Bill C-64

Pharmacare Act

An Act respecting pharmacare

This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and obliges the Minister to make payments, in certain circumstances, in relation to the coverage of certain prescription drugs and related products. It also sets out certain powers and obligations of the Minister — including in relation to the preparation of a list to inform the development of a national formulary and in relation to the development of a national bulk purchasing strategy — and requires the Minister to publish a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products. Finally, it provides for the establishment of a committee of experts to make certain recommendations.

[Nancy Hamzawi, Executive Vice-President, Public Health Agency of Canada]

Back in October 2022, the framework for diabetes in Canada was released, marking a major milestone to better support Canadians. Through budget 2021, the government committed $20 million to research through the Juvenile Diabetes Research Foundation and the Canadian Institutes of Health Research partnership to defeat diabetes, including $15 million matched by the JDRF.

Since February 29, you all have been having discussions on Bill C-64 around national universal pharmacare, with diabetes being a very important pillar to that bill.

Thank you very much.

Pharmacare Act

[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.

[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.

[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.

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

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

Madam Speaker, I will be splitting my time with the member for Milton.

I want to address what I would suggest is the ultimate potential assault on health care by the Conservative-Reform Party of Canada. For the record, to be very clear, one needs to look at what the member for Abbotsford said today, which has been repeated in many different ways by different members. I have often talked about the hidden Conservative-Reform agenda.

I personally see health care as an important issue going into the next federal election, and my intention is to point out the contrast. When I say that the Conservative Party has crazy policies, we should think about them saying that the federal government has no constitutional role. One would think they were separatists, like the Bloc. They believe the federal government should just be an ATM machine, hand over the cash and say nothing about health care because the federal government has no role to play. Both the Conservatives and the Bloc believe that there is no role for the federal government to play in health care.

Then, they say that it is a constitutional God-given right that provinces are the only ones that have anything to do with health care. That is absolutely wrong. I would ask members to cite a Supreme Court of Canada decision that says that the Canada Health Act is in violation of the Constitution. I would like members to tell me which premier or which province took the government to the Supreme Court and had a favourable ruling on that issue. The simple answer is that it has not happened. That is why the Conservative spin of misinformation continues to flow, and that is most unfortunate.

Unlike the Conservative Party, Liberals understand and value the important role that the federal government in Ottawa plays. In terms of the pharmacare program, it is interesting to hear from different opposition members, the Conservatives and the Bloc, as they have that unholy alliance on Bill C-64 for different reasons. We have well over 100 policies on pharmacare, depending on what province people are in or which company they work for. There are many different types of policies facing the pharmacare issue.

The idea of a national pharmacare program is nothing new. The Prime Minister is moving the issue forward. That is what Bill C-64 is all about. It recognizes there is a need for the national government to work, where it can, with provinces, to develop a national pharmacare program that has similarities in all regions of the country. The way I see it, there are two areas where we are focusing a great deal of attention today. I see it as a step forward. I believe that provinces will continue to look at what is being proposed and will come on board.

The arguments I hear from the Conservative Party today are the types of arguments one would have heard generations ago regarding health care when public health was brought in. Those are the types of arguments of deniers. I suspect we will never hear the Conservative Party saying they are going to get rid of the Canada Health Act. Maybe a good opposition day motion would be what people have to say about the Canada Health Act and whether they support it or not.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Madam Speaker, I do like the little cute condescension from the NDP: “when he reads the bill”. The bill, Bill C-64, is four pages. I did read the bill. It is really cute when they have that passive-aggressive tone. It is adorable.

If they sign on and if they do take the universal single-payer coverage, what are his constituents going to say when their coverage is less than what they had before?

What is he going to say to 27 million Canadians who are losing better coverage because they are going to add coverage that is not as good as what they have right now? They would have a lot of explaining to do to their constituents when they try to take away the coverage they have right now and give them less coverage.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Madam Speaker, the member for Regina—Lewvan was quite adamant that health care delivery is the purview of the provinces. I think that when he reads the bill, Bill C-64, he will be delighted to find that, in the pharmacare proposal that we are debating today, the delivery of pharmacare is delivered by the provinces.

The other thing I think he will be quite delighted with is the fact that provinces will have the ability to sign on or not to sign on with the pharmacare plan that is being debated. I think the only challenge he is going to have is that, when the Province of Manitoba and the Province of British Columbia sign on and when their residents start receiving free contraception and free diabetes medication and devices, the residents of his province, his constituents, are going to start asking why they are not able to tap into the benefits of universal pharmacare.

I would just ask him what he is going to say to them in those situations.

[Warren Steinley, Conservative, Regina—Lewvan, SK]

Madam Speaker, it is pleasure to rise to speak to Bill C-64 for a second time. I spoke at second reading of this bill on Thursday evening, and I am happy to speak to third reading of the pharmacare pamphlet.

I would like to repeat some of my remarks made during my speech at second reading. I have asked, time and time again, for any of the NDP-Liberal costly coalition members to tell me how many provincial ministers asked for a pharmacare bill at a federal-provincial-territorial meeting. Not one of the Liberal ministers, Liberal members or NDP members actually answered me. Quite frankly, they did not want to say out loud that the answer is zero. This was not at the top of a wish list for any of the provincial health ministers.

I have been talking with our health minister in Saskatchewan. He still has no details about what this pharmacare pamphlet would look like or how it would affect the people of Saskatchewan. The biggest fear at the provincial level is that coverage would lessen in Saskatchewan. They have done a good job of building health care back up in Saskatchewan after the nineties, when the NDP ruined health care in Saskatchewan, which I will get to later in my speech. The provincial health ministers are asking, “Where are the details?”

We have talked about how the federal Liberal government continues to bring in bills without any consultation. We have seen it in agriculture, in oil and gas, and even with the budget. At the agriculture committee on Thursday, I asked the agriculture minister about who he consulted in the ag sector when it came to increasing the capital gains tax exemption from a half to two-thirds. I have not gotten a straight answer from a lot of the Liberal ministers at committee, but to that minister's credit, he said that he did not even know that it was in the budget. A senior minister in the government did not know what was going to be in budget 2024.

I have had the honour of serving in the Government of Saskatchewan, and I know there is quite a process to get a budget approved. It goes through Treasury Board finalization, then through cabinet finalization, then through caucus finalization, and then back to cabinet for a final sign-off.

My colleague, the member for Abbotsford, who gave a great speech, was in government, and I think he probably saw most of what was going to be in the budget before it came out. When a senior minister who has been here for a long time, some might say too long of a time, admitted that senior ranking Liberals did not see the budget before it came out, I was dumbfounded. It was unbelievable.

It does not surprise me, then, that this bill was brought forward with very little consultation with anyone. We all know this was signed off on, on the back of a napkin, to placate the junior NDP partners, so they would prop up the corrupt government for years, or at least until the member for Burnaby South gets his pension. We know what this is about, and it is to ensure that the NDP-Liberal costly coalition stays in power. This is the price Canadians are going to pay.

Right now, 27 million Canadians are anxious about losing some of the health coverage they have right now as they have health coverage that they want to keep. I will admit that 1.1 million Canadians are under-insured or do not have insurance. Why does the government not focus on that? We could have had something rolled out that supplemented the provincial government programs. Instead, the costly Liberal coalition government always wants to be the one that rides in on the white horse, saying, “We are going to save you. We have a national plan.”

We have a national day care plan. A friend of mine is now number 300 on the wait-list in Regina, which is not that big of a city. The government has made day care spots less available in my city of Regina, Saskatchewan.

The federal government has a dental plan that no dentist wants to sign off on. I have a letter from the Saskatchewan Dental Hygienists' Association, where 99% of dental assistants and dental hygienists are female, and there was not one consultation with any of those stakeholder groups about what they should do or if they thought the dental care plan was a good idea. Once again, there was no consultation. This is a recurring theme.

We have a national lunch program for which the Liberals did not do any consultations with any school boards. In Regina, there are a lot of great corporate citizens who donate a lot of money to lunch programs. When we got together as a group and talked about this, I asked if anyone knew how many lunch programs were in our city. The Regina Food Bank covers some programs. Mosaic Market covers some programs. Nutrien covers some programs. If we put all those programs together, we could do a lot of good and almost get to where we need to so all kids could have food when they go to school.

There was no consultation on that either. The Liberals just come in on their white horses and think they are saviours. It is almost like someone over there has a God complex, one might say. They always want to be the one walking in and saving people, but they do not work with anyone else across the country.

Let us get to the pharmacare program. Once again, it is a pharmacare program, with no consultation, that no one asked for at a provincial level. My friend for Winnipeg North talked about how health care is not within provincial jurisdiction, but it is. Health care delivery is within provincial jurisdiction. He knows that, as he is a former MLA. Money transfers come from the federal government, but the day-to-day operational delivery of health care is one hundred per cent a provincial jurisdiction. He knows that.

It is interesting for the Liberals to bring in a national program, or a pamphlet, really, that covers two things, and then act like they are the conquering heroes. Who asked for this at a provincial level? I hope my friend from Winnipeg North will ask me a couple questions about that.

There is one more thing when it comes to health care in our country. The biggest threat to health care in Canada is whenever there is a provincial NDP government. The NDP in Saskatchewan devastated health care. When it was in government, it closed 52 hospitals in my province. It closed 1,200 long-term care beds in Saskatchewan during the nineties. It fired 1,000 nurses, hundreds of doctors, and rural Saskatchewan was divided.

The NDP is the pioneer of our two-tiered health care systems. In Saskatchewan, there is much different health care if someone is in rural Saskatchewan compared to urban Saskatchewan. The NDP went so far as to close the Plains Health Centre hospital in Regina. It was one of the best hospitals in the city and was the newest hospital. The NDP closed it because it was servicing too many rural Saskatchewanians. It was unbelievable.

We now have a government in B.C., an NDP provincial government, that is pioneering a pharmacare program, but it has it backward. It is giving B.C. residents free drugs that are killing them, instead of having a plan in place to give residents affordable drugs that would be life-saving. That is what B.C. is doing right now.

Instead of putting money toward life-saving drugs, the Liberals want a safe supply, which I do not think exists. They continue to spend taxpayers' dollars in British Columbia to give drugs to people who are killing themselves with those drugs. That is so opposite to what a government should be doing. The Liberals want to come in like they are champions of pharmacare. They should talk to some of their B.C. cousins about what is going on in that province. They should take some of the money they are spending putting illicit hard drugs on the street, and maybe supplement that with some programs that would give drugs to people that would help save their lives instead of end their lives.

I would end with one more conversation about how consultation is so disregarded by the government. Obviously, the NDP are going to vote for this terrible piece of legislation. The Liberals will vote for it.

One thing I would say to members is to please consult with the health ministers of the provincial governments because Saskatchewan is doing a great job. It has diabetes coverage for everyone up to age 25. We have a $25 cap on senior drugs, a program that helps seniors make sure they get the medication they need.

Provinces are in charge of the delivery of the health care system. Please let them keep that in their domain, and do the proper thing and consult with the health ministers in this country.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Madam Speaker, I was just saying how important contraceptives are to nearly nine million women in this beautiful country we live in, nearly one-quarter of the Canadian population.

Contraception, also known as birth control, is used to prevent pregnancy, whether it is required for family planning, medical treatment or overall reproductive health. Improved access to contraception improves equality, reduces the risk of unintended pregnancies and improves reproductive rights.

The single most important barrier to accessing contraception in Canada is cost. For example, the typical cost for select contraceptives 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.

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, 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. Although most drug plans list a range of contraceptive products, unfortunately only a fraction of Canadians are eligible for prescription birth control at low or no cost through a public drug plan.

Bill C-64 would ensure that Canadians have access to a comprehensive suite of contraceptive drugs and devices, because improved access to contraception improves health equality. This means that every woman would have the ability to choose a 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 and fundamentally supports.

In addition, ensuring access to a comprehensive suite of contraceptive drugs and devices at no cost to the patient can lead to savings for the health care system. British Columbia implemented this policy at the provincial level last April, and studies from the University of British Columbia suggest that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. In the first eight months of that policy being in place, more than 188,000 women have received free contraceptives.

Sexual and reproductive health is a priority for this government. This is reflected in Bill C-64 but, as I have mentioned, it also goes beyond that to other significant federal initiatives. As part of budget 2021 and budget 2023, the Government of Canada has continued to demonstrate its commitment to improving access to sexual and reproductive health care support, information and services for Canadians who face the greatest barriers to access; and to generating knowledge about sexual and reproductive health for health care providers.

Since 2021, the sexual and reproductive health fund has committed $36.1 million to community organizations to help make access to abortion, gender-affirming care and other sexual and reproductive health care information and services more accessible for underserved populations. An additional $16.7 million has been provided to the Province of Quebec.

Budget 2023 renewed the sexual and reproductive health fund until 2026-27. This initiative has funded 21 projects and is currently funding 11. The sexual and reproductive health fund is providing $5.1 million to the University of British Columbia contraception and abortion research team for a 25-month project from March 17, 2023, to March 31, 2025, entitled the “Contraception and abortion research team access project, advancing access to abortion for under-served populations through tools for health professionals and people seeking care”.

As a segment of the project centres on contraception, the project has partnered with the Canadian Pharmacists Association to develop educational resources that support pharmacists prescribing contraception and assist pharmacists in understanding and tailoring their approach for indigenous and racialized populations, including youth and other underserved populations.

With the support of the University of Toronto youth wellness lab, the project will also engage with family planning professionals, for example pharmacists, family physicians, obstetricians, gynecologists, nurses, midwives and social workers, to optimally design affirming and judgment-free services and contraception information care by, with, and for youth. Additionally, the medical expense tax credit has been included to include more costs related to the use of reproductive technologies, making conception more affordable.

In conclusion, our government is committed to improving the sexual and reproductive health of all Canadians. This includes helping to ensure access to a comprehensive suite of contraceptive drugs and devices for all Canadians. By working with provinces and territories, and guided by the principles within Bill C-64, we can make this a reality.

As we move forward, Liberals will continue to work with the provinces and territories, indigenous peoples and other stakeholders to ensure we get this right. The proposed Bill C-64 lays the groundwork for that process and would guide our collaboration. By passing this legislation, we could continue to build on the momentum we have already achieved. We are well on our way and I look forward to working with all parliamentarians to realize the next phase of Canadian health care.

Whether it is dental care; the Canada child benefit; $10 day care and the national learning strategy; helping the almost 3.7 million individuals who have diabetes; or providing dental care for seniors, and now moving into another segment of the population, which I believe is individuals with disabilities, we are going to be there and have the backs of Canadians today and into the future.

[Francesco Sorbara, Liberal, Vaughan—Woodbridge, ON]

Madam Speaker, it is always a pleasure to rise in the House. Happy Monday. I hope that we and our respective families are doing well. Before I begin, I wish to say that I will be sharing my time with the member for Winnipeg Centre this evening.

I am happy to speak today regarding Bill C-64, an act respecting pharmacare. It is another step for our government to make life more affordable for Canadians and provide the services that they need at this point in our term, and something that I am very proud of as a member of Parliament.

Before I get into my formal remarks, this weekend I was reminded of the work we are doing in helping Canadians, including the wonderful residents that I have the privilege of representing in Vaughan—Woodbridge. Close to my constituency office is one of the regional roads in the city of Vaughan in York Region, Weston Road. Along Weston Road, there are three signs that are placed up by our local dentists, all accepting the Canadian dental care program. Much like what is contained in the contents of Bill C-64, an act respecting pharmacare, here we have another foundational piece that is assisting Canadians in my riding and across the country. We know that over two million seniors have been approved for the dental care plan, and that over 120,000 have actually visited dentists. I have had many conversations with the seniors in my riding over the weekend who have used the plan and are very happy about it.

Along that vein, we are introducing a bill on pharmacare that will again help Canadians, 3.7 million of them, who have diabetes. We know that diabetes costs our health care system north of $30 billion a year. There are real savings in doing what we are doing and also taking preventative steps and providing contraceptives for Canadians.

This bill sets out the principles that will guide our government's efforts to improve the accessibility and affordability of prescription medicines and support their appropriate use. It also underscores the importance of working together with provinces and territories to make national pharmacare a reality for Canadians. We can all agree that Canadians should have access to the right medicines at an affordable price regardless of where they live.

That is what Bill C-64 does. It represents the first phase toward a national pharmacare, starting with the provision of universal single-payer coverage for a number of 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.

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. I will highlight how important this is to Canadians and, specifically, how important access to contraceptives is to almost nine million women—

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

Thank you very much, Mr. Chair. I understand that you find yourself in a difficult position. I know that because I happen to chair the Standing Committee on Agriculture and Agri-Food. In debates like these, things are not all black or white. There are lots of grey areas.

I apologize for my little digression. Nevertheless, there is disinformation, and the APF performs a very important role by making it possible for parliamentarians who are members of the AFP to discuss and harmonize their points of view, and come up with strategies to deal with the situation. That's also important for dealing with African issues. We've seen an increase in China's power in Asia. North Korea, Iran and other authoritarian eastern countries would like to exert influence in Africa. The APF provides a key forum for establishing bonds of communication and friendship among parliamentarians from everywhere, including America.

I am very proud of Mr. Drouin's work as the international chair of the APF. I believe that he's the first, or perhaps the second, Canadian to hold this position. It's relatively rare, all the more so as he's an MP from outside Quebec. Quebec is important, to be sure, but I'm convinced that the citizens of Glengarry—Prescott—Russell are very proud of their MP for his international work.

It's accordingly important for all MPs to understand the importance of the APF in the current geopolitical context.

I will now address the motion more specifically, point by point. To make sure that all Canadians fully understand the motion introduced by Mr. Beaulieu, I believe it's essential to reread it in its entirety:

That given the obscene and offensive comments made by the Liberal MP for Glengarry—Prescott—Russell to a witness defending the cause of the French language in Quebec, the committee report to the House: a) that the Chief Government Whip and member of the Liberal leadership team immediately remove MP Francis Drouin from the Standing Committee on Official Languages and; b) that MP Francis Drouin resign as the Chair of the Assemblée parlementaire de la Francophonie.

Mr. Samson's amendment initially proposes deleting the words “the committee report to the House” because they are unnecessary. He then proposes to completely eliminate point a). He goes on to recommend removing the portion of point b) that asks that MP Francis Drouin resign as chair of the APF. The amended wording would suggest instead that the committee write to the clerk of the Canadian branch of the APF to call a meeting to vote on the presidency of the Canadian branch of the Assemblée parlementaire de la Francophonie. Once again, this portion of the original motion is superfluous, because the APF already voted in favour of maintaining Mr. Drouin as chair. It was therefore altogether appropriate for this amendment to be proposed by my colleague from Sackville—Preston—Chezzetcook. Mr. Samson strongly defends the people in his riding.

Let us consider the word “obscene”, which is used in the English version of the motion. What is the definition of that word? Today, during question period, I found a definition. My colleagues might find another, of course, but according to the one I found on Google, the French word “obscène” generally refers to the portrayal or description of sexual subjects, offensive or disgusting by accepted standards of morality and decency. For example, we can refer to an obscene joke.

As I explained earlier, I believe Mr. Drouin's comments were not appropriate at a parliamentary committee. However, he has already apologized for it, again.

In the context of this motion, I think Mr. Drouin's words have nothing to do with the first part of the description of the word “obscene” that I found on Google, which refers to the representation or description of sexual subjects.

The definition of the word “obscene” then talks about matters that are offensive or repugnant to moral principles. As you know, I represent the riding of Kings—Hants, which consists of two counties: Kings and Hants. I reiterate: It is absolutely not proper, in a parliamentary context, to use the expression “full of shit”. However, if I am walking around the streets of my community with my friends, particularly in Hants, the expression “full of shit” might come up in the discussions. I want to point out that it is all a matter of context. I reiterate that I agree that Mr. Drouin's use of these words in Parliament is a problem. However, in a situation I might be in, in my riding, in the company of people from my community, even if that kind of language is not acceptable, it is not rare for it to be used.

I think all my colleagues have to ask themselves whether “obscene” is the appropriate word in Mr. Beaulieu's motion. In my opinion, it is too strong.

Now let us talk about the word “offensive”. Google gives three examples of the use of that word.

First, it corresponds to causing someone to feel deeply hurt, upset, or angry. For example, people might say that allegations made are deeply offensive to them. That definition may be closer to reality, as compared to the definition of “obscene”.

The second definition of “offensive” is that it means something that is actively aggressive or attacking. The example given is an offensive operation against the insurgents. That might apply to this case. It also gives the example of an offensive military campaign. That does not apply in this case; of course not.

I saw what was said between Mr. Drouin and the two witnesses, who appeared by video conference. It would certainly be reasonable to use the word “offensive” in the sense of causing someone to feel deeply hurt, upset or angry. That said, given that Mr. Drouin has apologized, we can see that this is not a personal attack. Rather, it is the witnesses' principle or point of view that was attacked. This was not appropriate on Mr. Drouin's part, and it is not necessary to protect him for that precisely. On that point, I agree with Mr. Beaulieu, that the motion talk about offensive comments in this context.

As we know, my mother tongue is English, so I took a look at the word “comments”, used in the plural in the English version. In French, it says “commentaires”. I think the committee should ask ourselves whether it is appropriate that the word be plural. I do not think so. In reality, we are talking here about only three words, which I am not going to repeat, out of respect for Ms. Kusie and the other members of the committee. I think it should use the word “comment”, in the singular. This was an inappropriate comment in the context of that exchange. I hope my colleagues will think this is an important point in this discussion.

I can continue to compliment my colleague from Glengarry—Prescott—Russell. I work closely with him on other committees. Like me, Mr. Drouin represents a rural riding, as do you, Mr. Chair; you represent the riding of Madawaska—Restigouche. If this motion were adopted by a majority of the members of this committee, it would create a precedent. It would be seen as being a personal attack against a member who is very proud to represent the people of his community.

A few important points regarding Glengarry—Prescott—Russell need to be made here, since that riding is mentioned in the motion.

What is the situation on the ground in that riding? To find out, I did a few hours' research.

The population of Glengarry—Prescott—Russell is 60% francophone. I think it is where the highest concentration of French speakers in Ontario is found. I believe the people of Glengarry—Prescott—Russell are very proud of their identity.

I looked at what municipalities are in that riding. First, there is the town of Hawkesbury, which hosts the very well-known Hawks hockey team. There is also the village of Casselman, as well as Embrun, Rockland and St. Isidore. My favourite municipality, which I visited with Mr. Drouin several years ago, is St‑Albert, where the St‑Albert cheese co-op is located. It is a truly lovely spot. I am sure that the people who work at St‑Albert Cheese know how important that institution is.

So we are talking here about a member who represents a rural riding in eastern Ontario that is 60% francophone, in a province where most people speak English. I think we have to give some thought to the people of Glengarry—Prescott—Russell, which Mr. Drouin represents. He is very proud of always defending the French language, whether in Quebec, of course, or in his riding, in Ontario. Obviously, he is always introducing new measures to preserve and promote French in Ontario and Quebec.

There we have it for the riding of Glengarry—Prescott—Russell.

The motion also talks about the comments made to a witness. I have seen the video clip of the exchange between Mr. Drouin and the witnesses who were there via video conference, and I think I recall that there were two witnesses, not one. So that is a problematic point in this motion. If Mr. Beaulieu were very passionate about the subject of this motion, it should say “witnesses”and not “a witness”.

I would like to hear what my other colleagues have to say on this subject. I may then move a subamendment concerning this point or the others I have raised, to make sure the grammar is correct and the context is accurate. Since we have now wasted a lot of time talking about this motion, we need to make sure that the text of the amendment and the motion are completely accurate.

I would like to raise another point, and it may be the last one, or maybe not; that remains to be seen. After my turn, Mr. Samson will have the floor. We have to listen to him at the caucus of members from Nova Scotia and the other Atlantic provinces. If my colleagues think my stories and speeches are boring, things are not going well.

The motion asks that “the committee report to the House”. We have to consider all the possible ramifications if this part of the motion were to be adopted. Of course, if this motion is adopted, I expect the Bloc Québécois will rise in the House to call for another vote. That will waste even more parliamentary time in the House. Today is June 3 and there are two or three weeks left until the House rises for the summer. So allow us to consider the various bills and the various other questions in the House of Commons.

Think, for example, about Bill C‑64. What does it consist of? Our friends in the NDP wanted legislation so that, for the first time in Canada, a regulatory framework could be created for prescription drug insurance funded by the government, out of public funds. This is a historic moment. It is essential that we move forward with that bill. If the process instigated by Mr. Beaulieu, and perhaps also Mr. Godin and the other Conservatives, is successful, that might mean that there will be another day of debate and a decision that it is not necessary to move forward with that other issue.

Do Mr. Godin's and Mr. Beaulieu's and the other members' constituents prefer to have prescription drug insurance or another day of debate on this motion? I think all our constituents want prescription drug insurance and do not want another political sparring match or another argument.

This bill is one of the examples. What are the others? Think about the objectives of the budget.

For example, we have a housing crisis in Canada. I know that Mr. Beaulieu does not like my stories, but I just want to tell you a little story in connection with the motion. In 2019, when I was elected, there was housing available in my riding. However, after the pandemic, the situation became very difficult. It has to be pointed out that more than 50,000 people in Ontario and the other parts of Canada decided to move to the Maritimes. That is the case in your province, Mr. Chair, and also in mine. We have a plan to create more housing, but in order to do that we need to adopt the measures provided in the budget.

However, the Bloc Québécois and the Conservatives think that we are making the best use of our time by taking a motion like this one, which is a personal attack on Mr. Drouin, to the House of Commons. They prefer to get into an argument and engage in a political game rather than discussing initiatives to improve housing. That is interesting.

Constituents in Alberta and British Columbia probably also think that action on housing is more important than this political game.

I would point out that in the context in which a committee adopts this kind of motion to report to the House, a member may then decide to raise a point of privilege or a point of order, to debate that idea.

The show is over. The Bloc wants to be able to sparkle in the sunlight, but it is over. I call on you, Mr. Chair, and on all my colleagues. We absolutely have to get back to work that is necessary.

I am going to give Mr. Samson a few more important points about this motion, but at this point, in this part of my speech, I want to reiterate to all my colleagues that we have to keep going with the other work. However, if this personal attack continues, I am prepared to continue improving my French here, before this committee, all the way to September. I am prepared to raise a variety of points. I am a lawyer. I do not have as much experience as you, Mr. Chair, but, if I think it necessary, I can find other points to raise about this motion, and keep going like that. I am going to keep going until the Conservatives and the Bloc, and maybe also Mr. Boulerice, I hope, decide that this game is not helping their constituents. Mr. Boulerice has several years' experience as a member of Parliament. I respect my honourable opposition colleague. He is a force to be reckoned with in the House of Commons, particularly during question period. If I am not mistaken, I think he is the only NDP representative in Quebec. That is impressive. It shows that he works very hard. Personally, I find him to be a source of inspiration.

I think Mr. Samson is always ready to talk about French and the rights of francophone communities. He is a former school board superintendent in Acadia, in Nova Scotia, and I am very proud of his work.

So I am going to close here and give him the rest of my time today.

Thank you, Mr. Chair. I am very happy to be with you here today.

[Brad Redekopp, Conservative, Saskatoon West, SK]

Madam Speaker, Liberals like to wrap themselves in the Canadian flag and proclaim themselves the great deliverers of health care in our country. It gets better. Allow me to read from former Liberal prime minister Paul Martin's 2004 election platform, which he infamously called a “fix for a generation”: “The priorities of a Liberal government begin with publicly funded, universally available health care. There is simply no other issue of such vital significance to Canadians. Liberals are proud of their founding role in making medicare a national priority.”

That sounded pretty good. It continues on, stating, “The objective of a Liberal government will be to agree with provinces and territories on a national pharmaceuticals strategy by 2006.” I would say that was a fail. That was former Liberal prime minister Paul Martin's 2004 election platform: a “fix for a generation”. Needless to say, national pharmacare did not happen in 2006. In fact, it is a full 20 years, a full generation, later, and we have a health care system that has fallen apart under the current NDP-Liberal government in Ottawa. Having broken our publicly accessible universal primary care system, we now have a Liberal Prime Minister who is setting his eyes on taking a wrecking ball to yet another part of our health care system. Why? In this backward town we call Ottawa, where common sense goes to die, Liberal logic says that if it is not broken, they need to break it.

What are the NDP-Liberals breaking today? It is the systematic dismantling of Canadians' access to their prescription drugs and treatments that are vital to their health. Just like 20 years ago, when that former Liberal prime minister brought disaster after disaster to primary health care, breaking it for a generation, if we follow our current NDP-Liberal Prime Minister down this path, our prescription drug system will forever be broken for generations to come. Rather than calling this a “fix for a generation”, I would say the fix is in.

It is against this backdrop of our broken primary health care system that Canadians need to take a good, hard look at this legislation. Bill C-64, the so-called pharmacare bill in front of us today, is not what the NDP or the Liberals are advertising. It is neither the implementation of universal prescription drug coverage, nor will it improve the options for the two items it promises to cover: contraception and diabetes medications. Instead, it goes out of its way to destroy Canadians' already pre-existing insurance coverage, provincial drug plans and freedom of choice in medication when pursuing treatments.

First, let us talk about federal-provincial relations. It is interventionist NDP-Liberal governments that use their control over the purse strings to force provinces into impossible decisions on patient care. Every time a premier tries to improve health care in their jurisdiction, the Liberal Prime Minister of the day will threaten to cut off health care funding to the province. Let us say a province wants to establish a few clinics offering MRIs outside of a hospital. To the Liberals, this is a mortal sin, and it cannot be allowed.

Earlier this year, the federal Liberal Minister of Health fined my home province of Saskatchewan $1 million for allowing MRI clinics to operate in 2021. This was an innovative idea that increased the number of MRIs performed at a lower cost. It was brilliant, but not so fast. The NDP-Liberal government saw that as a mortal threat and fined the province. As these clinics are still functioning because they are common sense, we can expect the fines to continue. How ridiculous is that? The answer is as simple as it is sad. They actually do not want the system to get better. They do not want better outcomes for people. The NDP and the Liberals learned long ago that as long as the health care system is broken, they can campaign in elections as the great protectors and saviours of the system. Canadians are not going to fall for that again. Remember, this whole thing depends on the federal government convincing the provinces to go along with this scheme, something we already know the Liberals are not good at doing.

Is this bill not doing something good? There is a second important thing to understand. This so-called pharmacare legislation will not bring universal prescription drug coverage to Canadians. Subsection 8(2) of the legislation, Bill C-64, under the heading “Discussions” says:

The Minister must...initiate discussions...with the aim of continuing to work toward the implementation of national universal pharmacare.

Let us break that down. What does the legislation require the minister to do? He must initiate discussions. That is fair enough. What do those discussions do? They have the aim of continuing to work towards a goal. Is that the big reveal? The minister is required to talk to some people to work towards an ideal. That sounds like every scam artist running a Ponzi scheme. Schmooze as many people as possible, and sell them on an idea that is nothing more than smoke and mirrors. This legislation is literally that: smoke and mirrors, conning Canadians into thinking there is a pot of prescription drug gold at the end of the rainbow.

It is not prescription drug gold at the end of this legislation. In fact, every single Canadian would be just that much poorer if and when this gets implemented because it is a direct attack on Canadians' private health insurance and drug coverage. Did members know that, according to The Globe and Mail, there are 102 government drug programs operating today, along with 113,000 private insurance programs? Statistics Canada reports that 79% of Canadians currently have health insurance that includes drug coverage.

The completely independent Parliamentary Budget Officer analyzed how much it would cost Canadian taxpayers if universal pharmacare were implemented. Their analysis is that pharmacare would cost about $40 billion every year. More importantly, that would be about $13 billion more than is being spent today. Let us keep in mind that pharmacare would replace existing public and private drug plans. Generally, private health care plans have better coverage than public ones. That would leave most people worse off. Therefore, overnight, four out of five Canadians would lose the prescription drug coverage they have through their employer, union, school, spouse, parent or provincial government plan.

The federal government is paying for it, which means we are paying for it through increased taxes. Either way we look at this, it would result in a multi-billion dollar spending increase paid for by us. Those who would really benefit from this are private companies who provide insurance to their employees because today the companies are paying for private drug insurance. Once this program kicks in, they could cancel those programs because the government would be paying for it. That would save those companies significant dollars. Essentially, it would be a transfer of dollars from the federal government directly to those companies, which is paid for by us.

Of course, the NDP-Liberals always love increasing taxes on unsuspecting Canadians. The other thing they love doing is limiting our choices to fit their narrow world view. There are two classes of drugs that the NDP-Liberals choose to cover in this so-called pharmacare bill: contraception and diabetes medications.

Let us talk about diabetes. Most people know that insulin is a shot given to diabetics to control their blood sugar levels, as needed. However, do people know that metformin is a prescription diabetes pill that is taken once or twice daily to help the body control its blood sugar properly, reducing the need for insulin? Do people know that metformin is prescribed commonly as a treatment for people before they have diabetes? With a daily treatment of metformin, that person may never develop diabetes, and that daily metformin is a dirt-cheap alternative to very expensive insulin. It keeps pre-diabetics from developing the disease, and it costs pennies, compared to insulin. Metformin is not covered.

What about Ozempic? We have all heard of Ozempic as the wonder weight-loss drug, but that is simply a side effect of being a diabetes drug that acts on the pancreas to control blood sugar. We also know that the best way to avoid type 2 diabetes is to be a healthy weight and to not be obese. Ozempic does that, but Ozempic is among the most expensive drugs on the market at about $75 a dose. Ozempic and metformin are used to prevent the disease of diabetes. Does that mean the NDP-Liberals are purposely going to deny treatment to those folks to prevent them from developing diabetes and are going to wait until they get the full-blown disease? How is that fair? Should that not be a decision for the patient and the doctor, and not for some bureaucrat in Ottawa?

Innovative Medicines did a comparison of the access of drugs covered by private insurance versus those in public plans. The results are as shocking as they are sad. In Canada, private insurance covers twice as many drugs as provincial plans do. The bottom line is that this bill, Bill C-64, proposes to take away people's private drug plan. That is what single-payer means. The result is that private companies and anyone else currently providing drug coverage in a benefit plan would cancel those plans and would force Canadians onto the government plan. Canadians would be stuck with a slimmed-down plan and would be forced to pay out-of-pocket for the rest.

After nine years, it is clear that this NDP-Liberal government simply is not worth the cost to Canadians' health. It has broken our primary health care system, and now with this so-called pharmacare legislation, it is setting out to break prescription drug coverage for 80% of Canadians who already have private insurance.

Conservatives will not stand idly by while the NDP-Liberals systematically break our country. If we form government, we would undertake the task to fix the immense damage this costly coalition has done. We would axe the tax. We would build the homes. We would fix the budget, and we would stop the crime. Let us bring it home.

[Kelly McCauley, Conservative, Edmonton West, AB]

Madam Speaker, I will be sharing my time with my colleague from Saskatoon West, or as we fondly know him, the member from Saskatoon West Edmonton Mall.

I rise on Bill C-64, which is officially called an act respecting pharmacare. I have two other names for it. One is the proper Liberal name of the bill, which is “fake news to satisfy the gullible NDP caucus act,” and then the longer title is the NDP “I hope no one notices we said we would force an election unless we got a comprehensive and entirely public pharmacare program but sold out for little act.” I am being a bit sarcastic here, but this is the truth.

The government has repeatedly stood in the House and said it is extensive pharmacare, but it is not. It is two items. The NDP members have constantly stood up with their colleagues across the way in the senior partnership, or the radical wing of the NDP, and said it is comprehensive pharmacare that is single pay. Despite what they would have one believe, it would just cover two items.

It does potentially cover diabetes drugs and birth control, but we do not know the details. What it would not do is cover the chronic diseases Canadians are suffering from most. The top ones are hypertension, osteoarthritis, mood and anxiety disorders, osteoporosis, asthma, obstructive pulmonary disease, ischemic heart disease, cancer, dementia and, rounding out the top list, diabetes. Only one item would be covered out of the major chronic issues that are diseases or afflictions hurting Canadians. Where is the coverage for those? It is nowhere to be found, which is why the government and other people in the House should not be calling it a pharmacare act.

The Liberals can name it a potential pharmacare act down the road, but they should not be misleading Canadians into believing that this is a pharmacare act. I asked where the coverage was for hypertension. Eight million Canadians suffer from this. Four million Canadians have osteoarthritis, two million have osteoporosis, and four million are suffering from asthma. How many of them would be covered by this so-called pharmacare act? The answer is zero. Two million Canadians are suffering from obstructive pulmonary disease. Not one would be covered. On ischemic heart disease, 2.4 million Canadians are suffering from this. Not one would be covered under this plan. Forty per cent of Canadians will be diagnosed with cancer in their lifetime, with 250,000 new cases every year. Not one would be covered under this so-called pharmacare act. For dementia, 750,000 people are affected, and not one would be covered. Where is the coverage?

I want to get back to my admittedly snarky comments about the NDP. I want to quote the National Post, which reads, “NDP members drew a line in the sand by passing an emergency resolution at their policy convention in Hamilton...that says the party should withdraw its support if the Liberals do not commit to ‘a universal, comprehensive and entirely public pharmacare program.’”

If one looks up the word “comprehensive”, the definition is, “complete, including all or nearly all aspects of something”. Is this all or nearly all aspects of pharmaceuticals? No, of course it is not. Anne McGrath, the New Democratic Party's national director, “said getting a bill that has teeth will be her party's biggest priority as parliamentarians return to the House of Commons”.

Canada has about 9,000 approved pharmaceutical drugs. The bill would cover maybe 200, so where are the other 8,800? Anne McGrath further stated, “Weak legislation is not going to be acceptable to New Democrats”. Maybe 200 for diabetes and birth control out of 9,000 seems to be acceptable.

She said, “It has to be strong. It has to have teeth. And I feel like that resolution gave [the NDP leader] and the caucus a lot of bargaining power. It gives them a lot of strength.” I wonder when my colleagues in the NDP are going to be withdrawing their support. They probably will not.

One issue I brought up in an earlier question is that a large majority of Canadians are covered, but some are slipping through the cracks. Some are not covered, and some are only partially covered, but they are covered by the province. Alberta, for example, covers most of the items brought up. Essentially, B.C., Quebec and Ontario do as well. Pretty much every province, except one or two in Atlantic Canada, covers diabetes or birth control for low-income Canadians. However, they are not covering the other items of importance, such as hypertension and some of the others.

The initial phase of this is going to cost about a billion and a half dollars. That money could be better used, by either giving it to the provinces for rounding out the services or, better yet, focusing on Canadians afflicted with rare diseases. A couple of families came to my office. Their young children were suffering from SMA, spinal muscular atrophy. It is a horrible disease. Generally, it is a death sentence by the time the child is two years of age. At about the time the children of these two families in Edmonton were diagnosed, a new drug had come out; it is called Spinraza. I have to give points to the pharmaceutical companies for how they come up with these names. Spinraza does not cure the disease, but it extends life to about 18 years old. Children would not have a great quality of life, but they could live to their late teens.

When Spinraza came on the market, Rachel Notley's NDP was in power in Alberta. We went to the local MLAs in the NDP to see if we could speed up coverage for the drug in Alberta; however, the NDP refused to look at this. The same NDP that says it is a line in the sand that it will force an election over refused to help this family. When the provincial United Conservatives were elected, Tyler Shandro was the health minister. He was much maligned, and I am sure a lot of it was probably deserved. However, he managed to get Spinraza approved for the family within two weeks. It is a very expensive drug.

Along came a better drug called Zolgensma. I truly believe it is a miracle drug. With Spinraza, children would spend about a month a year in intensive care, getting spinal taps and everything, for their treatment. Instead of that, Zolgensma is one shot in the arm. It seeks out the bad gene and copy-pastes the good gene over, basically stopping the disease in its track and giving the children a chance at a strong life. It would be about $45 million a year to treat everyone afflicted with this, everyone born every year in Canada. This is where the government should spend this money. It should focus on that.

It should not be spending money to replace programs that already exist. About 60% of Canadians have a program delivered through work. Instead of subsidizing that 60%, it should look after people like this in need. These two families had to fundraise for this drug. Ryan Reynolds, who was in Deadpool, helped fundraise for these two families. Luckily enough, a corporate benefactor came through and provided for everyone in Canada. This is an example where that billion and a half dollars could be better spent.

Another couple in my riding had a child suffering from PKU, which is a rare inherited disorder. It causes a buildup in amino acid in the body and prevents it from metabolizing protein. Children cannot have protein. It costs $5,000 a month out-of-pocket. The government should look after covering this.

Twenty-seven million Canadians already have coverage through work. This Liberal single-payer plan is going to subsidize either the companies that are already paying for this or big pharma. It is funny that big pharma just got an extra tax for too much profit through the Liberal government, a temporary Canada recovery dividend to attack big pharma, which it is now going to subsidize. It could also subsidize companies directly, including Loblaws. At the same time as it is demonizing Loblaws in the House, it will end up subsidizing it. Therefore, I do not support the act as it is. There are better ways to do it than the way the Liberals and NDP are doing it.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Mr. Speaker, it is an honour to rise to speak to such an important piece of legislation, our national pharmacare bill, Bill C-64, which was introduced by the member for Ajax, the minister responsible for health care. In my opinion, this particular legislation is a long time coming. When health care, what Canadians have become accustomed to in Canada, was first introduced many decades ago, I think that there was always an expectation that Canada would follow suit with a pharmacare piece of legislation.

Indeed, it is my understanding that Canada is the only country in the world that has a health care plan that does not also have a pharmacare plan. I think that it is incredibly important that this piece of legislation is here. I have been listening to the debate over the last number of weeks regarding this particular bill, and I have found it quite interesting what I have heard in the House about it.

For starters, I want to say that it is a piece of legislation that I see as a starting point. It is a point at which we can start to implement a national pharmacare plan, in particular to help some of the most vulnerable Canadians get access to medications they need. I will address that point in more detail in a moment. More importantly, this is a starting point in the sense that we will start by having two major medications that Canadians use, medications for diabetes and contraceptives for individuals who require them.

I say that because I know that almost four million people in Canada are currently using medications for diabetes. This piece of legislation, even though it is only a starting point covering two specific medications, would certainly have an impact on so many people in our country. With the portion that is just for diabetes, that is nearly four million people on its own.

Bill C-64 would establish a framework, and that is the important thing. It is a framework toward a national universal pharmacare plan in Canada for certain prescription drugs and related products, including free coverage of contraception and diabetes medication, as I have already mentioned. The bill would also provide that the Canadian drug agency work toward the development of a national formula to develop a national bulk purchasing strategy and support the publication of a pan-Canadian strategy regarding the appropriate use of prescription medications.

I think that the part regarding the bulk purchasing strategy is so incredibly important because this is where Canadians would see the benefit of having a national pharmacare plan. The idea that we can, as a whole country, purchase medications in bulk would give us that purchasing power that I think is needed to be able to make the purchases at a fair price, a price point that we as Canadians will ultimately be paying for through our taxes.

Finally, the last part of the bill is that, within 30 days of receiving royal assent, the minister would need to establish a committee of experts to make recommendations regarding the operation and financing of national universal single-payer pharmacare. The committee would be required to provide its report of recommendations to the minister no later than one year after the bill receives royal assent.

As I indicated earlier, when one talks about a program that is this big and this complex, it is important to have that proper oversight and to have a committee of experts making recommendations to the government on how to proceed. When we talk about the number of people who would be impacted by this, I find the conversation in the House to be really interesting, and this is something I alluded to a few moments ago, because it would be a benefit that everybody would be covered under the program. The reason why I say that is that I think it is very easy to make comments, such as I have heard from Conservatives in particular, that so many people are already covered. There are already people who are covered under their private plans. I think about 80% of people are covered in one way or another.

However, not everybody is covered in the exact same way. For starters, at least 20% of people are not covered under any plan, and these would be the most vulnerable because these are people who would have to go to the drug store to pay for their medication out of pocket. On the other end of the spectrum, there are a lot of people who are fully covered, and there are some really good plans out there. There are some really good employers. There are some really good institutions that provide plans to their employees and family members that are going to cover a lot, up to, in many cases, 100% of the cost of medication. Then, there is everything in between concerning what the coverage is and how much coverage there is. This is why it is so important that we talk about universal coverage. Sure, 80% of people might have some degree of coverage, but not everybody is covered the exact same way. I think it is extremely important that everybody has the same basic universal coverage.

When we look at the way we are treated when we go into hospitals, everybody is treated the exact same way. At least, it is supposed to be this way, and it could be argued that provinces are setting up things differently. If we go into a hospital emergency room, we will see triage. The hospital will determine the critical nature of a person's visit, how quickly a person needs to be dealt with, and everybody is treated the exact same way. Most importantly, when we are done and when we leave the hospital, we just go home. There is no one asking for a credit card or a billing address. We have the luxury of having a health care system that covers everybody, which does not ask people to pay when they are in, quite frankly, what would be their most vulnerable state.

I think one of the problems with my generation, and generations after mine and a few before, would be that the idea of having to pay for medical care seems almost foreign. It certainly does to me. I never think to myself, “Wow, I should go get this checked out, but what's it going to cost me to do that?” That is never something that enters my mind.

Members can just imagine that, if I were living in the United States, for example, there would be a lot of people who actually have to make that choice. They say, “Well, I should get checked out, but what is it going to cost me to do that?” This is one of those luxuries that we have with a single universal health care system such that we have here in Canada. It is not something that enters our mind because I think we believe, as a society, that there is a certain onus to take care of each other when it comes to our health care, which is what our health care system provides, notwithstanding the fact that we could get particular about what different provinces are attempting to do now. However, that is the reality of the situation.

When we talk about pharmacare and the drugs that we also need to be healthy, we have to ask ourselves why they are not treated the exact same way. What I see with the bill before us is an attempt to move in that direction.

There are two very important, or at least very popular, medications that a lot of Canadians use to start with. This comes from the same premise that, when somebody needs to take care of diabetes, for example, or somebody wants access to contraceptive medication, they should not have to filter into the equation of the decision whether they would have to pay for it, for starters, as 20% of the population would, or how much of it they would have to pay for. They should not have to ask, “Do I have to pay for a portion of it? Does my coverage only cover 60%, and so I have to pay 40%? Does that make it worthwhile to do this?” Canadians should not have to think that perhaps they could go against their doctor's advice and not get the medication because they think they will be fine.

These questions should not be asked by Canadians. There are a lot of seniors out there who rely on a lot of medications who should not have to say, “I have to make a decision between getting the medication I need or buying food.” They should not be making those choices, and they should not be saying that maybe they will only take half the dosage they have been prescribed because at least then they are still taking something but are not spending as much.

When we talk about health care and pharmacare, it is my position that it should be treated in the same way that we talk about health care and accessing care in terms of going to see a physician or going to the hospital. That is why I think the pharmacare bill is so important, because, as I said, it certainly does not cover every drug. It actually covers only two very important and widely used drugs, but it sets the framework for how things can evolve from here.

One of the things I find really interesting, when we are having this discussion about universality and the fact that it is just two pieces of very important medication, is what I have been hearing from Conservatives to this point. They are getting upset over the fact that it would not cover a lot and a lot of people would not be covered. They are basically saying that more should be invested. I have heard the member from Battle River—Crowfoot talking about how we are not doing enough. Nonetheless, they will still vote against the bill.

I cannot help but wonder why they are saying we need to do more, but then are against the idea fundamentally. I do not know whether Conservatives are doing what we have seen them do a number of times before, which is to start by talking about a piece of legislation and trying to critique it all day long, only to then vote in favour of it when the time comes, or whether they have a plan for universal pharmacare that is even more ambitious than this one. I find myself somewhere in between, trying to figure out what they are really trying to get at with this.

At the end of the day, we know that this is something that would help Canadians. We know, and I strongly believe, that the concept of having a universal pharmacare system, in the long run to cover many more drugs, is certainly my goal. That would be to the great benefit of all Canadians.

The legislation is a huge step forward in delivering better health care to Canadians. As I said, it lays out the plan for universal single-payer coverage for contraception and for diabetes medication. This would mean nine million women and gender-diverse Canadians all across the country could get access to the contraception and reproductive autonomy that they deserve.

Notwithstanding the fact that lately we have heard some Conservatives start to talk and to reopen discussions about reproductive autonomy from decades ago, the reality is that we believe that when somebody makes choices about what to do with their body, in particular when it comes to reproductive aspects, they should be able to make those choices. A woman should be able to make those choices. In my opinion, the government should be there to support them in making whatever choice they think is the best for them as an individual.

Although the piece of legislation before us, as I previously said, would not cover every medication, or a lot more medication as I would ultimately like to see, it certainly would be a starting point, a place to begin. It would be a place to lay the groundwork. It would be a place to engage the experts to provide feedback as to how we could move forward. It would allow us to start somewhere significant, given the number of Canadians it would affect, and then from there, to grow.

I am really looking forward to the day when we can say that our pharmacare and the medications that Canadians depend on so much will be treated in the exact same manner that we see in the rest of our health care system, in particular when we go to visit a doctor or we have to go to an emergency room, as I described earlier.

I really hope Conservatives vote in favour of this at the end of the day, despite some of what I have been hearing. This is a great opportunity to show the country that the bill is not something we will make political and that it is something that truly would benefit many Canadians. It would help the 20% or so of people who might not have some degree of coverage. It would equalize the very well-off people with some of the most vulnerable in our communities by saying it does not matter what one's socio-economic status is and it does not matter what one's income level is. We respect the fact that all Canadians should have access to the medications they need so badly, and that their doctors, through our health care system, could provide it to them.