44th Parl. 1st Sess.
May 6, 2024 11:00AM
- May/6/24 3:36:00 p.m.
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Mr. Speaker, the Conservatives should have stood up and should have the guts to actually defend the unbelievably negative things that they have tried to do around pharmacare.
My question to my colleague is very simple. When 17,000 of their constituents need access to diabetes medication and 25,000 need access to their reproductive health prescriptions, which are part of this bill, why are Conservatives blocking the ability of Canadians to access these medications?
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Mr. Speaker, I am grateful for the opportunity today to speak to Bill C‑64, an act respecting pharmacare.
This bill represents the next phase of our government's commitment to a national universal pharmacare program. It proposes the foundational principles of national universal pharmacare and our intent to work with provinces and territories to provide universal single-payer coverage for many contraceptives as well as diabetes medications.
This is an important step forward in improving health equity, affordability and outcomes, and it could save the health care system money in the long term.
Public health care in Canada was built on the promise that no matter where one lives or what one earns, one will always be able to get the medical care one needs. Despite this promise, Canada is the only country in the world with universal health care that does not provide universal coverage for prescription drugs.
When medicare was first introduced, prescription drugs outside of hospitals cost less and played a smaller role in health care. Today, prescription drugs are an essential part of our health, helping to control chronic conditions, treat temporary ones, and aid in overall health and well-being.
One area that has seen significant changes is diabetes treatment. Over 100 years ago, thanks to a Canadian team of researchers, Frederick Banting, Charles Herbert Best, John J. R. Macleod and James Bertram Collip, insulin was discovered.
Since this monumental scientific discovery, there have been several advancements in diabetes treatment, from the introduction of fully synthetic human insulin to glucose monitors and insulin pumps. These breakthroughs have immensely improved the quality of life for people who have to live with diabetes, enhancing self-esteem, increasing social participation and improving the overall health and well-being of these individuals.
They have also come with higher costs, creating affordability challenges for Canadians affected by diabetes.
Outside of hospital, prescription drug coverage comes from a mix of private insurance, out-of-pocket cash payments and various provincial programs. While the majority of Canadians have access to some form of public or private insurance, about 2.8%, or 1.1 million Canadians, do not have access to private or public drug coverage.
Although most Canadians have some form of drug coverage, this does not mean that those with insurance have equal access to the prescription drugs they need. The existing patchwork system of private and public drug plans leaves millions of Canadians under-insured, and that means their out-of-pocket prescription drug costs create a financial burden that leaves them struggling to afford an essential part of health care.
In 2021, Statistics Canada found that more than one in five adults in Canada reported not having the insurance they needed to cover their prescription drug costs. Being under-insured can take many forms, for example, Canadians may have high deductibles, resulting in significant out-of-pocket costs before their insurance coverage even kicks in. They may reach the maximum annual or lifetime coverage limits for their insurance and have to pay out-of-pocket, or they may have to make co-payments, which are often 20% of the drug's cost on private plans and sometimes more on public plans.
All provinces have drug coverage to protect Canadians from catastrophic drug costs, but deductibles under these plans can range from 0% to 20% of net family income. In many cases, Canadians will never reach the deductible, leaving them without any support for their drug costs. This variability across the country creates a postal code lottery.
Let us consider the advancements in diabetes treatments. For a working-age Canadian with no private insurance, out-of-pocket costs vary widely. In some parts of the country, out-of-pocket costs for people living with type 1 diabetes can be higher than $18,000 per year out-of-pocket; for type 2 diabetes, they can be higher than $10,000 per year in out-of-pocket expenses. Even those with private insurance can face high co-pays or exceed annual plan maximums, resulting in high out-of-pocket costs.
Even for cases in which an individual is not accessing devices that cost thousands of dollars, they can face significant out-of-pocket costs. For example, we can consider a woman in her mid-twenties who is working a minimum wage job. An IUD, one of the most effective forms of birth control, can cost up to $500 with no insurance. Even with private insurance, a co-pay of 20% would be $100. While IUDs can last from three to 12 years and save money over the long term, the high upfront cost can make them inaccessible.
Under-insurance can be a particular concern for young adults who age out of their parents' private insurance but who do not have their own form of private coverage. Lower-income Canadians also make up a disproportionate share of the under-insured. While most provinces have put in place drug coverage for those accessing social assistance benefits, a gap still exists. Many lower-income households that do not qualify for social assistance continue to struggle with out-of-pocket prescription drug costs.
Employment factors contribute to differences in insurance coverage. People with low-paying jobs, such as entry-level, contract and part-time positions, often report less adequate drug insurance coverage. This may even discourage people from accessing social assistance benefits or from applying for jobs, because once hired, they may lose their public drug insurance coverage. However, many entry-level and part-time jobs do not offer drug benefits. One study found that only 27% of part-time employees reported receiving medical benefit coverage.
Under-insurance can have serious consequences. Many Canadians with high out-of-pocket costs report foregoing essential needs, such as food and heat, or not adhering to their prescription due to drug costs. Statistics Canada found that, in 2021, close to one in five Canadians spent $500 or more out-of-pocket for their prescription medication, and almost one in 10 reported not adhering to their prescription medication because of costs. This includes delaying filling prescriptions or skipping doses to contain costs.
When people do not take their prescription drugs the way they are supposed to, their health can suffer. This results in serious consequences for the individual and their household, and unnecessary costs to the health care system in the long run, as patients are more likely to visit an emergency room or to be admitted to hospital when they do not receive consistent treatment. For example, the full cost of diabetes to the health care system in 2018 was estimated to be around $27 billion and could exceed $39 billion by 2028.
I think we can all agree that no Canadian should be put in a position where they must choose between the prescription drugs they need for their health and well-being and putting food on the table. This is unacceptable, and it is why we are continuing our work to improve accessibility, affordability and appropriate use of prescription drugs as we move forward with national universal pharmacare.
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- May/6/24 7:37:16 p.m.
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Mr. Speaker, it is an honour, as always, to stand in the House of Commons to represent the incredible people of Peterborough—Kawartha.
Tonight on the docket, what do we have here in Ottawa, in the House of Commons? We have a bill that was put forward by the Liberal—NDP coalition and it is called pharmacare.
I just want to give some context for folks at home of the summary. This is the official summary:
This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and provides the Minister with the power 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.
One can tell, with the word salad here, which we often see put forward by the government, that it just leaves a lot of loopholes to say that they are not going to over-commit and that they are not going to do anything, so they can then skirt out of it when it fails.
What is the bill? It is really the crux of the supply and demand agreement. It is simply a bill to keep the Prime Minister in power. The leader of the NDP sold his soul for this bill, and it is sad because he has also sold out Canadians. It is frustrating. It is infuriating. It is exhausting for everyone at home.
After nine years of the Prime Minister, here is what we have. I actually have to read it off of paper because there is so much that has happened.
There has been doubled housing costs, the highest food bank usage in history and a steady decline in the Canadian economy, meaning that Canadians are now poorer by $4,200 per person. This is Canada's worst decade for real economic growth since the 1930s. There are Facebook groups called “dumpster divers” because people cannot afford food.
Crime and chaos are at all-time highs. There are criminals running free and terrorizing neighbourhoods because of the Prime Minister's soft-on-crime policies. Domestic violence has increased. Compared to 2014, intimate partner sexual assault is 163% higher. Online child predators are up 300%.
Recruitment and retention in the armed forces is the lowest in history. Young people believe that they will never own a home. People have no motivation to go to work because 46% of their paycheque goes to taxes.
I had one gentleman message me. He said, “You know, Michelle, we work so hard. I'm almost embarrassed to say this because I make $100,000 a year. That sounds like so much money, but our interest rates have increased. Our mortgage costs have doubled. ” He said, “I decided I'll go take some overtime because we really can't make ends meet. We really have no money left at the end of the month. We can't afford to feed the kids. We're having to cut their sports. It's taking a toll on my marriage. It's taking a toll on our life.”
He goes and works 30,000 dollars' worth of overtime and he was taxed $22,000 out of that $30,000. That was time away from his family, time away from his kids, time away from everything, to go to work, to do the right thing. Work does not pay.
Why are people going to work? Why would one go to work? What a devastation to the soul, because people love to work. It is purpose. It is structure. We work for two things: because we have a purpose in this world and to collect a paycheque to provide for our families. The Liberal government has taken away both of those things.
Our birth rate is the lowest in history. Has anyone noticed a trend here? These are historic numbers that have never been seen before. People cannot afford to have a baby. They are saying they cannot afford a home and cannot afford to have kids. They are terrified. There are headlines like that of a Global News article, which says, “B.C. mother says lack of child care could leave her homeless”. Guess what? The Liberal-NDP government promised that it would make affordable, accessible child care, that it would save everybody, and that everything would be great. What has been delivered? Absolute chaos.
Women entrepreneurs have given their life; they have sacrificed everything to care for kids in their home, and they are losing their businesses because the Liberal-NDP government is so ideological that it does not offer flexibility and choice. It has to be the government's way always. It wants control, and that is what has happened.
I visited a child care facility in Manitoba this past weekend. It was absolutely incredible. It was able to build 22 child care spots in 18 months. It is remarkable what it has been able to do. A woman who spoke to me said that the CWELCC program, or the $10-a-day child care program, is actually a risk to children because moms and parents are having to choose between feeding their kids and putting their kids in safe child care. That is the reality of what has happened under the Liberal government.
Every day there are viral videos of Canadians who say they are moving because Canada is broken and no longer recognizable. We have a Liberal Prime Minister with historic records of corruption and scandals. Every single day is another scandal or another corruption. There is zero trust with the Canadian people. A guy came up to me on the street and said he just wanted me to know that people are exhausted. He is a restaurant owner and he said he was exhausted. He said that he cannot believe we have a Prime Minister who has destroyed our country in the way that he has, and that people are so tired. The NDP leader keeps him there with the bill before us that would deliver nothing, again.
There are 22 people a day dying from overdoses. Drugs have flooded our streets, and addiction has taken thousands of families hostage. I want to tell members a story because I think it is critical. Right now, the Conservatives are the only party saying “enough with the wacko drug policy, safe supply”. How does it work? I want to explain it because I think it is really important. Safe supply is, ultimately, the idea that somebody dealing with or battling with addiction walks in and is given a supply of Dilaudid. On the street, they are called “dillies”. It is a highly addictive opioid. Someone is given 30 of them, Dilaudid or dillies, then they go out, maybe want to do the right thing, and take them and try to level out.
However, it does not work, and they need something stronger, so they sell the Dilaudid. This is called diversion. They sell them on the street, and it brings down the value of the drug. Then they seek something stronger. Then there are all of these “safe” drugs; that is how the drug dealers sell it to high school kids. They go around and say, “Hey, this is safe. It is only a buck. Your parents can take it.” The kids buy it and now get addicted to opioids. There is a whole new generation addicted to opioids.
What happens is that the addict progresses, takes fentanyl, a street drug, and dies of a fentanyl overdose. That is why we have people, especially in the NDP, who say that people are not dying of safe supply and of diversion. However, they are dying as a direct result of the failed experiment of safe supply. That is a true story. The number one cause of death for children in British Columbia between the ages 10 and 18 is opioids. It is unbelievable. There is an outreach worker in Ottawa who tells the story of what is happening on the streets of Ottawa, outside pharmacies, of dillies being diverted to teenagers.
There was an arrest just outside my community, of a 14-year-old with safe-supply fentanyl. This is the reality of what has happened after nine years of the current Prime Minister. There are record applications for MAID, including from those who simply cannot afford to live so they are applying for medical assistance in dying.
What a time to be Canadian. I have just read historic stats to members. Never before in my lifetime have I ever seen Canada like this. Certainly why many of us chose to run for politics was to correct the course we are on. It is not a fluke, and it is not random, why we are here. It is all a lack of leadership. That is the reality of what we are dealing with in this country. When we have a leader whose sole mission is power and control, we can guess who loses; it is Canadians.
There are consequences to actions and consequences to policies, and Canadians are feeling the misery and suffering after nine years of the Prime Minister. How does this impact pharmacare? The Prime Minister knew he was tanking in the polls. He had to think up a plan, and he had to think it up quick, just like the good old Grinch. He said, “I know who I can exploit. I am going to go to the leader of the NDP. He will never be in power, so I will make him an offer, make him think he has power, and that is what I will have to keep myself in power. In case an election is called, this is how I will do it.”
Every single day, I get calls asking why there is not an election. We are done. Every single thing has an expiration date. The Prime Minister is long overdue his, but he is in power, and the pharmacare bill is a big piece of it. The leader of the NDP signed a coalition agreement, and maybe he had good intentions. Maybe he thought he was actually going to help Canadians, and maybe he thinks he is going to get something out of this.
I thought at the beginning of my term, and now I know, that power and control are what the Liberals want. That is the driving force for the leaders of the NDP and the Liberals in the House. The pharmacare bill is yet another marketing slogan. It sounds wonderful, but as with everything the Liberals announce, they promise us one thing and deliver another. In so many instances, they actually deliver nothing.
I want to tell a story that is really sad. The Liberals often hurt the most vulnerable because they set an expectation, saying, “We are going to promise the moon, the stars, the sun and $10-a-day day care for everyone, except that one person does not get it, and another and another do not get it. One does get it, that guy right there, but everybody else is a loser. There is one winner.” There are winners and losers. That is what the Liberal-NDP government does.
The government set out the Canada disability benefit. The minister of, at the time, disabilities and inclusion came to testify at the human resources committee in October of last year. We were waiting. We had witnesses. We were studying the bill, and we asked what the benefit would do. The minister said that the benefit “will lift...people out of poverty, big time.”
Along came budget 2024. The Liberals were so proud. They came out and said, “Here is our disability benefit: six dollars a day.” Rachel and Jason came to my office. They are with the Council for Persons with Disabilities in Peterborough. I said, “Tell me how you feel about the disability benefit.” They said, “Well, you know, we are grateful”, because this is what the Prime Minister does. He shames people. They cannot speak out, because they just have to be grateful for the scraps the government gives them. It takes everything away from people, and then it gives them little scraps. It belittles them and make them feel small and worthless.
Rachel and Jason said that it is basically like this: Members know that old game of trust, the trust and fall exercise we used to play as kids. We would close ours eyes and fall backwards, and the person behind was supposed to catch us. Jason and Rachel said to me that it is as if the person who catches is the Liberals, but not only do they not catch someone but they got out of the way and did not tell them.
That is the reality of the bill before us, and the Liberals make it seem like the Conservatives do not care about this. No, it is that we do not believe them. We do not trust them and we do not believe them, because they have not delivered anything they said they would. We are the only ones standing in here fighting for the Canadians who are genuinely struggling to survive. That is the problem with the bill. Not once have Liberals proven to us that they will deliver what they said they will.
There are historic highs of food bank usage in this country. Housing costs have doubled, and young people believe they will never own a home. However, the Liberals get up and say, “We have done a great job. We are such good people and Canadians should be grateful. We are really good. We are great.” Guess what? Canadians have caught on. They know so much; they see right through it. The bill is just another distraction of “We will give you this.”
Let us break down the facts. Currently we are spending more on serving the Prime Minister's out-of-control debt than we are on health care transfers. This is a true story. It is going to get worse and worse because he keeps spending and spending like a maniac. It is basic economics. Anybody who has ever had to balance a household budget knows this.
If someone makes $100 a month but spends $150, what happens? The person has to borrow the money. Then the next month, if that person makes $100 and again spends $150, they need to borrow more and are now at $200. They had to use their credit card to do that and are now paying credit card interest, so they are just putting money toward the interest and not even paying down their debt. Their credit score goes down and they go further and further into debt. They cannot spend time with their family and are stressed out of their mind.
This is Mental Health Week. The number one thing a good leader would do is make life affordable. That is the greatest gift we can give our kids. They do not need money and things; they need us. They need connection and they need time. Parents cannot give that because they are too busy working trying to pay for food and housing they cannot afford because of the Liberal Prime Minister.
There are six million Canadians without a family doctor, and wait times have never been longer. Where is the bill on that? I do not see it. The wait time from seeing a family doctor to getting specialist treatment is crazy. Listen to this. Something is wrong with a person, and they need to see the family doctor. The wait time has increased incredibly. The person does not have a family doctor, so there is problem number one. Number two is that the family doctor then has to recommend the person to the specialist.
The wait time to get to the specialist has increased 195%. This is the longest it has been in three decades. People are literally dying while waiting to see specialists and to get surgery. We have the longest wait times in the world, at 25 months, for new life-saving therapies. I do not see any money in the budget for that.
Who writes prescriptions? Doctors do, so if someone does not have a doctor, how are they going to get the prescription from the magical pharmacare bill? The Canadian Life & Health Insurance Association has stated that the bill would spend billions of dollars unnecessarily on drugs for people who already have coverage. Who cares about monetary policy, right? What possible consequences could come from not wanting to balance a budget? There are 27 million Canadians who rely on workplace plans and who would be placed at risk by the legislation. It would create the Canadian—
An hon. member: Monetary policy is not fiscal policy.
Ms. Michelle Ferreri: I love how the Liberals across the way are defending the Prime Minister, who said to the reporter, “Glen, we took on debt so you don't have to”.
An hon. member: No, you just don't know the difference between monetary policy and fiscal policy. They are two different things—
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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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