House of Commons Hansard #309 of the 44th Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was access.

Topics

Second readingPharmacare ActGovernment Orders

5 p.m.

Conservative

Dominique Vien Conservative Bellechasse—Les Etchemins—Lévis, QC

Mr. Speaker, this is just wishful thinking. I read the bill carefully. There is nothing specific in it and everything remains to be done. No agreements have been reached with the provinces and a list of drugs has not yet been compiled. All the bill says is that a strategy will be developed and a committee of experts will be set up.

This is just pure politics, completely partisan politics. As I demonstrated in my speech, the only reason this minority Liberal government proposed the pharmacare and dental care programs was to stay in power. It is supported by the NDP, which said that the Liberals had to bring in a pharmacare program to stay in power. Let us not kid ourselves this afternoon. That is the Liberal government's real motivation, and it is a national disgrace.

Second readingPharmacare ActGovernment Orders

5 p.m.

Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Mr. Speaker, we are offering it under a Westminster parliamentary system that is multiple centuries old. The member is talking about a minority government as though she has never even come close to understanding what happens in a minority. I am sorry if the NDP figured out how to actually get things done on behalf of Canadians while Conservatives would rather just yell and scream all day long about what they wish would happen; clearly, they do not use any kind of ability to act like adults in this room to get things done on behalf of their constituents.

Very simply, if Conservatives are going to be voting against this, is it safe to then say that they would remove this program if elected into government?

Second readingPharmacare ActGovernment Orders

5 p.m.

Conservative

Dominique Vien Conservative Bellechasse—Les Etchemins—Lévis, QC

Mr. Speaker, the Liberals put on quite the spectacle. Pharmacare was not even part of their election platform. As a minority, they rely on their NDP friends to keep their hold on power, sometimes with help from their Bloc Québécois friends too—we must not forget that. Then they turn around and criticize us for supporting or not supporting measures that they never raised with Canadians themselves. They cozy up to the NDP, which received only 7.7% of the vote in the last election, and have the nerve to lecture us. We are not going to take that.

Second readingPharmacare ActGovernment Orders

5 p.m.

Sackville—Preston—Chezzetcook Nova Scotia

Liberal

Darrell Samson LiberalParliamentary Secretary to the Minister of Rural Economic Development and Minister responsible for the Atlantic Canada Opportunities Agency

Mr. Speaker, I am thankful for the opportunity to speak to Bill C-64, an act respecting pharmacare. I am extremely excited to talk about this, because this is a very important program, another transformative initiative for Canadians. We are again supporting Canadians. We can think back to 1968, when we brought in medicare. We knew the Conservatives were against it then, and the Liberals brought it in; today, no one wants to get rid of medicare, because of its importance.

In this speech, I will be talking about the framework on pharmacare and also talking about diabetes and the three million people with diabetes, and how difficult it is for them. Also I will share some information about the pilot project we have been running in P.E.I., which has given us some information, as well as where we sit in the G20 when it comes to health care and drug care. Finally, I will talk about all those initiatives the Liberals have brought in, which are helping Canadians today and in the many years forward. It was the Liberal Party that brought those.

Let me start off by saying that this act is focused on certain drugs that we would bring forward, and related products.

Of course, my colleague will be joining me afterwards. I will be sharing my time with the member for Dorval—Lachine—LaSalle.

To continue, we are talking about certain drugs, such as contraceptives and diabetes medication. Again, as I said, there are over three million people with diabetes in Canada. Back in December 2023, we created the Canadian drug agency, and its focus is on three major areas. One is a formulary, which is putting up a list of all the drugs that would be included in this pharmacare program. Another is bulk purchasing. As some have mentioned already, we have already saved millions of dollars, and there are billions to be saved through that process, which will continue. Third, we will be publishing, of course, appropriate use of medication in Canada.

I also want to say that once this legislation is passed and receives royal assent, within 30 days the minister will appoint a committee of experts to make recommendations within a year, so that we can move on this as quickly as possible.

When I go to get some medication at the drug store, my pharmacist often tells me, “You have to do something for people with diabetes. The cost is unbelievable. Many Canadians are facing a cost they cannot afford to pay. You need to come forward with some type of initiative.” I am so pleased to be here today to talk about that.

In the last decade, we have seen a doubling of the number of people facing challenges with diabetes, which is extremely important. Today, 3.7 million people are living with this. If we do not do something to help them, 25% of those people have indicated that they cannot afford to pay for that medication. If we do not treat that disease, we know what some of the end products would be, and they are not very good. We are talking about blindness. We are talking about amputation. There are all kinds of challenges that come with that.

Just for insulin, for type 1 or type 2 diabetes, the cost can range anywhere between $900 and $3,000 or $4,000 a year, which is extremely high. The good news is that we are going to work with the provinces and territories and have a deal, so that they can have frontline services for these individuals.

Diabetes Canada said, “We are very pleased with the government's commitment to prioritize improved access to diabetes medications and devices. This monumental step demonstrates a genuine dedication from our political leaders to enhance the well-being of the over four million individuals living with diabetes in Canada.”

For example, last year in June we started a pilot project in P.E.I., and from that pilot project we have seen the medication costs drop by over 60%, helping the residents of P.E.I. In a very small province, they have already saved up to $2 million, out of pocket. That is extremely important, and when we talk about affordability, this is another step forward that our government is bringing to the table.

Where do we sit in the G20? Well, it is important. People ask why we are bringing this in. We are bringing this in because we probably should have brought it in before, but the time is now. We are the only country in the G20 that has health care insurance but yet does not include drugs. The U.K. has included some prescription drugs. Australia has a mixed formula of private and public. France has, of course, a health care system and is now paying significant portions toward drugs. There are other countries in the G20 that have some type of pharmacare, including Germany, Italy, Japan, South Korea, Argentina, Brazil, etc.

According to a CBC article, “the federal Advisory Council on the Implementation of National Pharmacare, led by Dr. Eric Hoskins, stressed how people's lives can suffer if they skip needed prescription drugs, and noted a Canada-wide program could eventually lead to system-wide savings of nearly $5 billion annually.” When they talk about how much it would cost, we could actually save up to $5 billion. I think that is also a very easy answer as to why we should move forward.

When I talk about our government, the values and ideology of the Liberal Party have always been to tighten up the gap, help the most vulnerable and make sure that all Canadians have opportunities to be successful. Let us look at some of the things that we brought forward: 1968, medicare; 1969, the Official Languages Act, making both languages the official languages of Canada; 1982, the Charter of Rights and Freedoms, which all Canadians should be very proud of. Some of the opposition members are hesitant today on some pieces of the charter and we will see where they go with that piece.

There is the new and improved universal child benefit. When the Conservatives had it, it was 30% to 40% less and it was taxable; now it is not. There is the new and improved CPP, in 2019, which went from $11,400 a year to almost $20,000 a year. Those are programs that are helping every Canadian. These are opportunities. This is what makes Canada great. This is why people want to move to Canada.

Let me speak about some more initiatives that we are bringing to the table. The national school food program would help over 400,000 young people. The new disability program would help over 600,000 people with disabilities, who we know comprise most of the individuals living in poverty. Those are major initiatives to help. We are also building the dental care program. Nine million Canadians would have access to the dental care program. These are big numbers. There are many Canadians who have challenges, and our government has been focused on how to support the individuals facing those challenges.

I am going to end with something that Canadians must listen carefully to. If the Conservatives ever came to power, what would they cut? They do not want to tell us. They say “a dollar for a dollar”, so if there is a deficit of $40 billion today, we know they are going to cut $40 billion tomorrow. That we already know; we just do not know which programs. Therefore, I am going to ask the Conservatives. Would they cut pharmacare? Would they cut dental? Would they cut the disability benefit for people with disabilities? Would they cut the school food program that we have been talking about for 20 years? Would they cut the CCB, which is helping young families? Would they cut the early learning and child care program? I do not know. I am sure the Conservatives do, and I would love for them to share that with Canadians.

Second readingPharmacare ActGovernment Orders

5:10 p.m.

Conservative

Frank Caputo Conservative Kamloops—Thompson—Cariboo, BC

Mr. Speaker, it is always a pleasure to rise on behalf of the people of Kamloops—Thompson—Cariboo. Before I begin my intervention, I want to recognize the life of Albert “Bert” Malfair. He was a father to a young woman I went to school with. He bravely served the RCMP to the point where he was chasing robbery suspects and was ultimately disabled from that in 1984. We are grateful for him. He recently passed away, and I pass my condolences to his family. May perpetual light shine upon him.

When my colleague gave his speech, he just so casually threw around the number of a $40-billion deficit. It has gotten that bad. That was a government that said it would have modest deficits and the budget would balance itself, and what has it done? It has spent, spent, spent. What do Canadians have to show for it? They have nothing. They are now struggling even more with heating and eating.

How does the member say these numbers so casually, $40 billion, $50 billion, $60 billion? We are spending more now on servicing the debt than we are on health care.

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Liberal

Darrell Samson Liberal Sackville—Preston—Chezzetcook, NS

Mr. Speaker, the difference between my colleague's party and our party is that they spend and we invest. We have invested in Canadians since 2015. Do members know why we can afford to invest? We can afford to invest because we have an AAA rating, one of only a few countries in the G7—

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Some hon. members

Oh, oh!

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Conservative

The Deputy Speaker Conservative Chris d'Entremont

Order. I cannot hear the hon. member, so let us try to keep the ruckus down a bit.

The hon. member for Sackville—Preston—Chezzetcook.

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Liberal

Darrell Samson Liberal Sackville—Preston—Chezzetcook, NS

Mr. Speaker, inflation has been brought safely down to 3% by the Bank of Canada, our prime rate is among the lowest ever in the history of Canada, and we have the lowest debt-to-GDP ratio in the G7. What else do they want? We are in a good, solid position to invest, and we are going to continue to invest for Canadians.

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Bloc

Simon-Pierre Savard-Tremblay Bloc Saint-Hyacinthe—Bagot, QC

Mr. Speaker, there is one thing I do not understand: Why is it difficult to provide for the right to opt out with full financial compensation? Everyone would be happy. Those who want in, stay in. Those who want out, take the money and do their own thing.

It is not going to lessen our desire to be independent, but it may make us less angry with the Liberals when we do get our independence. That is all there is to it. It is not complicated.

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Liberal

Darrell Samson Liberal Sackville—Preston—Chezzetcook, NS

Mr. Speaker, a Canadian is a Canadian. We have a program that is there for Canadians, and we are going to make sure that Canadians are respected in every province and territory, including Quebec. We are very proud to work closely with our colleagues, and we will continue to do so.

Second readingPharmacare ActGovernment Orders

5:15 p.m.

NDP

Lindsay Mathyssen NDP London—Fanshawe, ON

Mr. Speaker, the hon. member talked a lot about the cost savings in terms of this program. Of course, this goes right back into medicare and our health system.

The direct cost associated with unintended pregnancies here in Canada is an estimated $320 million, so the benefits of universal contraception do not just end unwanted pregnancies with prevention and cost savings, but can actually help in terms of prescription contraceptives for other health conditions like abnormal uterine bleeding and endometriosis, precancer of the uterus, polycystic ovary syndrome and the prevention of ovarian and uterine cancer.

Can the member talk about the importance of seeing those benefits and the cost savings to our system as well, in addition to the health of people who need that support?

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Liberal

Darrell Samson Liberal Sackville—Preston—Chezzetcook, NS

Mr. Speaker, often, it is not about throwing more money. There are ways of changing how we do things so that the end result of the investment is to supply and support more Canadians by investing less.

There are cost savings. We already talked about the cost savings with bulk purchase, which are in the billions of dollars, and there are more cost savings to be had in other areas that the member mentioned as well, such as contraception, etc.

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Mr. Speaker, I find it funny that the Conservatives were laughing when the member said that we are investing while they are spending. They laugh as though it is some kind of joke. Let us not forget that Tony Clement had money to spend on the G8 and used it to build gazebos in his backyard. Conservatives' memory is so short-term.

The reality is that the member is absolutely correct. We are investing in Canadians. We are investing in the future. We are asking those who make the most to pay a little bit more in order to keep those investments going. Would the member agree with me on that?

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Liberal

Darrell Samson Liberal Sackville—Preston—Chezzetcook, NS

Mr. Speaker, my colleague is 100% correct. We are not investing in gazebos. We are investing in pharmacare, dental care, a disability benefit, a school food program, CCB and early learning.

We continue to support Canadians. That is why people want to move to Canada. They are proud of our great—

Second readingPharmacare ActGovernment Orders

5:15 p.m.

Conservative

The Deputy Speaker Conservative Chris d'Entremont

Resuming debate, the hon. member for Dorval—Lachine—LaSalle.

Second readingPharmacare ActGovernment Orders

5:20 p.m.

Liberal

Anju Dhillon Liberal Dorval—Lachine—LaSalle, QC

Mr. Speaker, I am grateful for the opportunity today to speak to Bill C‑64, an act respecting pharmacare.

This bill represents the next phase of our government's commitment to a national universal pharmacare program. It proposes the foundational principles of national universal pharmacare and our intent to work with provinces and territories to provide universal single-payer coverage for many contraceptives as well as diabetes medications.

This is an important step forward in improving health equity, affordability and outcomes, and it could save the health care system money in the long term.

Public health care in Canada was built on the promise that no matter where one lives or what one earns, one will always be able to get the medical care one needs. Despite this promise, Canada is the only country in the world with universal health care that does not provide universal coverage for prescription drugs.

When medicare was first introduced, prescription drugs outside of hospitals cost less and played a smaller role in health care. Today, prescription drugs are an essential part of our health, helping to control chronic conditions, treat temporary ones, and aid in overall health and well-being.

One area that has seen significant changes is diabetes treatment. Over 100 years ago, thanks to a Canadian team of researchers, Frederick Banting, Charles Herbert Best, John J. R. Macleod and James Bertram Collip, insulin was discovered.

Since this monumental scientific discovery, there have been several advancements in diabetes treatment, from the introduction of fully synthetic human insulin to glucose monitors and insulin pumps. These breakthroughs have immensely improved the quality of life for people who have to live with diabetes, enhancing self-esteem, increasing social participation and improving the overall health and well-being of these individuals.

They have also come with higher costs, creating affordability challenges for Canadians affected by diabetes.

Outside of hospital, prescription drug coverage comes from a mix of private insurance, out-of-pocket cash payments and various provincial programs. While the majority of Canadians have access to some form of public or private insurance, about 2.8%, or 1.1 million Canadians, do not have access to private or public drug coverage.

Although most Canadians have some form of drug coverage, this does not mean that those with insurance have equal access to the prescription drugs they need. The existing patchwork system of private and public drug plans leaves millions of Canadians under-insured, and that means their out-of-pocket prescription drug costs create a financial burden that leaves them struggling to afford an essential part of health care.

In 2021, Statistics Canada found that more than one in five adults in Canada reported not having the insurance they needed to cover their prescription drug costs. Being under-insured can take many forms, for example, Canadians may have high deductibles, resulting in significant out-of-pocket costs before their insurance coverage even kicks in. They may reach the maximum annual or lifetime coverage limits for their insurance and have to pay out-of-pocket, or they may have to make co-payments, which are often 20% of the drug's cost on private plans and sometimes more on public plans.

All provinces have drug coverage to protect Canadians from catastrophic drug costs, but deductibles under these plans can range from 0% to 20% of net family income. In many cases, Canadians will never reach the deductible, leaving them without any support for their drug costs. This variability across the country creates a postal code lottery.

Let us consider the advancements in diabetes treatments. For a working-age Canadian with no private insurance, out-of-pocket costs vary widely. In some parts of the country, out-of-pocket costs for people living with type 1 diabetes can be higher than $18,000 per year out-of-pocket; for type 2 diabetes, they can be higher than $10,000 per year in out-of-pocket expenses. Even those with private insurance can face high co-pays or exceed annual plan maximums, resulting in high out-of-pocket costs.

Even for cases in which an individual is not accessing devices that cost thousands of dollars, they can face significant out-of-pocket costs. For example, we can consider a woman in her mid-twenties who is working a minimum wage job. An IUD, one of the most effective forms of birth control, can cost up to $500 with no insurance. Even with private insurance, a co-pay of 20% would be $100. While IUDs can last from three to 12 years and save money over the long term, the high upfront cost can make them inaccessible.

Under-insurance can be a particular concern for young adults who age out of their parents' private insurance but who do not have their own form of private coverage. Lower-income Canadians also make up a disproportionate share of the under-insured. While most provinces have put in place drug coverage for those accessing social assistance benefits, a gap still exists. Many lower-income households that do not qualify for social assistance continue to struggle with out-of-pocket prescription drug costs.

Employment factors contribute to differences in insurance coverage. People with low-paying jobs, such as entry-level, contract and part-time positions, often report less adequate drug insurance coverage. This may even discourage people from accessing social assistance benefits or from applying for jobs, because once hired, they may lose their public drug insurance coverage. However, many entry-level and part-time jobs do not offer drug benefits. One study found that only 27% of part-time employees reported receiving medical benefit coverage.

Under-insurance can have serious consequences. Many Canadians with high out-of-pocket costs report foregoing essential needs, such as food and heat, or not adhering to their prescription due to drug costs. Statistics Canada found that, in 2021, close to one in five Canadians spent $500 or more out-of-pocket for their prescription medication, and almost one in 10 reported not adhering to their prescription medication because of costs. This includes delaying filling prescriptions or skipping doses to contain costs.

When people do not take their prescription drugs the way they are supposed to, their health can suffer. This results in serious consequences for the individual and their household, and unnecessary costs to the health care system in the long run, as patients are more likely to visit an emergency room or to be admitted to hospital when they do not receive consistent treatment. For example, the full cost of diabetes to the health care system in 2018 was estimated to be around $27 billion and could exceed $39 billion by 2028.

I think we can all agree that no Canadian should be put in a position where they must choose between the prescription drugs they need for their health and well-being and putting food on the table. This is unacceptable, and it is why we are continuing our work to improve accessibility, affordability and appropriate use of prescription drugs as we move forward with national universal pharmacare.

Second readingPharmacare ActGovernment Orders

5:25 p.m.

Bloc

Simon-Pierre Savard-Tremblay Bloc Saint-Hyacinthe—Bagot, QC

Madam Speaker, I know that my colleague is a member from Quebec. The members of the National Assembly of Quebec unanimously requested a right to opt out of the pharmacare program with compensation. This means that we are not opposed to Canada having its own program. They say that as Quebeckers, we have the expertise and experience in social programs, we definitely do not want this program to be managed like the borders or the passports. We want the federal government to give money to Quebec and let Quebec manage its own affairs. If the others want to keep this program, we have no problem with that. We respect that.

Does my colleague, as a Quebecker, agree with the position of her national assembly?

Second readingPharmacare ActGovernment Orders

5:30 p.m.

Liberal

Anju Dhillon Liberal Dorval—Lachine—LaSalle, QC

Madam Speaker, indeed, I am a proud Quebecker.

Our program is going to help millions of women, people from various backgrounds and people with diabetes. It is going to help everyone, all Canadians and all Quebeckers.

Second readingPharmacare ActGovernment Orders

5:30 p.m.

NDP

Lindsay Mathyssen NDP London—Fanshawe, ON

Madam Speaker, members have spoken a lot today about the money saved by individuals and the money saved by the system, which we could reinvest into health care. By providing free contraception, an individual is said to have a lifetime savings of up to $10,000, which is huge.

I would like to hear more about the larger issue. How can this piece of legislation itself, through contraception, empower women and those who menstruate?

Second readingPharmacare ActGovernment Orders

5:30 p.m.

Liberal

Anju Dhillon Liberal Dorval—Lachine—LaSalle, QC

Madam Speaker, we have been talking a lot throughout our speeches, as have all our colleagues, about how we are investing in Canadians, and this is an investment. There is a saying that it is better to prevent than to cure. This is one of those times when we could prevent, for example, botched procedures or when women have to go out of their way to do things to protect themselves and to make sure there are not unwanted pregnancies. This national pharmacare program would help women and those who are gender diverse to be able not just to cure but also to prevent. It would make sure that they have optimal health and that their well-being and mental health are being taken care of at the same time.

Second readingPharmacare ActGovernment Orders

May 6th, 2024 / 5:30 p.m.

Liberal

Brenda Shanahan Liberal Châteauguay—Lacolle, QC

Madam Speaker, I listened to my colleague's remarks with great interest, particularly around the risk of people being uninsured. I am not sure everyone always realizes what that is and what it means until they get into trouble. I would like to hear her speak more on the different vulnerable population groups who could be working but who could be under-insured.

Second readingPharmacare ActGovernment Orders

5:30 p.m.

Liberal

Anju Dhillon Liberal Dorval—Lachine—LaSalle, QC

Madam Speaker, it would be surprising to most Canadians to learn that there is a huge under-insurance problem in this country. Many people, we could say, slip through the cracks. As I mentioned in my speech, for those who are part-time workers, who end up getting phased out of their parents' health insurance plans and for those who are taking social assistance, there is always a gap between the two insurances. We need to make sure that everybody is covered and that every Canadian is treated equally. It is all about equality and equity. This is how those gaps can be prevented.

As my hon. colleague from London—Fanshawementioned, it is important for women to be able to take care of themselves. It should not matter what one's income bracket is. One should be able to access contraceptives and these services in order to create a more equal society.

Second readingPharmacare ActGovernment Orders

5:30 p.m.

Conservative

Blaine Calkins Conservative Red Deer—Lacombe, AB

Madam Speaker, it is a pleasure for me today to speak to Bill C-64.

Before I go any further, I would like to let the Speaker know I will be splitting my time with my good friend and colleague from Souris—Moose Mountain.

The debate today is about Bill C-64, an act regarding pharmacare. At least everybody is being told that is what it is about. I would rather call it, I guess, the so-called pharmacare bill because I think that “the cost of keeping the Parliament going bill” is probably a name that has already been used.

This bill is very tepid. It is not a national pharmacare program. This is actually just a piece of legislation that is meant to check a box to keep a supply and confidence agreement in place.

To the NDP members, I cannot believe they actually think this is the pharmacare bill they envisioned. I have not met a program the NDP members would not want to nationalize, but they say it is a very sad day when one—

Second readingPharmacare ActGovernment Orders

5:30 p.m.

Some hon. members

Oh, oh!