reimbursed.

If the NDP thought it was important to introduce this, I would ask the member why there was no mention of rare disease patients in the motion if it is of concern to the national pharmacare system, because the architecture of the current regulatory system really disadvantages rare-disease patients' families.

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

Mr. Speaker, I am the daughter of a nurse. She talked a lot about some of the challenges that people with rare diseases face in the work that she did.

I want to point out that this motion is really talking about what the Hoskins report said, and this issue was addressed in that. It is very important that, as we look forward to making sure we have a comprehensive plan, we understand that there are rare illnesses for which we need to make sure medication is accessible. I remind the member that the NDP will always fight for the people who are suffering the most, who need help the most and who are the most vulnerable, because that is the core belief of our party: No one gets left behind.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I am very pleased to have an opportunity to discuss pharmacare today. To me it is clear the majority of members in this place are on side to see this motion pass. I certainly hope that is the case. It is the tone of the debate.

I want to ask my colleague this. As we go forward, we know that a national pharmacare plan and the bulk buying of drugs will bring down the price of these drugs for every Canadian. I wonder if we can also think about assuring that the drugs we register will do more good than harm.

I think the motion suggests it. I am very taken by the work of the UBC therapeutics initiative. It assesses the drug data package to make sure that we are resistant to big pharma deciding we need drugs that might have significant and dangerous side effects, to make sure we register the drugs and make them accessible to all Canadians, and to make sure they are the drugs that we need and will do more good than harm.

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

Mr. Speaker, when we look at the basis of the motion, and also the Hoskins report, one of the most important parts for me is that it takes a lot of power out of big pharma and insurance companies so we can have a better regulated system. We need to ensure accountability on the part of the people who are producing the drugs to make sure they are as safe as possible and make sure that people do not get sicker because of the medication they are taking.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, some time ago, the nation of Quebec brought in a pharmacare program for a number of reasons, including the one just raised by my NDP colleague. There has been talk about shared jurisdictions, but consecutive federal governments have failed to take responsibility for their own jurisdiction, particularly in relation to the regulatory framework for drug prices. What is my colleague's suggestion for that?

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

Mr. Speaker, it is important that we work together with all the provinces and territories to figure out how this process will unfold. That will obviously be a mandate. We know that provinces may choose to opt out, but I certainly hope there is an understanding that the collaborative nature of this process will see costs going down dramatically. I think the Parliamentary Budget Officer was very clear about that in his report a couple of years ago.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Mr. Speaker, I am pleased to rise today to speak on my party's opposition day motion on pharmacare. I have to say that my twentysomething self would be somewhat perplexed that I am actually doing this, and that is not just to think that as a gay man I might be an MP, but also that we still have not finished Tommy Douglas' dream of comprehensive public free health care.

Strangely, we have convinced ourselves we already have that. We seem, somehow, to be turning a blind eye to the gaps in that system. Tommy always thought it would be a step-by-step process, but that eventually we would get there. I think we have to ask ourselves how we have convinced ourselves for so long that pharmacare and dental care should not become part of our comprehensive public health care system.

I am very pleased to sit in an NDP caucus, led by the member for Burnaby South and by the member for Vancouver Kingsway on this important question of how to advance toward the goal that Tommy set so many years ago. It is a caucus that has put forward clear and achievable plans to fill those gaps.

When the Liberals proposed the so-called middle-class tax cut last December, we proposed in return that we limit the benefits of those cuts to those earning less than $90,000. With the savings from limiting that tax cut's benefits to the rich, we could in turn finance a dental care program for everyone earning less than $90,000 a year.

There is a practical step we could take and a way to pay for it, one that is clearly within our means and clearly doable. I am hoping, after we debate pharmacare, that we will move to that next stage of debating dental care in this Parliament.

As promised by our leader, our first private member's bill that is going to be brought before the House here will be by the member for New Westminster—Burnaby, Bill C-213. This lays out a specific plan for pharmacare, based on the principles of medicare. Once again, this is a program that is universal, comprehensive, accessible, portable and publicly administered.

My twentysomething self would also be perplexed about why we do not already have this. When Tommy Douglas set out his dream, first in the provincial campaign in 1960 in Saskatchewan, he knew it would be difficult, he knew it would be step by step. In 1962, when he tried to add doctors' visits to the existing hospital insurance plan, he had to face down a 23-day doctors' strike.

We know there will always be people who will step forward, who will say there are so many reasons why we should not take the path we know is the right path.

In 1965, B.C. joined Saskatchewan with a hospital and doctor visit insurance plan, and then in 1966, in Pearson's second minority government, we had a federal government that finally offered financial assistance to provinces that had such a universal plan. Sure enough, within 10 years, we had public health care plans established in every province across the country.

When Tommy moved to the federal level, he brought his dream with him. In 1961, he became the leader of the newly established NDP. In the first platform the NDP put forward, specifically, a proposal to have a pharmacare program on the same principles as a medicare program. Unfortunately, it has taken us a bit longer than I think Tommy thought it would to get an NDP federal government. I know that, because in his last term I had the great privilege of having Tommy as my MP.

Along the way there were other reasons to be optimistic about pharmacare. I guess I would have to admit that. First of all, as previous members have mentioned, we have had numerous commissions, advisory councils and studies dating back 60 years, probably to the first one that I saw, recommending a universal pharmacare program.

One would think we would get to this. Skipping over all that time, last June we had the Hoskins report from the Liberal government's own appointee. A Liberal from Ontario sat down and worked through all of the issues, and ended up recommending the same thing that we have all known we needed, according to the five principles of the Canada Health Act. It was something he judged we could implement by January 1, 2022.

Perhaps today's motion is the first step toward that date: January 1, 2022. I really hope it is. I am encouraged by the things I have heard from previous Liberal speakers, that they are going to support this motion. This motion commits the House to moving forward on pharmacare. It is not just an expression of opinion, as opposition day motions sometimes are. It is a commitment, if it is passed by the majority, that we will actually do something to get pharmacare in place.

I would hope that action would occur quickly. The NDP has offered that opportunity with our private member's bill.

However, we would not be disappointed if the government introduced a bill even before that and decided to move it through expeditiously as a government. I am not seeing that happen, but maybe today this opposition motion marks a change in direction toward finally getting this done.

Let me talk for a moment about why we should be doing universal pharmacare, and in doing so I could talk about savings to the health care system. The Hoskins report was very clear that overall expenditures on prescription drugs in this country would drop by about $5 billion a year. This would come from a number of sources. One is, of course, that we would get the ability to negotiate lower prices for drugs through strategies such as bulk buying of drugs, increasing generic substitutions and also eliminating administrative costs.

For those members in the House who like to go on about bureaucracy, let us look at the patchwork system we have across the country with literally more than 1,000 health care plans all being administered to accomplish the same purpose. The Hoskins report was very clear about the savings overall to the system if we adopted a universal, comprehensive and publicly delivered pharmacare program.

I could talk about the savings that would come to the health care system through better health outcomes. This goes beyond that $5 billion. What it would really mean is if we remove the barrier of cost for people to actually get the treatment they need, in terms of prescription drugs, they are going to be healthier. That would reduce the stress on our already overburdened health care system.

This would mean that we could do more with the same resources we have now if we did not have people who end up in the emergency room, in the hospital or ill because they could not afford their prescription drugs. That is an additional savings that would not show up in dollars, but it would show up in less stress on the dollars we are already devoting to our health care system.

I could also talk about savings to business. This may be a strange one for some people to think about, but there would be important savings to businesses here from adopting this kind of national comprehensive program. Right now, businesses and their employees jointly spend about $16.6 billion in expenditures on drug plans. What happens to that money? That money takes costs away from businesses and their employees and transfers it over to be shared by all of us through the taxation system.

Therefore it would reduce the burden that businesses have to carry, but also, and here is where I am going to be an advocate for small business again, a comprehensive universal plan like this would help level the playing field for employment in small business. Lots of small business owners tell me they have trouble getting the highly skilled help they need because the scale of their operation is not big enough for them to offer a good drug plan. If we have a comprehensive public plan, when it comes to hiring employees, small businesses can compete with the big companies that already have those benefit plans.

We can understand why people might prefer to work at a small business in the community they are from, but have to think about their family when it comes to drug protection. Maybe they would choose their second choice as an employer and go with a big company because of the drug plan that it offered, and the safety and security that it would appear to offer their families. There would be an important benefit for small business by this levelling of the playing field when it comes to prescription drugs.

I can also talk about equity. A good reason for a national pharmacare program that is comprehensive and universal is that the patchwork we have now means that the treatment people get in Canada depends on which province they live in, who their employers are and how big their wallets are. That is certainly something that I, as a Canadian, do not believe we aspire to in this country when it comes to the health of our citizens.

The real reason I believe we should have a public universal program for pharmacare is its impact on ordinary families. Let me take a minute to talk about what this really means in everyday situations.

One in five Canadian households reports a family member who in the past year has not taken his or her prescribed medicine due to its cost. This means more sick days in families and, in many cases, means earlier deaths in families because people were not taking their proper prescriptions.

More than three million Canadians per year report that they are unable to afford one or more of their prescription drugs, and there are the same outcomes. It is bad for families, bad for their health and bad for the health care system.

Almost a million Canadians reported that each year they cut back on food or home heating in order to pay for their medication. This is a cruel choice that we are forcing on Canadians who do not have prescription drug coverage.

Finally, Canadian adults are two to five times more likely to report skipping their prescriptions than those who live in a system which already has a comprehensive and universal public program.

Here in 2020, we are at a historic moment. The Liberals have a minority government. Universal health care came through a Liberal minority government. Well, here is another opportunity to move forward. We in the New Democratic Party have presented proposals consistent with the Hoskins report, which will help us get a detailed plan in place.

Today we have the motion from the member for Vancouver Kingsway before us, a motion that will commit us to move forward to where we all want to go in this country.

[Rachael Thomas, Conservative, Lethbridge, AB]

Mr. Speaker, in my riding of Lethbridge we have a university, and out of that place are coming incredible innovation and creativity and scientific advancement. In particular, there is some advancement with regard to medicine. Research is being done around creating software that would read a person's DNA, and then, based on the reading of that DNA, would be able to prescribe a medical compound. Rather than pharmaceuticals being what they already are on the shelf, they would be made directly for an individual based on that individual's DNA. This is absolutely incredible technology. It would forever change the face of medicine and the way that it is done.

This is something that would not be covered by a pharmacare program. In fact, a pharmacare program would stagnate the progress being achieved within the world of medicine, which means that Canadians would be put at an immense disadvantage and many of these diseases and and rare conditions that we talked about earlier would be without a cure for a very long time. It would be a huge detriment to our country.

How would the hon. member respond to that in terms of advocating pharmacare?

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Mr. Speaker, I certainly recognize that important medical research is going on across the country. What I cannot really understand from the member is why she thinks important medical advances would be excluded as a result of a national pharmacare program.

We could write the kind of formulary we want and we could put in place the procedures to decide how prescribing takes place. If a major advance were to come forward like the member is talking about, why would a national system not take advantage of that new technology? Why would it not build that into the system?

I am guessing we have a way to go yet, but there is no particular reason that those advances would not fit in a national, comprehensive and accessible pharmacare plan.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Mr. Speaker, there is an overwhelming amount of support in all regions of the country to have some form of pharmacare program, something that has been at the top of the public agenda for the last four or five years. When I address this issue a bit later, I will hopefully get the chance to clearly demonstrate why it has been getting the attention it has been given in the last four or five years.

Does the member not believe that we need to have negotiations with the provinces in order to maximize the benefits of a national pharmacare program for all Canadians?

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Mr. Speaker, I want to start by responding to the first part of what the member said.

I do not believe the demand in this country is for some form of pharmacare. That is not what the Hoskins report called for. It called for a universal, publicly delivered, accessible, portable public program. It did not call for “some form of pharmacare” or some patchwork of it.

The member mentioned talking to the provinces. The motion calls for convening talks right away to get to work on this. Obviously we are going to talk to the provinces and obviously we are going to have to build a system across the country.

My hon. friends in the Bloc are always worried about jurisdiction and the ability to opt out of programs. There are differences in Quebec. We respect those. Those kinds of talks would have to go on in order to implement a national, universal, publicly funded, accessible and portable pharmacare system, not just “some form of pharmacare”.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, the NDP has moved a motion calling on the government to implement the full Hoskins report.

However, the Quebec National Assembly unanimously reacted to this report on June 14, 2019, saying that Quebec has exclusive jurisdiction over health and refuses to adhere to a pan-Canadian pharmacare plan.

How does the New Democrat member, who sometimes appears to be democratic only in his aspirations, think that his desire for co-operation will be taken seriously? A democratic parliament sent a clear message in writing, but this motion does not consider or acknowledge the will of the Quebec nation.

How can he think we will take his desire to work together seriously?

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Mr. Speaker, when we take a serious look at the savings to both the federal and provincial governments in all the plans that are involved, it seems hard to believe that the Quebec government would not take part in discussions about such a national plan. I do not believe that it said it would never talk about this.

I know the Bloc members are excessively concerned about jurisdiction, but I know that ordinary Quebeckers are not so concerned about jurisdiction. They are concerned about affordability and the ability of the government to deliver programs like this.

I think we could look forward to very productive talks with Quebec on a national, universal, accessible, portable pharmacare program.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, I am pleased to rise to speak to the NDP's motion on universal pharmacare. I will be sharing my time with the member for Calgary Shepard.

I am going to talk about the affordability of having another government plan. Money does not grow on trees, but that is what the NDP would have us think: We can just wave a magic wand and $34 billion will appear to fund a universal, comprehensive, accessible, portable public prescription drug plan. That is what the Hoskins report says Canadians spent on prescription medication in 2018.

What will the federal government's contribution be to that very big cost? Where will that money come from? Will it come from increased taxes? Will it come from more borrowing by the federal government? Are we just going to keep adding to our national debt because our national debt is not quite as large as those of our trading partners? We have heard that quite often.

We often hear members opposite say that under their watch, one million Canadians have been lifted out of poverty. However, they failed to acknowledge that we went a further $80 to $100 billion in debt over that same period of time, and this during a time of full employment in a strong economy and good government revenues. If the government cannot balance a budget in good times, how is it going to manage the economy in the inevitable bad times? Of course, the government should not only be balancing the budget in good times but also be paying down debt. Under both Conservative and Liberal governments, that has been the tradition in Canada for many decades. Of course, these are not Chrétien or Martin Liberals; these are the other type of Liberals, the ones who think debt does not matter.

Pharmacare and medicare are primarily provincial matters. The federal government should be managing the national economy and staying out of the way of provincial governments so that they can do what they do best.

That brings me back to trees. Money can, in fact, grow out of trees. I am thinking of British Columbia trees, the ones that are not being harvested at the moment. There are a lot of reasons for that, including the lack of a softwood lumber treaty, the one that the government has failed to negotiate for us.

I have a great idea. Let us get our forest industry working again. Forestry is a wonderful renewable resource that could change the lives of many Canadians, yet it is being ignored. Let us get those revenues flowing again to the provincial coffers so that they can fund their provincial pharmacare plans and send revenues back to the federal government through income tax from fully employed Canadians.

While I am talking about resources, let me say that money also grows in the ocean, or at least it does when the west coast salmon industry is thriving, which it is not, for a lot of reasons, including ongoing mismanagement by the federal fisheries department. Let us pay more attention to that source of wealth. Let us get Canadian fishers out fishing again and paying taxes.

Money also grows in the ground. I am thinking of natural gas, for example, which is a potential big source of government revenues for my home province of B.C. Let us get the necessary infrastructure built so that we can start selling our clean, green liquid natural gas to the world. That can be a big part not only of our economy but also of Canada's contribution to the fight against global climate change.

Instead of economic development, we see railroad blockades by professional pipeline protesters thinly veiled as indigenous rights protectors.

Let us talk about indigenous reconciliation. This is—

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I rise on a point of order. With all due deference to my friend, I am sure at some point he will discuss pharmacare, but his discussion seems a little off topic so far.

[The Deputy Speaker, Conservative, Bruce Stanton]

Certainly members will know that comments and speech in here are intended to be and should be relevant to the question that is before the House. I heard the member speaking on some other topics. I will listen carefully to make sure that he is bringing the discussion back to the question at hand.

As a final note, members are certainly given a fair degree of latitude to do that, but must in fact bring their arguments to the point that is before the House.

The hon. member for Langley—Aldergrove.

[Tako Van Popta, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, I am talking about a strong economy, one that can fund a pharmacare program.

I am answering the question about how we can afford a pharmacare program of $34 billion, which is what the Hoskins report says pharmacare will cost. How can the government do that better than private enterprise is doing it already? We need a strong economy and right now, indigenous reconciliation, or the lack thereof, is standing in the way economic development. We want to get our pipelines built. We have some big projects that are going to wealth producers. The government is struggling to accomplish one of its main goals, indigenous reconciliation, which, of course, is great for indigenous communities but also good for Canada's economy. We need to get our economy going again.

Living off of borrowed money, in fact, does not create wealth. It redistributes wealth from future generations to this generation. That is a fair comment. How are we going to fund a pharmacare program? Is it going to be through borrowing money, which future generations are going to have to pay off, or are we going to create the wealth that will allow us to pay for a very rich pharmacare plan?

This brings me directly to the topic of the day. The NDP motion would have this House accept the Hoskins advisory council report and the implementation of a national pharmacare program based on that. The motion also says the House would “urge the government to reject the U.S.-style private patchwork approach to drug coverage, which protects the profits of big pharmaceutical and insurance companies”. Apparently the NDP does not like to see big companies making profits. Let me share my personal experience in the business world prior to coming to Ottawa.

In my previous life we employed many people. We had to pay competitive salaries and part of the competition was to have a very good, robust group benefits plan for the employees. If we did not offer that to future employees, they could go to other employers, so it was a very competitive world to get the best and the brightest people working for us. Our group benefit plans always included a very good pharmacare plan.

I would suggest that, contrary to what the NDP is suggesting, insurance companies can do a very good job. I would also say that big pharma has done a good job. Competition is good for pharmacare and I am afraid that the NDP motion would undermine that competition, which has served us very well over so many years.

The NDP does not like the patchwork that is currently in place and serving most Canadians quite well. Canadians are rightly proud of our universal public health care plan, but maybe it is not as good as we think it is. It is being challenged all the time. We keep saying that we do not want a two-tiered health care system. Just the fact that we have to say it suggests that it is being challenged.

I would tell the New Democratic Party not to ignore or completely write off a patchwork because it has served us very well for so many years. I will give the NDP credit for drawing to the attention of this House that there are some Canadians who fall through the cracks and I would support helping those people.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, I fundamentally disagree with many points that my hon. colleague is asserting.

First, I do not know where he gets the $34-billion cost. That does not emerge from any of the studies. I sat through the two-year study at the Standing Committee on Health. We know that national pharmacare, through the public system, will save us billions of dollars. He also suggests that the system is working well while his other colleagues stand and ask question after question about how it is failing Canadians with rare diseases in this country.

I have a two-part question. If he thinks this is a purely provincial matter and the federal government has no role to play in this, is it his position that the federal government should get out of health care and leave it entirely to the provinces, or does he think that we should continue to participate and provide transfer payments? Does he not agree that if we can save $4 billion to $8 billion by reorganizing our system, would that not make more money available to help all those Canadians who are not getting access to the drugs they need for their rare disorders?