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Mr. Taylor Bachrach (Skeena—Bulkley Valley, NDP)

Jun/3/24 4:12:24 p.m.
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Madam Speaker, the member for Kingston and the Islands in his speech observed a unique Conservative critique that we have heard emerge. The Conservatives criticize policies as not being good enough, and then they vote against them entirely. If pharmacare is not perfect, the answer, in their minds, is no pharmacare whatsoever. If dental care excludes some Canadians, instead of amending or improving it, the answer is no dental care unless someone has private coverage. If Canada ranks 62nd out of 67 countries on climate change, then the answer is somehow to have no climate plan. What does the member make of this unique logic?

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Pharmacare

Mr. Mark Gerretsen

Jun/3/24 4:13:10 p.m.
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Madam Speaker, I am glad that when I said that, the message got across. I was not exactly sure how to phrase it, but it is exactly what the member is saying. That is what we are seeing. The member for Battle River—Crowfoot said, in his 20-minute speech, that the system would not be a good one because it would not be for these people or those people, and that therefore we need no system. Conservatives do the same thing on just about every issue. I do not know why they are doing this. I wanted to ask the member for Battle River—Crowfoot, if he does not like the proposed pharmacare plan, to tell us about his pharmacare plan, because we know they do not have one. I just find it incredibly rich to continually hear Conservatives get up to talk down programs, almost implying that they would bring along an even better program. However, I think there is nobody in this room, and no Canadian who looks at this stuff objectively, who would think that Conservatives would be interested in a pharmacare plan, because we know they would not be.

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Mrs. Brenda Shanahan (Châteauguay—Lacolle, Lib.)

Jun/3/24 4:14:19 p.m.
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Madam Speaker, my colleague talked about the fact that the program would be addressing two main elements, contraceptives and diabetes. I am thinking from the affordability angle and would like to hear his comments on that. We know when people are all of a sudden confronted with a huge expense or an unexpected, long-term expense what that can do to their budget. I would like to hear him comment on how the pharmacare program would help.

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Mr. Mark Gerretsen

Jun/3/24 4:14:58 p.m.
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Madam Speaker, the affordability aspect of it, I think, is really important. I do not think it really matters what one's economic background or economic status is, but if any Canadian were to go into a hospital and receive a bill afterward, any of us would be taken aback by that just because of the concept. I have friends who live in the United States. One gave birth recently and received a bill for $26,000. It is absolutely insane. The same logic has to apply to the medications we need. It is not even just about helping people with the costs; it is also about the investment. If we help people take care of themselves now, we are not going to have to pay as much when they end up in the hospital because they were not able to afford the medications they were prescribed. What the bill is really about, and what I tried to emphasize in my speech, is that there are varying levels of affordability right now. Some people, 20% or so, have absolutely no coverage. Some people have the platinum level of coverage where they do not have to pay anything. Then there is everybody else in between. Some people pay 60%, and some people pay 40%, 20%,10% or whatever it is depending on who is covering them. At the end of the day, in my opinion, the coverage needs to be universal, just like the coverage is universal when it comes to receiving health care from a physician or in a hospital.

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Mr. Kelly McCauley (Edmonton West, CPC)

Jun/3/24 4:16:37 p.m.
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Madam Speaker, normally we see a lot of fireworks back and forth from the member to our side, and we did not see that in this speech, which is appreciated. I have a straightforward question. I think it was brought up by my colleague from the Bloc. Health care is provincial jurisdiction. The provinces are mostly covering a lot of things for low-income people or those who are not covered. Alberta does the same for the items that are in the bill for birth control and diabetes. The question is this: Because the provinces are already doing that, why not just fund the provinces to allow them to expand their programs rather than creating a duplicate process federally?

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Mr. Mark Gerretsen

Jun/3/24 4:17:27 p.m.
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Madam Speaker, first of all, on the member's comment, I apologize if I was not on my game and did not give him the fiery speech he was expecting, I will work on that for next time. All I will say is that is a great suggestion. I am sure there is a really good answer to it and that committee could get down to it. I will say to the member that it is the first real question I have heard from that side that I have actually had to reflect on. I do not mind saying that maybe he has a good point. Let us have a debate on that rather than having a debate on the false narratives that are going on. I know the members of the Bloc would say that they asked me the same thing, but the point is this: I believe that it is just like health care as it relates to physician care or hospital care, which is something that is established by the federal government and the actual implementation is done by the provinces. Can universal pharmacare get to that place and what the member is suggesting? Yes, it might be the case that one day that is where we can get to, but the standard has to be the same across the entire country. That is the really important thing and what I fear might be lacking if we allowed what he suggested to happen.

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Mr. Kelly McCauley (Edmonton West, CPC)

Jun/3/24 4:18:57 p.m.
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Re: Bill C-64

Madam Speaker, I will be sharing my time with my colleague from Saskatoon West, or as we fondly know him, the member from Saskatoon West Edmonton Mall. I rise on Bill C-64, which is officially called an act respecting pharmacare. I have two other names for it. One is the proper Liberal name of the bill, which is “fake news to satisfy the gullible NDP caucus act,” and then the longer title is the NDP “I hope no one notices we said we would force an election unless we got a comprehensive and entirely public pharmacare program but sold out for little act.” I am being a bit sarcastic here, but this is the truth. The government has repeatedly stood in the House and said it is extensive pharmacare, but it is not. It is two items. The NDP members have constantly stood up with their colleagues across the way in the senior partnership, or the radical wing of the NDP, and said it is comprehensive pharmacare that is single pay. Despite what they would have one believe, it would just cover two items. It does potentially cover diabetes drugs and birth control, but we do not know the details. What it would not do is cover the chronic diseases Canadians are suffering from most. The top ones are hypertension, osteoarthritis, mood and anxiety disorders, osteoporosis, asthma, obstructive pulmonary disease, ischemic heart disease, cancer, dementia and, rounding out the top list, diabetes. Only one item would be covered out of the major chronic issues that are diseases or afflictions hurting Canadians. Where is the coverage for those? It is nowhere to be found, which is why the government and other people in the House should not be calling it a pharmacare act. The Liberals can name it a potential pharmacare act down the road, but they should not be misleading Canadians into believing that this is a pharmacare act. I asked where the coverage was for hypertension. Eight million Canadians suffer from this. Four million Canadians have osteoarthritis, two million have osteoporosis, and four million are suffering from asthma. How many of them would be covered by this so-called pharmacare act? The answer is zero. Two million Canadians are suffering from obstructive pulmonary disease. Not one would be covered. On ischemic heart disease, 2.4 million Canadians are suffering from this. Not one would be covered under this plan. Forty per cent of Canadians will be diagnosed with cancer in their lifetime, with 250,000 new cases every year. Not one would be covered under this so-called pharmacare act. For dementia, 750,000 people are affected, and not one would be covered. Where is the coverage? I want to get back to my admittedly snarky comments about the NDP. I want to quote the National Post, which reads, “NDP members drew a line in the sand by passing an emergency resolution at their policy convention in Hamilton...that says the party should withdraw its support if the Liberals do not commit to ‘a universal, comprehensive and entirely public pharmacare program.’” If one looks up the word “comprehensive”, the definition is, “complete, including all or nearly all aspects of something”. Is this all or nearly all aspects of pharmaceuticals? No, of course it is not. Anne McGrath, the New Democratic Party's national director, “said getting a bill that has teeth will be her party's biggest priority as parliamentarians return to the House of Commons”. Canada has about 9,000 approved pharmaceutical drugs. The bill would cover maybe 200, so where are the other 8,800? Anne McGrath further stated, “Weak legislation is not going to be acceptable to New Democrats”. Maybe 200 for diabetes and birth control out of 9,000 seems to be acceptable. She said, “It has to be strong. It has to have teeth. And I feel like that resolution gave [the NDP leader] and the caucus a lot of bargaining power. It gives them a lot of strength.” I wonder when my colleagues in the NDP are going to be withdrawing their support. They probably will not. One issue I brought up in an earlier question is that a large majority of Canadians are covered, but some are slipping through the cracks. Some are not covered, and some are only partially covered, but they are covered by the province. Alberta, for example, covers most of the items brought up. Essentially, B.C., Quebec and Ontario do as well. Pretty much every province, except one or two in Atlantic Canada, covers diabetes or birth control for low-income Canadians. However, they are not covering the other items of importance, such as hypertension and some of the others. The initial phase of this is going to cost about a billion and a half dollars. That money could be better used, by either giving it to the provinces for rounding out the services or, better yet, focusing on Canadians afflicted with rare diseases. A couple of families came to my office. Their young children were suffering from SMA, spinal muscular atrophy. It is a horrible disease. Generally, it is a death sentence by the time the child is two years of age. At about the time the children of these two families in Edmonton were diagnosed, a new drug had come out; it is called Spinraza. I have to give points to the pharmaceutical companies for how they come up with these names. Spinraza does not cure the disease, but it extends life to about 18 years old. Children would not have a great quality of life, but they could live to their late teens. When Spinraza came on the market, Rachel Notley's NDP was in power in Alberta. We went to the local MLAs in the NDP to see if we could speed up coverage for the drug in Alberta; however, the NDP refused to look at this. The same NDP that says it is a line in the sand that it will force an election over refused to help this family. When the provincial United Conservatives were elected, Tyler Shandro was the health minister. He was much maligned, and I am sure a lot of it was probably deserved. However, he managed to get Spinraza approved for the family within two weeks. It is a very expensive drug. Along came a better drug called Zolgensma. I truly believe it is a miracle drug. With Spinraza, children would spend about a month a year in intensive care, getting spinal taps and everything, for their treatment. Instead of that, Zolgensma is one shot in the arm. It seeks out the bad gene and copy-pastes the good gene over, basically stopping the disease in its track and giving the children a chance at a strong life. It would be about $45 million a year to treat everyone afflicted with this, everyone born every year in Canada. This is where the government should spend this money. It should focus on that. It should not be spending money to replace programs that already exist. About 60% of Canadians have a program delivered through work. Instead of subsidizing that 60%, it should look after people like this in need. These two families had to fundraise for this drug. Ryan Reynolds, who was in Deadpool, helped fundraise for these two families. Luckily enough, a corporate benefactor came through and provided for everyone in Canada. This is an example where that billion and a half dollars could be better spent. Another couple in my riding had a child suffering from PKU, which is a rare inherited disorder. It causes a buildup in amino acid in the body and prevents it from metabolizing protein. Children cannot have protein. It costs $5,000 a month out-of-pocket. The government should look after covering this. Twenty-seven million Canadians already have coverage through work. This Liberal single-payer plan is going to subsidize either the companies that are already paying for this or big pharma. It is funny that big pharma just got an extra tax for too much profit through the Liberal government, a temporary Canada recovery dividend to attack big pharma, which it is now going to subsidize. It could also subsidize companies directly, including Loblaws. At the same time as it is demonizing Loblaws in the House, it will end up subsidizing it. Therefore, I do not support the act as it is. There are better ways to do it than the way the Liberals and NDP are doing it.

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Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

Jun/3/24 4:29:02 p.m.
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Madam Speaker, I disagree with the member across the way, and the Conservative Party's approach in general, in terms of dealing with the issue of pharmacare. The member seems to be saying that we have all these medications that are out there and asking why we are limiting pharmacare to two. The short answer is that this is a very significant first step, and there is a substantial cost to it. The bill would ensure that we do not get a varying patchwork wherein the province in which one happens to live determines what kind of a fee one would actually be paying. We have literally 100-plus different types of plans out there, including public and private; I would suggest there might even be some non-profit stuff out there. Does the member not recognize the true value of moving forward on such an important issue as pharmacare and that one way he can do so is by supporting the legislation?

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Mr. Kelly McCauley

Jun/3/24 4:30:06 p.m.
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Madam Speaker, the reality is that a huge number of Canadians, the majority, are already covered by plans, either through the government or through their work. The government should be looking for and helping those who are slipping through the cracks or those who have no coverage or nearly no coverage. It should not be looking at subsidizing big corporations, so they do not have to provide it to their employees, or subsidizing big pharma for these things. It should look after those slipping through the cracks or those who have no coverage at all.

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Mr. Yves Perron (Berthier—Maskinongé, BQ)

Jun/3/24 4:30:46 p.m.
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Madam Speaker, I would like to follow up with my colleague about the question that I asked earlier and he repeated. It was about health transfers to the provinces and Quebec, which has the expertise in this area. I would like him to tell me how he interpreted the answer the member gave earlier, when he told me that Quebec has the expertise and that Canada wants to learn from that expertise. Meanwhile, the federal government wants to crush that system with a new pan-Canadian system they claim will have all the facts.

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Mr. Kelly McCauley

Jun/3/24 4:31:31 p.m.
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Madam Speaker, I agree with my colleague from the Bloc. The provinces are responsible for health care. They are mostly providing that already. I look at Alberta: $2,400 for patients with diabetes currently regularly using insulin; $320 for diabetic medications for patients at high risk of hypoglycemia; $160 for medications for patients at low risk of hypoglycemia; and monies for pumps. The provinces are, by and large, already filling a lot of those gaps. The government, if it wishes to spend the money, should deliver the money to the provinces that are delivering the services so they can fill those last few gaps, rather than creating a whole new level of bureaucracy and potential problems. The government cannot pay its employees. It has messed up the Canada Life switch for public service pharmaceuticals. Somehow, I do not think the government is going to be able to cover 40 million Canadians with a new plan out of the blue.

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Ms. Laurel Collins (Victoria, NDP)

Jun/3/24 4:32:35 p.m.
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Madam Speaker, the Conservative member has been parroting talking points from the big pharmaceutical companies, and while he talks about the majority of Canadians already having coverage, people with diabetes who are covered are still spending thousands of dollars out-of-pocket for essential medication. Why does he not think those people deserve support?

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Mr. Kelly McCauley

Jun/3/24 4:33:05 p.m.
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Madam Speaker, that is funny; I have not once parroted big pharma talking points. I did parrot the NDP, though, with a comment that it would force an election unless a comprehensive plan was delivered. Why is the member still propping up a government that promised a comprehensive plan but is just delivering two items?

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Mr. Brad Redekopp (Saskatoon West, CPC)

Jun/3/24 4:33:29 p.m.
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Re: Bill C-64

Madam Speaker, Liberals like to wrap themselves in the Canadian flag and proclaim themselves the great deliverers of health care in our country. It gets better. Allow me to read from former Liberal prime minister Paul Martin's 2004 election platform, which he infamously called a “fix for a generation”: “The priorities of a Liberal government begin with publicly funded, universally available health care. There is simply no other issue of such vital significance to Canadians. Liberals are proud of their founding role in making medicare a national priority.” That sounded pretty good. It continues on, stating, “The objective of a Liberal government will be to agree with provinces and territories on a national pharmaceuticals strategy by 2006.” I would say that was a fail. That was former Liberal prime minister Paul Martin's 2004 election platform: a “fix for a generation”. Needless to say, national pharmacare did not happen in 2006. In fact, it is a full 20 years, a full generation, later, and we have a health care system that has fallen apart under the current NDP-Liberal government in Ottawa. Having broken our publicly accessible universal primary care system, we now have a Liberal Prime Minister who is setting his eyes on taking a wrecking ball to yet another part of our health care system. Why? In this backward town we call Ottawa, where common sense goes to die, Liberal logic says that if it is not broken, they need to break it. What are the NDP-Liberals breaking today? It is the systematic dismantling of Canadians' access to their prescription drugs and treatments that are vital to their health. Just like 20 years ago, when that former Liberal prime minister brought disaster after disaster to primary health care, breaking it for a generation, if we follow our current NDP-Liberal Prime Minister down this path, our prescription drug system will forever be broken for generations to come. Rather than calling this a “fix for a generation”, I would say the fix is in. It is against this backdrop of our broken primary health care system that Canadians need to take a good, hard look at this legislation. Bill C-64, the so-called pharmacare bill in front of us today, is not what the NDP or the Liberals are advertising. It is neither the implementation of universal prescription drug coverage, nor will it improve the options for the two items it promises to cover: contraception and diabetes medications. Instead, it goes out of its way to destroy Canadians' already pre-existing insurance coverage, provincial drug plans and freedom of choice in medication when pursuing treatments. First, let us talk about federal-provincial relations. It is interventionist NDP-Liberal governments that use their control over the purse strings to force provinces into impossible decisions on patient care. Every time a premier tries to improve health care in their jurisdiction, the Liberal Prime Minister of the day will threaten to cut off health care funding to the province. Let us say a province wants to establish a few clinics offering MRIs outside of a hospital. To the Liberals, this is a mortal sin, and it cannot be allowed. Earlier this year, the federal Liberal Minister of Health fined my home province of Saskatchewan $1 million for allowing MRI clinics to operate in 2021. This was an innovative idea that increased the number of MRIs performed at a lower cost. It was brilliant, but not so fast. The NDP-Liberal government saw that as a mortal threat and fined the province. As these clinics are still functioning because they are common sense, we can expect the fines to continue. How ridiculous is that? The answer is as simple as it is sad. They actually do not want the system to get better. They do not want better outcomes for people. The NDP and the Liberals learned long ago that as long as the health care system is broken, they can campaign in elections as the great protectors and saviours of the system. Canadians are not going to fall for that again. Remember, this whole thing depends on the federal government convincing the provinces to go along with this scheme, something we already know the Liberals are not good at doing. Is this bill not doing something good? There is a second important thing to understand. This so-called pharmacare legislation will not bring universal prescription drug coverage to Canadians. Subsection 8(2) of the legislation, Bill C-64, under the heading “Discussions” says: The Minister must...initiate discussions...with the aim of continuing to work toward the implementation of national universal pharmacare. Let us break that down. What does the legislation require the minister to do? He must initiate discussions. That is fair enough. What do those discussions do? They have the aim of continuing to work towards a goal. Is that the big reveal? The minister is required to talk to some people to work towards an ideal. That sounds like every scam artist running a Ponzi scheme. Schmooze as many people as possible, and sell them on an idea that is nothing more than smoke and mirrors. This legislation is literally that: smoke and mirrors, conning Canadians into thinking there is a pot of prescription drug gold at the end of the rainbow. It is not prescription drug gold at the end of this legislation. In fact, every single Canadian would be just that much poorer if and when this gets implemented because it is a direct attack on Canadians' private health insurance and drug coverage. Did members know that, according to The Globe and Mail, there are 102 government drug programs operating today, along with 113,000 private insurance programs? Statistics Canada reports that 79% of Canadians currently have health insurance that includes drug coverage. The completely independent Parliamentary Budget Officer analyzed how much it would cost Canadian taxpayers if universal pharmacare were implemented. Their analysis is that pharmacare would cost about $40 billion every year. More importantly, that would be about $13 billion more than is being spent today. Let us keep in mind that pharmacare would replace existing public and private drug plans. Generally, private health care plans have better coverage than public ones. That would leave most people worse off. Therefore, overnight, four out of five Canadians would lose the prescription drug coverage they have through their employer, union, school, spouse, parent or provincial government plan. The federal government is paying for it, which means we are paying for it through increased taxes. Either way we look at this, it would result in a multi-billion dollar spending increase paid for by us. Those who would really benefit from this are private companies who provide insurance to their employees because today the companies are paying for private drug insurance. Once this program kicks in, they could cancel those programs because the government would be paying for it. That would save those companies significant dollars. Essentially, it would be a transfer of dollars from the federal government directly to those companies, which is paid for by us. Of course, the NDP-Liberals always love increasing taxes on unsuspecting Canadians. The other thing they love doing is limiting our choices to fit their narrow world view. There are two classes of drugs that the NDP-Liberals choose to cover in this so-called pharmacare bill: contraception and diabetes medications. Let us talk about diabetes. Most people know that insulin is a shot given to diabetics to control their blood sugar levels, as needed. However, do people know that metformin is a prescription diabetes pill that is taken once or twice daily to help the body control its blood sugar properly, reducing the need for insulin? Do people know that metformin is prescribed commonly as a treatment for people before they have diabetes? With a daily treatment of metformin, that person may never develop diabetes, and that daily metformin is a dirt-cheap alternative to very expensive insulin. It keeps pre-diabetics from developing the disease, and it costs pennies, compared to insulin. Metformin is not covered. What about Ozempic? We have all heard of Ozempic as the wonder weight-loss drug, but that is simply a side effect of being a diabetes drug that acts on the pancreas to control blood sugar. We also know that the best way to avoid type 2 diabetes is to be a healthy weight and to not be obese. Ozempic does that, but Ozempic is among the most expensive drugs on the market at about $75 a dose. Ozempic and metformin are used to prevent the disease of diabetes. Does that mean the NDP-Liberals are purposely going to deny treatment to those folks to prevent them from developing diabetes and are going to wait until they get the full-blown disease? How is that fair? Should that not be a decision for the patient and the doctor, and not for some bureaucrat in Ottawa? Innovative Medicines did a comparison of the access of drugs covered by private insurance versus those in public plans. The results are as shocking as they are sad. In Canada, private insurance covers twice as many drugs as provincial plans do. The bottom line is that this bill, Bill C-64, proposes to take away people's private drug plan. That is what single-payer means. The result is that private companies and anyone else currently providing drug coverage in a benefit plan would cancel those plans and would force Canadians onto the government plan. Canadians would be stuck with a slimmed-down plan and would be forced to pay out-of-pocket for the rest. After nine years, it is clear that this NDP-Liberal government simply is not worth the cost to Canadians' health. It has broken our primary health care system, and now with this so-called pharmacare legislation, it is setting out to break prescription drug coverage for 80% of Canadians who already have private insurance. Conservatives will not stand idly by while the NDP-Liberals systematically break our country. If we form government, we would undertake the task to fix the immense damage this costly coalition has done. We would axe the tax. We would build the homes. We would fix the budget, and we would stop the crime. Let us bring it home.

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Mr. Kevin Lamoureux (Parliamentary Secretary to the Leader of the Government in the House of Commons, Lib.)

Jun/3/24 4:43:23 p.m.
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Madam Speaker, it is concerning now. The Conservatives are trying to maybe do a bit of a backtrack, and they are saying that it is just not good enough. Depending on the depth of the speech, we will find that the Conservatives do not support public involvement at the national level, period. End of story. Let us realize that there are over 3.5 million people with diabetes. About 25% of them have reported that they are not taking all the medications they could or should be taking and that cost is a barrier. There are people with diabetes who will go blind and those who will have amputations. There are all sorts of issues. Why does the Conservative Party not support Canadians' receiving this particular benefit?

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Mr. Brad Redekopp

Jun/3/24 4:44:29 p.m.
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Madam Speaker, we need to be very clear on what we are talking about here, which is a system that is proposing to blow up the existing network of private and public health care, pharmacare programs, of which 80% of Canadians already have coverage, at the expense of putting in a generic plan that everybody would have. As I said in my speech, many people would actually lose coverage. It would reduce what they could get. Certainly, there are people who are not covered, and I would agree that maybe there should be something to deal with those people. However, we should not have a single system that comes in and blows up everything to put in a universal, single-payer program. That makes no sense, and that is something I will not support.

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Mrs. Julie Vignola (Beauport—Limoilou, BQ)

Jun/3/24 4:45:12 p.m.
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Madam Speaker, we have already talked about the fact that Quebec has its own pharmacare plan and that the government refuses to include— Madam Speaker, am I disturbing my colleagues who are talking amongst themselves? May I ask my question?

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The Assistant Deputy Speaker (Mrs. Carol Hughes)

Jun/3/24 4:45:33 p.m.
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Order. I would ask members to take their conversations outside. I am sure that hon. members want to listen to the question. The hon. member for Beauport-Limoilou.

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Conversations

Mrs. Julie Vignola

Jun/3/24 4:45:48 p.m.
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Thank you, Madam Speaker. As I was saying, Quebec has a pharmacare program that may not be perfect, but it is already in place and public servants are managing it. My question is this. Is it not completely illogical to force a province that already has everything it needs to take care of such a system to pay taxes so that the Canadian government can create other positions and duplicate services already offered to Quebeckers, without bringing them any more benefits?

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Mr. Brad Redekopp

Jun/3/24 4:46:29 p.m.
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Madam Speaker, I thank the member for that great question, and it gets to the core issue, too, of the incompetence of the Liberal government in dealing with provincial-federal relations. We already know that provinces, like the Province of Quebec and others, have said that they are not going to sign onto this program because they have their own programs or they have different ideas. That is also part of the problem. We are going to end up with a patchwork system across the country, as has been mentioned before. I have no confidence that the current government can actually pull off the negotiations with different provinces to put in a program like this, let alone the fact that it is not a program worth putting in.

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