44th Parl. 1st Sess.
June 3, 2024 11:00AM
Madam Speaker, it is always a pleasure to rise in the House. Happy Monday. I hope that we and our respective families are doing well. Before I begin, I wish to say that I will be sharing my time with the member for Winnipeg Centre this evening.
I am happy to speak today regarding Bill C-64, an act respecting pharmacare. It is another step for our government to make life more affordable for Canadians and provide the services that they need at this point in our term, and something that I am very proud of as a member of Parliament.
Before I get into my formal remarks, this weekend I was reminded of the work we are doing in helping Canadians, including the wonderful residents that I have the privilege of representing in Vaughan—Woodbridge. Close to my constituency office is one of the regional roads in the city of Vaughan in York Region, Weston Road. Along Weston Road, there are three signs that are placed up by our local dentists, all accepting the Canadian dental care program. Much like what is contained in the contents of Bill C-64, an act respecting pharmacare, here we have another foundational piece that is assisting Canadians in my riding and across the country. We know that over two million seniors have been approved for the dental care plan, and that over 120,000 have actually visited dentists. I have had many conversations with the seniors in my riding over the weekend who have used the plan and are very happy about it.
Along that vein, we are introducing a bill on pharmacare that will again help Canadians, 3.7 million of them, who have diabetes. We know that diabetes costs our health care system north of $30 billion a year. There are real savings in doing what we are doing and also taking preventative steps and providing contraceptives for Canadians.
This bill sets out the principles that will guide our government's efforts to improve the accessibility and affordability of prescription medicines and support their appropriate use. It also underscores the importance of working together with provinces and territories to make national pharmacare a reality for Canadians. We can all agree that Canadians should have access to the right medicines at an affordable price regardless of where they live.
That is what Bill C-64 does. It represents the first phase toward a national pharmacare, starting with the provision of 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 to 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 will highlight how important this is to Canadians and, specifically, how important access to contraceptives is to almost nine million women—
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- Jun/3/24 4:51:48 p.m.
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Some individuals are having conversations, and I think they seem to forget that they are in the House of Commons right now. Their voices are starting to rise a little bit. I would ask them to take their conversations out for now, because I am sure that others want to hear the speech so that they can ask questions.
The hon. member for Vaughan—Woodbridge.
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Madam Speaker, I was just saying how important contraceptives are to nearly nine million women in this beautiful country we live in, nearly one-quarter of the Canadian population.
Contraception, also known as birth control, is used to prevent pregnancy, whether it is required for family planning, medical treatment or overall reproductive health. Improved access to contraception improves equality, reduces the risk of unintended pregnancies and improves reproductive rights.
The single most important barrier to accessing contraception in Canada is cost. For example, the typical cost for select contraceptives for an uninsured Canadian woman is up to $25 per unit, or $300 per year, for oral birth control pills, and up to $500 per unit for a hormonal IUD, which is effective for five years.
Some populations are disproportionately affected by the lack of coverage. Women, people with low incomes and young people, all of whom are more likely to work in part-time or contract positions, often lack access to private coverage. One study found that women from lower-income households are more likely to use less effective contraceptive methods or no contraceptive method at all. Although most drug plans list a range of contraceptive products, unfortunately only a fraction of Canadians are eligible for prescription birth control at low or no cost through a public drug plan.
Bill C-64 would ensure that Canadians have access to a comprehensive suite of contraceptive drugs and devices, because improved access to contraception improves health equality. This means that every woman would have the ability to choose a contraceptive that is best for her, regardless of her ability to pay. This would contribute to her right to have bodily autonomy, which is what this government fully and fundamentally supports.
In addition, ensuring access to a comprehensive suite of contraceptive drugs and devices at no cost to the patient can lead to savings for the health care system. British Columbia implemented this policy at the provincial level last April, and studies from the University of British Columbia suggest that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. In the first eight months of that policy being in place, more than 188,000 women have received free contraceptives.
Sexual and reproductive health is a priority for this government. This is reflected in Bill C-64 but, as I have mentioned, it also goes beyond that to other significant federal initiatives. As part of budget 2021 and budget 2023, the Government of Canada has continued to demonstrate its commitment to improving access to sexual and reproductive health care support, information and services for Canadians who face the greatest barriers to access; and to generating knowledge about sexual and reproductive health for health care providers.
Since 2021, the sexual and reproductive health fund has committed $36.1 million to community organizations to help make access to abortion, gender-affirming care and other sexual and reproductive health care information and services more accessible for underserved populations. An additional $16.7 million has been provided to the Province of Quebec.
Budget 2023 renewed the sexual and reproductive health fund until 2026-27. This initiative has funded 21 projects and is currently funding 11. The sexual and reproductive health fund is providing $5.1 million to the University of British Columbia contraception and abortion research team for a 25-month project from March 17, 2023, to March 31, 2025, entitled the “Contraception and abortion research team access project, advancing access to abortion for under-served populations through tools for health professionals and people seeking care”.
As a segment of the project centres on contraception, the project has partnered with the Canadian Pharmacists Association to develop educational resources that support pharmacists prescribing contraception and assist pharmacists in understanding and tailoring their approach for indigenous and racialized populations, including youth and other underserved populations.
With the support of the University of Toronto youth wellness lab, the project will also engage with family planning professionals, for example pharmacists, family physicians, obstetricians, gynecologists, nurses, midwives and social workers, to optimally design affirming and judgment-free services and contraception information care by, with, and for youth. Additionally, the medical expense tax credit has been included to include more costs related to the use of reproductive technologies, making conception more affordable.
In conclusion, our government is committed to improving the sexual and reproductive health of all Canadians. This includes helping to ensure access to a comprehensive suite of contraceptive drugs and devices for all Canadians. By working with provinces and territories, and guided by the principles within Bill C-64, we can make this a reality.
As we move forward, Liberals will continue to work with the provinces and territories, indigenous peoples and other stakeholders to ensure we get this right. The proposed Bill C-64 lays the groundwork for that process and would guide our collaboration. By passing this legislation, we could continue to build on the momentum we have already achieved. We are well on our way and I look forward to working with all parliamentarians to realize the next phase of Canadian health care.
Whether it is dental care; the Canada child benefit; $10 day care and the national learning strategy; helping the almost 3.7 million individuals who have diabetes; or providing dental care for seniors, and now moving into another segment of the population, which I believe is individuals with disabilities, we are going to be there and have the backs of Canadians today and into the future.
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- Jun/3/24 4:58:15 p.m.
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Madam Speaker, we have said it before and we will say it again: Quebec is ahead of the game when it comes to pharmacare and many other areas.
I would like to know whether my colleague is aware that in Quebec, a woman who has limited means and no insurance can go to a family planning clinic and get her birth control pills free of charge. Quebec is ahead in this area. It already has public servants working on pharmacare.
Why not simply agree to a transfer and avoid duplicating the work of public servants for Quebeckers?
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- Jun/3/24 4:59:02 p.m.
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Madam Speaker, it is very important to work with all of the provinces, including Quebec.
Quebec was the first province in Canada to implement the early learning and child care program.
That was a model used nationally in Canada. We have much to learn when working with the provinces and that is what we continue to do. In this case, as identified by the member, if the Province of Quebec has gone down this path, I wish to applaud it and we will continue to work with all the provinces in our country.
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- Jun/3/24 4:59:43 p.m.
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Madam Speaker, my colleague across the way talks about working with Quebec. Alberta has quite an extensive plan for both diabetes and birth control, and other issues.
Will the member commit to working with the Province of Alberta to give it the funding it needs to increase its programs, rather than creating a second program altogether?
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- Jun/3/24 5:00:06 p.m.
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Madam Speaker, the ultimate goal of putting in place measures, like the Canadian dental care plan, and coverage for contraceptives for women and for individuals who have diabetes right now, is to improve their health care outcomes. Of course, Liberals will always work with all provinces and sit down with them, but the ultimate goal has to be to improve the health care system and health outcomes for Canadians. We will continue doing that.
Liberals will put in place the 10-year plan for $200 billion. We have come to agreements with all the provinces, if I am not mistaken. I will double-check that, but I am pretty sure we have. That is what we will continue to do as a government: work collaboratively and effectively for the benefit of all Canadians in this blessed country that we live in.
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- Jun/3/24 5:01:00 p.m.
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Uqaqtittiji, when I spoke to this bill, I talked about the importance of Jordan's principle. Unfortunately, the need for it arose because there were jurisdictional disputes about who was to pay the cost of health care for Jordan River Anderson.
I think what is trying to be done with the pharmacare act is to avoid similar scenarios, where people with diabetes, or women or gender-diverse people get the medication they need so their lives can improve.
Can the member talk about why having such parallels is so important, so we are not fighting over jurisdiction and people get the care they need as soon as they can?
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- Jun/3/24 5:02:00 p.m.
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Madam Speaker, my residents, like the residents of the member for Nunavut, do not care about jurisdiction. They care about the delivery of services, and the outcomes of those services that are provided to them and their families. We need to ensure we maintain a high standard of living, or, in this case, health care system.
When I speak to the residents of Vaughan—Woodbridge, they want to know the government is providing the services that are needed, which are accessible and affordable, much like the Canadian dental care plan that we are putting in place. That is what we need to work toward and work with all levels of government on.
In Ontario, there are actually four levels of government, including the regional government. We will continue to work with all levels in collaboration as mentioned by the member for Nunavut.
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Madam Speaker, it is such an honour to rise again to speak about the very important bill before us to put in place the beginnings of a pharmacare strategy, particularly as it relates to free contraception and diabetes medication.
As the critic for women and gender equality, I want to focus my comments more on contraception and the fact that this is long overdue if we want to talk about reproductive rights and if we want to talk about creating societies that really, truly uphold equality for women and gender-diverse people. What I found bizarre during the debate is that so many men in this place have fought with such fury against women's reproductive rights. It almost feels like I am back in the 1800s, with the great interest by men in this place fighting against the rights of women over our bodily autonomy and reproductive rights.
It is no surprise. The so-called freedom party, the Conservative Party, is certainly not free when it comes to people's bodily autonomy. I want to point to a couple of comments that were made quite recently. This was in the news today from when the Alberta Conservative member for Peace River—Westlock did an interview with a Liberal MP across the way. The Conservative member stressed that he supports Alberta Premier Danielle Smith's transgender policy that would vote to criminalize cannabis possession again if given the opportunity. Certainly with respect to bodily autonomy, he is supporting Danielle Smith. He also said, in regard to gay marriage, “I vote gay marriage down.”
It is freedom for some and not for others. I have written articles about this, actually, about how Conservatives believe in freedom for some and not for others. I would say there is not much pride in that level of homophobia, when the Conservative member for Peace River—Westlock said, “I vote gay marriage down.” Happy Pride from folks in the House, except for members from the Conservative Party, who have come out with petitions not supporting trans rights. Again, it is another attack on bodily autonomy.
Here we are, talking about women's reproductive rights, and there are a whole bunch of men in the Conservative Party fighting with great enthusiasm against our reproductive rights, against trans rights and against the rights of folks to have same-sex marriage. It is not just the member for Peace River—Westlock. In fact, the member from Carleton, the leader of the Conservative Party, voted against same-sex marriage in the 2000s and against backdoor anti-abortion legislation, Bill C-311 just in the last session, unanimously with all the Conservatives.
When we are talking about freedom, we are not talking about freedom for women and gender-diverse persons to have control over their reproductive rights. When we talk about the transgender community, we are certainly not talking about freedom of bodily autonomy for the transgender community. In fact despite our saying “happy Pride” and raising the pride flag today, there are members of the Conservative Party saying, “I vote gay marriage down”, full stop.
It is one thing for the Conservative leader to say “love is love” and that people can support whom they want, but when it came to Jordan Peterson, known for his anti-trans rhetoric, his homophobia, and his very clear views that violate the reproductive rights of women and gender-diverse people, he came out in full support of Jordan Peterson's agenda. Is that freedom? It is freedom for some and not for others.
The NDP has fought really hard to put in place a pharmacare plan that would include a suite of contraceptives so women and diverse-gender folks can have control over their body, over their livelihood and over their life. I know there are some men in the Conservative Party who want us to go back to the rhythm method. Thank God we have gotten past that to where people can make choices about their body, certainly women, and have control by taking things like birth control. I do not know many men who are running down the street begging for a birth control pill, so the fact they have taken so much time to obstruct a feminist agenda and a woman's right to choose is really telling to me. We cannot go back to that time.
I hear more and more Conservative members tabling anti-trans petitions that have been put forward in the name of so-called protection of the bodily autonomy of women and girls. They table bills that include backdoor legislation in the name of being tough on crime for violent offenders, even though it is opposed by all women's organizations that actually deal with gender-based violence. They are now trying to vote against women and gender-diverse people's access to contraception.
I have to ask this: Why do Conservatives hate women and gender-diverse people so much? Why are they so nosy about going into people's bedrooms? Why is there a thought in their head about who somebody should sleep with or whether somebody is gay or LGBTQ? Why does the so-called freedom party care so much about looking into everybody's bedrooms and finding out what they are doing, figuring out what contraception they are taking, whom they love or whether they want to have an abortion or not? There is nothing free about the party. It feels, actually, like we are going back into the 1800s.
Then Conservatives make the excuse that it is “only” contraception or “only” diabetes medication, which is peculiar to me. It is not surprising that they would think that it is “only” contraception, because the only people I have actually heard talk about pharmacare are men. I could be wrong but I have been here for a lot of the debate. Why would they care about pharmacare? Why would they care about contraception when primarily it has been a women's responsibility historically to deal with contraception? If they want to run out at all hours of the night buying condoms, that is fine. Do they expect women and gender-diverse people to have no choice over their bodily autonomy or reproductive choices so that they can have the rhythm method? This is 2024.
The fact is that, in the midst of Pride, we have to get more security at Pride marches because of anti-trans and anti-LGBTQ rhetoric, and people in the Conservative caucus are cheering on Roe v. Wade, which is not the only one as there are quite a number of social Conservatives, so that we can go back to the era when women were having back-alley abortions with coat hangers and bleeding to death, or 10-year-olds in the United States were having to give birth. I do not want to listen to that hooey. It is just privileged, sexist, homophobic, transphobic hooey.
Women and gender-diverse people have fought hard for their rights. They continue to fight for their rights, and it will not be very easy to just roll over them so there can be the new dude paradise.
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- Jun/3/24 5:12:36 p.m.
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Madam Speaker, the member has been listening, no doubt, to a number of the Conservatives speak to the legislation, in essence saying that we would not be providing drug X or drug Y, and asking why not this drug, and so forth. Just to pick up on her comments, there are going to be nine million people who would potentially benefit from the passage of the legislation. Could she provide her perspective not only on the degree to which it is being well received in all regions of the country but also on the number of people it would actually affect?
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- Jun/3/24 5:13:19 p.m.
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Madam Speaker, absolutely it would have a really positive impact, but the Liberals are not off the hook here. They might talk about the right to access safe abortions and the right to a safe abortion, but they have failed in terms of providing access, and this does not include the number of Liberal MPs who are listed as anti-choice. I am glad that the Liberals are on board with the NDP pharmacare plan to put in place free contraception and diabetes medication, but they need to look at stuff in their own backyard, including ensuring that all women and gender-diverse people can access safe, trauma-informed abortion care.
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- Jun/3/24 5:14:12 p.m.
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Madam Speaker, before I ask a question, I want to talk about something that came to mind when I was listening to my colleague's speech. I am wondering how some men would react if, tomorrow morning, all of the women in this Parliament introduced a bill that forced men to get a vasectomy until they were ready to procreate. Perhaps that is extreme, but no more so than preventing a woman from making her own choice about whether to go forward with a pregnancy or not. In my opinion, preventing her from making that choice is just as extreme, and we should not go there.
That being said, I would like to hear my colleague's thoughts on how difficult it is to access services in remote areas, particularly any sort of gynecological care services. What does that involve in terms of time, travel and cost for women who need urgent gynecological care?
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- Jun/3/24 5:15:11 p.m.
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Madam Speaker, quite frankly, most women, historically, have gotten their tubes tied, which is a very major surgery, when we know that vasectomies are much easier. We are not asking people to get vasectomies. We are just saying, if we want a birth control pill, can someone give it to us? There is not just the fact that it is still up to women, in terms of the primary responsibility to consume the contraception, but there is also the fact that people whom it will never affect are violently fighting against it when there are easy solutions.
Let us put all the solutions on the table. We are not even asking for that; we are just asking for free contraception. I think that is pretty reasonable. Ensuring that women can have a choice over their body is a lot cheaper than the emotional turmoil we have heard about with stories shared in the House because they did not have proper contraception to be able to make choices.
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- Jun/3/24 5:16:21 p.m.
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Uqaqtittiji, I do want to ask my hon. colleague a question regarding parental rights, because Conservatives use that as a guise, I think, to pretend to care about women's bodies or unborn babies. I think that the pharmacare act could help make a difference regarding contraceptives and how Canadians need to be better informed when Conservatives are pretending to care through words or slogans like “parental rights”.
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- Jun/3/24 5:17:00 p.m.
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Madam Speaker, in fact we are studying this in the status of women committee, and just how women's legal groups, particularly, want to actually get rid of claims about parental alienation because they have no scientific basis, which is what they are saying. It actually results, very often, in women and gender-diverse people who are experiencing violence being more victimized. This is well researched.
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- Jun/3/24 5:17:42 p.m.
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Madam Speaker, I will be splitting my time with the member for Regina—Lewvan.
I would like to get back to the basics on the bill before us, which is on a national pharmacare program. Before we can even consider a program like this, I believe Canadians need to place all of this into context within the fiscal mess that has been created by the Liberal government going forward.
As members know, we are facing a fiscal wall. We are leaving behind, for future generations to pay back, a massive national debt. In fact, over the last nine years, this Prime Minister and his Liberal government have amassed more indebtedness than all previous Canadian governments combined since Confederation. That is one piece of the context.
What about the ongoing deficits being run by this Liberal government? There is no end to them. In fact, time and time again, the finance minister has been asked to at least give us a timeline when we will return to balance, when Canada will begin again to live within its means and not spend more money than is being brought in by taxes. Each time, the Minister of Finance and Deputy Prime Minister has said nothing. She will not respond to that question, because the answer is that there is no plan. How can we, as a nation, justify billion-dollar program after billion-dollar program without having a plan to bring our fiscal mess back into order? The only way to do that is to come back into balanced budgets, which has not happened.
There is also the challenge of increasing taxes on Canadians. Carbon taxes, which have been the subject of much debate in the House, keep going up and up. Fuel taxes are going up and up. In fact, it was not long ago when my colleague for Mission—Matsqui—Fraser Canyon was at committee, and they were grilling the Minister of Small Business. The minister had asserted that she had reduced taxes on small businesses. The simple question that my colleague asked was which tax the minister had reduced on small business. And the answer was, well, humming and hawing. Finally the minister turned to her officials and said that perhaps her officials could answer that question. The officials looked dumbfounded, because they did not have an answer either. The truth is, taxes have not been reduced on small businesses. Across the board, taxes have been raised on Canadians.
Now, within that context, this Liberal government wants to introduce another billion-dollar spending program. The Liberals could have come to us and said, “Listen, the recent budget shows that we will be returning to balance within the next, say, five years, and within that context we'd like to bring forward a program that is going to help those who have no pharmacare coverage.” However, that is not what they did. This government came forward and said that it was going to spend another $40 billion, $50 billion additional, that it would go into deficit by another $40 billion, and that it would throw in this program that would put Canada in the hole for years to come. However, who has to pay all of that back? I heard some heckling over here in the corner because they do not like to hear the truth, but it will be future generations of Canadians, with interest thereon. So that is the context in which this whole pharmacare discussion needs to take place.
This is not a pharmacare plan. Like so many others, this is an empty promise that will leave Canadians deeply disappointed and angry.
Let us remember it was the current Prime Minister who promised affordable housing back when he was first elected in 2015. Instead, what we have is a doubling of housing prices, rents, down payments, interest rates and mortgage payments, and another broken promise. Oh yes, the carbon tax would not cost Canadians anything and we now know from the PBO that in fact that is not true. The Prime Minister promised taxes would go down. He promised safe streets and instead we have chaos, crime and drugs on our streets and social disorder. With so many broken promises, we could go on and on. We could spend hours talking about broken promises, but the pharmacare plan is destined to be just another one of those broken promises.
Now, there is another problem. By its own definition, the pharmacare plan is intended to be a single-payer plan. That means the Government of Canada pays and it is universal, so, of course, the fear is for the 97% of Canadians who already have some kind of coverage, typically through their union plan or company plan, or they may have bought coverage. They would now lose that coverage because the pharmacare plan that is being proposed by the current Liberal government is a very narrow one. It would cover a very small number of medicines when, in fact, most plans across Canada are expansive. Now, it looks like the government wants to insert itself and introduce a plan that would actually cannibalize many of the other plans across Canada. There has been no consultation with the insurance industry and there has been no consultation with the provinces.
Let us remember that health care is the purview of the provinces and yet we have the government starting to step into dental care and pharmacare. That is on top of all the billions and billions of dollars in health care transfers every single year. Somehow, the provinces have not been consulted adequately. We know that some provinces are already providing additional pharmacare support and some provincial leaders are saying, “Listen, instead, give us the cash because we are already providing these services.” Others are saying, “Listen, we have a long list of priorities for our health care system and that is not the top priority. We have a number of other priorities.” For example, how about that mental health funding that was supposed to come to the provinces? It has never happened. Oh, what about that palliative care funding that the Prime Minister promised to the provinces years ago? What happened to that? It is gone. Therefore, the lack of consultation with the provinces and repeated stepping into areas that are the exclusive jurisdiction of the provinces is, I believe, leading us down this road where, without a fiscal plan that will lead us back to budget balance, we continue to heap more spending onto the taxpayer and that is unsustainable.
This pharmacare program is a big program, like so many other programs that the current government tries to introduce and implement. In fact, it was the member for Kingston and the Islands who said that this program is big and complex. Well, if it is big and complex, there is one guarantee: The current Liberal government will not be able to manage it effectively. We think of all the scandals, the spending scandals, GC Strategies, the ArriveCAN scandal and the TMX pipeline that went seven times over budget after the Liberal government purchased that pipeline.
This is the question that Canadians have to ask themselves: Do we trust the current Liberal government and the Prime Minister to manage a pharmacare program that is billions of dollars in the coming years? Do we trust them to manage this program efficiently and effectively? I believe the answer from Canadians would be a resounding no.
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- Jun/3/24 5:27:51 p.m.
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Madam Speaker, there is the contrast right there from the member. The Conservative Party does not see the national role with regard to health care, even though we have the Canada Health Act and even though the member cannot point out any Constitution that says the federal government does not play a role in health care.
The Conservatives oppose the dental plan. They oppose the pharmacare plan. They oppose the $200 billion we have committed to the provinces over the next 10 years for future generations of health care delivery. Canadians will have a very clear choice to make whenever that next election is, which is going to be, in good part, based on the Conservatives' hidden agenda on health care. Some of that agenda was just unveiled by the member opposite, who made it very clear the Conservative Reform Party of Canada does not support the type of health care system Canadians expect from the national government in working with the provinces.
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- Jun/3/24 5:29:01 p.m.
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Madam Speaker, that is simply preposterous. In fact, what I think I heard the member do just now is actually suggest there be constitutional reform to make health care the purview of the federal government instead of the provinces. Now that is a huge step. It is pretty clear and acknowledged across the country, and if one asks the provinces, they will acknowledge it, that health care is a provincial responsibility. Yes, there is a choice Canadians will have to make. In fact, we have asked the Liberal government time and time again to let Canadians make that choice now and to let us have a carbon tax election now. It refuses to do so. Why? Its members are afraid of losing. We, as Conservatives, can do much better on the health care front than these Liberals have done over the past failed nine years.
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- Jun/3/24 5:29:59 p.m.
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Madam Speaker, the member for Winnipeg North is wrong when he talks about the national government, because Quebeckers' national government is in Quebec City. This is the federal government. We know that the reason the federal government is interfering in health is because of a loophole in the Constitution called the federal spending power. This is the only federation in the world that has not regulated that in one way or another, because the federal government is predatory and invasive toward the provinces.
The federal government's role is clear. It is to take Quebeckers' money, write a cheque and transfer it to the Government of Quebec and to the provinces so that they can provide care, because the federal government is incapable of providing care. When it does so, particularly for the military, that care is inefficient, ineffective and very costly.
Here is my question for my Conservative colleague. If and when his party takes office, will it commit to respecting the federal government's constitutional role, meeting the demands of all of the provinces and territories and substantially increasing unconditional health transfers to the provinces?
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