44th Parl. 1st Sess.
June 3, 2024 11:00AM
- Jun/3/24 6:01:48 p.m.
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Madam Speaker, I just spoke for about 10 minutes about how important health care is to Canadians, and how important it is that we, as a national government, step up to the plate on things such as a national pharmacare program and a national dental care program, to be there for our constituents, and what does the Reform-Conservative Party across the way say? “What about the billions of dollars? Instead of spending them on health, maybe we should be dealing with the debt or the impact it is going to have on inflation?”
Yes, we have inflation in Canada, but I will contrast our inflation rate to that of any other country in the world. We are doing reasonably well. However, I can say that we cannot trust the Conservatives. With their hidden agenda, health care is not safe.
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- Jun/3/24 6:02:54 p.m.
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Madam Speaker, I am certain my colleague is expecting my question.
Health care is a jurisdiction of Quebec and the Canadian provinces. Quebec already has a pharmacare program. It is not perfect, but we can improve it.
Why is the government stubbornly trying to duplicate services in Quebec by offering its own separate insurance plan instead of letting Quebec manage it with the right to opt out with compensation?
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- Jun/3/24 6:03:28 p.m.
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Madam Speaker, there will be people in the province of Quebec who will, in fact, benefit from this particular program. If we canvass the entire country, we will see, depending on the province or territory, different types of policies regarding the issue.
What we are looking at through this legislation is ultimately working with the provinces so that if a person has diabetes in Canada, they can anticipate medications at no cost, whether they live in Halifax, Montreal, Quebec City, Winnipeg, Toronto, Edmonton, Vancouver or Whitehorse. That is the idea of having a national program. Different provinces have different programs, and private insurance companies have different deductibles, depending on the company, which is the reason why it is important that the federal government step up. Unfortunately, the Conservatives and the Bloc are voting against this.
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- Jun/3/24 6:04:29 p.m.
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Uqaqtittiji, I know personally of people who, because they do not have the diabetes medication they need, are at risk of amputations. There are people, as well, who deserve better protections for contraceptives. For example, not all indigenous women can have access to contraceptives, especially when we know that, on this fifth anniversary of the publication of the MMIWG's calls for justice, this particular bill can make a difference in making sure that indigenous women get the protections they need.
I wonder if the member can share with us his response on why it is so important to provide diabetes medication, as well as contraceptives, why safe abortions are severely needed and why contraceptives are a particular need that was focused on in this bill.
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Madam Speaker, I believe there is at least one province, possibly even more, that has acted on the issue of contraceptives. We will find, as I said, that there are different policies in different provinces, and so forth.
What is really important to recognize is that Bill C-64 would help an estimated nine million people in dealing with contraceptives. When we think about diabetes medications, we are talking about over 3.5 million people. That is a lot of good reasons to get behind this legislation and ensure there are some standards across the nation.
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Madam Speaker, it is an honour to rise this evening to discuss the bill before us, Bill C-64, an act respecting pharmacare. We can all agree, or I hope we can all agree, that Canadians should have access to the right medicines at an affordable price regardless of where they live in our country. That is precisely what Bill C-64 would do. It represents the first phase toward a national pharmacare plan, starting with the provision of universal single-payer coverage for 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 and for all Canadians who use it.
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. The single most important barrier to access to contraception in Canada is cost. For example, the typical cost for select contraceptives in our country 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.
It occurs to me that if oil and gas companies were going to start selling diabetes medications, insulin or contraceptives, the Conservatives might be all for it. It seems like they are the only group, the only organization, and the only affordability measures the Conservatives can come up with are supports for oil and gas.
However, Canadians have lots of expenses, and one of the main expenses associated with inequality and inequities in our society is their medications. We are here to help. 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 and thereby not have access to a drug plan, 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 as a result of their lower-income situation.
Bill C-64 would ensure that Canadians have access to a comprehensive suite of options when it comes to contraceptive drugs and devices, because improved access to contraception improves equality. This means that every woman in Canada would have the ability to choose the 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 supports.
Sexual and reproductive health is a priority for this government. This is reflected in Bill C-64, as I have mentioned, but it goes beyond that in other significant federal initiatives. Our government is committed to improving the sexual and reproductive health outcomes for all Canadians, and this includes helping to ensure access to a comprehensive suite of contraceptive drugs and devices for everyone. By working with provinces and territories and guided by the principles within Bill C-64, we can make this a reality.
The proposed Bill C-64 lays the groundwork for that process, and through it, with collaboration with provinces and territories, we are helping to fight for affordability for all Canadians. By passing this legislation, collectively, we can all continue to build on the momentum we have already achieved.
I looked into this. Pharmacare in Canada is deeply popular with people who vote for all parties. It is almost 90%, in fact. This is something I expect all members of Parliament to get behind. It is something a lot of Canadians support, regardless of party.
An hon. member: Oh, oh!
Mr. Adam van Koeverden: Madam Speaker, there are a lot of reasons to heckle in this House. Perhaps the Conservatives disagree with me on some key issues, but I find it really remarkable that they want to heckle and tell me that we should not be fighting for Canadians to have access to the drugs they need in order to live healthy and fulfilling lives. It really is remarkable and just re-emphasizes that if oil and gas was selling insulin and IUDs, the Conservatives would be the first ones to line up and say that we need to support these companies. It does not seem like they are really in it for Canadians, particularly lower-income Canadians, who are struggling with their bills. It is clear to me that the Conservatives only care about the oil and gas lobby. In fact, I think they are trying to put the oil and gas lobby out of business.
With the time remaining, I would like to—
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- Jun/3/24 6:11:01 p.m.
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The hon. member for Renfrew—Nipissing—Pembroke is rising on a point of order.
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- Jun/3/24 6:11:07 p.m.
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Madam Speaker, our earpieces are not working, because I could not hear any of the heckling on this side of the floor to which the member opposite was referring.
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- Jun/3/24 6:11:19 p.m.
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I did not react to it, but yes, there was heckling.
The hon. parliamentary secretary has the floor.
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Thank you, Madam Speaker. There is not only heckling but also unnecessary interruption.
I will use my remaining time to talk about diabetes and those living with diabetes. Diabetes is a disease with no cure. There is a treatment, and it is thanks to Canadian science, which is something that our government supports. Canadian scientist Frederick Banting and his team came up with an interim solution, I suppose we could call it; it is a treatment for diabetes that allows diabetics to live. Without it, diabetics would not have the opportunity to live fulfilling lives, but we still need to fight for a cure. Before we get there, we should also ensure that we reduce inequality and inequities in the populations impacted by diabetes.
There is a really interesting infographic from the Public Health Agency of Canada. Anybody who is watching this debate might be interested in how diabetes and inequality intersect in Canada. I was actually very surprised to learn that diabetes and employment status are related; there is a positive correlation between them. When people are employed, they are less likely to suffer from diabetes and live with diabetes. When people are permanently unable to work, they are more likely to have diabetes, which means that they naturally have a lower income. It is the same for education level, surprisingly. Almost 10% of those individuals with less than a high school education will have diabetes or prediabetes throughout their life; for university graduates, that goes down to between 3.5% and 6.1%. There is also a positive relationship within income quintiles. All five income quintiles are associated with a positive relationship. As income goes up, people are less likely to have diabetes. Therefore, providing folks living with diabetes with free access to medication, to insulin and to supports for managing their illness is also an affordability measure that would make a difference for a lot of Canadians.
Diabetes also affects people disproportionately in different categories. There are complex social and environmental behavioural factors that result in inequalities in the burden of diabetes between certain populations in Canada. The prevalence of diabetes is 2.3% higher among South Asian Canadians, and it is 2.1% higher among Black adults.
For indigenous adults, the prevalence of diabetes is similarly staggering, at 1.9% higher for first nations Canadians living off reserve. Inequities experienced by first nations, Inuit and Métis populations are a direct result of colonial policies and practices that included massive forced relocation, loss of lands, creation of the reserve system, banning of indigenous languages and cultural practices, and the creation of the harmful residential school system. Unaddressed intergenerational trauma adds to the ongoing challenges faced by indigenous peoples, and providing them with a reliable and affordable treatment for diabetes would support affordability.
This would also reduce the number of times people with diabetes have to access health care as a result of their illness. People with diabetes are more at risk of all sorts of life-changing health crises, such as a heart attack or stroke, kidney failure, blindness and amputation. At this very moment, there are about 3.7 million Canadians, or 9.4% of our population, who have been diagnosed and have to manage their condition for their entire life. If members can believe it, in 2015, 25% of Canadians with diabetes indicated that they followed their treatments to a T, but they were affected by cost; in some cases, those Canadians were rationing medications to save money. Therefore, a quarter of the people who are following their treatments are affected by cost. There are other Canadians who are undiagnosed, and there are Canadians who are not following their treatments. We need to make sure that they live a healthy and fulfilled life, and one way to do that is to ensure that they have access to this vital medication.
About one out of three people is living with diabetes or prediabetes today in Canada, and rates of diabetes are ever rising. It is estimated that, by 2028, over 13 million Canadians, or 32% of the population, will have diabetes or prediabetes. Through Bill C-64 and the work of the national framework for diabetes, we can improve aspects of preventative care as well. We can do this through information sharing and knowledge transfer, while also ensuring that those living with diabetes have access to insulin and other diabetes medications.
This is a cost-saving endeavour. The Conservatives have continually referred to this as a spending program, as if it would not be invested directly in the health of Canadians. Not only would it be invested in their long-term health outcomes, but it would also be invested directly in their affordability. It would support affordability, and, as I pointed out, that is something that is positively correlated with other risk factors.
We introduced the national framework for diabetes in 2022 to align multisectoral efforts to reduce the impact of diabetes in Canada. The framework comprises about six interdependent and interconnected components that represent the range of areas where opportunities to advance efforts on diabetes could and will be beneficial.
Bill C-64 would support people living with diabetes, whether through improving access to the medications they need or giving them the tools they need to have a better quality of life in Canada. We are here for Canadians. Our plan to provide universal coverage for contraception and diabetes medications would be transformative, and I still have faith that the Conservatives will see the light and recognize that this is a very popular and worthwhile endeavour.
We should all get behind national pharmacare for Canadians.
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- Jun/3/24 6:17:27 p.m.
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Madam Speaker, I rise on a point of order.
I just want to raise to the attention of the House a really important matter that happened, and I am sure that I can have unanimous consent. We know the important role that pages play in the House of Commons to help support us. One of the annual traditions here in the House of Commons has been the actual ability to have a soccer game among pages and MPs, and last week—
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- Jun/3/24 6:17:50 p.m.
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I want to remind the hon. member that the question of props is an issue, so I would invite the member not to handle a prop.
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- Jun/3/24 6:18:09 p.m.
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Madam Speaker, I will be very quick, but I just want to recognize that there is an annual game played among MPs and pages. It is a long-standing tradition, and the game took place last week. I am pleased to present the fact that the—
Some hon. members: Oh, oh!
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- Jun/3/24 6:18:25 p.m.
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That would be more in the nature of a member's statement than a point of order.
The hon. member for Renfrew—Nipissing—Pembroke has the floor.
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- Jun/3/24 6:18:36 p.m.
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Madam Speaker, a national drug program or pharmacare program would be a great idea if we were not a trillion dollars in the hole. As a consequence of being so in debt, taxes are going up and driving our doctors out of the country. How is a pharmacare program going to help people who do not even have a doctor to provide a prescription and have no way of getting a prescription? How is the government going to decide who gets the medicine when there is a drug shortage, as we have seen recently with diabetes? How are they going to decide who lives and dies?
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- Jun/3/24 6:19:26 p.m.
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Madam Speaker, it is beyond the pale that Conservatives continue to refer to a national pharmacare plan as an expenditure that we just cannot afford. It is so unfortunate.
This is an affordability measure. It is a way to support Canadians who are vulnerable. It is a proven method to ensure that vulnerable, lower-income and disproportionately impacted Canadians will receive the financial support they need. There are Canadians living in period poverty, who cannot access contraception and who just simply do not have regular access to diabetes medications.
A government is required to be able to do many complicated things simultaneously. We need to address the doctor shortage. We need to meet Canadians where they are and ensure they have the medications that they deserve and that they need in order to live full and fulfilled lives.
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- Jun/3/24 6:20:22 p.m.
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Madam Speaker, I thank my colleague for his speech. He just responded to the Conservatives by saying that this money needs to be spent to provide a service. I agree with him. However, we have to be efficient. To be efficient, we should entrust this money to the people who are competent.
A system already exists in Quebec. My colleague is well aware of it. I am going to give him a mission to fulfill within his party, his government. He needs to convince his caucus and the people who run it to transfer the money to Quebec, unconditionally.
I can assure the House that the Quebec government will get the job done on health care because that falls within its jurisdiction.
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- Jun/3/24 6:21:15 p.m.
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Madam Speaker, I thank my colleague for his question, but it is always the same story with the Bloc Québécois. The Bloc members always say that in Canada, the provincial government, in this case Quebec, is wholly responsible for the health care system. In actual fact, that is the case until the bill arrives and it is time to pay for the health care system.
Canada's health care system is a shared responsibility between the federal and provincial governments. We need only think of the health care provided at the regional level in my riding. It is so important that we find solutions together.
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- Jun/3/24 6:22:31 p.m.
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Madam Speaker, we hear from the Conservative caucus about the costs of pharmacare. The member spoke about how this is needed for an affordability measure, but we have not heard about how national single-payer pharmacare saves money. The Parliamentary Budget Officer tabled a report saying that $1.4 billion would be saved because national single-payer pharmacare gives governments the negotiating and bargaining power to drive down drug costs. Therefore, it is not surprising to see Conservatives oppose it when their friends, the lobbyists, the CEOs and big pharma keep saying the same things that they do.
Can the member speak to how Conservatives are constantly looking out for the corporations at the very top instead of everyday Canadians who are struggling to pay for essential medications?
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- Jun/3/24 6:23:30 p.m.
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Madam Speaker, my colleague is absolutely correct. This is not only a cost-savings measure for the government, the health care system or people who live with diabetes or require contraception, but it is also a way to save money within the system. When Canadians stick to their regimen and take their diabetes medication, they will visit the hospital less often. We want to make sure not only that they live healthy and fulfilled lives but also that we save money in the health care system. However, it is the case again that Conservatives are really only here for the lobbyists and never for everyday people—
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