Debates of March 12th, 2020

Opposition Motion—Pharmacare

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

Mr. Speaker, I will quote from the executive summary of the Hoskins report. Sentence number one is “Canadians spent $34 billion on prescription medicines in 2018.” That is sentence number one.

The second part of the question was related to possible savings that would come out of getting rid of the patchwork. That is a theory. It is not proven. I think the current system, which is competition and profit motivated, has served us very well. As an employer, I have paid a lot of money to hire employees, and I had to provide a very good pharmacare plan for them or they would go work for the competition. Competition actually does work.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Mr. Speaker, I would like to refer to the comments of the member for Vancouver Kingsway. As he remarked, the health committee did a rich study on this a couple years ago. The data is a little older than what Dr. Hoskins used, but the numbers in that report showed that the cost to the public was around $28 billion. That would be reduced to $20 billion with a national pharmacare program that followed the Quebec model. Of that, $13 billion is already paid for by different levels of government, so the gap is only about $6 billion.

Also from that report, we had testimony that said between $7 billion and $9 billion accrues as a cost to the different public systems by virtue of people not being able to take their medicines properly. In that sense, a national pharmacare program not only makes sense and is good for the country, but it will basically be covered off by many other lines on the balance sheet.

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

Mr. Speaker, I am not sure that there was a question in there.

Big pharma spends a lot of money on designing new drugs. The profit margin is what drives them to do that. There is going to be a cost involved. Just making it a universal plan does not necessarily bring down all those costs.

I recognize that provinces already have pharmacare plans in place, and that a national plan would work together with them. I recognize that. It would not all be a cost to the federal government, but the total cost in 2018 was $34 billion. What will the federal government's contribution be toward that, and how will the federal government fund that contribution?

[Andréanne Larouche, Bloc, Shefford, QC]

Mr. Speaker, I thank my colleague for his speech.

Since he likes to talk numbers, does he recognize that the biggest part of the problem comes from the fact that Canada has some of the highest drug prices in the world? Drugs here cost 19% more than the OECD median, according to the federal government's own statistics.

The Bloc Québécois has been urging the government for years to change the list of countries that it uses to set prices and exclude the United States and Switzerland, where prices are way too high, almost prohibitive. I would like to know what my colleague thinks about that.

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

Mr. Speaker, we have heard some examples of drugs that are more expensive in Canada than elsewhere, but for every example like that, there is an example of drugs that are cheaper in Canada than elsewhere.

There are state governments and other big employers that come to Canada to purchase drugs because they are more affordable here than in the United States. I do not know where the idea that Canada is the most expensive place for medication comes from. Certainly it is for some, but not for all. I do not think that is a fair general statement.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Mr. Speaker, I am pleased to join the debate at this late hour.

For my introduction I have a good Yiddish proverb, which is, “It isn't done as easily as it's said”. It actually sounds way better in Yiddish. However, the proposal in the motion sounds good. It is something I think a lot of people would definitely get behind. If we called it the national grocery store plan to provide food to everybody for free or at a huge discount, of course a lot of people would think it was a great idea.

We have heard about the Hoskins report. The terms in the report that are repeated often include “value for money” and “cost-effectiveness”. A lot of members have talked about the price, but I want to talk about access, access to medication for rare-disease patients.

Currently, this is a highly regulated part of the free market. Pharmaceutical companies, whether they are big, small or medium-sized, compete in a very tightly controlled market, both through the patent system and in the generic markets. It is hyperregulated. In Canada, there are very few buyers.

What government members have talked about doing with a Canadian drug agency is something that the pCPA already does, and it discounts. This is why I disagree with the PBO report. The discount members keep talking about for medication is already assumed in what the pCPA was able to achieve by doing bulk purchasing and negotiating on behalf of all the provinces together.

My problem with the architecture of the current system is that there is very little parliamentary oversight. What a national pharmacare would do is put this system, and members will forgive for the pun, on steroids. In the current system, which would be expanded in a national pharmacare system, drugs will be approved and then governments will quibble over the cost with the manufacturers. I have yet to see a government manufacture a single drug or a single vaccine. This is a problem of access.

I have mentioned my constituents Sharon and Joshua Wong before. Sharon has a very rare form of lung cancer, and she has never smoked in her life. For her particular lung cancer, only 2% of patients have it, and hers is even rarer than that. She has an ROS1-positive type of lung cancer. There is a drug in Canada for it, and thank goodness it is approved, but it is not for reimbursement in my home province of Alberta.

I have talked to Pfizer and to the Government of Alberta, and I have talked directly to the assistant deputy minister responsible for it. I have to say that none of them is willing to budge. My constituent cannot access it, but it is not for lack of being able to pay. The drug is just not available to access because the public insurer and the manufacturer cannot agree on the price to be paid for it. In between all of this is a trapped family and 13-year-old Jonathan may not see his mother live much longer. This is not an issue of price. It is an issue of access to drugs for rare disease patients. This is a system that will be made worse.

On cystic fibrosis, I have had several constituents come to me over the years to talk about the fact that Orkambi has been twice refused by CADTH in Canada. It was refused in October 2018 and November 2017. It was refused because of value for money, the cost-effectiveness. It is right there in the pharmacoeconomic report produced by CADTH, which says that there is no value for money and so it is not going to approve it. However, it is approved in America. This patchwork system of America approved it, and cystic fibrosis patients there have access to Trikafta, Orkambi and Kalydeco.

In my province of Alberta, the health minister, the hon. Tyler Shandro, got Kalydeco approved and reimbursed for patients in Alberta, and for that I thank him. At least some patients with cystic fibrosis will have access to the drug through their public insurer, and it is also available through many private insurers.

This is my problem with national pharmacare. It is not going to solve the problem that my colleagues in the NDP believe that it will, and I respect their work as parliamentarians.

I sat at that committee several times and listened to the discussion about national pharmacare. If members read the presumptions inside the Hoskins report, it says that all provinces would have to participate. Quebec has said that it will not because it has RAMQ, Régie de l'assurance maladie du Quebec. The Government of Alberta, in an official letter written in November of last year to the Minister of Finance, has said that it will not participate in the plan. Alberta has its own plan and can do this itself.

The Conference Board of Canada has said that only between 1.6% and 1.8% of Canadians do not have access to any plans and it is not even an issue of cost. They do not have access, and that is the greatest problem.

We talk about savings for small business. Small business can join a chamber. The chamber network has an excellent insurance benefit drug plan. Small business could go to a CPHR, a certified professional human resources association. I used to be a registrar for one of these associations before becoming a member of Parliament. A small business could go to one of them to find a benefit program that would work for it.

The issue is access and a national pharmacare program would make the issue worse because the regulatory system does not work for patients with rare diseases. I have another example that I want to give the House.

The PMPRB, call it what it is, is a price control board for trademark medication. The entire consultation it has done is a sham. It did not involve patient groups. If members want to check online they just need to Google the Canadian Organization for Rare Disorders, which called the entire consultation process a sham. It excluded families of patients. It cancelled meetings. It did not want to hear from patients all across Canada. It is going to discourage companies, big and small, from coming to Canada to get listed on the formularies across the provinces. That is not helping patients. That is not helping people in my riding. That is not helping my kids. I am not here representing big pharma. I am here representing my constituents and my kids, who have a rare disorder called Alport syndrome. I know lots of people who have Alport syndrome. There are companies doing clinical trials on this.

Another example of why this PMPRB, this price control board, is a sham is the impact it is going to have on families. One-third fewer clinical trials are going on right now in Canada as a result of the announcement on what the Minister of Health is doing on the price control board. There is already a one-third drop and it was at a low point. This is the problem.

I understand that the Liberals will be supporting this motion. In the lead-up to the introduction of national pharmacare, they are paving the way towards a single-payer, single-user universal pharmacare system despite two provinces saying they are out. Other provinces may bow out as well, thus reducing the cost savings in it. The assumptions in the Hoskins report fail under all of those currently evolving decisions being made by other governments, and they leave behind patients with a rare disease.

Money was announced in budget 2019 but there has been nothing with respect to how the money will be spent, whether it will be a pooling of risk, whether it will be a separate insurance system, and how to bring costs down.

I mentioned at the beginning of my remarks that this is a highly regulated part of the market. It is difficult to get a patented medication onto the market. A whole bunch of hurdles have to be cleared along the way, so many companies struggle with it. Companies have to get a product on the market before their patent runs out, otherwise competitors begin to enter the market. The pan-Canadian system, the PCPA system we have right now, even if we look at the list of generic drugs and how we pay for generics, is a percentage of the trademark medication.

Nobody has really talked about what happens when a pharmaceutical company owns both the trademark and the generic drug. If it is just a percentage, why not just raise the price? There is no price transparency. When we buy Tylenol, we can see how much we are going to pay. We can buy Advil if we so choose. The price can be seen clearly. There is no visible price metric that is easily seen by patients, by organizations that are pro consumer or pharmaceutical company or the government.

I want to draw the House's attention to a book called Overcharged: Why Americans Pay Too Much for Health Care, by Charles Silver and David Hyman. The Dean of Harvard Medical School wrote the foreword. The book talks about the importance of price transparency, which does not exist in the current system. It is all inside baseball. The bureaucrats in the towers of Health Canada get to decide things. I am afraid with a national pharmacare system they will get more power to decide what type of medication will be approved.

Earlier today I heard the House leader for the New Democrats talking about New Zealand. New Zealand is absolutely the worst system in the world for someone with a rare disease. The vast majority of patients with a rare disease do not have access to their medication in New Zealand. We should not want to copy a system like that.

[Paul Manly, Green, Nanaimo—Ladysmith, BC]

Madam Speaker, the Green Party supports this motion. It is a very good time to be moving toward universal pharmacare in our country. We know this will save our health care system money. We are the only country with a universal health care system that does not include universal pharmacare.

People who have chronic diseases and cannot afford their medicine end up with catastrophic medical issues. They end up in the hospital, which costs much more than if they had been able to get medicine provided to them through a universal single-payer pharmacare system.

We know that half the visits to emergency departments by seniors are related to them not taking the medication they need. Per capita, my riding has the largest population of people over the age of 75. Hospital officials will tell us that people need their medicines.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, this is from a report of a few years ago on the estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. It stated that 117 essential medicines on the model list accounted for 44% of all prescription drug expenditures in 2015. It is a very small group of medications that cost so much. We do not talk about that here. We are talking about everything; one model to fit them all.

The member talks about how much money we will save. The only way to save money on national pharmacare would be on the backs of rare disease patients because they would have to be cut off from that medication in order to save pennies and dollars. They will wind up in an emergency room because they will not have access to the medications they need.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Madam Speaker, the member does not want to support this measure because it will not solve the problem for people with rare diseases. Not implementing this would also not help that problem.

I encourage the hon. member to come on board. We can address those problems as part of the implementation of a national pharmacare program.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, the first order of good government is do no harm. I will go back to my business experience at the Chamber of Commerce. Before we would roll out a new program for our membership, we would first test everything that could possibly go wrong. If something did not work, we did not roll it out across the board to our entire membership base. The same principle should have applied to Phoenix.

Again, this program will not work the way the members expect it to. For example, Spinraza is a medication for SMA sufferers. I have a young constituent, Evan Palmer, who is in a wheelchair. For the longest time, the CADTH recommendation was to not cover him because he was too young and therefore not deserving of it. Every year he would wind up in a PICU bed at the children's hospital. A PICU bed costs about $10,000 a night. Therefore, for 30 days a year, it would cost $300,000. The medication was $150,000.

When I went to the minister of health in Alberta and made the business case for it, he said that I was absolutely right and that this should be done. Thanks to my local MLA Matt Jones, the minister in Alberta ignored the recommendation of CADTH, this regulatory body, and went ahead and negotiated a great deal for constituents like Evan Palmer to get access to the medications they needed. A business case can be made, but do no harm in the first place.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, I thank my colleague for his speech.

He spoke a lot about rare diseases and the high cost of drugs. I have a few numbers to illustrate what he was saying. Between 2007 and 2017, the average annual cost of treatment for the top 10 selling patented medicines in Canada increased by 800%. The number of medicines with annual per-patient treatment costs of at least $10,000 increased sevenfold, going from 20 to 135.

Does my colleague agree that we need to support the regulations excluding the United States and Switzerland, which would enable us to save $9 billion over 10 years? That could impact the most expensive drugs.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I thank the hon. member for Shefford for the question. I will answer the first part of the question in French, and then I will switch to English to talk about the more technical aspects.

I agree that some countries should be removed from the list of countries that are considered when setting average prices.

I will switch to English, because this is a technical answer.

The PMPRB is also looking at quality-adjusted life year, which basically says, “this is the value of every single year of a life”, to determine whether it should finance that medication.

I am not saying that national pharmacare may not work. I am saying that it would likely fail and make things worse by limiting access to expensive medication at the beginning. These are real people, with real problems and real families, who will have to go overseas to get the medications they need.

[Jenica Atwin, Green, Fredericton, NB]

Madam Speaker, I wish to thank my NDP colleagues for giving me the opportunity to speak. I will be splitting my time with the member for Edmonton Strathcona.

One third of working Canadians do not have employer-funded drug coverage. One in five households reported a family member who had not taken a prescribed medicine in the past year due to its cost.

Every year, nearly three million Canadians say they cannot afford to fill one or more of their prescriptions.

In the 2019 election, I heard these statistics echoed at doors and across party lines. I am excited by the idea of national pharmacare and the support I know we have from members of the House to improve the lives of Canadians. I am also excited by how much work has already been done to understand what our national pharmacare plan needs to look like.

Last June, the well-known published final report of the advisory council on implementation of national pharmacare, also known as the Hoskins report, advised that it had received questionnaires from more than 15,000 people and organizations, received more 14,000 petitions or letters, reviewed more than 150 written submissions, investigated global best practices and hosted town halls and round tables. It uncovered significant gaps in drug coverage.

Of the nearly three million Canadians who said they were not able to afford their prescriptions, 38% had access to private insurance coverage and 21% had public coverage. However, with co-pays and exemptions, they still did not have the resources to afford their medications. Almost one million Canadians were forced to cut back on food or home heating to pay for their medication.

Nearly one million Canadians have had to borrow money to pay for their prescription drugs.

This highlights the crushing poverty weighing on Canadians. It has many causes but with pharmacare, we can take one worry away. We can alleviate some of the stress and uncertainty in their lives.

In the Hoskins report, the advisory council laid out several recommendations to address these gaps, and I will reiterate them.

Its first and foremost recommendation was that the federal government work with provincial and territorial governments to establish a universal, single-payer, public system of prescription drug coverage in Canada. A two-tiered system would create further inequity, leaving low-income and unemployed Canadians at risk. The administration of such a program would be cost-ineffective. A privately administered system would create profit incentives where public interest must be the first priority.

The council also recommended that national pharmacare benefits be portable across provinces and territories. This reinforces the need for federal leadership to come alongside provincial health departments to ensure the system is truly national in scope.

Another recommendation was to make everyone in Canada eligible for a pharmacare program to ensure that everyone can get the drugs they need to maintain their physical and mental health.

It also recommended a national formulary be developed to list which prescription drugs and related products should be covered to ensure all Canadians would have access equally to the medicines they needed to maintain or improve their health, no matter where they were living in Canada.

Clearly this is a big job. We are going to need leadership from our Prime Minister and his cabinet, and we are going to need significant financial investment from the federal government to make this happen.

It is remarkable that Canada is the only developed country that has a universal health care program that does not include universal coverage for prescription medication, especially when we know there are real costs associated with people who need to skip doses or avoid filling prescriptions because they cannot afford to buy them. These decisions put strain on our health care system.

People are struggling to stay healthy their whole lives, which leads to complications and chronic illnesses later in life.

Individuals end up in urgent health care situations, needing to return to hospital emergency rooms and taking up hospital beds, because they can not afford to properly manage their conditions and illnesses at home.

The Parliamentary Budget Officer has already indicated that this will save federal, provincial and territorial governments billions of dollars, and that does not even consider the quality of life for Canadians who require prescription medicines.

A recent study by St. Michael's Hospital's MAP Centre for Urban Health Solutions found that providing free medicine resulted in a 44% increase in people taking their essential medications and led to a 160% increase in the likelihood of participants being able to make ends meet.

Ensuring people have access to the medications they need throughout their life will have real, positive impacts, such as poverty reduction, as people become able to direct their money toward food, rent, home heating or child care. When a chronic condition is well managed with medications, individuals can better access the workforce and participate in their communities.

People with rare diseases should not have to go bankrupt because of their diagnosis.

Those living on fixed incomes, such as seniors, are not stuck with increasing pharmaceutical costs. For people in immediate mental health crisis, the extra financial anxiety of a new medication does not have to weigh on them.

I am struck as well by the consensus that exists around this issue.

The majority of MPs in the House are members of parties that made this issue a priority in the last election.

Polls show that 90% of Canadians support equal access to prescription drugs, regardless of income. When I saw national pharmacare reference in the mandate letters of four ministers, I was hopeful that we would actually see this happen in the 43rd Parliament, but I am a little concerned that nothing seems to be moving on this front yet, and I am so thankful for this motion from my NDP colleagues.

Maybe we will be pleasantly surprised when the budget is tabled, but I fear that the government may be losing its courage, perhaps because of the lobbying that is being carried out by pharmaceutical and insurance companies. I hope the government is being vigilant against letting entities with deep pockets and full-time Ottawa-based lobbyists buy influence on our policy development process.

I have spent time with representatives from community organizations and health care professionals and their unions. They said that we need universal public pharmacare. These groups include the Heart and Stroke Foundation, National Nurses United, the Canadian Diabetes Association, the Canadian Counselling and Psychotherapy Association, the Canadian Health Coalition, the Canadian Labour Congress, and I could go on. These organizations represent average Canadians, workers in the health field and those who are living with, or caring for, people with chronic or acute disease. These are the people we work for.

The Canadian Medical Association shared stories of doctors fighting for national pharmacare. Dr. Nav Persaud had this to say: "Why did I spend all those years training to become a doctor if at the end of it, when I give someone a diagnosis, they don't fully benefit because they can't afford the treatment?"

The advisory council on the implementation of national pharmacare left us with the way forward: "It will take time, significant federal investment and close collaboration among all health system partners to turn Canada's patchwork of prescription drug insurance plans into a national public pharmacare program.”

But it is possible. Thanks to the work of the council, the path forward is clear. The data are incontestable, Canadians are on board and parliamentarians in the House are mostly on board. We are here to represent the people, and this is what the people want.

My final reflection is this: What are we waiting for?

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I am really pleased to hear the remarks of my hon. colleague from the Green Party and her contributions to this important subject. I was particularly happy and thought it was really helpful in this debate when she named so many of the organizations that represent so many Canadians in various aspects of life across Canada that are in support of Canadian public pharmacare.

This is not just something that political parties are pushing here. This is something that comes from the grassroots of our communities, from doctors, health professionals, nurses, hospitals, patient groups, unions, employer groups, industry and health economists.

I wonder if my hon. colleague could elaborate on that and if she would tell the House her sense of the support that exists in her community and in stakeholder groups across this country. Does she believe that it has majority support of Canadians across our land?

[Jenica Atwin, Green, Fredericton, NB]

Madam Speaker, I think back to the election process and knocking on countless doors, visiting every long-term care facility and senior care facilities in my riding to discuss these issues of health care and high costs. I have a very high demographic of seniors in my riding as well, and this was something that they acknowledged would help them.

They talked about the times they had to make the decision between heating or food and medication. We have heard that line so many times, but it is because it needs to be repeated. That should not be happening in Canada. There were nurses and doctors as well. We had so many meetings with these organizations over the past few months, and it was unanimous. It seemed to be a no-brainer, and I really hope that we can make this happen for them.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, the member for Fredericton mentioned that some members do not agree, so I thank her for recognizing that fact. I am pleased that she is here in the House and not her predecessor, whom I disagreed with often in this place.

Despite having disagreements, obviously we can agree that no patient should be left behind. The primary argument I have been making is that rare disease patients will be left behind in a national pharmacare system, because finding value for money and finding cost-effectiveness in the way the Hoskins report talks about requires picking which medications we will cover, and the current regulatory infrastructure and architecture that the federal government has will be simply enhanced.

Would the member agree that we should first fix the regulatory system we have before we try to impose an Ottawa-centric system on every single province across Canada?

[Jenica Atwin, Green, Fredericton, NB]

Madam Speaker, I am happy to be here as well, instead of my predecessor. I also want to thank the hon. member for his advocacy for rare diseases. We also care deeply about that issue. We know we need to work harder.

To address the issue, maybe we should deal with the regulatory system as it is first, but I do not think we have time to wait. I think we can do these alongside of one another. It certainly should be part of the considerations for national pharmacare, but I do not think it has to mean we are leaving those patients behind.

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

Madam Speaker, I might be accused of always asking the same question, but that is because we never get an answer in the House. I will ask it anyway. I very much appreciated my hon. colleague's speech, and I have a great deal of empathy for anyone dealing with the tragedy of a rare disease. On that, I agree with everyone who spoke here today.

On the other hand, I do not how this will unfold. Last June, the National Assembly voted unanimously on a motion stating that Quebec would refuse to adhere to a pan-Canadian pharmacare plan. Whether the CAQ, the PQ or Québec solidaire is in power, everyone in Quebec wants nothing to do with this. We have our own system. It is not perfect, but it works pretty well.

What we want is for Ottawa to give us the money. We have no problem with Canada creating a national pharmacare program. What we want are health transfers. We have been asking for that for years now. Quebec's health care system is underfunded. We want a 5.2% health transfer. If Ottawa wants to create a national program, that is fine, but we want money.

What are my colleague's thoughts on that?

[Jenica Atwin, Green, Fredericton, NB]

Madam Speaker, that is a challenge. It is going to take all provinces on board for this to be cost-effective and so it is really important that we have these debates in the House, that it goes to committee and we make sure that the interests of Quebec are looked after.

I look at all the statistics, the support and organizations, and I have a hard time understanding why someone would not want that program. We have also advocated for increases in health transfers. It seems like it would be the best thing for Quebec, as well as Canada. I would like to know more about why.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Madam Speaker, I stand today to speak about my support for this motion.

I want to start with the COVID-19 pandemic. It is a timely reminder that we are all global citizens and are all connected to one another. The health of Canadians is connected to the health of people around the world. Some days we may even take our health and health care system for granted, but not today of course. The global pandemic is a stark reminder that our health is fragile and so is our health care system.

Across the planet, countries that have had the infrastructure and capacity to quickly isolate and treat patients have had the most success at flattening the curve of infection. These countries have been able to save the lives of what will probably end up being thousands if not tens of thousands of people. While Canadians are rightly proud of our national health care system, we lack the critical element that other countries possess: the ability to provide ongoing medical treatment through pharmaceuticals. As I said, we are all connected. My health affects others' health. If I cannot access the medications I need, others may suffer the consequences. Canadians understand that.

I am a new member of Parliament, and one of the members who have never run for office. It was a real privilege to knock on doors in my riding of Edmonton Strathcona to learn from my constituents. I was particularly struck by the intelligence and generosity of opinions expressed by the people of Edmonton, people who clearly understand the growing disparity between the haves and the have-nots in Canada.

Edmonton Strathcona is a very diverse riding, with Canadians from every region of the world and from as wide a range of socio-economic backgrounds and situations as we would see in any major city in this country. When speaking with my constituents on their doorsteps about the NDP's priorities, I was not surprised to hear overwhelming support for our platform from those struggling to make their needs met. However, I was a bit surprised by how often my constituents who were not struggling were concerned about the very same things.

I will never forget one young man, a successful business owner living in a beautiful new infill home. He told me that his number one priority was health care for struggling Canadians. We talked for a long time about the NDP's plan for pharmacare, dental care and mental care, and he told me about his two young daughters and the children at their daycare and school. He was deeply concerned for his daughters' well-being of course, but he emphasized that their well-being was directly linked to that of their friends.

He described to me those he knew, many of them new Canadians who were not able to access the medicine that they needed. They or their children were going without necessary medications because they did not have drug coverage. He then looked me straight in the eye and said, “This is ridiculous. My child's health is in danger because these people can't pay for their drugs. You need to do something about this.” I am here hoping that I can.

Last week, Alberta was facing an economic crisis. Unemployment in Alberta has skyrocketed over the past nine months. Edmonton has the highest unemployment rate in the country. Thousands of Albertans have lost all or some of their employer-provided prescription drug coverage.

To make matters worse, Jason Kenney's United Conservative Party government just cut prescription drug coverage for thousands of seniors and their dependants, cut funding support for medical assistance devices for seniors and cut access to necessary biologics for thousands of others. In total, 46,000 Albertans have lost their health care and medication coverage or have had it drastically altered. Now these Albertans will have to pay out of their own pockets, if they can. If they cannot, they will pay with their health and possibly their lives.

One family affected by Jason Kenney's cruel cuts reached out to me recently. Helen spent 35 years in our community serving as a nurse. She had to retire before age 65 because of a brain injury. Thankfully, her husband Steve, who is over 65, had coverage for her and their son through a provincial seniors drug program. All three members of this family have health issues. When Jason Kenney kicked dependants off the seniors drug program, Helen and her son lost their coverage.

Today, this family is facing an additional $4,000 in drug costs. That is $4,000 per month. Helen and Stan are desperate for answers. Right now, they are looking into selling their home to cover the additional costs, but they do not know if that strategy will work. With unemployment so high in Alberta, housing prices in Edmonton are really declining.

This family is facing the most difficult decision of their lives. They are having to decide between their home and their health. This family and hundreds of thousands of other families across Canada live with these impossible dilemmas because Canada does not have a national universal pharmacare program.

When Jason Kenney cut this family's drug coverage, he saved the Alberta government millions of dollars, $72 million to be precise, and that is a lot of money. If we put that into context, the costs and savings hardly add up. For every tax dollar that Jason Kenney sent to foreign stockholders with his corporate tax cut, he got 1.5¢ in return from people like Helen and Stan. The cruelty is mind-boggling.

If we want to get a sense of how many Helens and Stans there are out there, we can ask a health care worker. Doctors know, and that is why they support universal pharmacare. Nurses know, and that is why they support universal pharmacare. Nearly every health care professional in our country supports universal pharmacare.

As I have mentioned in the House before, I am a cancer survivor. In fact, I have the incredibly good news to share that last week I was declared cancer-free. While I should have celebrated that news, I struggled to do so because I realized that I was lucky to access medication and the care that I needed to stand here as a cancer survivor. That is not the case for people in my province.

I had the opportunity to visit with my pharmacist the other day and discuss this issue with her. She told me that people would be shocked to learn how many people go without medicine because they cannot afford it. They stand in line with their prescriptions in hand and submit them, but when they find out how much their prescriptions cost, they leave. Those are the easy cases for her. Far more difficult for her are the ones who do not just leave, the ones who try to buy one or two pills, the ones who offer to pay for part of the cost now and some of it later, the ones who cry and the ones who beg.

She told me about one woman who, after paying for a prescription of medication her child needed, simply gathered up her child and her purse from her shopping cart and walked away, abandoning her groceries. This did not happen in a low-income area of Edmonton. This happened in the heart of Edmonton Strathcona, in an area full of lovely homes and well-educated residents.

It is not going to get better; it is only going to get worse. Last week, Alberta was facing an economic crisis. That was last week. This week, Albertans are facing economic collapse.

Tommy Douglas, the father of medicare, knew that our health care system was not complete without pharmacare. He recognized more than 40 years ago that health care is not universal if Canadians still have to pay out of pocket for their medications. In 1984, he said:

Let’s not forget that the ultimate goal of Medicare must be to keep people well rather than just patching them up when they get sick. That means clinics. That means making the hospitals available for active treatment cases only, getting chronic patients out into nursing homes, carrying on home nursing programs that are much more effective, making annual checkups and immunization available to everyone. It means expanding and improving Medicare by providing pharmacare and denticare programs. It means promoting physical fitness through sports and other activities.

The lack of pharmacare is a gaping hole in our health care system and Canadians are falling through.

For the past 23 years, the federal Liberals have made pharmacare a priority, or so they have said. It has been a cornerstone of the Liberals' platform in every election of the past two decades. The Prime Minister promised pharmacare in 2015 and 2019, and I suspect the Prime Minister will make the same promise again when the next election is called. How cynical must one be to continue to do this to Canadians? It is time to stop promising pharmacare. It is time to enact pharmacare.

[Earl Dreeshen, Conservative, Red Deer—Mountain View, AB]

Madam Speaker, I heard part of what the member had to say about some of the issues and concerns in Alberta. I was involved with the hospital boards back in the Chrétien times, when the amount of money that was transferred to the provinces went from 58% to 25%. I saw the problems we were trying to solve when Ralph Klein tried to look after what was left of the health care system after the devastation that had taken place because of the Liberals. When we were in power, we made sure there was money going into it. As a matter of fact, there was a guarantee of 3% going to the provinces that would be there forever and when the Liberals came in that went below 3%.

The Liberals always talk about how the Conservatives were cutting money and how they were these great folks who were going to save medicare. It is the same sort of thing with the NDP making comments like that about the problems and issues Alberta has. If we decide to take on this pharmacare for all, it is going to hurt everybody who is looking at rare disorders and the concerns we have there. I think the member should recognize the issues that are really out there for Alberta.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Madam Speaker, I would like to echo some of the people who have already spoken in the chamber this evening. I have deep concerns about our ability to meet the needs of those with rare diseases. It is something I have met with my constituents on frequently. There are constituents I will be visiting next week when I am back home, and I want to make sure they understand how important this is to me.

That said, it is a little rich to hear from my Conservative colleagues that they are blaming the race to the bottom between the Liberals and the Conservatives on who cut more to health care. Certainly, we saw a cut to the transfer payments under Stephen Harper. What we need to do is not necessarily talk about that, but talk about how we can make our system better. Universal pharmacare is of course the best way to do that.

[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 wonder if my colleague could provide her thoughts on how important it is that we work with the provinces to maximize the benefits of any sort of national pharmacare program.

At the very least, we owe it to the provinces to have those detailed discussions. Otherwise, if the federal government were to do it alone in some of the provinces that have taken a fairly strong stand, we would not have the same maximum benefit of a pharmacare program for Canadians from coast to coast to coast.

[Heather McPherson, NDP, Edmonton Strathcona, AB]

Madam Speaker, part of the motion the NDP has put forward would make sure that conversation takes place. Considering the high support Canadians have expressed for a universal pharmacare program, I am quite confident that it would not be difficult to convince them to encourage their provincial leaders to support such a move.

[Paul Manly, Green, Nanaimo—Ladysmith, BC]

Madam Speaker, discussing universal pharmacare is a really important thing. It is something this Parliament should do. We have talked about the cost savings and how much money we can save our health care system by providing prescription medicine to people who cannot afford it.

I wonder if the hon. member could expand on the cost savings to our system and how this is going to help Canadians and our health care system.