44th Parl. 1st Sess.
May 6, 2024 11:00AM
- May/6/24 7:03:02 p.m.
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Madam Speaker, I studied the pharmacare system when I served on the Standing Committee on Health. The Liberals did not do anything until they introduced this bill.
The Quebec system has a list of drugs, a formulary, and I think it is the best system in the country. What does the member think about the fact that this bill targets only two drugs for this pharmacare system?
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- May/6/24 7:03:40 p.m.
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Madam Speaker, I thank my colleague for her intelligent question and for recognizing that Quebec's list is working well.
We have a good system, but it could be improved, as I mentioned earlier. That is why we want the money. We are often told by government members that we, the Bloc, see the feds as an ATM and that all we want is our money. Well, it actually is “our” money, since it is our citizens who paid the taxes, so, yes, we want our money in order to provide services to Quebeckers in our areas of jurisdiction.
To finish answering my colleague's question, the list could certainly be improved. We sincerely hope so. My biggest fear, however, is that the federal government will come up with a list that will likely be much worse than Quebec's, because when it comes to social issues, I am sorry, but Quebec is ahead of the curve.
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- May/6/24 7:04:40 p.m.
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Madam Speaker, I like my colleague a lot, but I find it hard to accept that the Bloc Québécois is refusing to listen to the people in Quebec who are in favour of this bill.
The Centrale des syndicats démocratiques, the Confédération des syndicats nationaux, or CSN, the Centrale des syndicats du Québec, or CSQ, and the Fédération des travailleurs et des travailleuses du Québec welcome the introduction of this bill.
Luc Beauregard of the CSQ said:
Quebec's hybrid system, with a public plan and private plans, has not lived up to its promises. We think it should absolutely not be used as a model for the rest of Canada. It is a costly, ineffective and unfair plan.
Quebec's unions say that we must pass this bill. Why is the Bloc Québécois not listening to these voices in Quebec?
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- May/6/24 7:05:35 p.m.
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Madam Speaker, we can quote unions, too. The CSN is on the side of Quebec independence. I do not know if my colleague agrees with them on that point. I am guessing he does not agree with them on everything.
The unions know we are part of Canada for now, and they want more money so their members will be able to pay less for their medication.
When we meet with them and explain that if the federal government gets involved, there will be redundancy, it will cost more, it will be less efficient, and that it would be much better if we had our own money, I think that, at the end of the day, they agree with us.
We obviously place great trust in the members of Quebec's National Assembly, who have sent out a clear message.
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Madam Speaker, it has been interesting to listen to what members have to say about Bill C-64. In some areas, I am not surprised. In other areas, I am surprised. Let me provide a bit of an overview before I get into more detail.
When I think of pharmacare and the potential that pharmacare has for all Canadians, I think that we undervalue and underestimate the degree to which Canadians as a whole would support not only the concept, but also the implementation, of a true pharmacare program. This is not new for me. I have been talking about pharmacare for many years. I have been an advocate for it because I understand and believe in the benefits of a national program.
There is no province or territory in Canada that has absolutely free prescribed medications for its population. Everything depends on the province that one is in. It could be based on age or affordability, but there are all sorts of different variations. There is public sector participation and private sector participation. There is a wide spectrum, a smorg, of different ways that pharmaceuticals are being delivered in Canada. That is the reason I asked the Bloc member to provide more detail of the plan in Quebec. Someone will stand up to says it is free in Quebec, but this bill clearly demonstrates that it is not free.
Many would say that, if we have to pay a deductible or an annual premium, and if things are not in it that should be incorporated, it is not free. I am glad the member said that there is room for improvement. No matter what program we are talking about, there is always room for improvement. I suggest that the way we should be looking at the whole issue of pharmacare is to take a holistic approach to the expectations people have for health care in general.
I have said many times in the past how important health care is to all people in Canada, in all regions of our nation. That has not been lost on the government. The Bloc will say it does not want Ottawa to be involved, other than to hand out money. That particular attitude does not surprise me, and I will add further comments on that in a bit.
What really surprises me is the Conservative Party's approach to health care. It is demonstrated with Bill C-64. People need to be aware of this. At the end of the day, we value and treasure health care here in Canada. The Canada Health Act protects the integrity of the system in all regions. It is one of the reasons the federal government allocates the billions of dollars it does for federal transfer payments.
We have seen a national government and, in particular, a prime minister, our Prime Minister, who has taken a health care initiative, recognizing how important it is to Canadians. We are looking at ways to enhance it, to build a stronger health care system. Nationalized health care or the Canada Health Act are established, and many other countries today that have that form of legislation or that sort of delivery of health care have already incorporated a national pharmacare program.
One does not have to be a Liberal or a New Democrat to see the benefits of it. I used to be the health critic in the province of Manitoba, and I understand just how critical medicine actually is to our health care system.
We can think about it in the sense that, if a person gets sick and goes into a hospital, they receive medications in that emergency setting. I do not believe any province is actually charging for that. This is virtually universal now across Canada. It might be because of an ulcer issue, some sort of a bleed or any other need that might be there. If a person has to stay in a hospital facility for however long a time, the hospital staff does not say, “Well, here's a bandage. By the way, you're going to have to pay for that.” Or for medication, maybe a painkiller, they do not put out their hand, saying, “We want money before we inject the painkiller.”
However, the moment that person leaves the hospital, then it changes. This may not happen in every province, as some provinces might cover prescribed medications more than others, some might not charge as much, some will have a deductible and, as I said, some will have those annual premiums. What happens, generally speaking, is that the individual leaves the hospital and finds that now they are going to have to start paying for the medications.
I cannot tell members how many 55-plus facilities, personal care facilities or independent living facilities I have been to where they talk about the cost of medications, with diabetes being one of them. They will tell us, “Look, we cannot afford the medication.” As a result, I would suggest that there are many people who end up going back to hospitals because they are not getting the medications they require. This is because of decisions they have actually had to make in terms of buying and purchasing the medication versus food or possibly rent, or the amount of medications that are required and the bill that is associated with that. Those are the types of things that end up costing communities, society and the taxpayer a whole lot more when that individual ends up returning to the hospital because they were not taking the medications that were necessary in order to keep them out of the hospital facility.
The problem with the debate on the pharmacare issue is that I would have liked to hear more about, collectively as a House, seeing the value of this and that we want to move forward. This is what Bill 64 is doing; it is moving us forward on a very important issue. I would rather have seen everyone coming to an agreement that, yes, this is good stuff, we should be supporting it, and then adding value to that.
I think of Cardine, whom I met at a local restaurant on a Saturday. She was talking about the issue of the shingles vaccination and how this is something people should not necessarily have to pay for. I raised that with some of my colleagues.
An hon. member: Oh, oh!
Mr. Kevin Lamoureux: Madam Speaker, I know it is not on the list. At the end of the day, some provinces, from what I understand, provide coverage for shingles vaccination for those 55 and over, or maybe 60 and over, whereas some provinces do not. However, I was suggesting, by bringing it up, that this is the type of discussion I would like to hear more about, but not in terms of how we keep Ottawa away from the issue of pharmacare or developing a national program. I do not think that is what our constituents want to hear. I believe they want to see consistency, where they can, in the different regions of our country.
I have presented many petitions in the House on the issue of pharmacare. I have consulted and talked about pharmacare at the door for years. I understand who has what kind of responsibility in health. As I said, I was a health care critic in the province of Manitoba.
However, I do not understand denying the opportunity for a federal government to participate in providing contraceptives or diabetes medications. I do not understand how opposition parties could oppose that, no matter what province they are from. Tell me a province, and I say that to all members, that provides any form of support for contraceptives today. I am not aware of any, but I could be wrong on that.
How could anyone say that the legislation would not be of benefit for all Canadians? It is a major part of the legislation. When we think of diabetes, we are not talking about a few hundred or a few thousand Canadians; we are talking about hundreds of thousands of Canadians who would be affected by Bill C-64.
What are opposition members afraid of? If they were truly listening to what people are saying in their communities, I would suggest that they should talk more about the issue of health care. I talk a great deal about health care in my riding. I understand why it is so important.
An hon. member: It's provincial.
Mr. Kevin Lamoureux: Madam Speaker, a Conservative heckles across the way, and she is consistent with other Conservative members who say it is a provincial responsibility. That is the attitude. We can remember, at the beginning, I said that the Bloc does not surprise me. I understand why Bloc members do not support it. It is a separatist party. It would just as soon Ottawa hand over the money, then Quebec would take the money and develop the programming.
In contrast, the Conservative Party thinks it is a provincial responsibility. People need to be aware, because it is the same as the member's off-the-cuff heckle. I would suggest that it is not just a provincial responsibility. If the member truly understood the Canada Health Act and, more importantly, her constituents, she would quickly realize that it is not just a provincial responsibility.
Even when I was in the Manitoba legislature, I argued and articulated that health care is not solely the responsibility of the Province of Manitoba. I like to think that, at the end of the day, all provinces have a responsibility to follow the Canada Health Act. When I talk to people about the pharmacare program and Bill C-64, it is a positive discussion. I have yet to hear anyone, outside the Conservative Party, tell me that Ottawa moving forward with respect to a national pharmacare program is a bad thing. I cannot recall anyone saying that we should not be doing this.
That might precipitate a few emails to me, but at the end of the day, I believe it is because people truly appreciate and understand the value.
That is why I said before the interruptions that one has to take a holistic approach to health care. Let us look at what has happened since 2015, when a new Prime Minister was elected and the agenda of health care started to change in a very positive way. It was not that long ago, and I referred to this earlier, that we actually had the Prime Minister in Winnipeg at a press conference at the Grace Hospital. My colleague would be very familiar with the Grace Hospital. At the end of the day, we had the premier of the province, the provincial minister of health, the Prime Minister and the federal Minister of Health. We talked about the future of health care and how the $198 billion over 10 years would have a positive impact not only for today but for tomorrow, thinking of generations ahead. We talked about how it would impact the province of Manitoba.
Let us think about the number of agreements that have been achieved by the government with the different provinces and territories and indigenous community leaders, all dealing directly or indirectly with the well-being and health of people. Something that was missing previously was the type of financial commitment, along with the sense of co-operation. Then we look at the type of national programs that we would bring in, which would make a difference.
People talk about the dental program as an example. Having a dental program ultimately helped literally thousands of children over the last year, including children who would not have been able to see a dentist or get some of the dental work that they received as a direct result of a national program. There are actually children in the province of Manitoba who end up going to emergency departments because their dental work has been neglected. Moving forward with a dental program is a good thing.
We just came out with the national food program, where we are delivering more nutritious food for children throughout the country. Hundreds of thousands of children will actually benefit from the program.
That is why I said that health care is a lot more than just a hospital facility. People need to look at everything from independent living and community living to what takes place in our schools. They need to think in terms of the medications; the bill is about getting people talking about medications and the important role they play in health care. Along with that, I would suggest that there is a general attitude that says we are committed to the Canada Health Act and to making sure that we continue to provide the type of progressive programs that would complement the health and well-being of Canadians. That is the way I see Bill C-64. It complements the Canada Health Act, and people should not fear it. They should accept it and look at ways in which we can improve upon it.
We often hear about the issue of bulk buying, as an example, and the hundreds of millions of dollars that have been saved in that area. I would suggest that we could do even more. I look forward to seeing the ongoing debate on this very important issue. I would hope that my Conservative friends, in particular, would revisit their positioning with the idea of getting behind the legislation and voting in favour of it.
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- May/6/24 7:29:14 p.m.
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Madam Speaker, let us take things down a notch by asking a fundamental question. I have a two-pronged question for the parliamentary secretary.
First, does my colleague think that the child care program is a good program? Does he think that it works well across Canada?
Second, does he not think that the pharmacare program could work just as well, if the federal government would respect Quebec and its jurisdictions for once and give the Government of Quebec the money that belongs to Quebeckers? That would not cost the rest of Canada anything. This is just a matter of respecting the systems that are already in place and those who blazed the trail.
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- May/6/24 7:30:04 p.m.
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Madam Speaker, I think the Province of Saskatchewan led the way, which encouraged Ottawa to ultimately come up with the Canada Health Act, and today Canadians have a fantastic health care system. Sure, there are some imperfections there, but at least we have a quality national health care program.
The Province of Quebec had a wonderful child care program. Ottawa was able to look at the Quebec example and establish a national child care program that all provinces have signed on board with, thereby ensuring that we have a strong, healthy national health care program. I think Ottawa is in a good position to be able to deliver for Canadians in all regions of the country and I would hope we would get participation. I would encourage the provinces to look at ways we can continue to work together in certain areas to ensure that we have healthier communities.
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- May/6/24 7:32:18 p.m.
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Mr. Speaker, whether it be the Prime Minister, members of cabinet or members of Parliament within the Liberal ranks, I think that we all have been very strong advocates on that particular point. I would suggest to the member that there is potential. As I cited, Saskatchewan played a very important role in regard to health care. Quebec played a very important role in regard to child care. I would love to see Manitoba play an important role on the further development of a pharmacare program that would be something that we could share with different provinces. I believe the best way we can deliver the best type of pharmacare program would be to have different levels of government working together for the betterment of Canadians.
I am an optimist. I am going to hold out and believe that the Province of Manitoba and others will seriously look at ways to make the program more successful.
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- May/6/24 7:59:47 p.m.
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Mr. Speaker, the member for Châteauguay—Lacolle just asked my colleague who just spoke a question saying that they do not live in the same world. The member for Châteauguay—Lacolle also lives in a world where the National Assembly unanimously voted for a first resolution, then a second, and then a third.
For years, we have been calling for Quebec to have the right to opt out with full financial compensation when Ottawa institutes new spending programs in the jurisdictions of the provinces and Quebec. She supposedly lives in that world, but it does not seem like it because across the way, in their alternative world, the federal government is supposed to be able to manage a hospital, which it has never been able to do properly.
I have the following question for my Conservative colleague. Perhaps the Conservatives will form the government some day; it is hard to say. When that happens, will they agree with the concept and principle of a right to opt out with full financial compensation for Quebec when the federal government institutes programs in the jurisdictions of the provinces and Quebec?
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- May/6/24 8:20:11 p.m.
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Mr. Speaker, by now, Canadians are used to broken promises from the Liberals. In 2015, members will remember that they were going to make housing affordable, and now housing prices, mortgages and rents have doubled. They also promised the last election under first-past-the-post, but maybe not.
However, on pharmacare, I think maybe Canadians need a history lesson because the Liberals have been promising to do pharmacare since 1992, and they have never done it. The bill before us is also not pharmacare. It is a plan to get a plan to maybe do pharmacare. It is not going to be national. Quebec has already said that it is not going to participate.
Could the member just admit that this is an attempt to pacify the NDP to make sure that it does not pull its support and trigger an election?
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- May/6/24 8:33:46 p.m.
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Mr. Speaker, let us bring a little bit of cheer to all this by asking questions about the content.
I would like the member to tell me whether he thinks that the child care program is working well in Quebec and the rest of Canada. We know that the federal government recognized Quebec's jurisdiction and its right to opt out of that program with full compensation.
Does my colleague not believe that the pharmacare program could also work just as well if the federal government were to respect Quebec's expertise and jurisdiction by simply transferring the money?
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- May/6/24 8:34:20 p.m.
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Mr. Speaker, I thank my colleague for his question. It is true that Quebec is a leader in Canada in many areas, including women's rights and reproduction.
It is important to recognize when a province or territory is a leader or ahead of its time when it comes to important, progressive issues. The federal government must consider all of its options to create a level playing field.
To level the playing field, it is important that we find ways to ensure that great ideas in provinces such as Quebec, Manitoba or British Columbia are shared by all Canadians.
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- May/6/24 8:50:34 p.m.
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Mr. Speaker, one issue seems fundamental to me in this context. The Government of Canada and the rest of Canada want pharmacare. That is fine for them, but it goes against the spirit of the Constitution.
I would be curious to hear my colleague's thoughts. Quebec already has a pharmacare system. Would she agree that Quebec should have the right to opt out with full compensation?
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- May/6/24 8:51:07 p.m.
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Mr. Speaker, the federal government is responsible and obliged to uphold national standards. We know that Quebec is ahead of the game on a number of issues. I will give the hon. member a couple of examples. On child care, Quebec is decades ahead, as well as on social programs, certainly.
Absolutely, when we are talking about provinces, the federal government is obliged to provide provinces with what they need to be able to offer these services.
I would, however, give a caveat to New Brunswick. In New Brunswick, currently, women cannot access an abortion. There need to be guidelines, in terms of public health transfers, if provinces are not upholding what the Liberal government has called the human right to access safe, trauma-informed abortion care.
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- May/6/24 9:05:42 p.m.
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Mr. Speaker, my question is simple. Does my colleague think that the pharmacare system they want to put in place will be ineffective if the government gives Quebec the right to opt out with full compensation?
What is that going to change given group purchasing is already happening? The group purchasing argument no longer holds water. There is no other argument.
Why not respect Quebec's will? The member does not live that far away. He must have some understanding of Quebeckers. I would like to have a nice honest answer to that.
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- May/6/24 9:06:24 p.m.
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Mr. Speaker, I will suggest to the member that this is an incredible opportunity for us, as a federal government, to work closely with provinces and territories. We have much to learn from Quebec. The member for Winnipeg Centre mentioned a few things earlier in her debate. Quebec has been a pioneer and a leader, whether it is pharmacare or child care. We have an opportunity to work with each other, to learn from each other and to replicate the models that work best for all Canadians.
Our federation works best when all orders of government, in this case, federal and provincial governments like that of Quebec, are working together to find solutions for all Canadians, whether they live in Quebec or elsewhere.
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- May/6/24 9:20:34 p.m.
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Mr. Speaker, we are supposed to be studying a bill on pharmacare, yet we have addressed every issue under the sun since the evening began. We even debated abortion, in terms of who is for it or against it.
I keep asking the same question over and over, but I get no answer from the Conservatives. If it ever comes to power some day, will the Conservative Party support Quebec's right to opt out with full financial compensation when Ottawa creates programs in areas under Quebec's jurisdiction, yes or no?
Yes or no, do the Conservatives support the right to opt out with full financial compensation?
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- May/6/24 9:21:21 p.m.
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Mr. Speaker, I thank my colleague from the Standing Committee on Industry and Technology for his question.
If a Conservative government is elected, I would like Quebec to keep its jurisdictions, just as I would like British Columbia to keep its jurisdictions. The Conservative Party wants open federalism that respects the jurisdictions of Quebec and British Columbia.
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- May/6/24 9:33:08 p.m.
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Madam Speaker, my colleagues and I have been saying the same thing from day one: We are in favour of pharmacare for all Canadians. We think it is a good idea and it is high time for Canada to consider it. However, we have said and keep saying that this is a provincial jurisdiction.
If the other provinces want to have a federal program, then they can fill their boots. We know that the Constitution says that this is a jurisdiction of Quebec. Quebec already has its system. Why not leave us with our system? Let the government give us our share. We will keep making group purchases and everything will be fantastic in the best of all possible worlds.
Where is the problem?
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- May/6/24 9:34:08 p.m.
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Madam Speaker, I agree with the fact that everything we do as a federal government has to be done in collaboration with the provinces and territories. We must communicate with Quebec, we must learn from Quebec and will continue to collaborate. It is not something we are going to do alone. We cannot. The provinces cannot do it alone either. We need to work together.
I thank the Bloc for everything they contribute to the House.
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