Debates of March 12th, 2020

Opposition Motion—Pharmacare

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Madam Speaker, that is something we know will be the case. Having a national universal pharmacare program means we would be able to save by buying pharmaceuticals in bulk and by having a better system that works for all Canadians, not just those who can afford it. I would suggest that, yes, there would be a significant cost savings to Canadians.

[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]

Madam Speaker, I will be splitting my time with the wonderful member for Brampton South.

Allow me to start off by just expressing my appreciation. I want to acknowledge the fantastic work of our health care providers and researchers who have provided in a very professional manner the facts and science that is necessary for the national government here in Ottawa, our provincial governments or others, in making good decisions, and those health care providers who have been providing wonderful services and, no doubt, will continue to provide with regard to the coronavirus.

I have been listening all day to the debate on a very important issue that the House of Commons is debating today, but we have had many other opportunities to debate. We have had debates on this matter in many forms, everything from private member's business to budget bills to other pieces of legislation. I suspect that it has taken in many forms. I have had the opportunity on behalf of the constituents of Winnipeg North to present many petitions on this very important issue.

I want to comment on the last question I just put on the floor. If Canada wants to have the best pharmacare system in the world, we need to work with our provincial governments. The only way we can actually maximize the true benefits of a national pharmacare program is to incorporate as much as possible or at least afford the opportunity for provinces to get on board. In some cases that is going to require a considerable amount of selling. We have heard from members opposite that the Alberta government wants nothing to do with it. We have heard members from the Bloc party say that Quebec already has one.

I would suggest that we have a great health care system because the province of Saskatchewan, along with many others, initiated a health care system that was truly unique in North America. As a result, in part with the federal government, we were able then to make it into a national program that was even better than what Saskatchewan had started off. Now we can take a look at what is happening in Quebec. There has been great leadership coming from Quebec and even some of the other provinces. We can incorporate some of those ideas and discussions.

I hope that the premiers and the ministers of health from all regions will recognize what it is that the Prime Minister, cabinet and many members of the House of Commons have recognized. It is that Canadians want to see a national pharmacare program.

This is not a new issue. I do not know why the NDP insist on politicizing it by saying that the Liberals have been promising it for a long time. I could politicize it by saying it was the Parti Québécois in Quebec that actually brought in the best program to date and the NDP administrations over nine NDP governments have done diddly-squat on pharmacare. They have demonstrated nothing in terms of leadership on the pharmacare file. Usually, it is the provinces that lead in improving the quality of health care in our provinces. I come from a province that has had many years of New Democratic administrations.

Taking a look at why it is such a hot debate today, I suggest that it goes back to the 2015 election. I can tell colleagues that there were 338 Liberal candidates back in 2015 who were going to doors talking about pharmacare. When we were fortunate enough to be able to come back to Ottawa with a majority government, we had a Prime Minister who was very keen on pushing that issue forward.

A majority of the MPs who were elected were saying that this is what Canadians want in all regions of our country.

We were reflecting what Canadians wanted in all regions of our country. Nothing has changed. We still recognize that. We are continuing to move forward. Often, if we listen to New Democrats, one might think that we could just wave a wand and, poof, there would be a national health care program. It does not work that way. They know that.

I did a little research. A nice thing about Hansard is we can always find what members have said in the past. In the Province of Manitoba, we have Hansard, too. I happened to be an MLA back in 1996. Here is quote from when I was having a discussion with the minister of health in 1996. The Minister of Health at the time said:

Pharmacare has never been a part of the Canada Health Act and it never will be a part of the Canada Health Act. Manitoba has one of the most generous programs in this country.

Now, I do not know how factual that was back then. However, we can look at what my favourite MLA in the Manitoba legislature said two years ago, on March 13, 2018, and I am a little biased, my favourite MLA is my daughter. This is what she said in the Manitoba legislature:

It is critical that members of this House understand why this is such an important issue.

She was referring to the national pharmacare program.

Manitobans should not be forced to choose between their prescribed medications and heat in their homes. Unfortunately, they are.

The time is now. There is momentum for us to have a national health care program. It is not individuals, per se, who deserve the credit for raising the profile of this particular issue. It is the health care providers. It is the many stakeholders. Most importantly, it is Canadians as a whole, and the lobbying, talking at the doors and communicating with MPs who want to see it.

I believe all legislatures have Hansards. I would challenge colleagues on all sides of the House to show me where we have had a great, huge debate in the last 30 years on pharmacare, where there was a call for the national government to do something.

[Don Davies, NDP, Vancouver Kingsway, BC]

Two years ago.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

That is right, two years ago. Why is that? We have union movements. We have others who are saying, “We want to see a national pharmacare.”

For the first time, and I have been around as a parliamentarian for 30 years, it is an issue that has really come to the top. This is because, for the first time in many years, probably going back to the late 1960s, we have a Prime Minister, a Minister of Health and, I believe, a majority of current members in this chamber who understand and value what a national pharmacare program could do for the citizens of Canada.

I believe that is the reason it is being debated today. There is some very tangible movement towards it. We do not need to go back to 1996, as I just did, or back to 1997, making reference to what Liberals were saying back then. We should be talking about today. We should be talking about what Canadians want for us to do, and that is to be working together, putting partisan politics aside and realizing that when we do have something worthwhile pursuing, parties would in fact come together.

I am very pleased. From what I understand, New Democrats, Greens and the Liberals understand the benefits of a national pharmacare program. The Bloc is sympathetic to it, but might disagree in terms of the Province of Quebec playing an important role in a future national program.

They could play a leadership role, but I think it is important that we have one strong national program, and that is what we should be pursuing.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I have listened to the debate so far from various members. I have talked about access for rare disease patients being very important. There is a University of Ottawa study from the IFSD Institute, which is where the former Parliamentary Budget Officer, Kevin Page, went. It did a study on what pharmacare would cost and what the different implications would be. It took some of the Hoskins report, some of the underlying variables, and it estimated that we would have to raise the GST by 2% across all of Canada in order to finance this pharmacare system.

Does the member agree with that assessment? If he does not agree with it, will he then commit not to raise a single extra dollar in taxes on hard-working Canadians to pay for the national pharmacare system that will not work for rare disease patients?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I would hope that there would be detailed negotiations and discussions between Ottawa and provincial jurisdictions. Financing is a very important component of it. To try to give an impression that, when we net everything out, there would be a huge cost to society, I would dispute that. I do not agree with that assessment and I do not believe that all reports would draw the same conclusions. At the end of the day, there is a huge cost factor by us not doing it. That is what I would ultimately argue.

As we have been doing from day one, we have to allow things like a standing committee. We had a commission and we allocated hundreds of millions of dollars to try to make sure we did this thing right. I believe that we are getting closer. I would like to think that it is only a question of time. We have been advancing. I look forward to the future and hope we will be able to achieve what I know a majority of Canadians would like to see in all regions of our country.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I heard the member speak a lot about what has been going on in provincial legislatures. I cannot comment on that. I have never been a member of a provincial legislature. However, I am a member of the House of Commons and I can only comment on what is here before us.

I want to ask the member a very simple yes or no question. Will he be supporting this motion?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I would suggest that the member needs a better understanding of how health care is administered in Canada. He says he was never an MLA, but as a member of Parliament, we have a responsibility to have an appreciation of how we administer health care, given the importance of health care to our country.

The member should be very much aware that we have now had several Liberal members of Parliament standing up saying they will be voting in favour of this motion. It is something we have been talking about all the way back to the 2015 election when we were knocking on doors and talking with Canadians first-hand and bringing the concerns of Canadians back to the government caucus when we won back in 2015.

[Han Dong, Liberal, Don Valley North, ON]

Madam Speaker, I am very pleased to add a voice to today's debate. It is a very important issue. I heard the member from the NDP party mention that he has never been in the legislature. I actually was an MPP for the Ontario legislature and I remember going to hospitals and talking to businesses on their views of Ontario's pharmacare. We had a plan. Unfortunately, the current provincial government decided to cancel it. It is just a shameful, shameful move.

I heard loud and clear from the parents of a child who was diagnosed with cancer and the drug payment every month was in the five digits. As MPs, we are making a decent amount of money, but even then, I would have been broke.

How can we expect an Ontario family or other Canadians to afford this kind of drug? I think national pharmacare is the way to go. I have no problem supporting today's motion.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, my colleague and friend truly understands what it is we are trying to accomplish. I appreciate his comment. As a former member of a provincial legislature, he understands the important role that a provincial government plays, but he also understands the important role the national government plays. One of the ways we can deal with the patchwork of differences between provinces and provide the assurances that Canadians truly want in terms of a national program is by working with provinces to get the program that would best benefit all Canadians, no matter where they live in Canada. That means we need a strong national government with a strong Prime Minister and that is something that we have.

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, as a member of the Standing Committee on Health, we conducted a study on pharmacare in the last Parliament. With 18 years of experience in the health care field, I know how important national pharmacare is and how beneficial it would be for Canadians and Bramptonians.

I am pleased to be participate today in this important discussion on prescription drugs for Canadians. As part of budget 2018, we created the advisory council on the implementation of national pharmacare to provide independent advice to the government on how best to implement national pharmacare in a manner that would be affordable for Canadians and their families, employers and government.

Budget 2019 announced the next critical steps toward the implementation of national pharmacare. These include working with the provinces, territories and stakeholders on the creation of a Canadian drug agency, taking steps toward the development of a national formulary and creating a national strategy for high-cost drugs for rare diseases. It is important we continue with our measured and considered approach to implementation. We know that a national pharmacare program would bring cost savings to the health system.

In the meantime, the government has been working with partners on initial steps to make Canada's existing prescription drug system more efficient and responsive. This work will help with the successful implementation of a national pharmacare program.

In budget 2017, the government provided support for this commitment with an investment of $140 million over five years followed by $18.2 million each year on an ongoing basis for Health Canada, the Patented Medicine Prices Review Board and the Canadian Agency for Drugs and Technologies in Health to improve access to prescription medications, lower drug prices and support appropriate prescribing.

Drug spending in Canada is high. It has increased significantly and needs to be addressed. Drugs are now the second-largest category of spending in health care. The Canadian Institute for Health Information estimates drug spending reached over $40 billion in 2019.

Part of that spending results from an increase in the utilization of drugs resulting from the effects of both an aging population and a rise of chronic conditions. However, it is also a result of high drug prices.

Canadian prices for drugs are very high by international standards. According to the PMPRB, Canada's price regulator for patented drugs, our patented drugs prices are behind only the U.S. and Switzerland and well above the average for countries of the OECD. Indeed, OECD median prices are on average almost 20% below those in Canada.

Although the situation with respect to generic drug prices has improved in recent years, there is still room for improvement. As the PMPRB reported last year, in 2018 Canada ranked as having the 11th highest generic drug prices, just behind the United States, and, on average, OECD median generic drug prices were 15% lower than in Canada.

The government has taken action to address these challenges through targeted measures to lower drug prices and improve the affordability of prescription drugs to better protect Canadian consumers from excessive prices. The government has modernized the way prices for patented drugs are regulated.

The PMPRB was created in 1987 as a consumer protection pillar after a major set of reforms to the Patent Act. The PMPRB's mandate is to ensure that patent holders do not abuse their patent rights by charging consumers excessive prices.

Last August, the government updated the patented medicines regulations, which, together with the Patent Act, provided the PMPRB with the tools and information it needed to monitor and regulate patented drug prices in today's pharmaceutical environment. These are the most significant reforms to the regulations since their introduction in 1987.

The amendments, which come into force this July, are expected to save roughly $13 billion in the first 10 years of implementation.

Several changes were made to patented medicine regulations. The first updated the list of comparator countries. The PMPRB currently benchmarks the list prices of the patented drugs sold in Canada against the list prices in seven other countries. As the current countries used for these comparisons have some of the highest prices in the world, the benchmark fails to protect Canadians from excessive drug prices. The new regulation changes the countries that the PMPRB compares Canadian prices against. With the revision, the list of comparator countries includes a complement more like Canada economically and with similar price protections, such as Australia and the United Kingdom.

In addition to changing the list of comparator countries, there were other changes to the regulations, which help the PMPRB regulate the price for patented drugs. It is known, for example, that not all drug discoveries are alike. Some drugs represent breakthroughs that extend the lives of Canadians, while others offer a slight or no improvement over products already on the market.

While many factors go into determining a non-excessive drug price, value for money should be one of them. There must be evidence that a drug is likely to prolong life or improve the quality of life to justify a higher price tag. The amendments included new price regulatory factors, which will enable the PMPRB to ensure that the prices manufacturers charge Canadians reflects the value the drugs bring to the health care system.

Finally, the amendments also supported greater transparency in drug prices. When the PMPRB was created, prices paid in the market were similar to public list prices. Now, as a result of significant discounts and rebates to third party payers, the prices paid in the market are significantly lower than list prices. These rebates are typically negotiated in confidence with the agreement that they not be disclosed publicly. The amendments enable the PMPRB to see the actual prices being paid in Canada and not just the list prices published by the industry. Without this information, the PMPRB would be left to regulate prices on the basis of inflated prices that do not reflect the actual prices being paid in the market.

Through consultation on the changes to the regulations, Health Canada heard from a number of stakeholders including, among others, provinces and territories, industry, patient organizations and health policy experts. Changes reflected the feedback received as part of the consultation process. This suite of measures laid the groundwork for national pharmacare, and is the foundation of a system that would enable Canadians to access and afford the drugs they need.

The government is also working closely with the provinces and territories to reduce drug costs. As a member of the pan-Canadian pharmaceutical alliance, we are combining our collective buying power to make prescription drugs more affordable for public drug plans, while lowering generic drug prices for all payers. The initiative has been extraordinarily successful. The pCPA has completed 345 negotiations with the makers of patented drugs and has an additional 34 currently under way.

In 2018, the alliance also conducted negotiations on a five-year agreement with the Canadian Generic Pharmaceutical Association, providing significant savings for all Canadians who use generic prescription drugs. Through this initiative, the prices of nearly 70 of the most commonly prescribed generic drugs in Canada were reduced by 90% of the price of their brand-name equivalents. As of April 2019, the work of the pCPA had resulted in annual savings of more than $2 billion through negotiated price reduction for both patented and generic drugs.

Taken together, these two measures will have a significant impact on the affordability of drugs and represent the kind of improvement that must be made to ensure the success of national pharmacare. Last June, we welcomed the recommendation from the advisory council on the implementation of national pharmacare. These recommendations are—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Unfortunately, that is all the time the member has.

Questions and comments, the hon. member for London North Centre.

[Peter Fragiskatos, Liberal, London North Centre, ON]

Madam Speaker, I know my hon. colleague has a passion for working with advocates on diabetes and being a strong voice in the country on diabetes research. How will pharmacare help those living with diabetes?

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, the hon. member has a passion for the health care field as well.

As members know, our government's top priority is the health and safety of Canadians. We recognize the serious impact. When I was working on the health committee, we conducted a study. We heard loudly that more than 20% of Canadians could not get their medications. Without getting medications, they have serious consequences.

That is why, guided by the initial recommendation in the council's interim report, budget 2019 announced federal investments to move forward on three fundamental elements of national pharmacare, including creating a national drug agency. Also, budget 2019 announced critical steps toward implementing a national universal pharmacare.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, I thank my colleague for her speech.

As she mentioned, we know that the Patented Medicine Prices Review Board, which regulates drug prices, ties Canadian prices to those of countries where they are most expensive.

We thought we had won our case in 2017, with the publication of proposed regulations that excluded the United States and Switzerland and met our demands. However, as a result of pressure from the pharmaceutical industry, the government withdrew its regulations before they were scheduled to come into force, that is in January 2019.

This time, if I have understood correctly, her government plans to implement this measure in July 2020.

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, as I said, guided by the initial recommendations in the council's interim report, budget 2019's first step was to create a Canada drug agency to take a coordinated approach toward assessing the effectiveness of negotiating drug prices. Part of the work of the agency is the development of a national formulary, promoting more consistent coverage across the country and creating a national strategy for the high cost of drugs for rare diseases to help Canadians get better access to the effective treatments they need.

That is why budget 2019 proposed to provide Health Canada with $35 million over four years, starting in 2019-20, to establish a transition office to support the creating of a Canada drug agency and a national formulary, so everyone could benefit from it. This is the initial step toward national pharmacare.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

Madam Speaker, I would like to hear from my Liberal colleague across the way whether she will support this motion and whether she will work to ensure that whatever system the government comes forward with, it is universal, comprehensive, accessible, portable and public. Will she commit to supporting that kind of a system?

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I appreciate the great passion from the hon. member. As he knows, in the health committee, I was a great advocate for national pharmacare. We conducted a study. As a health care professional for 18 years, I heard loudly what national pharmacare meant and how people needed it. That is why our government is taking important steps.

In 2016, we conducted a study on health care and other rare diseases. I talked to patients about rare diseases. It is a most important issue as a health care professional.

In 2018, the alliance concluded negotiations for a five-year agreement with the Canadian Generic Pharmaceutical Association, providing significant savings for all Canadians. That is why I commend our government for taking steps for universal pharmacare, which never happened before.

I know we need to do a lot more to better protect Canadians.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

It being 6:38 p.m., pursuant to an order made earlier today, all questions necessary to dispose of the opposition motion are deemed put and a recorded division deemed requested and deferred until Monday, March 23, 2020, at the expiry of the time provided for Government Orders.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I suspect if you were to canvass the House you would find unanimous consent to call it 6:53 p.m.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Is that agreed?

[Some hon. members]

Agreed.

A motion to adjourn the House under Standing Order 38 deemed to have been moved.

International Development

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Madam Speaker, it is a great honour to speak in the House. I am honoured to speak on behalf of my constituents in Edmonton Strathcona and on behalf of Albertans.

With each passing day, I ask myself if there is a future for my children in Alberta. For 60 years, Alberta has become gradually and increasingly dependent on a single resource sector, a single resource that has driven the economies of Alberta and Canada in times of boom, but also devastated families and communities in times of bust. It is Albertans who have always paid the price for this dependence. Now Albertans face more than just another devastating bust cycle. Albertans are facing economic collapse.

Forty years of Conservative leadership in Alberta dedicated to rip and ship has cost Albertans dearly. It has meant that the value gained from a single resource and the jobs created declined even as production grew. Now, with the global climate crisis threatening our very existence, the world no longer needs or wants this single resource, a resource that accounts for 30% of Alberta's economy today.

Last week, I asked the government what it was going to do to help ensure a future for Alberta. I noted that unemployment in Edmonton, where I live, is the highest in Canada. I asked for investment in Alberta to create jobs now and investment to help diversify our economy for the future. I asked for our government to stop misleading Albertans, to stop telling us that there was going to be some sort of renewal of oil and gas and that it was coming back to $95 a barrel. I asked why the government is failing on diversification and failing to support Alberta workers. The Prime Minister responded, saying, “That is why we have worked to build the Trans Mountain pipeline expansion”. This is not good enough. Albertans desperately need this government to work with us to diversify our economy.

Last week Canadian crude was $47 a barrel. Today it was worth less than $20 a barrel. At the moment, it is $17.58. Last week Alberta was in the midst of an economic crisis. This week we are facing economic collapse. However, we do not have to. We can build a better future for Alberta if this government decides to take action.

My riding of Edmonton Strathcona is home to The King's University, the south campus of the Northern Alberta Institute of Technology and the University of Alberta. There are amazing researchers, inventors and innovators from academia and industry. Since my election, I have been privileged to hear a steady stream of ready-to-implement ideas to lower our greenhouse gas emissions and build our economy. In fact, I am convinced that we have the answers we need to address climate change and diversify our economy if we have the means to implement them.

Translation of research and development into commercialization and practice has always been a challenge for science and innovation. Every great idea or advancement requires funding to come to realization. Some projects, like advanced carbon sequestration practices, do not have access to venture capital because they do not have commercial outcomes. Others, like sulphur removal technologies, may have future commercial appeal but require funding for prototype development now.

Funding for these new ideas is one way to support Alberta. The Liberal government could help Alberta right now by creating an Alberta infrastructure bank for energy and other diversification projects and by targeting investment for—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

I have to ask the parliamentary secretary to provide an answer.

The hon. Parliamentary Secretary to the Minister of International Development.