44th Parl. 1st Sess.
May 6, 2024 11:00AM
- May/6/24 3:46:01 p.m.
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Mr. Speaker, I view this legislation not as a pharmacare plan but a spending plan and what will be another empty broken promise, just like the carbon tax was going to be revenue-neutral and just like housing was going to become more affordable under the current government. Frankly, I do not see enough trust from Canadians to see another project fail to be delivered properly.
I have been getting a lot of questions from constituents regarding the proposed plan. People are asking me if they should cancel their existing insurance plans because, like many others, the majority of Canadians are already covered. They are worried there is going to be a reduction in availability of coverage under the single-payer system that is being partially promised, partially proposed and, ultimately, I expect, poorly delivered.
Perhaps the minister could clarify, for the hundreds and thousands and millions of people across Canada who are wondering if they are in limbo, if they are going to lose the quality of the coverage they have through their private insurance and whether they should cancel it now and await further clarification from the government, what eventually may be covered under the pharmacare plan.
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- May/6/24 5:33:19 p.m.
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Madam Speaker, it would be surprising to most Canadians to learn that there is a huge under-insurance problem in this country. Many people, we could say, slip through the cracks. As I mentioned in my speech, for those who are part-time workers, who end up getting phased out of their parents' health insurance plans and for those who are taking social assistance, there is always a gap between the two insurances. We need to make sure that everybody is covered and that every Canadian is treated equally. It is all about equality and equity. This is how those gaps can be prevented.
As my hon. colleague from London—Fanshawementioned, it is important for women to be able to take care of themselves. It should not matter what one's income bracket is. One should be able to access contraceptives and these services in order to create a more equal society.
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- May/6/24 5:45:24 p.m.
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Madam Speaker, health care delivery is provincial jurisdiction. The private insurance companies out there are already talking about how their systems and programs, which deliver tremendous results for Canadians, are going to be undercut. This is going to lead to a public system that does not offer the same value and benefits that the private system already does. Conservatives are going to respect provincial jurisdiction.
It is too bad that the government has squandered $600 billion in debt and the debt servicing that goes along with it, so we are actually spending more on servicing our debt than we are on health care transfers. If only we had prudent fiscal management, we could transfer the money to the provinces so that each province could make a decision for itself about what coverage it wants to have for its citizens. That is the way Conservatives would have handled this.
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- May/6/24 6:03:22 p.m.
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Madam Speaker, I find it hilarious that the Conservatives are protecting big insurance companies. I find it particularly entertaining that the member and his party, which would not be affected by this, including with contraception, fight so diligently against the reproductive rights of people. I find it funny.
Does the member support access to trauma-informed abortion care and access to reproductive rights, which would include free contraception care for those who do not have insurance and those who fall outside the programs, or does he think the Conservatives should just keep violating reproductive rights in real time as we are seeing in the House?
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- May/6/24 6:31:45 p.m.
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Madam Speaker, I want to put on the record that the best thing we can do for women is to give them financial autonomy and make life affordable so that they can make the choice to leave an abusive relationship. Under the Liberal-NDP government, domestic violence is up 72%.
The Canadian Life and Health Insurance Association has stated that the bill “will spend billions of dollars unnecessarily on drugs for people who already have coverage.” With a cost-of-living crisis, and an inflationary deficit where people cannot afford to live, is the hon. member okay with this wasteful spending?
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- May/6/24 7:02:10 p.m.
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Madam Speaker, it is true that contraceptives are not yet covered. That is why we need money. We are going to improve our system.
Since my colleague is asking questions about how it works, I will quickly explain. We have a mixed system in Quebec. People who are not covered by private group insurance pay, if I remember correctly, between $0 and $731 in premiums per year, depending on their income. That is how it works for people in the public system. For everyone else, the employer deducts an insurance premium from the employee's earnings.
I should also point out that ours is the most progressive taxation system in North America. The tax rate is income-based. There is no better place in North America for that.
The Quebec system is certainly not perfect, as I said in my speech. However, we are going to improve it. All we have to say to the government is let us manage it on our own.
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- May/6/24 9:15:42 p.m.
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Mr. Speaker, I take that comment, and I take the comment from the member for Winnipeg Centre. I will say “to save their epidermis”. There we go.
The bill could have negative consequences for the 27 million Canadians who rely on private insurance. The non-profit insurance sector has serious concerns about its future should Canada pursue a single-payer pharmacare system. Providers like Blue Cross could be wiped out entirely. As usual, the government tabled the bill without consulting a single stakeholder in the private and not-for-profit insurance industry. Killing private and not-for-profit insurance would be devastating for millions of Canadians.
Across the country, private coverage is, on average, 51% more extensive than provincial public counterparts. When a new drug is approved by Health Canada, it takes an average of 226 days for private insurers, including Blue Cross, to approve its coverage. Public plans take an average of 732 days after Health Canada approval to add the drug to the list of covered treatments. Canadians with serious health conditions that require drugs and treatments that are only just going through the approval process in Canada cannot afford to wait another two-plus years after Health Canada approves them.
Today, more than six million Canadians are without a family doctor. A half-baked public pharmacare system would do nothing to change that and to address their needs. Rather than spending another $1.5 billion setting up a system that would not cover the vast majority of medications, the government should be focusing on ways to support provinces in the recruitment of new doctors and nurses.
That is why Conservatives have proposed a national blue seal program. This program would ensure that when a foreign-trained doctor or nurse arrives in Canada, they could quickly apply to have their credentials recognized and would be given an answer within 60 days as to whether they could practice in Canada. Once approved, they would be able to work in any province that signs on to the federal plan. Right now, a doctor licensed in Ontario cannot practice in Nova Scotia. A nurse licensed in B.C. cannot practice in Manitoba. It is time to change this anachronistic system.
In closing, the program would not be a universal pharmacare program, and it would not do anything to help the 1.1 million Canadians without access to pharmacare coverage nor the 6.5 million Canadians who cannot even see a doctor. It would be yet another expensive bloating of the federal government, adding more gatekeepers and more debt for Canadians to pay for while delivering next to nothing. I would add that, in a riding like mine with a large indigenous population, it would not be accessible to indigenous Canadians or rural areas either, because the amount of money is simply not enough to do even what the government says it is going to do.
After nine years, the only drugs the government has been able to deliver are hard drugs, like fentanyl, heroin and meth, which are flooding our streets and killing thousands every year. Conservatives will bring home the doctors and nurses our health care system so desperately needs. We will axe the tax. We are going to build the homes, fix the budget and stop the crime to lower the cost of living for all Canadians. That is what they want us focused on.
I encourage all members to support the amended motion put forward by the member for Cumberland—Colchester, dispose of the bill before us and start working to actually address the serious problems in health care across Canada.
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- May/6/24 9:19:25 p.m.
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Mr. Speaker, I think I heard the member opposite say that the people in his riding do not want this pharmacare plan. They do not want their diabetes medication or pharmacare for reproductive health to be covered.
It sounds to me as though he is more concerned about the insurance companies and how well they are going to make out after the legislation goes through. Is that the case?
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- May/6/24 9:24:43 p.m.
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Mr. Speaker, I really appreciate this opportunity and all opportunities to speak in the House on behalf of the residents of Hamilton Mountain, particularly with respect to this very important piece of legislation, which is necessary to help millions of Canadians who are struggling to pay for their prescription medications.
We have heard lots about access to and the affordability of prescription drugs in Canada. Statistics Canada data from 2021 indicates that one in five Canadians reported not having insurance to cover the cost of prescription medication in the previous 12 months. The same Statistics Canada data also found that a higher proportion of new Canadians reported not having prescription drug insurance coverage. Having no prescription insurance coverage was associated with higher out-of-pocket spending and higher non-adherence to prescriptions because of cost. This results in some Canadians' having to choose between paying for these medications and paying for other basic necessities such as food and housing. We likely all know someone who is struggling with this issue. Members may know someone, or maybe have heard stories about a person with diabetes who does not have insurance coverage through work and has to pay for their insulin, syringes and test strips out of pocket; a student who had insurance coverage up to a certain age through their parents and then lost that coverage; or a cancer patient who does have insurance but is still not covered under their plan for the type of medication they need to treat their cancer.
That is why we have introduced legislation based on the principles of accessibility, affordability, appropriateness and universality. These principles will help guide ongoing efforts to advance the implementation of national pharmacare. We need pharmacare that helps make prescription drugs more accessible. This includes improving the consistency of access to drug coverage and needed medications across the country. We also need pharmacare that helps make prescription drugs affordable. This includes reducing financial barriers for Canadians, such as deductibles and copays. Additionally, we need pharmacare that helps ensure that the prescription drugs that people are taking are appropriate. This includes getting the right drug to the right patient at the right time to support their physical and mental well-being. Finally, we need pharmacare that is universal. This means we need to work to ensure that the principles of accessibility, affordability, and the appropriate use of prescription drugs are applicable to all Canadians, regardless of where they live.
These pharmacare principles align with the work that is already being done on national pharmacare. This work includes our partnership with Prince Edward Island with respect to the improving affordable access to prescription drugs initiative, our implementation of the first-ever national strategy for drugs for rare diseases and the recent announcement of the creation of a Canadian drug agency. Going forward, these principles would be reflected in the upcoming bilateral agreements for universal coverage of contraception and diabetes medications.
Let me spend a moment to explain how those principles are already being put into action. On August 11, 2021, the Government of Canada announced it would work with the Government of P.E.I. to improve affordable access to prescription drugs and inform the advancement of national universal pharmacare by providing $35 million over four years to add new drugs to its list of covered drugs and lower out-of-pocket expenses for drugs covered under existing public plans for island residents.
As of December 2023, P.E.I. has expanded access to over 100 new medications to treat a variety of conditions, including heart disease, pulmonary arterial hypertension, multiple sclerosis, psoriasis and cancer. In addition, effective June 1, 2023, P.E.I. reduced copays to $5 for almost 60% of medications regularly used by island residents. I am pleased to share that, through this initiative, within the first three months, P.E.I. residents have saved over $2 million in out-of-pocket costs on more than 200,000 prescriptions.
As of July 1, 2023, P.E.I. also made adjustments to the catastrophic drug program, lowering the cap on the amount of money a household needs to spend out of pocket on eligible medications. As a result, no eligible P.E.I. household will have to spend more than 6.5% of their household income on eligible medications. Once that 6.5% cap has been reached, eligible medication costs for the remainder of the year will be paid by the program. As members can see, this collaboration is already creating more affordable access to needed medications for island residents.
On a national level, we have launched the first-ever national strategy for drugs for rare diseases in March 2023, with an investment of up to $1.5 billion over three years. Most of this investment will be going to provinces and territories through bilateral agreements to improve access to new and emerging drugs for Canadians with rare diseases, as well as support enhanced access to existing drugs, early diagnosis and screening for rare diseases.
Similarly, we are providing $33 million over three years to support first nations and Inuit patients with rare diseases, and $68 million is being invested in various initiatives to support collaborative governance, data infrastructure and research for drugs for rare diseases.
Through this, the government will help increase access to and affordability of effective drugs for rare diseases to improve the health of patients across Canada. These principles will be further demonstrated and reflected in the next step of national pharmacare outlined in this bill, which describes our intent to work with provinces and territories to provide universal, single-payer coverage for a number of contraception and diabetes medications.
In addition, and separately from the bill, we will also create a fund for diabetes devices and supplies. This fund will be rolled out to support access to diabetes devices such as continuous glucose monitors, insulin pumps, syringes and test strips. This new coverage, to be delivered by provinces and territories that enter into a bilateral agreement, provides an excellent opportunity to see the principles of affordability, accessibility, appropriateness and universality at work. Canadians, no matter where they live or how much they earn, will be able to receive the contraception and diabetes medications they need. In turn, Canadians will be healthier, empowered to make important life decisions and will not have to skip doses due to the cost of these two types of essential medications.
In closing, we will continue to work on national pharmacare initiatives that include the principles of accessibility, affordability, appropriateness and universality laid out in this bill, because Canadians need national pharmacare that embodies these principles. We look forward to working with all parliamentarians to pass the pharmacare act so that these principles will continue to guide our ongoing efforts to advance the implementation of national pharmacare.
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