Debates of June 3rd, 2024

Pharmacare Act

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, the member across the way says that we cannot propose a motion of that nature because we are not in opposition. Maybe in 10 years, or whenever it might happen, we will have the opportunity.

I suspect that even Conservative reformers, the very far right, would recognize that Canadians treasure and value the health care system we have today. They see it as a part of our Canadian identity. The federal government played a critical role in that. It was the Province of Saskatchewan that led the way in ensuring that the federal government here in Ottawa would be able to expand upon it so that all Canadians would be able to benefit by it. Bringing forward the idea that if someone has diabetes, no matter where they live in Canada, they would have public assistance in terms of those medications and have public support, I see that as a positive thing.

Today, the reality is that it depends on what province and what sort of private insurance that someone may have, maybe not as much of a deductible. It varies across the land. Many Canadians do not even have the opportunity to have virtually any subsidy, in terms of the medications required for diabetes.

It has been reported that just over 3.5 million Canadians are dealing with diabetes today. I heard that as many as 25% of those individuals reported that because of the cost, they are not taking all the medications they should be taking to deal with their diabetes. What is the consequence of not being able to take the medications? It could mean someone could prematurely lose their eyesight and become blind. It could mean having an amputation as a direct result. Again, affordability depends on the province where a person lives or on the company the person works for.

We have a national government saying that it believes this is a wonderful, positive step forward to see strong national leadership in providing this medication. This would profoundly change, in a positive way, the lives of many Canadians in every region of the country, including all provinces. This is factual. This would ultimately put us in a better light moving forward. This should come as no surprise.

We have had different social groups, such as unions, come to Parliament. They have been advocating for it. We have had a standing committee deal with it. We have had it incorporated into budgets. We have had statements from ministers of finance in regard to this, and the Prime Minister has been talking about it for a number of years. I have brought forward many petitions on the issue. There is no surprise here. If members actually consulted with their constituents, they would find that there is a wide spectrum, in terms of appetite, for the federal government not only to continue dealing with this, but also to consider other possibilities.

Why is it that the Conservative reformers feel that the federal government's role in health care should be diminished? They are not only against pharmacare but also against the dental plan. They are also against the commitment to provide $200 billion for 10 years for future generations of health and to provide the cash resources to support provinces. That is what I hope to be talking a lot about in the next federal election in 16 to 18 months. I believe that a vast majority of Canadians are behind this policy.

[Greg McLean, Conservative, Calgary Centre, AB]

Madam Speaker, I am always enlightened when I hear the member for Winnipeg North say those words on the floor of the House of Commons, because he must be the only member from his party who can actually address these things. We hear him many times over, and I thank him again for those comments.

There is something my party and I are united on as far as what we oppose is concerned. We oppose these ongoing deficits that are growing and getting to be more and more of an impact on Canadians, especially with inflation. Inflation is going to run this country into the ground and, frankly, make everything more expensive, including the drugs that the member is talking about. They are going to cost more and more, and we are going to be in a spiral as we go forward here. We are united against ongoing deficits and ongoing spending.

The member has not even looked at how much this is going to cost the treasury going forward; it is only a guess. Where is it going to stop? We cannot spend any more. We are just going to keep spending ourselves into eternity here. Can he tell us where the end is in sight?

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

The hon. leader of the government in the House is rising on a point of order.

Business of the House

[Steven MacKinnon, Liberal, Leader of the Government in the House of Commons]

Madam Speaker, while my colleague is preparing his excellent answer for the member, I would like to request that the ordinary hour of daily adjournment of the next sitting and the sitting on Thursday of this week be 12 midnight, pursuant to order made Wednesday, February 28.

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

Pursuant to an order made on Wednesday, February 28, the minister's request to extend said sittings is deemed adopted.

Bill C‑20—Notice of Time Allocation

[Steven MacKinnon, Liberal, Leader of the Government in the House of Commons]

Madam Speaker, an agreement could not be reached under the provisions of Standing Order 78(1) or 78(2) with respect to the report stage and third reading of Bill C-20, an act establishing the public complaints and review commission and amending certain acts and statutory instruments.

Under the provisions of Standing Order 78(3), I give notice that a minister of the Crown will propose at the next sitting a motion to allot a specific number of days or hours for the consideration and disposal of proceedings at the said stages of the bill.

The House resumed consideration of the motion that Bill C-64, An Act respecting pharmacare, be read the third time and passed.

Pharmacare Act

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Madam Speaker, I just spoke for about 10 minutes about how important health care is to Canadians, and how important it is that we, as a national government, step up to the plate on things such as a national pharmacare program and a national dental care program, to be there for our constituents, and what does the Reform-Conservative Party across the way say? “What about the billions of dollars? Instead of spending them on health, maybe we should be dealing with the debt or the impact it is going to have on inflation?”

Yes, we have inflation in Canada, but I will contrast our inflation rate to that of any other country in the world. We are doing reasonably well. However, I can say that we cannot trust the Conservatives. With their hidden agenda, health care is not safe.

[Julie Vignola, Bloc, Beauport—Limoilou, QC]

Madam Speaker, I am certain my colleague is expecting my question.

Health care is a jurisdiction of Quebec and the Canadian provinces. Quebec already has a pharmacare program. It is not perfect, but we can improve it.

Why is the government stubbornly trying to duplicate services in Quebec by offering its own separate insurance plan instead of letting Quebec manage it with the right to opt out with compensation?

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, there will be people in the province of Quebec who will, in fact, benefit from this particular program. If we canvass the entire country, we will see, depending on the province or territory, different types of policies regarding the issue.

What we are looking at through this legislation is ultimately working with the provinces so that if a person has diabetes in Canada, they can anticipate medications at no cost, whether they live in Halifax, Montreal, Quebec City, Winnipeg, Toronto, Edmonton, Vancouver or Whitehorse. That is the idea of having a national program. Different provinces have different programs, and private insurance companies have different deductibles, depending on the company, which is the reason why it is important that the federal government step up. Unfortunately, the Conservatives and the Bloc are voting against this.

[Lori Idlout, NDP, Nunavut, NU]

Uqaqtittiji, I know personally of people who, because they do not have the diabetes medication they need, are at risk of amputations. There are people, as well, who deserve better protections for contraceptives. For example, not all indigenous women can have access to contraceptives, especially when we know that, on this fifth anniversary of the publication of the MMIWG's calls for justice, this particular bill can make a difference in making sure that indigenous women get the protections they need.

I wonder if the member can share with us his response on why it is so important to provide diabetes medication, as well as contraceptives, why safe abortions are severely needed and why contraceptives are a particular need that was focused on in this bill.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Madam Speaker, I believe there is at least one province, possibly even more, that has acted on the issue of contraceptives. We will find, as I said, that there are different policies in different provinces, and so forth.

What is really important to recognize is that Bill C-64 would help an estimated nine million people in dealing with contraceptives. When we think about diabetes medications, we are talking about over 3.5 million people. That is a lot of good reasons to get behind this legislation and ensure there are some standards across the nation.

[Adam van Koeverden, Liberal, Parliamentary Secretary to the Minister of Environment and Climate Change and to the Minister of Sport and Physical Activity]

Madam Speaker, it is an honour to rise this evening to discuss the bill before us, Bill C-64, an act respecting pharmacare. We can all agree, or I hope we can all agree, that Canadians should have access to the right medicines at an affordable price regardless of where they live in our country. That is precisely what Bill C-64 would do. It represents the first phase toward a national pharmacare plan, starting with the provision of universal single-payer coverage for contraception and diabetes medications. This legislation is an important step forward to improve health equity, affordability and outcomes and has the potential of long-term savings to the health care system and for all Canadians who use it.

In budget 2024, we announced $1.5 billion over five years to support the launch of national pharmacare and coverage for contraception and diabetes medications. The single most important barrier to access to contraception in Canada is cost. For example, the typical cost for select contraceptives in our country for an uninsured Canadian woman is up to $25 per unit, or $300 per year, for oral birth control pills and up to $500 per unit for a hormonal IUD, which is effective for five years.

It occurs to me that if oil and gas companies were going to start selling diabetes medications, insulin or contraceptives, the Conservatives might be all for it. It seems like they are the only group, the only organization, and the only affordability measures the Conservatives can come up with are supports for oil and gas.

However, Canadians have lots of expenses, and one of the main expenses associated with inequality and inequities in our society is their medications. We are here to help. Some populations are disproportionately affected by the lack of coverage. Women, people with low incomes and young people, all of whom are more likely to work in part-time or contract positions and thereby not have access to a drug plan, often lack access to private coverage. One study found that women from lower-income households are more likely to use less effective contraceptive methods or no contraceptive method at all as a result of their lower-income situation.

Bill C-64 would ensure that Canadians have access to a comprehensive suite of options when it comes to contraceptive drugs and devices, because improved access to contraception improves equality. This means that every woman in Canada would have the ability to choose the contraceptive that is best for her, regardless of her ability to pay. This would contribute to her right to have bodily autonomy, which is what this government fully supports.

Sexual and reproductive health is a priority for this government. This is reflected in Bill C-64, as I have mentioned, but it goes beyond that in other significant federal initiatives. Our government is committed to improving the sexual and reproductive health outcomes for all Canadians, and this includes helping to ensure access to a comprehensive suite of contraceptive drugs and devices for everyone. By working with provinces and territories and guided by the principles within Bill C-64, we can make this a reality.

The proposed Bill C-64 lays the groundwork for that process, and through it, with collaboration with provinces and territories, we are helping to fight for affordability for all Canadians. By passing this legislation, collectively, we can all continue to build on the momentum we have already achieved.

I looked into this. Pharmacare in Canada is deeply popular with people who vote for all parties. It is almost 90%, in fact. This is something I expect all members of Parliament to get behind. It is something a lot of Canadians support, regardless of party.

[An hon. member]

Oh, oh!

[Adam van Koeverden, Liberal, Milton, ON]

Madam Speaker, there are a lot of reasons to heckle in this House. Perhaps the Conservatives disagree with me on some key issues, but I find it really remarkable that they want to heckle and tell me that we should not be fighting for Canadians to have access to the drugs they need in order to live healthy and fulfilling lives. It really is remarkable and just re-emphasizes that if oil and gas was selling insulin and IUDs, the Conservatives would be the first ones to line up and say that we need to support these companies. It does not seem like they are really in it for Canadians, particularly lower-income Canadians, who are struggling with their bills. It is clear to me that the Conservatives only care about the oil and gas lobby. In fact, I think they are trying to put the oil and gas lobby out of business.

With the time remaining, I would like to—

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

The hon. member for Renfrew—Nipissing—Pembroke is rising on a point of order.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Madam Speaker, our earpieces are not working, because I could not hear any of the heckling on this side of the floor to which the member opposite was referring.

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

I did not react to it, but yes, there was heckling.

The hon. parliamentary secretary has the floor.

[Adam van Koeverden, Liberal, Milton, ON]

Thank you, Madam Speaker. There is not only heckling but also unnecessary interruption.

I will use my remaining time to talk about diabetes and those living with diabetes. Diabetes is a disease with no cure. There is a treatment, and it is thanks to Canadian science, which is something that our government supports. Canadian scientist Frederick Banting and his team came up with an interim solution, I suppose we could call it; it is a treatment for diabetes that allows diabetics to live. Without it, diabetics would not have the opportunity to live fulfilling lives, but we still need to fight for a cure. Before we get there, we should also ensure that we reduce inequality and inequities in the populations impacted by diabetes.

There is a really interesting infographic from the Public Health Agency of Canada. Anybody who is watching this debate might be interested in how diabetes and inequality intersect in Canada. I was actually very surprised to learn that diabetes and employment status are related; there is a positive correlation between them. When people are employed, they are less likely to suffer from diabetes and live with diabetes. When people are permanently unable to work, they are more likely to have diabetes, which means that they naturally have a lower income. It is the same for education level, surprisingly. Almost 10% of those individuals with less than a high school education will have diabetes or prediabetes throughout their life; for university graduates, that goes down to between 3.5% and 6.1%. There is also a positive relationship within income quintiles. All five income quintiles are associated with a positive relationship. As income goes up, people are less likely to have diabetes. Therefore, providing folks living with diabetes with free access to medication, to insulin and to supports for managing their illness is also an affordability measure that would make a difference for a lot of Canadians.

Diabetes also affects people disproportionately in different categories. There are complex social and environmental behavioural factors that result in inequalities in the burden of diabetes between certain populations in Canada. The prevalence of diabetes is 2.3% higher among South Asian Canadians, and it is 2.1% higher among Black adults.

For indigenous adults, the prevalence of diabetes is similarly staggering, at 1.9% higher for first nations Canadians living off reserve. Inequities experienced by first nations, Inuit and Métis populations are a direct result of colonial policies and practices that included massive forced relocation, loss of lands, creation of the reserve system, banning of indigenous languages and cultural practices, and the creation of the harmful residential school system. Unaddressed intergenerational trauma adds to the ongoing challenges faced by indigenous peoples, and providing them with a reliable and affordable treatment for diabetes would support affordability.

This would also reduce the number of times people with diabetes have to access health care as a result of their illness. People with diabetes are more at risk of all sorts of life-changing health crises, such as a heart attack or stroke, kidney failure, blindness and amputation. At this very moment, there are about 3.7 million Canadians, or 9.4% of our population, who have been diagnosed and have to manage their condition for their entire life. If members can believe it, in 2015, 25% of Canadians with diabetes indicated that they followed their treatments to a T, but they were affected by cost; in some cases, those Canadians were rationing medications to save money. Therefore, a quarter of the people who are following their treatments are affected by cost. There are other Canadians who are undiagnosed, and there are Canadians who are not following their treatments. We need to make sure that they live a healthy and fulfilled life, and one way to do that is to ensure that they have access to this vital medication.

About one out of three people is living with diabetes or prediabetes today in Canada, and rates of diabetes are ever rising. It is estimated that, by 2028, over 13 million Canadians, or 32% of the population, will have diabetes or prediabetes. Through Bill C-64 and the work of the national framework for diabetes, we can improve aspects of preventative care as well. We can do this through information sharing and knowledge transfer, while also ensuring that those living with diabetes have access to insulin and other diabetes medications.

This is a cost-saving endeavour. The Conservatives have continually referred to this as a spending program, as if it would not be invested directly in the health of Canadians. Not only would it be invested in their long-term health outcomes, but it would also be invested directly in their affordability. It would support affordability, and, as I pointed out, that is something that is positively correlated with other risk factors.

We introduced the national framework for diabetes in 2022 to align multisectoral efforts to reduce the impact of diabetes in Canada. The framework comprises about six interdependent and interconnected components that represent the range of areas where opportunities to advance efforts on diabetes could and will be beneficial.

Bill C-64 would support people living with diabetes, whether through improving access to the medications they need or giving them the tools they need to have a better quality of life in Canada. We are here for Canadians. Our plan to provide universal coverage for contraception and diabetes medications would be transformative, and I still have faith that the Conservatives will see the light and recognize that this is a very popular and worthwhile endeavour.

We should all get behind national pharmacare for Canadians.

[Kody Blois, Liberal, Kings—Hants, NS]

Madam Speaker, I rise on a point of order.

I just want to raise to the attention of the House a really important matter that happened, and I am sure that I can have unanimous consent. We know the important role that pages play in the House of Commons to help support us. One of the annual traditions here in the House of Commons has been the actual ability to have a soccer game among pages and MPs, and last week—

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

I want to remind the hon. member that the question of props is an issue, so I would invite the member not to handle a prop.

[Kody Blois, Liberal, Kings—Hants, NS]

Madam Speaker, I will be very quick, but I just want to recognize that there is an annual game played among MPs and pages. It is a long-standing tradition, and the game took place last week. I am pleased to present the fact that the—

[Some hon. members]

Oh, oh!

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

That would be more in the nature of a member's statement than a point of order.

The hon. member for Renfrew—Nipissing—Pembroke has the floor.

[Cheryl Gallant, Conservative, Renfrew—Nipissing—Pembroke, ON]

Madam Speaker, a national drug program or pharmacare program would be a great idea if we were not a trillion dollars in the hole. As a consequence of being so in debt, taxes are going up and driving our doctors out of the country. How is a pharmacare program going to help people who do not even have a doctor to provide a prescription and have no way of getting a prescription? How is the government going to decide who gets the medicine when there is a drug shortage, as we have seen recently with diabetes? How are they going to decide who lives and dies?