44th Parl. 1st Sess.
May 30, 2024 10:00AM
Madam Speaker, I am thankful for the opportunity to speak to a very important piece of legislation, Bill C-64, which deals with pharmacare and develops a framework for it. This bill, along with other investments made by our government, would help millions of Canadians who are struggling to pay for their prescription drugs. We had a very healthy process at HESA, the Standing Committee on Health. I want to thank all witnesses who appeared before the committee and those who sent written testimony because it really helped us understand the positive impact of this legislation.
This bill is a priority for our government. It establishes the fundamental principles for implementing a national pharmacare program in Canada. It also sets out our plan to work with the provinces and territories who so desire to propose universal single-payer coverage for a certain number of contraceptives and diabetes medications.
Since this bill was introduced, we have heard many facts about access to and affordability of prescription drugs within Canada. Statistics Canada's data from 2021 indicates that one in five Canadians has reported not having enough insurance to cover the cost of prescription medication in the previous 12 months. We know that having no prescription insurance coverage is associated with higher non-adherence to prescriptions because of cost. We also know that this results in some Canadians having to choose between paying for these medications and paying for other basic necessities, like food and housing.
This is why our government has consistently made commitments toward national pharmacare. Bill C-64 recognizes the critical importance of working with provinces and territories, which are responsible for the administration of health care. It also outlines our intent to work with these partners to provide 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 for 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 would like to highlight the potential impact that these two drug classes, for which we are seeking to provide coverage under this legislation, would have on Canadians.
We have heard stories of people, or know someone, in our constituencies struggling to access diabetes medication or supplies due to a lack of insurance coverage through their work, or of an individual who has limited insurance coverage so they cannot choose the form of contraception that is best suited for them. For example, for a part-time uninsured worker who has type 1 diabetes and is also of reproductive age to manage her diabetes, it would cost up to $18,000 per year, leaving her unable to afford the $500 upfront cost of her preferred method of contraception, a hormonal IUD. With the introduction of this legislation, this individual would save money on costs associated with managing her diabetes and would be able to access a hormonal IUD at no cost, with no out-of-pocket expenses, once the legislation is implemented in her province.
Studies have demonstrated that publicly funded, no-cost universal contraception can result in public cost savings. Evidence from the University of British Columbia has estimated that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. Since April 1, 2023, British Columbia is the only province in Canada to provide universal free contraceptives to all residents under the B.C. pharmacare program. In the first eight months of this program, more than 188,000 people received free contraceptives.
The same cost-cutting principle applies to diabetes medication.
Diabetes is one of the most widespread chronic diseases in Canada. Although there is no cure for diabetes, there are treatments to manage the disease.
One in four Canadians with diabetes has reported not following a treatment plan due to cost. Improving access to diabetes medications would help improve the health of some of the 3.7 million Canadians living with diabetes and would reduce the risk of serious life-changing health complications such as blindness and amputations. Beyond helping people with managing their diabetes and living healthier lives, if left untreated or poorly managed, diabetes can lead to high and unnecessary costs on the health care system due to its complications, including heart attacks, strokes and kidney failure. The full cost of diabetes to the health care system could exceed almost $40 billion by 2028, as estimated by Diabetes Canada.
The bill demonstrates the Government of Canada's commitment to consulting widely on the way forward and working with provinces, territories, indigenous peoples and other partners and stakeholders, including other political parties, to improve the accessibility, affordability and appropriate use of pharmaceutical products by reducing financial barriers and contributing to physical and mental health and well-being.
Beyond our recent work on Bill C-64, I would like to highlight some of the ongoing initiatives that this government has put in place to support our efforts toward national pharmacare.
On a national level, our government 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. As part of the overall $1.5-billion investment, our government will make available up to $1.4 billion over three years to willing provinces and territories through bilateral agreements.
The strategy marks the beginning of a national approach to meeting the need for drugs used to treat rare diseases.
This funding would help provinces and territories improve access to new and emerging drugs for Canadians with rare diseases and would support enhanced access to existing drugs, early diagnosis and screening for rare diseases.
I would also like to highlight another initiative under way, which involves the excellent work by Prince Edward Island through a $35-million federal investment. Under this initiative, P.E.I. is working to improve affordable access to prescription drugs, while at the same time informing the advancement of national universal pharmacare. The work accomplished by P.E.I. has been remarkable. Since December of last year, P.E.I. has expanded access to over 100 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 five dollars for almost 60% of medications regularly used by island residents. I am pleased to share that through this initiative, P.E.I. residents have saved over $2.8 million in out-of-pocket costs as of March of this year.
Finally, on December 18, 2023, the Government of Canada announced the creation of Canada's drug agency, the CDA, with an investment of over $89.5 million over five years, starting in 2024-25. The CDA will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future, helping Canadians achieve better health outcomes. I am pleased to share that as of May 1, Canada's drug agency has officially launched.
In closing, members can see the extraordinary amount of hard work that has been dedicated to national pharmacare.
Bill C‑64 is a major step forward in our commitment to guaranteeing affordable, quality drugs for all Canadians. Our universal coverage plan for contraceptives and diabetes drugs will change the lives of individuals, families, society and our health care system.
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Madam Speaker, I want to thank the hon. member opposite for his advocacy on rare diseases and drug coverage. I have heard him speak before quite convincingly, and I thank him for the hard work he is doing.
The member is absolutely right. We have allocated $1.5 billion over three years, but that delivery will come through provinces and territories. We are doing the hard work to engage in bilateral agreements with provinces and territories so that we can flow that money through provinces and cover the cost of medication through bilateral agreements for rare diseases. That work is ongoing.
The work that we are doing through Bill C-64 on pharmacare is an add-on to that work. It complements the work that we are doing on rare diseases, and I look forward to continuing to work with the member opposite on this very important issue.
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- May/30/24 6:57:34 p.m.
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Madam Speaker, the truth is that the Conservatives do not support a pharmacare program. They do not support a Canadian dental care plan. They are throwing up all kinds of obstacles and denying the existence even of a Canadian dental care plan because they do not support that kind of really important help.
In fact, ideologically, they are motivated by private health care. If they have their way, that is what they will be championing, but on this side of the House, in this government, we strongly believe in a universal, single-payer system of health care and making sure that the most vulnerable in our communities get the care they need. That is why the Canadian dental care plan is such a success just in three weeks. The numbers cited by the member opposite are absolutely correct, and we will see more seniors and young people getting that health care because oral health is health.
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- May/30/24 6:59:10 p.m.
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Madam Speaker, the member and I share an experience. We have both served in the provincial legislatures in our respective provinces, Manitoba for him and Ontario for me. We know that one of the biggest responsibilities provinces have is the delivery of health care. That is why it is imperative that the federal government work with provinces and territories in delivering these programs. That is what this pharmacare framework legislation is all about. I am very much looking forward to entering into those bilateral agreements with provinces and territories once this bill is passed into law.
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Mr. Speaker, I think throughout the debate on Bill C-64, whether at second reading stage or at committee, we have seen nothing but fearmongering on the part of the Conservatives, for a simple reason: They do not support the bill. They do not want Canadians to have pharmacare. In fact, they support a private health care system. That is why they have chosen every which way to put up blockades against the bill by inventing stuff. We heard the member opposite, the health critic for the official opposition, throughout the committee process make things up while witnesses kept telling him that was not the case. He is still repeating the same mistruths.
I want to ask the member, who gave an excellent speech, this: How does he feel the legislation, if passed by Parliament, would help his constituents get the medications they so deserve and need?
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- May/30/24 8:58:52 p.m.
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Mr. Speaker, I respect the member opposite a lot. I listened to his speech quite diligently, and I am a bit perplexed because, on one hand, he spoke about and advocated for private health care insurance. He talked about how Canadians should just get private insurance for medicine if they do not have any, but then he went on to talk about affordability and the high use of food banks.
I hope the member can explain to all of us how he wants to ensure affordable fees against a pharmacare system that is going to save hundreds of dollars for Canadians who do not have private health care insurance so that they can afford to buy good, nutritious food for themselves. I would love to hear that explanation.
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- May/30/24 9:14:13 p.m.
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Mr. Speaker, I have a lot of admiration for the member for St. John's East. I always listen quite attentively when she is speaking because she brings a wealth of knowledge and experience as a registered nurse, and now in her role as the chair of the national seniors caucus.
I know she spends a lot of time talking to seniors. I would like to know what she is hearing from seniors across our country around the Canadian dental care plan, as it has helped over 120,000 seniors in just three weeks. What is she hearing from seniors in terms of pharmacare, like access to diabetes medications at no cost?
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- May/30/24 9:46:49 p.m.
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Mr. Speaker, just like the hon. member, I also ran on pharmacare, both when I was a provincial member in Ontario and federally.
I am really excited to see that our government party is working closely with the NDP to make this a reality for millions of Canadians. During this process, especially through the committee, we heard a lot of fearmongering from the Conservatives, especially when it comes to private health care, that somehow this pharmacare would take away primary health care. That was not the case in the Ontario experience.
Could the member for Victoria respond to the fearmongering that the Conservatives have been raising about the state of people's private health care when we pass pharmacare through this legislation?
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- May/30/24 10:35:03 p.m.
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Mr. Speaker, I appreciate being recognized again.
It is a great honour for me to work with the hon. member for Thunder Bay—Rainy River on the HESA committee. Given his medical and legal background, I find him quite beneficial to me for my understanding of a lot of health care issues.
One of the things we heard a lot about at committee is the impact of this framework legislation on private health insurance. There was a lot of fearmongering on the Conservatives' part that somehow it would disappear.
Could the hon. member for Thunder Bay—Rainy River comment and give us his views on what impact this bill would have on private health insurance?
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- May/30/24 11:03:39 p.m.
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Mr. Speaker, I know that the member for Davenport has been a long-time supporter of pharmacare, and just like me, she has campaigned on this. Can she tell me the impact that this legislation would have on her community?
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- May/31/24 12:41:46 a.m.
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Mr. Speaker, first of all, let me wish you a happy birthday. I am sure you will get some quality time with your family.
We remain deeply concerned about the overdose crisis and its impact on individuals, friends, families and communities across the country. In fact, Canadians are concerned about the crisis. Every loss of life is tragic. It is not a partisan issue; it is a health care issue. There is no one-size-fits-all solution to the crisis. A complex health and social issue requires a multi-faceted response. This is why we continue to support provinces and territories to build up their health services so they are available when people need them.
Building on significant investments made in the full continuum of services to address the crisis since 2017, as well as significant increases in health funding for provinces and territories, budget 2024 announced $150 million over three years to support municipalities and indigenous communities to rapidly access funds to mobilize efforts and address their urgent needs to save lives now.
The overdose crisis is bigger than any one government or organization. It will take the collective efforts of everyone, including provinces, territories, indigenous leaders, professional and regulatory bodies and health care providers, to stop the needless harm and deaths of Canadians and address the many other costs of substance abuse.
Substance use and addiction are health issues and not criminal ones, as I said earlier. People need care, not jail. Our government has been committed to various approaches that divert people who use drugs from the criminal justice system to appropriate health and social services whenever possible. For example, in August 2020, the Public Prosecution Service of Canada issued guidelines directing that alternatives to prosecution should be considered for personal possession offences, except when there are serious aggravating circumstances.
In addition, as of November 2022, police and prosecutors are legally required to consider alternatives to laying charges or prosecuting individuals for drug possession, such as diversion to treatment, a warning or taking no further action. This means that individuals can avoid being criminalized and can get the help they need to address underlying issues, recognizing that substance use is primarily a health and social issue.
We have also invested in prevention. Youth are more vulnerable to substance-related harm and are more likely than adults to engage in risk-taking behaviours, such as substance use, for a variety of reasons, including the stage in brain development and need for social inclusion. Further, earlier and more frequent exposure to substance use is leading to greater risk of harm.
Through budget 2023, we committed $20.2 million for a new youth substance-use prevention program to support communities across Canada to build capacity to implement and adapt the Icelandic Prevention Model to Canada. This internationally recognized model focuses on building strong and healthy communities, instead of targeting individual behaviour. It has been shown to be effective in decreasing long-term substance use among youth.
In conclusion, we are committed to continuing to work to find solutions to this ever-evolving crisis. This will require having youth try innovative actions, monitoring them closely and following the data in order to find what works. We cannot arrest our way out of the crisis. Our response needs to be compassionate and grounded in prevention, harm reduction, treatment, recovery and, of course, enforcement.
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- May/31/24 12:46:37 a.m.
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Mr. Speaker, all of us want to save lives, but what will not save lives is a bunch of slogans, and that is the only thing we keep hearing from Conservatives. We are very much open to new ideas that are going to help people suffering from mental health, substance abuse and addiction challenges. We are not the only ones around the globe who are facing the crisis. All of us are working hard to find solutions. Just yesterday I had a conversation with former senator Vern White on precisely this issue, to look at ways we can ensure that those Canadians among us who are suffering from substance abuse can get the care they need. That will require trying different things to find the perfect way forward.
I can assure members that what is not going to help is a bunch of slogans. We need to address the issue as a health care issue and show the care and the compassion that Canadians deserve so that we can save Canadian lives.
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