Debates of March 12th, 2020

Opposition Motion—Pharmacare

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, I was listening carefully to my colleague's speech. He knows I have an interest in this particular file, and I have more of a comment than a question.

When the member talked about single-payer, streamlining and efficiency when referring to national pharmacare, I hope he does not envision it from the same people who ran Phoenix or the F-35 procurement and who run most of the government. The CRA typically fails at delivering the needed services for taxpayers.

I will give a specific example, because the only time the member mentioned rare diseases was when he was quoting from the Hoskins report. I have an example from my riding where the public health care system failed in my province.

Sharon Lim and Joshua Wong are users of the public health care system. There is a drug approved through CADTH, and there are approved drugs in Canada, but this one is not approved for reimbursement through a public insurer, which I think the national pharmacare system would make even worse. In their particular case, they cannot even get access through the special access program to a competing drug. This is a perfect example of a problem that is unique to the public insurance system, which will be made worse.

I heard the member talk about cost effectiveness and value for money, but those are decisions that should be made by patients and their doctors, not by bureaucrats in these towers here in Ottawa. This will affect patients with rare diseases such as cystic fibrosis, Alport syndrome and every single rare disease out there.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, I deeply appreciate my hon. colleague's concern for those with rare diseases and I absolutely agree, as the health critic for the NDP, that we need to find a better way for families suffering across this country and individuals who have rare diseases who cannot get access.

Interestingly, the example the member points out is a family who, under the current system, under the current private-public patchwork, cannot get access to the drugs they need. This is why the NDP is proposing a solution.

In the 1960s, there was a great debate in this country over public health care, and a very common argument against public medicare was that Canadians would not be able to get the services they need. That turned out to be a hollow argument.

Would Canadians today give up their public health care system and trade it for the U.S. style, the private-public patchwork? Do they think that would be a better way to access health services? No, because in this country Canadians know that every Canadian should get access to the health care they need, regardless of their ability to pay. We say the same thing should happen with prescription medicine.

It is absurd to have a medicare system that does not cover medicine. We know that the most efficient way to deliver health care services is through the public model. Study after study proves that. It is not me saying that, but academics, stakeholders and industry groups. It is renowned around the world. This is the best way, and that is why every single country does this.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, I appreciated my colleague's passionate speech.

Quebec has had a pharmacare program since 1996, and it might even be due for some upgrades. Can my colleague explain why no other province has adopted such a program since 1996?

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, it is a pleasure to sit with my hon. colleague on the health committee.

The member pointed out that Quebec has been a leader in this country on universal pharmacare. It is the only province right now that covers all of its citizens' pharmaceutical needs.

There are some criticisms of the model that Quebec uses, because it has a hybrid model that requires employers to cover their employees, while anybody else is covered by the public system. The health committee heard evidence that we should specifically not adopt that model for all of Canada, because Quebec has the highest per capita cost of delivering prescription drugs in the country.

Consequently, New Democrats believe it will benefit the Government of Quebec and Quebeckers to remain involved in the project we propose, considering its clear benefits to the people of Quebec, but we totally respect that it is Quebec's decision to retain its own system. It could absolutely withdraw from national pharmacare and use those funds to improve its existing system.

The NDP would like to sit down with all provinces, including Quebec, and look at how we can build a national system for delivering pharmacare, similar to the way we worked together on health care. However, it will absolutely be up to Quebec to decide if it wants to opt in or opt out, with federal compensation, because we respect Quebec's ability to do so if that is Quebec's choice.

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

Mr. Speaker, I thank my colleague from Vancouver Kingsway for the motion, which is something we have talked about in this place before. As he has said many times, after many years—decades, in fact—it is high time that we got something done on this file.

I would like him to speak a little more on something that I always find strange in this debate. A lot of members from other parties routinely stand and say they want efficiency in government and less money spent overall. We know that prescription drug coverage for provinces is one of the major cost drivers in health care. Drug coverage on a federal scale is a way to drive down those prices, which are putting upward pressure on provincial budgets. It is always mystifying to me that when we come up with an idea that would, without sacrificing services, drive down the cost of something that governments are already providing, we do not see more support on the other side of the House.

I wonder if the member could speak to that phenomenon and maybe help Canadians understand how that could be.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, I thank my hon. colleague from Elmwood—Transcona for the wonderful work he does on behalf of his constituents in the House. He is a fine parliamentarian.

It is so important to emphasize to Canadians the economic advantages of what New Democrats are proposing. The Parliamentary Budget Officer, taking 2016 as a model year, calculated the amount spent in the country during that time on all drugs that would be covered under a pharmacare system. He found that about $24 billion was spent that year. He then ran a model to find out what would have been spent if there had been a public single-payer system covering exactly the same drugs. He found that $20 billion would have been spent, and that is with conservative assumptions.

He attributed no savings to cost-related non-adherence. He attributed no savings to streamlining the administration. The savings came only through bulk buying and a more disciplined way of delivering these drugs to Canadians.

As I said in my speech earlier, that is low. There are academics who say we will save much more, between $6 billion and $8 billion to $10 billion per year. As an economic imperative, this is essentially a policy no-brainer.

I want to come back to the most important thing of all, and that is Canadian patients. We should not be content in this country when seven and a half million Canadians cannot get medicine. We cannot be okay with that. We cannot be content with that when we know there is a way to make sure all Canadians get the medications they need. This is imperative.

New Democrats are asking the government and the Liberals to act now, commit to public pharmacare and endorse the Hoskins advisory council's recommendations. Let us get to work and provide pharmacare to everybody.

[Darren Fisher, Liberal, Parliamentary Secretary to the Minister of Health]

Mr. Speaker, I am certainly pleased to stand today to address the motion from the hon. member for Vancouver Kingsway. I congratulate him on his speech and I thank him for his work on the health committee.

The government is committed to implementing a national universal pharmacare program that ensures that all Canadians have access to the prescription drugs that they need. This is our goal, as clearly stated in the 43rd Speech from the Throne. It is a goal that we have been working towards for some time. While we are now closer than ever, it is important that we continue our measured, considered approach to implementation. We need to get this right.

This morning I will explain the steps the government is taking to make prescription drugs more accessible and affordable for Canadians. I will also explain why these actions are key to the implementation of a national pharmacare program.

Canadians should not have to choose between buying groceries and paying for medication, but for many people, paying for prescription drugs is a heavy burden and for others it is completely out of reach. Surveys show that more than seven million Canadians are either entirely uninsured or under-insured.

This means that many of these Canadians cannot afford to fill their prescriptions. They simply do without the medication they need. If their health absolutely depends on taking these drugs, they may forgo necessities, such as food and heat, so that they can pay for their prescriptions. We can no longer afford to do nothing. We cannot afford to wait.

That is why we asked Dr. Eric Hoskins and a panel of eminent Canadians to provide the government with a blueprint for a national pharmacare program. After hearing from many thousands of Canadians, the council found a consensus of opinion that everyone in Canada should have access to prescription drugs based on their need and not on their ability to pay.

The government shares this view. With national pharmacare on the horizon, addressing the affordability of drugs is imperative.

How do we do that? The first step is to update specific parts of our regulatory regime and bring them into line with the rest of the world.

Let me begin with a few words about the evolving use of pharmaceuticals in Canada and the associated increasing costs, costs that impact everyone.

Pharmaceuticals are important to the health of Canadians and a vital part of Canada's health care system. Drugs help cure or manage previously debilitating or fatal diseases, allowing Canadians to live longer and healthier lives. Diseases that were deadly 100 years ago, such as tetanus, diphtheria, polio and many others, can now be prevented by vaccination. An HIV diagnosis was a death sentence at one time. New drugs offer innovative treatments for diseases like arthritis, hepatitis C and many types of cancer.

All this innovation comes at a cost. It is part of the reason that Canadians are paying higher prices for prescription drugs than they should. Patented drug prices in Canada are the third-highest in the world, behind only the United States and Switzerland. Canadian prices are, on average, almost 25% more than the OECD median for the same patented drugs. As a result, the private and public drug plans that cover the majority of Canadians are rapidly becoming unsustainable.

Let me give an example. Diabetes affects an estimated 3.4 million Canadians and is one of the leading causes of death in Canada. Canada spends nearly $600 million annually on new oral anti-diabetic drugs. The two top-selling oral anti-diabetic drugs cost Canadian public drug plans close to $1,000 per year per patient, twice as much as in France. Imagine the savings if Canada paid France's prices for these drugs. That is a lot of money. It is money that could be used to cover the cost of drugs for people with limited or no insurance coverage.

A second example is a drug used to treat a rare soft-bone disease. This disease used to be almost always fatal, but this drug changed the prognosis. However, it is one of the most expensive drugs in Canada, costing more than $1 million per year per patient, depending on the required dosage. Unfortunately, this high price resulted in difficult decisions and delayed access to the drug for many Canadians.

If Canada paid lower prices for all drugs, there would be more money available in drug plans to provide better coverage or to provide coverage to those without insurance.

Even outside the area of rare diseases, pharmaceutical costs keep going up. Drugs are now the second-largest category of spending in health care, and biologics and other specialty drugs account for an increasing share of these total drug costs. This rate of growth in drug costs is unsustainable, and it is hurting Canadians every single day.

As a trend toward higher-cost specialty drugs continues, we cannot continue to pay higher-than-average prices for drugs. What could we do? The answer is not to spend more. We already spend more per capita on pharmaceuticals than nearly every country in the world. We need a solution to bring fair prices and sustainable drug costs for Canada.

Part of the problem was that Canada's approach to patented drug price regulations was outdated. Our previous pricing regulations were established in the 1980s. We have more than 100 different public drug plans and thousands of private drug plans, which means that drug coverage is provided by a patchwork of payers.

It was well past time to bring these regulations into the 21st century. Canada needed a modernized approach to regulating patented drug prices, one that would provide long-term sustainability and protect Canadians from excessive prices. That is why last summer the government modernized the patented medicines regulations to provide the Patented Medicine Prices Review Board, or PMPRB, with the tools and information it needs to protect Canadians from excessive prices for patented medicines.

I want everyone to remember that Canada pays the third-highest costs in the world. As a comparison, we pay double what France pays on some drugs.

We will now benchmark prices against countries that are similar to Canada economically and similar from a consumer protection standpoint. Previously, the price ceilings for patented drugs in Canada were set by comparing our prices against prices in seven predetermined countries: France, Germany, Italy, Switzerland, Sweden, the United Kingdom and the United States. The list of countries has now been updated by removing the United States and Switzerland and adding Australia, Belgium, Japan, the Netherlands, Norway and Spain, for a total of 11 countries as comparables.

We then wanted the PMPRB to see the actual prices being paid in Canada, not just the list prices being published by pharmaceutical companies. When the PMPRB was created, the market prices of drugs matched the list prices. Over time, as a result of the significant confidential discounts and rebates negotiated by third party payers, actual prices paid in the market became significantly lower than list prices. Without access to this information, the PMPRB was left to regulate domestic price ceilings based on inflated list prices.

With the modernized regulations, patentees will be required to report Canadian price information as the net of all adjustments, such as rebates and discounts, so that the PMPRB is informed of the actual market prices being paid in Canada.

Finally, we wanted to consider the value that a drug offers and its overall affordability. Most other countries with national pharmacare programs already do this. When setting a price, we need to consider three things. First is the value for money: Does the drug offer a therapeutic benefit that justifies its cost? Next is the size of the market: How many people will benefit from the drug? Last is to consider Canada's GDP and GDP per capita: Can we afford to pay for the drug?

These changes will provide the PMPRB with the tools it needs to protect Canadians from excessive drug prices and bring us in line with the policies and practices of most other developed countries. This was a critical step toward improving the affordability and accessibility of prescription drugs. Taken together, we anticipate that these regulatory changes will save roughly $13 billion over the next 10 years. That is a significant saving for Canadians.

From those savings, public and private drug plans will have greater capacity to improve benefits for plan members or to consider new therapies not currently covered. All Canadians, including those with drug plans and those paying out of pocket, will benefit from lower prices for prescription drugs.

Modernizing pricing regulations complements the work already under way at Health Canada to streamline the regulatory review process for drugs by enabling priority drugs to reach the market more quickly. It supports the work already taking place under the pan-Canadian pharmaceutical alliance to negotiate lower prices for prescription drugs. As a member of this alliance, the Government of Canada is able to combine its buying power with that of the public plans in the provinces and territories.

It is estimated that the alliance saves public drug plans more than $2 billion a year. Successful negotiations result in more affordable prescription drug prices for public plans and lower generic drug prices for all players.

Before we can implement a national pharmacare program in Canada, we have to address the rising cost of drugs in the country by taking the steps I have outlined. Doing so will improve the viability of a national pharmacare program. National pharmacare, in and of itself, would be another step that could help us control drug prices.

I am confident that this government is on the right path. We are now exploring options as we move forward with a national pharmacare plan, and we are making significant investments.

Budget 2019 earmarked $1 billion over two years beginning in 2022, with up to $500 million ongoing to help Canadians with rare diseases access the drugs they need. This is very important. This is an investment that must be made.

Budget 2019 also proposed $35 million over four years to support the creation of the Canadian drug agency, an important step toward a national pharmacare program. We have pledged to work with provinces, territories and stakeholders on the creation of the Canada drug agency. This agency could use its negotiating power to achieve better prescription drug prices on behalf of Canadians. Negotiating better prices could help lower the cost of prescription drugs for Canadians by up to $3 billion over the long term.

I appreciate the opportunity to discuss some of the important work we are doing to prepare for the implementation of a national pharmacare program. Part of this effort involves addressing the affordability of prescription drugs, an essential building block for pharmacare. To do that, we have brought our regulatory approach to pharmaceutical pricing in line with approaches that are used in the rest of the world. The actions we have taken to improve the system will help to bring down the prices of prescription drugs.

I would very much like to thank the hon. member for Vancouver Kingsway for his motion. I am pleased to say that we are moving forward steadily. Each of the actions I have described today is helping to pave the way for an effective pharmacare program.

From bringing down prescription prices to improving the management of these drugs in our health care system, we are taking the time necessary to get this right, keeping in mind that the provinces and territories will have a key role to play in determining how pharmacare will take shape.

Pharmaceuticals are an important part of Canada's health care system. That is why federal, provincial and territorial ministers of health have made affordability, accessibility and appropriate use of prescription drugs a shared responsibility.

The updates we have made to the patented medicines regulations, when taken together with the Patent Act, will provide the PMPRB with the tools to protect Canadians consumers from excessive patented drug prices.

All of these measures are important steps in our plan to prepare for the implementation of a national pharmacare program. It is critical that the government work closely with the provinces and territories, as they play a key role in the development of a drug agency, the strategy for high-cost drugs and for rare diseases. Together we are making progress toward a more efficient and effective system.

Based on these initiatives and others I have outlined today, it is clear that we are in fact moving forward with the recommendations from the Hoskins report. I am pleased to support today's motion and urge other hon. members in the House to do so as well.

We must continue to collaborate with the provinces and territories. Our government looks forward to continuing these discussions while taking the critical next step to implement national universal pharmacare.

[Daniel Blaikie, NDP, Elmwood—Transcona, MB]

Mr. Speaker, we are here 23 years after the Liberals initially promised this in their platform. They have had many years of majority government since making that promise. We just came off a Liberal majority government and the Liberals have not even had a meeting with the provinces to discuss the idea, to feel them out and see where they are with this.

If the Liberals are really serious about developing a single-payer national public comprehensive pharmacare plan, when will they call a meeting with the provinces for the express purpose of figuring out what the concerns of the provinces are so they can start to develop a plan to deal with those and make an offer that would be acceptable to the provinces to move ahead on? I do not want NDP MPs standing here 23 years from now, talking about 46 years of inaction by the Liberals. They first promised it in 1997.

When is the government going to actually convene a meeting with the provinces to talk about a national pharmacare plan? When is it going to happen?

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Mr. Speaker, a lot of work has already happened in the last couple of years. A lot of collaboration has already begun and there are a lot of positive steps.

As we move forward on implementing national pharmacare, we have to continue to collaborate with the provinces and territories. I believe there is a meeting very soon, this spring in fact. Our government looks forward to continuing these discussions while taking critical next steps to implement national pharmacare.

[Dan Albas, Conservative, Central Okanagan—Similkameen—Nicola, BC]

Mr. Speaker, the parliamentary secretary specifically referenced the cost of drugs and what the government was doing to try to address that. I would just give this feedback for the member and for the government.

I was contacted last night by Theresa from my riding, who is the grandmother of nine-year-old Ruby. Ruby has cystic fibrosis. She has to do all sorts of things that kids her age never would have to contemplate, and it is very hard on her and her family.

Theresa specifically has said that Trikafta is not available. She says:

And now we have a government who is overhauling this already cumbersome system starting with the PMPRB...who has been mandated to decide the ceiling price that will be paid for prescription medicines. However, they have not been differentiating medicines for rare diseases, like cystic fibrosis, from more common diseases. They just want to get the medicines at the lowest price they can. We all want that, however, it isn't reasonable to think that rare diseases should be decided upon the same way others are as research development for rare diseases requires a will to proceed that is a far greater commitment of pharmaceutical firms.

The member has said that his government is trying to take action on the cost, but he is actually denying access for important medicines to help children like Ruby.

Could the member explain to Theresa why his government's plan is benefiting Canadians, particularly those who are wrestling with this horrible disease?

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Mr. Speaker, this is a very serious issue. We need to do some serious work on a rare diseases strategy for Canadians. It is very important. As it pertains specifically to Trikafta, the company has not submitted an application to market this product in Canada.

However, working toward the rare diseases strategy, budget 2019 put forward a billion dollars over two years and $500 million each year ongoing to come up with a way to solve this issue so Canadians have access and affordability.

I spoke about the fact that we paid the third-highest prices. Why is Canada paying the third-highest prices for pharmaceuticals in the world? Why is it twice as much as some countries? Why are we paying 25% more than OECD countries on average? We need to find a balance between affordability and accessibility so all Canadians can be safe and healthy.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

Mr. Speaker, I would point out to the government and all members that Quebec did not wait for an agreement to be negotiated with the provinces before bringing in its own program, because we believe it is important that everyone have pharmacare coverage.

I would like to focus specifically on the cost of prescription drugs. We are talking about a universal program, but the cost of medication is a serious problem. Canada has the highest drug costs in the OECD. Drug patent policies, for example, are a federal jurisdiction, and no action has been taken on that. In our health care system, drug prices have the highest inflation rates.

I would like to know how we can incorporate lower drug costs into a real policy.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

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

I want to congratulate Quebec on doing a great job with moving toward national pharmacare. Quebec has one of the models for our country.

As the member said, Canadians do pay the highest prices in the world for prescription drugs, the third-highest behind the United States. We already have done more than any government in a generation to lower drug prices. We have new rules on patented drugs that will save Canadians over $13 billion. We joined the pan-Canadian pharmaceutical alliance. Now we are taking the next critical steps to implement national pharmacare. We will not rest until Canadians can get and afford the medications they need.

[Ken Hardie, Liberal, Fleetwood—Port Kells, BC]

Mr. Speaker, we have heard in the past that the patchwork quilt of programs available to people cover perhaps as many as 60% of Canadians. However, as has been pointed out, this leads to inefficiencies and higher prices. One concern that many would have is whether a move to a single-payer public system to cover the costs of pharmaceuticals would involve a shift of costs from private companies, which currently contribute through their individual plans, to the government.

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Mr. Speaker, I would not want to presuppose an outcome or what may or may not come to be when so much of the responsibility, so much of partnership with the federal government will be the provinces and territories. It is so important to not try to foist upon provinces and territories what the federal government wants, but to work closely with the provinces and territories to determine what is best for them and for Canadians to ensure access and affordability for all Canadians.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, I want to thank the parliamentary secretary for laying out the government's position on this motion.

Many members know I have a lot of problems with the way we currently have our system designed. I am worried that a national pharmacare system will compound all those problems.

The parliamentary secretary did not address the fact that a lot of medications today are a substitute for surgeries and things that would have required a hospital stay in the past. He did mention CADTH and the Canadian drug agency. Therefore, I have a two-part question.

First, will the Canadian drug agency be subject to the Auditor General, to parliamentary oversight and to the Access to Information Act, the way CADTH is not today? CADTH is not subject to any type of parliamentary oversight, which was discussed once at the Standing Committee on Health.

Second, with respect to the $1 billion that has been set aside in future budgets for rare diseases, there are no details on that. I have a lot of patients in my riding with different rare diseases, such as cystic fibrosis. Cambia has been refused twice now, on October 2018 and November 2017, by CADTH, a government agency, and Trikafta is not coming to Canada. The Prime Minister even got the name of the medication wrong yesterday when he called it “trifacta”. When will cystic fibrosis patients get the medications they need? Also, will any of these agencies be subject to parliamentary oversight?

[Darren Fisher, Liberal, Dartmouth—Cole Harbour, NS]

Mr. Speaker, this is a very sensitive and serious issue in Canada. We spoke earlier about Trikafta and how there had been no application for its approval in Canada yet. I know there are other issues.

For serious or life-threatening conditions, such as cystic fibrosis, there is the special access program. It does work and it has worked. However, we would not necessarily put specifics on what the $1 billion looks like until we form a partnership with the provinces and territories in order to move forward.

The $1 billion over two years and the $500 million ongoing each year is to ensure we can solve these problems the member has spoken about in the House before, which, frankly, are very serious and affect me personally.

I appreciate the comments of the member and the questions he has asked. We know we have to work on a rare diseases strategy. We have put the money in budget 2019 and in future budgets. We will continue to do the absolute most we can for Canadians.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Mr. Speaker, it is an absolute pleasure to split my time with the member for Mégantic—L'Érable, my seatmate and a well-informed member on this topic.

I think members from all parties can agree that we want Canadians to receive the best possible health care. However, universal or national pharmacare would have serious implications for all Canadians, without changing the status quo for most. According to a 2017 report by The Conference Board of Canada, 98% of Canadians either have or are eligible for private or public drug coverage, so we know that the vast majority of Canadians can access the medications they need without financial burden.

If we implemented a universal pharmacare program, this would not be the case. To pay for a universal system, taxes would have to be raised for all Canadians. We do not know how much that could cost, but estimates are around $15 billion annually. Under a universal system, the most vulnerable Canadians would see their cost of living go up due to higher taxes.

Canadians who currently have the coverage they need would give up some of their disposable income to fund the new system, while seeing no change to their quality of life or access to prescription medication. One thing I consistently hear from my constituents is that they cannot afford more taxes. They cannot afford higher living costs. Things are stretched tight as it is.

The government needs to be mindful of the economic times we are in. Oil prices are in free fall, COVID-19 is predicted to have significant impacts on our economy, rail blockades caused millions of dollars in lost economic development and companies are rethinking investing in Canada because of our “political climate”. Just yesterday, the TSX fell by almost 700 points, and we are now in what is called a bear market.

We are in uncertain times. Some have even called it uncharted territory. Right now, many Canadians are worried about their jobs and livelihoods. Now is not the time to implement a pharmacare program that would come at a massive cost on the backs of taxpayers. I am especially worried because of the huge deficit we already have, which is close to $30 billion. In December of last year, finance department documents showed it was at $26.6 billion and expected to keep rising. We will find out more when the finance minister releases his budget on March 30, the date we finally learned just yesterday.

We have this huge deficit, and I am still scratching my head and wondering why. We have been in relatively good economic times for the past few years. Canada was in good shape until 2015 thanks to the previous Conservative government that had the restraint to save and make tough decisions. The government has squandered that good fortune. Instead, it has gone on a spending spree and racked up unsustainable levels of debt and will leave the bill to our children and grandchildren.

Most economists know that one saves money in the good times and puts money away for a rainy day, as the saying goes. That did not happen, and now we are heading into a series of stormy days. The government cannot give any sort of clear answer on how it is going to respond to a recession. My guess is that it has no idea.

This is a crucial time for Canada. Companies no longer see Canada as a place to make a safe investment. The government has actively worked to shut down the energy industry with legislation like Bill C-69 and Bill C-48. Thousands of hard-working men and women are finding themselves out of work in my home province of Alberta, and this has had a ripple effect on the entire economy. What does all this have to do with pharmacare? As I said earlier, Canadians cannot afford higher taxes, especially in these uncertain economic times.

In last year's budget, the government pledged to work with provinces, territories and stakeholders to create the Canadian drug agency and to spend $35 million to establish a Canadian drug agency transition office. The government's advisory group was headed by a former provincial Liberal, Dr. Eric Hoskins, a man who is no stranger to endless deficits and debt. It is no surprise that the report he authored recommended the creation of a universal system. It is always buy now, pay later.

The Canadian Chamber of Commerce has warned the government of the impact on workers should pharmacare be implemented. Its chief economist, Trevin Stratton, said millions of Canadians would lose access to medications they have under the current plans. He said the government needs to “carefully reflect” on how millions of Canadians who already have access to prescription drug coverage would be impacted.

Some families experienced this recently when the Ontario government implemented free prescription medication for people under the age of 25. This program, OHIP+, cost roughly $500 million a year when it was implemented in 2017. Private insurance for those under the age of 25 became obsolete. Many parents complained that medications for rare diseases were not on the list of approved medications under OHIP+. These medications had been covered under private insurance.

I worry that the same thing will happen with this government when it implements a universal pharmacare system across the country. The prescription medication that many people are currently using and covering the cost of through their private insurance may become unavailable if not approved.

Not only will a universal system put more strain on Canadians through higher taxes and deficit, but access to much-needed prescription drugs may be threatened. The Liberals have been promising a pharmacare plan for decades and have done absolutely nothing about it. It was in their 1997 election platform and was promised again in 2004. Any promises to implement pharmacare are purely for political posturing. In fact, their 2019 budget contained almost no health care money until 2022, well after the election.

We on this side of the House know that one of the best things we can do to help Canadians is keep taxes and the cost of living low. Fiscal restraint is required to ensure the prosperity of our future generations. We need to make good decisions now, and I do not believe adopting a universal pharmacare program is a smart decision. As I stated, it would have serious financial impacts through higher taxes and bigger deficits. It would threaten access to medications currently covered through private drug plans. Research shows that about 98% of Canadians already have or are eligible for private or public drug coverage.

While we know that some Canadians legitimately struggle to pay for access to prescription medications, this is not the case for the majority of our population. We already have one of the best health care systems in the world, and we should be proud of the system in place.

Instead of focusing on big-ticket items like national pharmacare, the government needs to focus on the unfolding economic crisis. We need urgent action to unleash our economy. Budget 2020 must include cuts for workers and entrepreneurs to reward investment and work, a reasonable plan to phase out the deficit and reassure investors, a rule to eliminate red tape and liberate businesses, an end to corporate welfare for favoured companies and an end to the wasteful Liberal spending that we have seen over the past four years.

We are all in the House to help our constituents and all Canadians. We want to see them be successful and get ahead. Implementing an expensive pharmacare system will not achieve this. It will put more tax burdens on hard-working Canadians and it is not needed by the vast majority of our population. These uncertain economic times are not suitable for introducing a $15-billion pharmacare plan.

[Laurel Collins, NDP, Victoria, BC]

Mr. Speaker, according to the Hoskins report, universal single-payer public pharmacare will reduce out-of-pocket costs for families by $6.4 billion a year. That means families are saving money, families that are struggling with the high cost of housing and struggling with the high cost of child care.

Does the member opposite agree that we should be putting that money back into people's pockets and focusing on the high cost of prescription medication and the cost not only to the economy but to the day-to-day living experience of Canadians?

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Mr. Speaker, ultimately that was the key component of my speech. As I indicated, yes, we do need to keep more money in the pockets of Canadians and keep our taxes low. Implementing a $15-billion pharmacare program is ultimately the antithesis to all of that.

According to The Conference Board of Canada numbers, only 1.8% of Canadians lack or are ineligible for any prescription drug coverage. To make the argument that we are suddenly putting more money back into constituents' pockets simply does not add up if we are going to spend $15 billion of public taxpayer money to do quite frankly the opposite.

[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, for the first time we have a Prime Minister who understands the issues and challenges that many Canadians have with trying to decide between medication and food. Issues of poverty are very real and tangible.

Our caucus has long been advocating to ensure that medications are affordable and will be there for individuals who need them. For the very first time we have a Prime Minister who has really taken this issue head on to meet the needs of Canadians who require these types of medications. The cost of pharmaceuticals is too high.

I am wondering if my Conservative colleague across the way could give his thoughts in regard to the individuals who find this so difficult and are choosing between medication, food and often proper shelter because of the cost of their medications. Would he not agree that this issue has to be dealt with?

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Mr. Speaker, the Liberals have been advocating on this for so long. It was in their 1997 election platform, yet no progress has been made. They have been in government a few times between then and now and have not been able to cross the threshold with it.

Ultimately, we all want to make sure that Canadians have access to the drugs they need when they need them. I would refer the member to The Conference Board of Canada report, which indicates that only 1.8% of Canadians, less than 2%, do not have access right now. We want to make sure we are doing everything we can for that 1.8%, but dumping $15 billion into the budget as the solution certainly does not address that 1.8%. It would also impact so many other Canadians through the cost of living regarding, as the member indicated, the price of food and higher taxes we will see with that cost.

The Conservatives say there is a better way. We can all agree that we need to address that 1.8%, but a pharmacare plan is certainly not the way to do it.

[Luc Thériault, Bloc, Montcalm, QC]

Mr. Speaker, I would really like my colleague to explain what he thinks can be done to control drug prices, given that this is a federal jurisdiction first and foremost.

[Matt Jeneroux, Conservative, Edmonton Riverbend, AB]

Mr. Speaker, I am glad my colleague on the health committee brought up that point. Right now, we are seeing investment in drugs in Canada come to a grinding halt. The changes the government has put in place with the PMPRB, which comes into effect in July, have really had a significant impact on companies' ability to move forward with the drugs they intend to market, which means there is a lack of investment in Canada, research and product investment. That has come to a grinding halt because we are moving forward at a rapid pace.

I had the opportunity just yesterday to ask the health minister at committee whether we could pause this just a bit because patients are coming to our offices to tell us they were not involved in the consultation process. Whether it be for rare disorders, as we heard in some of the earlier debate, or for future drugs, patients really have not been at the table.

The Conservatives are asking the health minister to consider including more of those conversations. We are going to see that a lot of these drugs will not be available in Canada and will go to the United States.

[Luc Berthold, Conservative, Mégantic—L'Érable, QC]

Mr. Speaker, let me begin by acknowledging the excellent work of my colleague, the hon. member for Edmonton Riverbend, who is our shadow minister for health. I also want to acknowledge the work of all members of the Standing Committee on Health and the government members who are working very hard to keep Canadians informed on this major crisis we are going through as a result of the terrible COVID-19 virus.

Setting aside all the partisanship we see in the House, I think we have to recognize that we are facing a major national crisis. Whether on the government side or in the various opposition parties, a great many people are currently working hard to make sure that we can deal with this crisis in an intelligent manner and that the right measures are taken at the right time.

Again, I commend and thank all Canadians, public officials and provinces for their work and their efforts to help us cope with this crisis. I know that these people are spending an enormous amount of time trying to find the best possible solutions. I think we too must work very hard to overcome this crisis and at the very least keep these people in our thoughts.

Canadians must receive the best health care available, whether it is preventative measures, hospital stays or medications. That goes for all Canadians. Even the most vulnerable members of our society must also have access not just to common medications, but also to the most innovative drugs.

The Liberal Party included a universal pharmacare program in its election platform, but it was not transparent about the cost. It should be noted that this is not the first time that the Liberals have talked about pharmacare. It was in their 1997 and 2004 platforms, as well as in the 2019 budget and election platform. Unfortunately, nothing has been done in all that time.

We even heard the Parliamentary Secretary to the Leader of the Government in the House of Commons say to us that, for the first time, Canada has a Prime Minister who is interested in the pharmacare program. Is it not ironic to hear someone from that side of the House tell us that all the previous prime ministers did not really intend to deal with this issue even though it was in their election platform? I was rather shocked to hear those comments, which probably foreshadow what will once again happen with the Liberal promises.

The Standing Committee on Health spent two years studying whether a national pharmacare system could be implemented. The Liberals created a task force, which is another approach. When a government does not know what to do, it creates a committee. When it does not know what to say, it consults the committee. When no results are forthcoming, it blames the committee. That is probably what will happen once again with this other promise, this intention to implement a pharmacare program, because there is no reason to believe that this time, things will be different. The Liberals are masters at raising hopes with their promises, but they are even better at creating disappointment because they never keep their promises when it counts.

Those of us on this side of the House are well aware that many Canadians have a hard time getting and paying for prescription drugs. However, the Liberals make empty promises and blab on and on in committee and in the task force, while the most vulnerable Canadians are left to fend for themselves. Instead of looking for real solutions, the Liberals are implying that one day there will be a universal pharmacare problem, which is an empty promise that they have been making for decades.

Budget 2019 does not contain a pharmacare program. Instead, the budget proposes working with the provinces, territories and stakeholders to create a new Canadian drug agency and spend $35 million to establish a Canadian drug agency transition office. Blah, blah, blah.

The advisory council on the implementation of national pharmacare published its final report and submitted recommendations to the Government of Canada. These recommendations included implementing single-payer, public pharmacare. According to the report, a program with limited coverage would cost an additional $3.5 billion in 2022, and comprehensive coverage would cost an additional $15 billion a year if implemented by 2027. The Parliamentary Budget Officer says that pharmacare would have cost taxpayers $20.4 billion if it had been implemented in 2015-16. That is a lot of money.

The Conservative Party wants to ensure that Canadians get the best health care possible, but how can we trust the Liberals when they cannot even give us the facts and be transparent? They suggest that they might do certain things, but then they go ahead and do the opposite. In 2015, when the Liberals said that they were going to run small deficits, many Canadians believed them. Five years later, they have racked up $100 billion in deficits, when the deficit should have been only about $26 billion or $28 billion for that period. The Liberals were supposed to balance the budget, but they did not. Such is the Liberal reality.

We, on this side of the House, respect Quebec's decision to institute a universal pharmacare program. Quebec had the jurisdiction to implement its own program. It did so. All Quebeckers are now covered by a public and private universal pharmacare program.

The system is not perfect and, of course, it could be improved. However, a first step was taken by a government that is responsible for caring for its people. That is the path we should take. The goal is not to put a little flag on pill bottles, but to ensure that all Canadians have access to the medication they need.

I think history has shown us that the federal government is not necessarily in the best position to implement, administer and run a program as important as this one. The economy was doing well. The global economy was doing well. During that time, the government spent freely. It put the country in debt. It used up all the wiggle room that the previous Conservative government had left behind. Now we are facing a major crisis, and there is no more wiggle room. The government does not have a penny left to pay for initiatives. We cannot trust the Liberals to manage universal pharmacare. They will lose control again, as they have done so many times already. There are plenty of examples.

I am the infrastructure critic. When we ask the government to provide us with a list of projects that have received funding from its $186-billion plan, we are told there is no list. In other words, the Liberals have lost track of 52,000 projects. That is they number they gave us.

We ask them for a list, but they cannot give us one, and today they say they are going to implement pharmacare for all Canadians. They are going to lose the game plan. They are going to lose something. This will not work. The cost will spiral out of control. This government is not capable of managing Canadians' money. We know that from experience. If it spent less time giving handouts to Loblaws, Mastercard and its buddies in the private sector, maybe it would have more time to spend on health care. It would be able to transfer more money to the provinces so that they could get started on their own agendas, as Quebec did.

In the last election campaign, the Conservatives pledged to increase and maintain Canadian health transfers and social programs. Those are logical choices that demonstrate our respect for provincial jurisdictions.

In conclusion, I want to mention an outstanding company in my riding, eTrace Medical Diagnostics. This company has developed a made-in-Quebec technology for early detection of cancer by breath analysis. That means cancer could be diagnosed earlier. This could lower the cost of treatment for all Canadians by diagnosing cancer at a very early stage just by analyzing a person's breath.

Several weeks ago, I sent the entire document to the Minister of Health to request a meeting with that company. The company does not want any money, it wants to know what it will take to get this technology deployed by Canadians for Canadians and not by foreign powers, because the company might be sold.

I received no response from the Minister of Health. I did not even receive an acknowledgement of receipt.

These are concrete measures to ensure that Canadians can get better treatment and to lower the cost of drugs. When we know that cancer is one of the worst diseases, that it affects the most Canadians and that we have a solution, I wonder why the government is hesitating and will not even meet a company that is on the verge of something that may change the lives of millions of people in Canada and around the world.