(a) acknowledge the government’s intention to introduce and implement national pharmacare;
(b) call on the government to implement the full recommendations of the final report of the Hoskins Advisory Council on the Implementation of National Pharmacare, commencing with the immediate initiation of multilateral negotiations with the provinces and territories to establish a new, dedicated fiscal transfer to support universal, single-payer, public pharmacare that will be long term, predictable, fair and acceptable to provinces and territories;
(c) urge the government to reject the U.S.-style private patchwork approach to drug coverage, which protects the profits of big pharmaceutical and insurance companies, but costs more to Canadians; and
(d) recognize that investing in national pharmacare would help stimulate the economy while making life more affordable for everyone and strengthening our health care system.
He said: Mr. Speaker, it is a great privilege and an honour for me to rise on behalf of my colleagues in the New Democratic Party caucus and on behalf of the New Democratic Party of Canada and all of those Canadians from coast to coast to coast who care so deeply about our health care system.
It is timely to note at this time that Canadians find themselves in the grip of what can fairly be called a major public health crisis. The COVID-19 public health outbreak is affecting communities across our land. The one thing that Canadians feel extremely proud of and strong about at a time like this is that we have a strong public health care system that helps keep everybody across this country healthy and responds to keeping people healthy and, most importantly, regardless of anybody's ability to pay, but rather as a birthright of citizenship in this country.
That is why it gives me great pleasure to stand today and speak to an issue that represents an immediate, urgent and critically important gap that exists in our current health care system, and that is the lack of public coverage for prescribed pharmaceuticals, the medicines that Canadians need as their doctors prescribe.
I am going to cover four basic elements in my remarks today. I am going to read the motion, I am going to discuss the need, I am going to discuss the solution and I am going to talk about the responsibility that we have as legislators in this country.
First I will read the motion. New Democrats propose:
(a) acknowledge the government’s intention to introduce and implement national pharmacare;
(b) call on the government to implement the full recommendations of the final report of the Hoskins Advisory Council on the Implementation of National Pharmacare, commencing with the immediate initiation of multilateral negotiations with the provinces and territories to establish a new, dedicated fiscal transfer to support universal, single-payer, public pharmacare that will be long term, predictable, fair and acceptable to provinces and territories;
(c) urge the government to reject the U.S.-style private patchwork approach to drug coverage, which protects the profits of big pharmaceutical and insurance companies, but costs more to Canadians; and
(d) recognize that investing in national pharmacare would help stimulate the economy while making life more affordable for everyone and strengthening our health care system.
I want to briefly review the need, the context in which the motion emanates, and what is really happening in all of our communities across our country.
Right now, as we gather today, one in five Canadians, that is 7.5 million people, either have no prescription drug coverage whatsoever or have such inadequate or sporadic coverage as to effectively have none at all.
Currently, each province offers different levels of drug coverage for different populations, creating significant and profound inequalities in prescription drug coverage between regions.
Canada currently does have a U.S.-style patchwork of more than 100 public and 100,000 private drug insurance plans. One in five Canadian households reports a family member who, in the past year alone, has not taken the prescribed medicine simply due to cost.
Nearly three million Canadians per year are unable to afford one or more of the prescription drugs their doctors prescribe as important and sometimes essential for their health. Of those three million Canadians who cannot afford their medications, 38% do have private insurance and 21% have public insurance, but these insurance plans are not sufficient to cover the medicine they need.
One million Canadians per year cut back on food or home heating in order to pay for their medication. One million Canadians per year borrow money to pay for prescription drugs.
Canadian adults are two to five times more likely to report skipping prescriptions because of costs than residents of comparable countries with universal pharmacare systems, like the United Kingdom. In fact, Canada is the only country with a modern economy that has universal health care coverage and does not provide some form of universal access to prescription coverage.
A recent study from the Canadian Federation of Nurses Unions reveals the human costs of this problem. It has found, just studying two different serious health conditions, diabetes and heart disease, that every year up to 1,000 people die purely because they do not have access to the medicine that would save them. That means that there are thousands of Canadians, if we include all medical conditions, maybe tens of thousands of Canadians, who die unnecessarily and prematurely because this country simply does not provide them with the medicine they need.
On the other hand, despite this horrific deficit in human terms, economically, Canadians perversely consistently pay among the highest prices in the world for prescription drugs due to our fragmented patchwork of drug coverage. In fact, prescription drug spending in Canada has increased every year since the current Liberal government took power in 2015. I am going to pause, because in 2015 the gave a mandate letter to then-Minister of Health Jane Philpott, and in that mandate letter he specifically tasked her, as a major goal, with reducing the cost of prescription drugs in Canada. I think Canadians know anecdotally that their access to drugs has not increased in the last five years, and they know that the price of prescription drugs certainly has not gone down.
I wanted to get the scientific answer to that question, so two months ago I wrote a letter to the Canadian Institute for Health Information, CIHI, and I asked what has happened to drug prices in Canada since 2015, when the Liberals took power. What it found was shocking. It found that on absolute terms, Canada as a country has spent more money every single year on prescription drugs since the Liberals took office and, on a per capita basis, each Canadian in this country has spent more money on prescription drugs every single year since the Liberals came to power.
That mandate, which was given in 2015, to reduce prescription costs has not only gone completely unfulfilled, it has actually gotten worse. From an institutional point of view, prescription drugs represent the second-largest category of spending in Canadian health care, surpassing spending on physician services. Only what we spend on hospitals costs us more as a nation than what we spend on prescription coverage.
What happens when patients cannot afford their prescription drugs? Besides getting sicker, which I will talk about in a moment, they access provincial and territorial health systems more often as their condition deteriorates. In 2016 about 303,000 Canadians had additional doctor visits, about 93,000 sought care in emergency departments and about 26,000 were admitted to hospital after being forced to forgo prescription medication due to cost.
HealthCareCAN, the national voice of health care organizations and hospitals across Canada, estimates that between 5.4% and 6.5% of all hospital admissions in Canada are the result of cost-related non-adherence to prescription medication, resulting in costs that they estimate to be at least $1.6 billion per year.
It has been almost one year, a Parliament and a general election ago, since the Hoskins advisory council on the implementation of national pharmacare issued its report. What was the conclusion of that Liberal-appointed committee, headed by a former Liberal minister of health from Ontario, a committee that crossed the country listening to consultations from every stakeholder group across the country?
What did the committee recommend this Parliament do? It said that Canada must implement universal, single-payer public pharmacare and get started on it now. Not only that, it gave us a blueprint.
The Hoskins advisory council told Parliament to work collaboratively in partnership with provincial and territorial governments to begin the implementation of national pharmacare in 2020, right now. It advised that we should have federal legislation in place by January 1, 2022, that outlines how governments will work together and share costs. It listed federal responsibilities and said that legislation must include the steps required for provincial and territorial governments to opt into national pharmacare. That is in less than two years.
The council said that Parliament must act immediately so that we offer universal coverage for at least a list of essential medicines by January 1, 2022. That is about 20 months from now. It suggested that we implement a detailed national strategy and distinct pathway for funding and access to expensive drugs for rare diseases by January 1, 2022, and said that this country needs to offer a fully comprehensive formulary, covering all medicines that Canadians need, that are cost-effective and that are required to keep them healthy and covered by a public single-payer system, no later than January 1, 2022.
Liberals often accuse the NDP of being in a hurry. Let me just pause for a moment and review the history of pharmacare. It was in 1964 that the Royal Commission on Health Services, chaired by Justice Emmett Hall, who was appointed by the Conservative then prime minister John Diefenbaker, issued a report to Canadians saying that Canada needed to offer prescription drug coverage in this country. That was almost half a century ago.
It was 23 years ago, in 1997, that the Liberal Party of Canada promised Canadians in a platform, in writing, that if the Liberals were elected and given the privilege of serving as the government they would bring in public pharmacare and they would produce a timeline in that Parliament for doing so. Incidentally, the Liberal government has had at least three majority governments since then, as well as a minority. They have had 13 years of majority government and minority government to make that happen since that time, and they have failed to do so.
Is half a century for bringing necessary medicine to Canadians too much of a hurry? Is 23 years to have a political party deliver on a promise that it made to Canadians in a solemn platform, in a public way, too much of a hurry?
Almost a year has passed since the Liberal-appointed advisory committee recommended the same thing as seven different royal commissions, task forces, Senate committees and House of Commons committees of all types have recommended and come to the same conclusion on. I want to pause and emphasize that every single body that has ever looked at this question of what is the most effective, efficient and fair way to make sure that all Canadians get the medicine they need when they need it, has found that it is through a public single-payer model.
The NDP does not just talk. We act. We do not dawdle. We work, we create and we deliver. The NDP has done the work that the Liberals promised to do and have failed to do, and that the Conservatives refused to even commit to. That is, we have drafted the very first, historic, groundbreaking legislation to make pharmacare a reality in the Canada pharmacare act. We will be introducing that legislation in the House of Commons in the weeks ahead.
What would the proposed act do? It is based on the recommendations of the Hoskins advisory council, along with the other expert reports, and we have modelled it on the Canada Health Act because prescription medicine should be covered, like every other medically necessary service, through our public health care system.
Our act would enshrine the principles and national standards of pharmacare in federal legislation, separate and distinct from, but parallel with, the Canada Health Act.
That means that the federal government would take a leadership role and ensure pharmaceuticals were delivered to Canadians just as other services are delivered, with provinces respecting the principles of universality, comprehensiveness, accessibility, portability and public administration.
Like the Hoskins report, our legislation would come into force exactly when Dr. Hoskins said it should: on January 1, 2022. The bill says that the federal government should take leadership by providing a stable fiscal transfer to the provinces that agree to respect the principles of it and make sure their citizens get the drugs that are covered on a negotiated formulary at no cost, just like they do every other medically necessary service.
I want to pause a moment and go to those who cannot afford it. Study after study, from the Parliamentary Budget Officer to academics, says that we can cover every single Canadian in this country and save billions of dollars doing so. The Parliamentary Budget Officer, using conservative assumptions, said that we would save $4.2 billion every single year by bringing in public pharmacare. Academics have said that is a low estimate and it would be billions more.
Why is that? It is because by bringing pharmacare under our public health care system, we could have national bulk buying led by the federal government for 37.5 million Canadians. We could have streamlined administration. We could take those 100,000 separate private plans and fold those into a single streamlined, efficient and effective administration program in each province. We would save money from the results of cost-related non-adherence, because we know that when Canadians do not take their medications, they get sicker, and when they get sicker, they end up in the ICU.
It has been estimated that having one diabetic in the ICU for three or four days because that person did not take his or her insulin costs more money than giving that person free insulin for life. That is the kind example I am talking about, and we would save money by having universal pharmacare.
Finally, we would save money by using a disciplined, evidence-based formulary, and by having an independent body in this country that assesses medication based on science and that gets the best value for money and efficacy. That would form the basis for prescribing practices in this country, and it would better prescribing practices.
It is time to act. Canadians cannot wait any longer for this and should not have to wait any longer. This is an essential health care policy initiative. It is essential from an economic point of view. It has been found that an average Canadian family would save $500 a year with public pharmacare and that the average employer would save $600 per insured employee. I have rarely seen a public policy that has broader stakeholder agreement than public pharmacare.
Outside of the pharmaceutical companies and the insurance companies, every single stakeholder group that appeared before the Standing Committee on Health said that it supported what the New Democrats are proposing. Employers support it because they want a healthy workforce. They know that pharmaceuticals are the fastest-growing and most expensive part of their extended private health care plans, and they cannot afford it. They know it is better to have this delivered through the public health care system. That is why Canada spends less money per capita than the United States does in delivering health care, and we cover every single Canadian.
It is time to act. I no longer want to hear the Liberal government give excuses about why it cannot move faster and it is studying the situation and has work to do. I have never heard the or the , or in fact any Liberal health minister since 2015, utter a commitment to public health care. I have heard the Liberal tell his business colleagues that he prefers a U.S.-style private-public patchwork, but there has been radio silence from the government on public pharmacare. That ends today.
I challenge my Liberal colleagues to stand in the House today and tell Canadians if they support public pharmacare or if they support a private, U.S.-style patchwork. Canadians deserve to know. After 50 years of study after study telling us that Canadians need pharmacare, the New Democrats are going to continue to fight for patients and do what we have always done, which is to create and build public health care in Canada, just like Tommy Douglas envisioned back in the 1940s.
We are going to continue working hard until every Canadian has pharmacare, dental care, eye coverage, auditory coverage and full comprehensive coverage under a public health care system.
:
Mr. Speaker, I am certainly pleased to stand today to address the motion from the hon. member for . I congratulate him on his speech and I thank him for his work on the health committee.
The government is committed to implementing a national universal pharmacare program that ensures that all Canadians have access to the prescription drugs that they need. This is our goal, as clearly stated in the 43rd Speech from the Throne. It is a goal that we have been working towards for some time. While we are now closer than ever, it is important that we continue our measured, considered approach to implementation. We need to get this right.
This morning I will explain the steps the government is taking to make prescription drugs more accessible and affordable for Canadians. I will also explain why these actions are key to the implementation of a national pharmacare program.
Canadians should not have to choose between buying groceries and paying for medication, but for many people, paying for prescription drugs is a heavy burden and for others it is completely out of reach. Surveys show that more than seven million Canadians are either entirely uninsured or under-insured.
This means that many of these Canadians cannot afford to fill their prescriptions. They simply do without the medication they need. If their health absolutely depends on taking these drugs, they may forgo necessities, such as food and heat, so that they can pay for their prescriptions. We can no longer afford to do nothing. We cannot afford to wait.
That is why we asked Dr. Eric Hoskins and a panel of eminent Canadians to provide the government with a blueprint for a national pharmacare program. After hearing from many thousands of Canadians, the council found a consensus of opinion that everyone in Canada should have access to prescription drugs based on their need and not on their ability to pay.
The government shares this view. With national pharmacare on the horizon, addressing the affordability of drugs is imperative.
How do we do that? The first step is to update specific parts of our regulatory regime and bring them into line with the rest of the world.
Let me begin with a few words about the evolving use of pharmaceuticals in Canada and the associated increasing costs, costs that impact everyone.
Pharmaceuticals are important to the health of Canadians and a vital part of Canada's health care system. Drugs help cure or manage previously debilitating or fatal diseases, allowing Canadians to live longer and healthier lives. Diseases that were deadly 100 years ago, such as tetanus, diphtheria, polio and many others, can now be prevented by vaccination. An HIV/AIDS diagnosis was a death sentence at one time. New drugs offer innovative treatments for diseases like arthritis, hepatitis C and many types of cancer.
All this innovation comes at a cost. It is part of the reason that Canadians are paying higher prices for prescription drugs than they should. Patented drug prices in Canada are the third-highest in the world, behind only the United States and Switzerland. Canadian prices are, on average, almost 25% more than the OECD median for the same patented drugs. As a result, the private and public drug plans that cover the majority of Canadians are rapidly becoming unsustainable.
Let me give an example. Diabetes affects an estimated 3.4 million Canadians and is one of the leading causes of death in Canada. Canada spends nearly $600 million annually on new oral anti-diabetic drugs. The two top-selling oral anti-diabetic drugs cost Canadian public drug plans close to $1,000 per year per patient, twice as much as in France. Imagine the savings if Canada paid France's prices for these drugs. That is a lot of money. It is money that could be used to cover the cost of drugs for people with limited or no insurance coverage.
A second example is a drug used to treat a rare soft-bone disease. This disease used to be almost always fatal, but this drug changed the prognosis. However, it is one of the most expensive drugs in Canada, costing more than $1 million per year per patient, depending on the required dosage. Unfortunately, this high price resulted in difficult decisions and delayed access to the drug for many Canadians.
If Canada paid lower prices for all drugs, there would be more money available in drug plans to provide better coverage or to provide coverage to those without insurance.
Even outside the area of rare diseases, pharmaceutical costs keep going up. Drugs are now the second-largest category of spending in health care, and biologics and other specialty drugs account for an increasing share of these total drug costs. This rate of growth in drug costs is unsustainable, and it is hurting Canadians every single day.
As a trend toward higher-cost specialty drugs continues, we cannot continue to pay higher-than-average prices for drugs. What could we do? The answer is not to spend more. We already spend more per capita on pharmaceuticals than nearly every country in the world. We need a solution to bring fair prices and sustainable drug costs for Canada.
Part of the problem was that Canada's approach to patented drug price regulations was outdated. Our previous pricing regulations were established in the 1980s. We have more than 100 different public drug plans and thousands of private drug plans, which means that drug coverage is provided by a patchwork of payers.
It was well past time to bring these regulations into the 21st century. Canada needed a modernized approach to regulating patented drug prices, one that would provide long-term sustainability and protect Canadians from excessive prices. That is why last summer the government modernized the patented medicines regulations to provide the Patented Medicine Prices Review Board, or PMPRB, with the tools and information it needs to protect Canadians from excessive prices for patented medicines.
I want everyone to remember that Canada pays the third-highest costs in the world. As a comparison, we pay double what France pays on some drugs.
We will now benchmark prices against countries that are similar to Canada economically and similar from a consumer protection standpoint. Previously, the price ceilings for patented drugs in Canada were set by comparing our prices against prices in seven predetermined countries: France, Germany, Italy, Switzerland, Sweden, the United Kingdom and the United States. The list of countries has now been updated by removing the United States and Switzerland and adding Australia, Belgium, Japan, the Netherlands, Norway and Spain, for a total of 11 countries as comparables.
We then wanted the PMPRB to see the actual prices being paid in Canada, not just the list prices being published by pharmaceutical companies. When the PMPRB was created, the market prices of drugs matched the list prices. Over time, as a result of the significant confidential discounts and rebates negotiated by third party payers, actual prices paid in the market became significantly lower than list prices. Without access to this information, the PMPRB was left to regulate domestic price ceilings based on inflated list prices.
With the modernized regulations, patentees will be required to report Canadian price information as the net of all adjustments, such as rebates and discounts, so that the PMPRB is informed of the actual market prices being paid in Canada.
Finally, we wanted to consider the value that a drug offers and its overall affordability. Most other countries with national pharmacare programs already do this. When setting a price, we need to consider three things. First is the value for money: Does the drug offer a therapeutic benefit that justifies its cost? Next is the size of the market: How many people will benefit from the drug? Last is to consider Canada's GDP and GDP per capita: Can we afford to pay for the drug?
These changes will provide the PMPRB with the tools it needs to protect Canadians from excessive drug prices and bring us in line with the policies and practices of most other developed countries. This was a critical step toward improving the affordability and accessibility of prescription drugs. Taken together, we anticipate that these regulatory changes will save roughly $13 billion over the next 10 years. That is a significant saving for Canadians.
From those savings, public and private drug plans will have greater capacity to improve benefits for plan members or to consider new therapies not currently covered. All Canadians, including those with drug plans and those paying out of pocket, will benefit from lower prices for prescription drugs.
Modernizing pricing regulations complements the work already under way at Health Canada to streamline the regulatory review process for drugs by enabling priority drugs to reach the market more quickly. It supports the work already taking place under the pan-Canadian pharmaceutical alliance to negotiate lower prices for prescription drugs. As a member of this alliance, the Government of Canada is able to combine its buying power with that of the public plans in the provinces and territories.
It is estimated that the alliance saves public drug plans more than $2 billion a year. Successful negotiations result in more affordable prescription drug prices for public plans and lower generic drug prices for all players.
Before we can implement a national pharmacare program in Canada, we have to address the rising cost of drugs in the country by taking the steps I have outlined. Doing so will improve the viability of a national pharmacare program. National pharmacare, in and of itself, would be another step that could help us control drug prices.
I am confident that this government is on the right path. We are now exploring options as we move forward with a national pharmacare plan, and we are making significant investments.
Budget 2019 earmarked $1 billion over two years beginning in 2022, with up to $500 million ongoing to help Canadians with rare diseases access the drugs they need. This is very important. This is an investment that must be made.
Budget 2019 also proposed $35 million over four years to support the creation of the Canadian drug agency, an important step toward a national pharmacare program. We have pledged to work with provinces, territories and stakeholders on the creation of the Canada drug agency. This agency could use its negotiating power to achieve better prescription drug prices on behalf of Canadians. Negotiating better prices could help lower the cost of prescription drugs for Canadians by up to $3 billion over the long term.
I appreciate the opportunity to discuss some of the important work we are doing to prepare for the implementation of a national pharmacare program. Part of this effort involves addressing the affordability of prescription drugs, an essential building block for pharmacare. To do that, we have brought our regulatory approach to pharmaceutical pricing in line with approaches that are used in the rest of the world. The actions we have taken to improve the system will help to bring down the prices of prescription drugs.
I would very much like to thank the hon. member for for his motion. I am pleased to say that we are moving forward steadily. Each of the actions I have described today is helping to pave the way for an effective pharmacare program.
From bringing down prescription prices to improving the management of these drugs in our health care system, we are taking the time necessary to get this right, keeping in mind that the provinces and territories will have a key role to play in determining how pharmacare will take shape.
Pharmaceuticals are an important part of Canada's health care system. That is why federal, provincial and territorial ministers of health have made affordability, accessibility and appropriate use of prescription drugs a shared responsibility.
The updates we have made to the patented medicines regulations, when taken together with the Patent Act, will provide the PMPRB with the tools to protect Canadians consumers from excessive patented drug prices.
All of these measures are important steps in our plan to prepare for the implementation of a national pharmacare program. It is critical that the government work closely with the provinces and territories, as they play a key role in the development of a drug agency, the strategy for high-cost drugs and for rare diseases. Together we are making progress toward a more efficient and effective system.
Based on these initiatives and others I have outlined today, it is clear that we are in fact moving forward with the recommendations from the Hoskins report. I am pleased to support today's motion and urge other hon. members in the House to do so as well.
We must continue to collaborate with the provinces and territories. Our government looks forward to continuing these discussions while taking the critical next step to implement national universal pharmacare.
:
Mr. Speaker, it is an absolute pleasure to split my time with the member for , my seatmate and a well-informed member on this topic.
I think members from all parties can agree that we want Canadians to receive the best possible health care. However, universal or national pharmacare would have serious implications for all Canadians, without changing the status quo for most. According to a 2017 report by The Conference Board of Canada, 98% of Canadians either have or are eligible for private or public drug coverage, so we know that the vast majority of Canadians can access the medications they need without financial burden.
If we implemented a universal pharmacare program, this would not be the case. To pay for a universal system, taxes would have to be raised for all Canadians. We do not know how much that could cost, but estimates are around $15 billion annually. Under a universal system, the most vulnerable Canadians would see their cost of living go up due to higher taxes.
Canadians who currently have the coverage they need would give up some of their disposable income to fund the new system, while seeing no change to their quality of life or access to prescription medication. One thing I consistently hear from my constituents is that they cannot afford more taxes. They cannot afford higher living costs. Things are stretched tight as it is.
The government needs to be mindful of the economic times we are in. Oil prices are in free fall, COVID-19 is predicted to have significant impacts on our economy, rail blockades caused millions of dollars in lost economic development and companies are rethinking investing in Canada because of our “political climate”. Just yesterday, the TSX fell by almost 700 points, and we are now in what is called a bear market.
We are in uncertain times. Some have even called it uncharted territory. Right now, many Canadians are worried about their jobs and livelihoods. Now is not the time to implement a pharmacare program that would come at a massive cost on the backs of taxpayers. I am especially worried because of the huge deficit we already have, which is close to $30 billion. In December of last year, finance department documents showed it was at $26.6 billion and expected to keep rising. We will find out more when the releases his budget on March 30, the date we finally learned just yesterday.
We have this huge deficit, and I am still scratching my head and wondering why. We have been in relatively good economic times for the past few years. Canada was in good shape until 2015 thanks to the previous Conservative government that had the restraint to save and make tough decisions. The government has squandered that good fortune. Instead, it has gone on a spending spree and racked up unsustainable levels of debt and will leave the bill to our children and grandchildren.
Most economists know that one saves money in the good times and puts money away for a rainy day, as the saying goes. That did not happen, and now we are heading into a series of stormy days. The government cannot give any sort of clear answer on how it is going to respond to a recession. My guess is that it has no idea.
This is a crucial time for Canada. Companies no longer see Canada as a place to make a safe investment. The government has actively worked to shut down the energy industry with legislation like Bill and Bill . Thousands of hard-working men and women are finding themselves out of work in my home province of Alberta, and this has had a ripple effect on the entire economy. What does all this have to do with pharmacare? As I said earlier, Canadians cannot afford higher taxes, especially in these uncertain economic times.
In last year's budget, the government pledged to work with provinces, territories and stakeholders to create the Canadian drug agency and to spend $35 million to establish a Canadian drug agency transition office. The government's advisory group was headed by a former provincial Liberal, Dr. Eric Hoskins, a man who is no stranger to endless deficits and debt. It is no surprise that the report he authored recommended the creation of a universal system. It is always buy now, pay later.
The Canadian Chamber of Commerce has warned the government of the impact on workers should pharmacare be implemented. Its chief economist, Trevin Stratton, said millions of Canadians would lose access to medications they have under the current plans. He said the government needs to “carefully reflect” on how millions of Canadians who already have access to prescription drug coverage would be impacted.
Some families experienced this recently when the Ontario government implemented free prescription medication for people under the age of 25. This program, OHIP+, cost roughly $500 million a year when it was implemented in 2017. Private insurance for those under the age of 25 became obsolete. Many parents complained that medications for rare diseases were not on the list of approved medications under OHIP+. These medications had been covered under private insurance.
I worry that the same thing will happen with this government when it implements a universal pharmacare system across the country. The prescription medication that many people are currently using and covering the cost of through their private insurance may become unavailable if not approved.
Not only will a universal system put more strain on Canadians through higher taxes and deficit, but access to much-needed prescription drugs may be threatened. The Liberals have been promising a pharmacare plan for decades and have done absolutely nothing about it. It was in their 1997 election platform and was promised again in 2004. Any promises to implement pharmacare are purely for political posturing. In fact, their 2019 budget contained almost no health care money until 2022, well after the election.
We on this side of the House know that one of the best things we can do to help Canadians is keep taxes and the cost of living low. Fiscal restraint is required to ensure the prosperity of our future generations. We need to make good decisions now, and I do not believe adopting a universal pharmacare program is a smart decision. As I stated, it would have serious financial impacts through higher taxes and bigger deficits. It would threaten access to medications currently covered through private drug plans. Research shows that about 98% of Canadians already have or are eligible for private or public drug coverage.
While we know that some Canadians legitimately struggle to pay for access to prescription medications, this is not the case for the majority of our population. We already have one of the best health care systems in the world, and we should be proud of the system in place.
Instead of focusing on big-ticket items like national pharmacare, the government needs to focus on the unfolding economic crisis. We need urgent action to unleash our economy. Budget 2020 must include cuts for workers and entrepreneurs to reward investment and work, a reasonable plan to phase out the deficit and reassure investors, a rule to eliminate red tape and liberate businesses, an end to corporate welfare for favoured companies and an end to the wasteful Liberal spending that we have seen over the past four years.
We are all in the House to help our constituents and all Canadians. We want to see them be successful and get ahead. Implementing an expensive pharmacare system will not achieve this. It will put more tax burdens on hard-working Canadians and it is not needed by the vast majority of our population. These uncertain economic times are not suitable for introducing a $15-billion pharmacare plan.
:
Mr. Speaker, let me begin by acknowledging the excellent work of my colleague, the hon. member for , who is our shadow minister for health. I also want to acknowledge the work of all members of the Standing Committee on Health and the government members who are working very hard to keep Canadians informed on this major crisis we are going through as a result of the terrible COVID-19 virus.
Setting aside all the partisanship we see in the House, I think we have to recognize that we are facing a major national crisis. Whether on the government side or in the various opposition parties, a great many people are currently working hard to make sure that we can deal with this crisis in an intelligent manner and that the right measures are taken at the right time.
Again, I commend and thank all Canadians, public officials and provinces for their work and their efforts to help us cope with this crisis. I know that these people are spending an enormous amount of time trying to find the best possible solutions. I think we too must work very hard to overcome this crisis and at the very least keep these people in our thoughts.
Canadians must receive the best health care available, whether it is preventative measures, hospital stays or medications. That goes for all Canadians. Even the most vulnerable members of our society must also have access not just to common medications, but also to the most innovative drugs.
The Liberal Party included a universal pharmacare program in its election platform, but it was not transparent about the cost. It should be noted that this is not the first time that the Liberals have talked about pharmacare. It was in their 1997 and 2004 platforms, as well as in the 2019 budget and election platform. Unfortunately, nothing has been done in all that time.
We even heard the say to us that, for the first time, Canada has a Prime Minister who is interested in the pharmacare program. Is it not ironic to hear someone from that side of the House tell us that all the previous prime ministers did not really intend to deal with this issue even though it was in their election platform? I was rather shocked to hear those comments, which probably foreshadow what will once again happen with the Liberal promises.
The Standing Committee on Health spent two years studying whether a national pharmacare system could be implemented. The Liberals created a task force, which is another approach. When a government does not know what to do, it creates a committee. When it does not know what to say, it consults the committee. When no results are forthcoming, it blames the committee. That is probably what will happen once again with this other promise, this intention to implement a pharmacare program, because there is no reason to believe that this time, things will be different. The Liberals are masters at raising hopes with their promises, but they are even better at creating disappointment because they never keep their promises when it counts.
Those of us on this side of the House are well aware that many Canadians have a hard time getting and paying for prescription drugs. However, the Liberals make empty promises and blab on and on in committee and in the task force, while the most vulnerable Canadians are left to fend for themselves. Instead of looking for real solutions, the Liberals are implying that one day there will be a universal pharmacare problem, which is an empty promise that they have been making for decades.
Budget 2019 does not contain a pharmacare program. Instead, the budget proposes working with the provinces, territories and stakeholders to create a new Canadian drug agency and spend $35 million to establish a Canadian drug agency transition office. Blah, blah, blah.
The advisory council on the implementation of national pharmacare published its final report and submitted recommendations to the Government of Canada. These recommendations included implementing single-payer, public pharmacare. According to the report, a program with limited coverage would cost an additional $3.5 billion in 2022, and comprehensive coverage would cost an additional $15 billion a year if implemented by 2027. The Parliamentary Budget Officer says that pharmacare would have cost taxpayers $20.4 billion if it had been implemented in 2015-16. That is a lot of money.
The Conservative Party wants to ensure that Canadians get the best health care possible, but how can we trust the Liberals when they cannot even give us the facts and be transparent? They suggest that they might do certain things, but then they go ahead and do the opposite. In 2015, when the Liberals said that they were going to run small deficits, many Canadians believed them. Five years later, they have racked up $100 billion in deficits, when the deficit should have been only about $26 billion or $28 billion for that period. The Liberals were supposed to balance the budget, but they did not. Such is the Liberal reality.
We, on this side of the House, respect Quebec's decision to institute a universal pharmacare program. Quebec had the jurisdiction to implement its own program. It did so. All Quebeckers are now covered by a public and private universal pharmacare program.
The system is not perfect and, of course, it could be improved. However, a first step was taken by a government that is responsible for caring for its people. That is the path we should take. The goal is not to put a little flag on pill bottles, but to ensure that all Canadians have access to the medication they need.
I think history has shown us that the federal government is not necessarily in the best position to implement, administer and run a program as important as this one. The economy was doing well. The global economy was doing well. During that time, the government spent freely. It put the country in debt. It used up all the wiggle room that the previous Conservative government had left behind. Now we are facing a major crisis, and there is no more wiggle room. The government does not have a penny left to pay for initiatives. We cannot trust the Liberals to manage universal pharmacare. They will lose control again, as they have done so many times already. There are plenty of examples.
I am the infrastructure critic. When we ask the government to provide us with a list of projects that have received funding from its $186-billion plan, we are told there is no list. In other words, the Liberals have lost track of 52,000 projects. That is the number they gave us.
We ask them for a list, but they cannot give us one, and today they say they are going to implement pharmacare for all Canadians. They are going to lose the game plan. They are going to lose something. This will not work. The cost will spiral out of control. This government is not capable of managing Canadians' money. We know that from experience. If it spent less time giving handouts to Loblaws, Mastercard and its buddies in the private sector, maybe it would have more time to spend on health care. It would be able to transfer more money to the provinces so that they could get started on their own agendas, as Quebec did.
In the last election campaign, the Conservatives pledged to increase and maintain Canadian health transfers and social programs. Those are logical choices that demonstrate our respect for provincial jurisdictions.
In conclusion, I want to mention an outstanding company in my riding, eTrace Medical Diagnostics. This company has developed a made-in-Quebec technology for early detection of cancer by breath analysis. That means cancer could be diagnosed earlier. This could lower the cost of treatment for all Canadians by diagnosing cancer at a very early stage just by analyzing a person's breath.
Several weeks ago, I sent the entire document to the to request a meeting with that company. The company does not want any money, it wants to know what it will take to get this technology deployed by Canadians for Canadians and not by foreign powers, because the company might be sold.
I received no response from the Minister of Health. I did not even receive an acknowledgement of receipt.
These are concrete measures to ensure that Canadians can get better treatment and to lower the cost of drugs. When we know that cancer is one of the worst diseases, that it affects the most Canadians and that we have a solution, I wonder why the government is hesitating and will not even meet a company that is on the verge of something that may change the lives of millions of people in Canada and around the world.
:
Mr. Speaker, I will be sharing my time with the member for .
I am pleased to speak to the motion moved by my NDP colleagues.
To start, the motion is calling on the House to:
(a) acknowledge the government’s intention to introduce and implement national pharmacare;
(b) call on the government to implement the full recommendations of the final report of the Hoskins Advisory Council on the Implementation of National Pharmacare....
I will stop there.
I am a member of the Bloc Québécois and a member from Quebec. During the last election campaign, I pledged to be the voice of Quebeckers in the House of Commons and to defend their interests. When a national assembly speaks unanimously on an issue concerning the relationship between Quebec and Ottawa, the Bloc Québécois takes notice and ensures that this consensus is echoed in the House of Commons.
I will read the motion that was adopted unanimously by the National Assembly on June 14.
THAT the National Assembly acknowledge the federal report [the Hoskins report] recommending the establishment of a pan-Canadian pharmacare plan;
THAT it reaffirm the Government of Québec's exclusive jurisdiction over health;
THAT it also reaffirm that Québec has had its own general prescription insurance plan for 20 years;
THAT it indicate to the federal government that Québec refuses to adhere to a pan-Canadian pharmacare plan;
THAT it ask the Government of Québec to maintain its prescription drug insurance plan and that it demand full financial compensation from the federal government if a project for a pan-Canadian pharmacare plan is officially tabled.
Our National Assembly is speaking with one voice across party lines. It is fair to say that, when our National Assembly, a parliament of the people, of the Quebec nation, speaks with one voice across party lines, it is Quebec that is talking.
I would have liked my NDP colleague to take into account the will of the Quebec nation in the wording of his motion, especially since the 2005 Sherbrooke declaration is part of his party's history. The Sherbrooke declaration recognized asymmetrical federalism and intended to give Quebec the systematic right to opt out. It does not sound as though the NDP wanted to take into account the unanimous voice of Quebeckers in this motion. That is why the Bloc Québécois will vote against it.
The more progressive the successive federal governments, the more they seem to get bored of their areas of jurisdiction and their responsibilities. The government wants to create social programs. That is a noble intention, but it falls outside the government's jurisdiction.
When it comes to health, the federal government would have been more help to the Quebec nation and the various provinces if it had kept its 2015 election promise to increase health transfers. More than $4 billion over four years could have been invested in the respective health networks in order to take care of our population and fulfill our responsibilities.
The federal government has a hard time managing programs like Phoenix, and Canadians are not likely to forget that anytime soon. Rather than try to assert jurisdiction over health care with respect to access to medication, the federal government should focus on controlling the cost of medication. Drug prices are soaring, and the government is being complacent by refusing to immediately enforce the new Patented Medicines Regulations, which would save $9 billion over 10 years.
I began my speech with such enthusiasm, but I must not forget to stop after 10 minutes because I am sharing my time with the member for , who is listening to me very intently right now.
The Bloc has more faith in Quebec than it does in Canada, so it is surprising that a progressive party like the NDP wants a nation that is behind the times compared to ours to tell us how to be progressive.
Generally speaking, if we compare the two, Quebec's social safety net is broader than Canada's. Quebec also has the best family policy in North America, with parental leave and child care. Post-secondary studies are easier to access in Quebec than anywhere else in North America, and we have low tuition fees and plenty of financial aid. Our tax system is the most progressive in North America because income inequality, as measured by the Gini coefficient, is 0.31 for Quebec compared to 0.42 for the United States and 0.37 for Canada.
I would now like to talk about Quebec's pharmacare program, which has been in place since 1996. Yes, we have our own pharmacare program, and all Quebeckers are covered. It may not be perfect, but it is unique in North America.
Under Quebec's Act respecting prescription drug insurance, every person living in Quebec must be covered at all times by a pharmacare program. Workers and their families must be covered by private insurers. The rest of the population is covered by the public system administered by the Régie de l'assurance maladie du Québec. It is therefore a hybrid system. The public portion of the program costs the Quebec government $3.6 billion.
However, recognizing that the Quebec system is the best on the continent and emphasizing Quebec's right to make its own decisions does not mean that our system is perfect. Here is the problem. For the public part of the program, the government has managed to negotiate lower drug prices and limit dispensing fees. Pharmacists, and especially drug companies, have made up for that by inflating the prices they charge private insurers, so much so that the cost of private insurance has skyrocketed. That means more money not going into workers' pockets.
This problem is being exacerbated by a transformation in the pharmaceutical industry. It has been quite a while since the industry discovered any new molecules that could be used for a wide range of diseases. Newer medications are targeted at narrow groups of people, which means that research costs are spread over fewer people. As a result, costs are soaring.
Between 2007 and 2017, the average annual cost of treatment for the top 10 selling patented medicines in Canada increased by 800%. The number of medicines with annual per-patient costs of at least $10,000 increased sevenfold, from 20 to 135. These high-cost medicines account for 40% of new patented medicines. Fully 30% of insurer spending is allocated to these medicines, which cover less than 2% of beneficiaries.
Quebec's hybrid system may have reached the limit of what it can do for Quebeckers, but that decision is up to them. Quebeckers are perfectly able to look after their system and make improvements.
:
Madam Speaker, I would like to congratulate my colleague from Montcalm on his excellent speech. I could almost say that there is nothing more to add. In fact, he said it all and left me with practically nothing to say.
In any event, as the Standing Orders would have it, I will add my voice to that of the hon. member for Montcalm. There may be some overlap, but that will only illustrate that the Bloc Québécois speaks in the House with one voice, the voice of Quebec.
We have heard our NDP colleagues present the same arguments in the House a few times now, either during question period or in their interventions. I have heard some extremely compelling arguments about the difficulty many Canadians have paying for the drugs they need for their health. I have to say that I appreciate the arguments being made by our NDP colleagues and why they are making them here.
The problem is that they are making these arguments in the wrong parliament. Under the Constitution Act, 1867, and the new version that was imposed on us in 1982, which changed nothing in this area, health is the exclusive jurisdiction of the provinces. The federal government has a very bad habit of meddling in the provinces' jurisdictions and neglecting its own. Rather than looking after its own affairs, it seems that it is always tempted to stick its nose in the affairs of others.
We saw this, for example, in the recent crisis involving the Wet'suwet'en. Under the Constitution, the federal government still has fiduciary responsibility for first nations in Canada, but the continued to repeat that it was up to the provinces and police forces to intervene. It was a crisis that strictly affected western Canada and relations between the federal government and a first nation, but every day the Prime Minister repeated that it was up to the provinces and the police to intervene.
The federal government meddled in the health sector. It left a bad taste in our mouth, and we are still talking about it today. My colleague referred to this, and I would like to expand on this subject.
One day, the federal government woke up and wondered whether it would be a good idea if all Canadians across the country had the same pharmacare coverage. The provinces answered that health care is their domain. The government then offered to foot 50% of the bill, hoping that would get the provinces on board. The provinces approved and said they agreed.
Today, the federal government is covering about 17% of the bill. Right now, we have to fight tooth and nail just to get the federal government to do the bare minimum and cover the increases to system costs, since the provincial health transfer escalator is 3% a year. However, health care costs across Canada, especially in Quebec, are rising at a rate of about 5%. We would like the federal government to increase its contribution, not to 50% as initially promised, but to a mere 25%. We are therefore requesting an annual escalator of just over 5%, but even that is asking too much.
For Quebec, it is a case of once bitten, twice shy. We are not exactly eager to have the federal government put its paws all over this yet again. The Quebec government gets the money to pay for its own pharmacare plan from the overall health care budget, but this overall budget is being underfunded by the federal government.
Are we going to let the federal government put its paws all over health care again? Certainly not. We suffered through previous federal government interference in health care. Years and decades later, we are still asking the federal government to reverse the changes that were made to health transfers by the previous Conservative government, which capped them at 3% a year.
That does not cover rising health care costs. There is a shortfall because annual increases to federal health transfers have been anemic. There is a shortfall, which means that the federal contribution to health is actually shrinking. That is a fact. Do we want the federal government to do more? No, for goodness' sake, no more federal involvement. The more it does, the more harm it causes. We do not want that.
My NDP colleague said she understands that Quebec is distinct and wants its own system. Why is that not reflected in the motion, as my colleague from requested? This is the second time this has happened. The first time, the New Democrats were so surprised that the Bloc Québécois voted against their motion. I turned to the NDP's House leader, who wanted to me support his motion today, and I asked him why the motion did not say anything about letting Quebec maintain its own drug program and giving it the right to opt out with full compensation. The NDP's latest motion says nothing about that either. Why is it so hard for them to understand?
We are not going to make any commitments based solely on our colleagues' empty words. Empty words have caused nothing but trouble for Quebec and the provinces. Provinces are still struggling with what came to be called a fiscal imbalance. The tax base they were allocated to fulfill their responsibilities was far below what they needed. At the federal level, however, the tax base exceeded the government's needs, which means that, historically, the federal government has ended up with a lot of money. Not knowing what to do with that money, it decided it would be a good idea to take it and stomp right over provincial jurisdictions.
If the government is so flush with cash to invest in health care, it should increase transfers so that the provinces and Quebec can meet their needs. We are facing a global public health crisis, yet we are still quibbling over an increase to health transfers.
I think that if the federal government wants to do something, it should focus on its own areas of responsibility. With regard to prescription drugs, there are two things that fall to the federal government. First, the federal government needs to increase health transfers. That is the first thing. As I mentioned, Quebec has its own pharmacare plan, but it is funded from the overall health care budget. If the government increases its health transfer contributions, it will give the Quebec government some breathing room, which will help the province maintain its pharmacare plan and its health care system in general.
The second thing that the federal government needs to do is something we have been long waiting for, but it always gets put off. It involves amending the regulations so that Canadians stop overpaying for drugs. Our drug prices are aligned with those of several other countries, which, for a variety of market-related reasons, traditionally set prices too high. The United States is a classic example. The government needs to amend the regulations and stop aligning Canada's drug prices with those of the U.S. That alone will substantially change the cost of medication.
Instead of trying to meddle even more in Quebec and provincial jurisdictions, you should mind your own business and do what you have to do. One thing you must do at the federal level is amend the regulations.
:
Madam Speaker, I will be splitting my time with the member for .
Today, I am rising in the House once again to address the issue of pharmacare. It is unfortunate, frankly, that we are still only addressing this issue through opposition day motions. It is a testament to the fact that the government has not brought anything to the House that would advance the cause of a national pharmacare program. It is something that we know we need. We have made these arguments many times before, and Canadians themselves have a real and intense sense of the need.
In a telephone town hall in my riding, we held a straw poll of the several hundred people on the call. We asked how many people, either themselves or people they knew, close friends or family members, were cutting their pills in half, choosing to go without food, struggling to pay the rent or going without their prescription drugs because they had to choose between food and rent. We asked how many were dealing with the consequences of not being able to manage their illnesses, and it was about a third of people in Elmwood—Transcona. That is consistent with national polling that says a lot of Canadians are in this boat. Why are they?
If we look at international drug pricing, we know that Canada pays among the highest prices for drugs. The , earlier in this debate, said we need to figure out why it is that Canada is paying among the highest prices in the OECD. We know why. It is because we are one of the only countries without a national pharmacare plan. It is not a puzzle or a mystery. We know exactly why. The Parliamentary Secretary to the Minister of Health was talking about how they are working at the problem around the edges and wondering why they are not having any success.
We know from report after report, going back to the 1960s, that the way to make serious progress on this issue is to cut right to the heart of the matter and have a proper national, universal, single-payer public pharmacare plan. If we were to do that, we would see Canada's standing on the OECD drug price list go down significantly. It is not a mystery. The only mystery is why a party that promised this 23 years ago in its election platform, and has had a number of majority governments since, has not been able to get it done. It is charitable to call it a mystery. It is a mystery if we do not give what I think is an obvious explanation to those who are not in a charitable mood, which is that drug company and insurance lobbyists clearly have a lot of influence on the government, and that is why we are not able to make headway on this important issue.
What we hear from the Liberals is that the NDP wants to move too fast, that it is in such a hurry. When we talk about a policy proposal from the 1960s, and a Liberal promise from over 23 years ago, I hardly think that New Democrats are moving too fast. That would be like saying that somebody who took out a 25-year mortgage on their home was moving too quickly and the person should not have amortized the home over 25 years, but longer. We can do a lot in 25 years. People have died waiting for a national pharmacare plan, and I hope there will not be any more. The evidence and the research is there. We hoped we had the conditions in this Parliament to make it happen.
Earlier in the debate today, there was talk of establishing medicare across the country and how that was a function of collaboration between a Liberal minority government under Pearson at the time and the NDP in the 1960s. New Democrats had hoped that there was the willingness on the part of the Liberals to make a bold policy move. The circumstances today are the same as then, and we are willing to work with the government.
We have drafted legislation that provides a framework and put forward the motion today. The research is already out there. Not only is it out there by the Parliamentary Budget Officer and a number of civil society and academic groups that have studied the issue, but the government commissioned its own report from the last Parliament that recommended exactly what we are proposing. The research is done. The conditions in Parliament have been obtained.
If the Liberals need somebody to blame, they can tell the insurance and drug companies, “We were trying to look out for your profits, but those bloody NDPers just would not give us a break and we had to do it.” Liberals can blame us; that is fine. We do not mind looking bad in the books of insurance and pharmaceutical companies if it means getting a win for Canadians struggling to pay for their drugs. They can blame us. That is how we have gotten a lot of good stuff done in this country.
The problem is that the government does not want a deal, and it does not want to move forward. I think the frustration here is that a lot of Canadians felt if we got a Parliament that looked like this one, we could move forward on a common-sense policy proposal.
Often when we talk about helping people out, common objections that come up are what it is going to cost and where we are going to find the money. The fact of the matter is that we can afford to not only maintain the existing level of service, but expand it to everyone and save billions of dollars at the same time. The money is already being spent. In fact, we are already overspending on prescription drugs in Canada. We have the research. We thought we had the political conditions to be able to get this done.
Part of what is happening, if we look at this and the reluctance of the Liberals to use this Parliament to make significant gains, is a little like outdated conventional wisdom. This is not grandpa's Liberal Party. It has not been the same since 1993, but there is still an image in the heads of a lot of Canadians. They think back to constructive minority Liberal governments that worked with the NDP to get good things done, but today it is like putting butter on a burn. That was something that people used to do because it seemed like a good idea.
However, when we look at the evidence that we have so far in this Parliament, and from the Liberal majority governments from 1993 onward, we can see that it is becoming a dated notion. The evidence disproves the claim that Liberals are here to do real progressive work and are willing to sign on to innovative new social policies that not only save money but also expand service for Canadians. I think that is a message that Canadians should take seriously.
There was a lot of talk in the last election about what a minority Parliament could produce, and I know that for people not just in Elmwood—Transcona, but right across the country, there was a real hope that we would be able to get this kind of collaboration. This is a starting point, as I have said. We have done a lot of work in order to make it as easy as possible for the Liberal government to move ahead. It is something that we desperately want to see. It is something that, when we look at the potential benefit to Canadians in their everyday life, is huge, and it is rare that we get that kind of benefit while saving money at the same time.
According to the Parliamentary Budget Officer, we are talking about over $4 billion a year that we are already spending that we would not have to spend. Members can look at some of the other studies. They talk about $6 billion, $8 billion or $10 billion a year that we could be spending. I think the PBO report is universally acknowledged as being quite conservative in its assumptions.
Here we are. We have the political conditions. We have the research. We can get it done. That is exactly what we need to do, and we are waiting for that to happen.
An hon. member: You have to call for split time again. They did not hear you.
Mr. Daniel Blaikie: I know.
:
Madam Speaker, first I want to thank my hon. colleague for splitting his time and thank him for his excitement about me speaking. I am honestly in awe of his speech. He spoke eloquently and made it so clear how this is sensible and straightforward.
In Canada, we have a universal health care system and it is a source of pride for many people in our country, especially when we look south at the inequalities in the U.S. private health care system. Everyone should be able to access health care. It is not just for the people who can afford it. Health care is a fundamental human right.
However, Canada, as has been mentioned before, is the only industrialized country with a so-called universal health care system that does not include universal comprehensive public coverage for prescription medications. When it comes to medications, we are actually more similar to the U.S. than we are different. One out of every five Canadians is not taking their medication because they cannot afford it. Many Canadians are cutting their pills in half or even skipping their medication completely. Too many Canadians are ending up in the ER and in hospitals for longer stays because they cannot afford the essential prescriptions that they need. Hundreds have died prematurely every year.
Even people with private drug coverage have been seeing their employer benefits shrink, finding themselves working in more precarious jobs and feeling the squeeze on their family budget. Out of the three million Canadians who cannot afford their medication, 38% of those are on private insurance, but that private insurance does not actually cover enough of their costs and 21% have some form of public insurance that does not fully cover their costs.
Canada's currently fragmented, patchwork system of drug coverage, where each province is offering different levels of coverage with more than 100 public and more than 100,000 private drug insurance plans, is not working for Canadians. This patchwork system is also one of the main reasons why as a country we are consistently paying among the highest prices in the world for prescription drugs. Why is this allowed to occur when it does not make sense for Canadians?
The Liberals have been promising pharmacare for 23 years over and over again, but instead of delivering on that promise to Canadians, they have been helping deliver bigger and bigger profits to pharmaceutical and insurance companies. We recently found out that a so-called national pharmacare working group was sponsored by some of the biggest pharmaceutical and insurance companies in the world. We know that these pharmaceutical companies have been lobbying pretty effectively against single-payer pharmacare. A truly universal pharmacare system is not in the interest of these multinational corporations, but it is in the interest of hard-working Canadians. It is in the interest of small businesses and start-ups.
The federal government's own expert panel found that a universal single-payer system would save businesses over $600 per year, per employee. It would also particularly help small businesses and start-ups currently unable to afford employee drug coverage since it not only removes financial burdens from these businesses, but it also boosts productivity and results in fewer sick days.
It is in the interest of Canadians and small businesses. Health experts say that this is the way to go, but it is not in the interest of big pharmaceutical lobbyists. Who is the government going to listen to? For 23 years, over and over again, each time the Liberals say they are going to look out for Canadians, they turn around and look out for multinational pharmaceutical corporations. Last year, they promised pharmacare again, but they have taken no concrete action to make it happen.
In order to establish universal public pharmacare across Canada, Parliament must pass enabling legislation and the federal government must negotiate transfers with the provinces and territories, yet the Liberal government has remained silent on these foundational steps. Despite campaigning on pharmacare last fall, it has not committed to a truly universal single-payer system as recommended by its own Hoskins report. It also has not provided any timelines for implementation.
People are struggling now and they need action now. A resident of Victoria shared with me that he is on a disability pension and he spends about $100 a month on prescription medication. He knows he should be eating healthier food to complement his medication, but he is struggling to afford both.
This choice is all too common, choosing between essential medication and life's basic necessities. This is a choice that people should never have to make. The government has an opportunity to remedy this. The NDP is introducing this motion and, if passed, if we established a Canadian pharmacare act and provided the first steps in making universal pharmacare a reality, we could address the concerns of this resident and the many Canadians who are struggling to pay for essential medication.
Yesterday, the World Health Organization declared COVID-19 a pandemic. Once implemented, a pharmacare plan would be free for Canadians, it would make emergency wait times shorter, free up hospital beds and save the government $4.2 billion. Countries around the world are facing the possibility of having their health care systems overwhelmed. Now more than ever we need to make sure that ER wait times are shorter and that we have free hospital beds for those who really need them. We need to make sure that Canadians have access to the services that they depend on.
Canadians are struggling to access medication, and they are struggling with affordability of housing, food, dental care and child care. It is hard to make ends meet while everything is getting so expensive. This plan would save Canadians an average of $500 a year, and it would save employers $600 a year or more per insured worker.
I heard from so many of my community members who struggle to afford their medication, and I promised that I would fight for them. I promised that I would fight to take the next big step for our country with a truly universal, public, single-payer pharmacare system.
Like so many, when we are talking about health care and the cost of medication, it feels personal. My dad was diagnosed with terminal cancer just over 10 years ago. At the time, the doctors told him that he had about nine months and that he should be preparing his family. At the time, he joked and said that the downside was that he had cancer so bad that they could not do anything for him. The upside was that he had cancer so bad that they could not do anything for him. Luckily they did. He was put on an experimental clinical trial with an experimental treatment of calcium flushes for the bone cancer, and he is still with us today. He still has cancer, and his medication costs have fluctuated over the years, sometimes totalling $3,000 a month. Thankfully, most of it is covered.
If members could not already tell, my dad has a dark sense of humour, like many cancer survivors. He joked with me a few months ago that, thank God he has terminal cancer so that his medication is covered. However, there is a sad seed of truth in that. Many people in our country are struggling to pay for essential medication. Nobody should have to make the choice between food and medication, between paying for their rent and keeping a roof over their head and paying for their prescriptions. We need a government that is truly committed to universal pharmacare, not one that is trying use a hodgepodge of pharmacare promises, a patchwork system and more empty words to signal to voters that they are still progressive.
Adding medication to our national health care plan cannot be another broken Liberal promise. It cannot be, “Maybe someday we'll get around to it.” This is about life and death, and we need a government that understands that. We need to think boldly again, and we need to do the hard work to continue to build a country that we can be proud of, a Canada where people have access to the services they need when they need them, where nobody is making these impossible choices, and where politicians understand that these issues are personal to so many Canadians.
To me, fighting for that Canada, it is personal. We need courageous action from our elected officials, so I urge each colleague to support the Canadian pharmacare act because it is the right thing to do for constituents. It is my hope—
:
Madam Speaker, I will be sharing my time with the member for .
Today's motion is about pharmacare. Perhaps I will lead with my conclusion. I will be supporting this motion. I will be supporting it because quite frankly I am sick of knocking on the doors of seniors who tell me they have to split their medication because they cannot afford it, not only putting themselves in a difficult financial position but reducing the effectiveness of the medicine they have been prescribed.
Most of the people I talk to at home, and I dare say most Canadians, are happy with their own coverage right now. However, the golden thread that runs through the social fabric of Canada is that as Canadians, we care as much about our neighbours as we do about ourselves. It is incredibly frustrating for me to know that one in five Canadian households report that a family member is not taking his or her medication because he or she cannot afford it. I am sure that the 36 million Canadians who do not suffer from this problem are disappointed to know that one million Canadians cut back on their food or home heating because they cannot afford the cost of their pills. When my neighbours cannot afford the cost of their medication, it decreases the quality of my life to know I live in a society that does not adequately take care of its vulnerable.
One of the greatest frustrations I have as a federal member of Parliament is that the number one issue for my constituents is their health care system, whether that is access to a family doctor, the quality of mental health services, in-home care for their aging parents or a lack of access to quality medications. They sometimes end up at my office, despite the fact that health care is primarily a provincial responsibility under our Constitution. It is cold comfort for the people who bring these kinds of concerns to my office for me to say that I have to wash my hands of it because it is a provincial responsibility. What they are looking for is help in often desperate circumstances.
Despite the fact that there is this constitutional division of power, there are concrete things the federal government can do, such as transfer more money to the provincial health care systems, invest in research, invest to ensure we can do something to combat the family doctor shortage, or, yes, implement a national pharmacare program to ensure people have access to the medications they have been prescribed so they can be healthy, regardless of the financial circumstances they may have been born into through no fault of their own.
There are two categories of problems I see with the lack of access to an adequate national pharmacare system.
First is the lack of access to medication because of issues surrounding affordability. I find this to be a real problem. It discriminates against our seniors on the basis of their age, because they do have increased health care concerns as they get older. It discriminates against people who are living in poverty, because they cannot afford to access drugs.
It is heartbreaking to knock on a door that is answered by a child who has not had enough to eat that day and then to sit down with his or her parents, who explain the child has been prescribed medication to which they do not have access. It also discriminates against people who have an underlying health condition that may not be the subject of coverage through private or public insurance plans. In fact, of the people who report they cannot afford their medication, 38% have access to a private insurance plan and 21% have access to public coverage that does not cover their needs.
Second, in addition to the lack of access is an issue around the lack of systemic savings that we are not benefiting from because we have not been moving forward.
The , a colleague of mine from Nova Scotia, quite eloquently has described the fact that Canada is the third most expensive country in the world when it comes to the costs of medication, ranking only behind the United States and Switzerland.
We are so proud of our public health care system and the universality of it. No matter where people come from or who their parents are, they will be taken care of when they fall ill. The same is not true, and a lot of Canadians do not appreciate this, when it comes to access to the medications they need, which are often to sustain life or remain healthy.
Part of the reason this is the case in Canada is that we have a very serious patchwork of provincial and territorial programs and over 100,000 private sector health care plans in Canada. We do not necessarily benefit from the opportunity that presents itself when we can negotiate bulk purchases of medications. Some efforts have yielded success by partnering with various provinces. However, if we adopt the Costco model and buy in greater volume, we can reduce the price per unit and extend access to people who currently cannot afford their medication.
I have seen estimates in excess of $4 billion of systemic savings that come not only from a reduced cost in the price of medication, but also fewer visits to emergency rooms, fewer hospitalizations and more seniors being taken care of in their homes because they can afford access to the medication they need to be well.
We all can appreciate that there is a problem with access to medication in Canada. Over the past few years we have been working toward solving this problem.
Just a few years ago, we appointed an advisory committee, led by Dr. Eric Hoskins, the former minister of health for the Province of Ontario. That effort led to a report that identified the path forward to a national pharmacare program. The committee flagged that it would not happen overnight, but there were certain things that needed to happen to bring down the cost of drugs so we could benefit from the systemic savings that would accrue once we implemented those steps.
One of the very first steps we thankfully moved forward with in the last federal budget, with a $35-million investment, was the creation of the Canada drug agency. This body would be able to assess the effectiveness of drugs that could be proposed to enter into the Canadian system. It would provide an opportunity to negotiate better prices because of the purchase of increased volume that could be administered through the provincial public health care systems. The creation of a national formulary would allow us to ensure we would have consistent coverage, regardless of which community or province in Canada one may live.
In addition to the creation of the Canada drug agency, we have created a national strategy for high-cost drugs and rare diseases. This is important. Quite a few Canadians live with a condition that, despite the fact they may have coverage, do not have access to the medication because of its exorbitant cost or their insurance policy may not provide coverage for their particular condition or its required medication. We have earmarked $500 million annually for this approach.
It is simply not fair that the circumstances of people's birth means they would not be entitled to benefit from the medication that could keep them alive. There are still problems in Canada. Tragic cases pop up in every corner of our country each week. However, by moving forward with this rare disease strategy, we will be able to help some of the most vulnerable Canadians.
In addition to the creation of a drug agency and rare disease strategy, we have also moved forward with changes to patented medicine regulations, changes that will save billions of dollars to our health care system. One of these changes adds additional factors that need to be considered so the cost of drugs reflect the benefits to public health care system in which they can enter. Some of the regulations will require better reporting to ensure our regulations reflect the actual cost of medication.
Perhaps most important, from my perspective, is we have changed the comparator basket of countries we look at to set drug prices for Canada by removing the United States and Switzerland, the two most expensive countries in the world, and added other comparator countries with similar economies, such as the Netherlands and Japan, which will lead to a systemic reduction in the cost of medication in our country and, most important, for Canadians who need that help.
Health care is front of mind for people back home, whether it is access to a family doctor, the fact that their parents cannot find a place in a long-term care facility or the underserved mental health services in their communities. I hear about these things non-stop because people recognize there are problems. Whether they live with those problems or not, they are equally concerned for the people who live in their communities who do not have access to life-saving services and, importantly, life-saving medication.
There is something we can do. We can implement a national pharmacare program to ensure that no matter where people live, no matter where they were born or their parents' economic situation, they will not be denied access to medication because of their financial circumstances.
It is Canada in the 21st century. Canadians expect that they and their neighbours will have access to the medications they need to be well. By implementing a national pharmacare program, we can turn that dream into a reality for the millions of Canadians who go without the medicines they so desperately need.
:
Madam Speaker, it is a pleasure to rise today to discuss the motion tabled by the member for related to pharmacare. I too will be supporting this motion, because I believe and our government recognizes that the cost of drugs can directly affect the lives of Canadians.
Families should not have to choose between putting food on the table and paying for the drugs they need. That is why we have committed to implementing universal pharmacare to ensure that all Canadians have equitable and affordable access to the medicines they need.
Today I would like to highlight how the federal government is supporting innovative research to advance drug discovery and develop new therapies to improve the health of Canadians.
The Canadian Institutes of Health Research is the main federal agency responsible for funding health research across Canada. Every year the Government of Canada, through this group, invests over $1 billion in research initiatives that will generate new knowledge and evidence and lead to better and more affordable treatments for Canadians. Clinical trials are the cornerstone of an evidence-based practice and ensure timely access to new drugs and treatments for Canadians.
In 2016, CIHR launched the innovative clinical trials initiative. With an annual investment of $11.7 million, this initiative is supporting research focused on the development and implementation of innovative methods in clinical research. This specific initiative is part of the larger strategy for patient-oriented research, a national coalition of federal, provincial and territorial partners dedicated to the integration of research into care.
The SPOR innovative clinical trials initiative will contribute to increasing Canadian competitiveness in innovative clinical trials research and provide a stimulus for researchers to adopt new methodologies to conduct clinical trials. It will also encourage collaboration with various stakeholders, including patients, decision-makers and key stakeholders.
Innovative clinical trials use designs that are alternative to traditional trials methodologies. These new methods can reduce the cost of conducting trials, reduce the amount of time needed to answer research questions and increase the relevance of research findings to patients, health care providers and policy-makers. The direct outcome of these new methods is improved effectiveness of the trials while keeping the same high safety and effectiveness standards for the drugs. This will result in lowering the cost of drug development, ensuring that new, affordable and effective drugs are available for Canadians.
As part of this initiative, CIHR is supporting the CLEAN Meds project, led by researchers at Unity Health Toronto. Through a randomized controlled trial, researchers are investigating the effects of providing patients with free and convenient access to a selected set of medications. Each person is randomly assigned to either receive usual access to medications or to receive access to essential medications at no cost.
Preliminary findings from the CLEAN Meds trial demonstrate that the distribution of essential medicines at no charge for one year increased adherence to treatment medicines and improved some disease-specific health outcomes. These findings could help inform changes to medicine access policies such as publicly funding essential medicines.
Through the innovative clinical trials initiative, CIHR is also supporting a team led by Dr. Jacob Udell at the Women's College Hospital in Toronto. This work is looking at ways of leveraging big data to facilitate recruitment of patients in clinical trials, measurement of patient characteristics and follow-up of patient outcomes. It is expected that this approach will transform how clinical trials are conducted in Canada, which would ultimately contribute to lower drug development costs.
Leading researchers across the country are also conducting research to improve the safety and effectiveness of drugs. For example, CIHR is supporting a research project led by Dr. Michal Abrahamowicz at McGill University that aims to improve monitoring of adverse drug reactions. While most new drugs help improve patients' health, some may have important unintended side effects and others may be less effective than existing drugs. This research will allow for the development of new statistical methods that will allow for more accurate assessments of the safety and effectiveness of different drugs used by Canadians, and help to reduce the risk of serious adverse events.
Of course, underpinning all of this research are CIHR's research investments into the development of new drugs and therapies. For example, through CIHR's investigator-initiated programs, our government is investing $4.7 million in a research program led by Dr. Hanns Lochmüller at the Children's Hospital of Eastern Ontario Research Institute, right here in Ottawa, to discover and test several new therapies to treat neuromuscular diseases. Over 50,000 Canadians have a neuromuscular disease, of which there are over 150 types. Neuromuscular disease is associated with progressive muscle weakness, disability and early death, and can cause significant economic burdens on families that are affected.
Through his research, Dr. Lochmüller is using a combination of genomics, molecular biology, animal models and clinical trials to improve the diagnosis and treatment of neuromuscular disease. His objectives are to reveal the genetic mechanisms of 20 new genes associated with neuromuscular diseases, discover five new therapies and study seven therapies, four of which were repurposed and three new. The hope is that this research will lead to new ways to treat neuromuscular diseases.
Through the Canada research chairs program, CIHR is also supporting research led by Dr. Weihong Song at the University of British Columbia on Alzheimer's disease. Dementia has a significant and growing impact in Canada. We know that there are more than 419,000 Canadians aged 65 and older diagnosed with dementia. The impact of dementia on individuals, their families and the health care system is significant. In the absence of a cure or effective therapy, the total annual health care costs and out-of-pocket caregiver costs for Canadians with dementia are expected to exceed $16 billion by 2031. As the Canada Research Chair in Alzheimer's Disease, Dr. Song is studying the cause of dementia found in Alzheimer's disease and working to discover new drugs targeting Alzheimer's disease.
CIHR is also supporting groundbreaking research by Dr. Mick Bhatia at McMaster University in the hopes of uncovering new treatments for leukemia, a cancer that starts in blood stem cells.
Our government is committed to accelerating medical breakthroughs for people affected by rare diseases. Approximately one million people are affected by more than 7,000 different rare diseases in Canada. These diseases often appear at birth or emerge in early childhood. One-third of children with rare diseases die before their fifth birthday. For the vast majority of these conditions, there is no treatment available.
Canada, through CIHR and Genome Canada, is a founding member of the International Rare Diseases Research Consortium, which was established in April 2011 with a goal to develop 200 new therapies for rare diseases by 2020. I am pleased to note that the consortium had surpassed this target a few years early, with over 279 new medicinal products and therapies for rare diseases developed by 2017.
To conclude, I would like to reiterate that ensuring equitable access to necessary medicines is a priority for our government.
:
Madam Speaker, I will be splitting my time with the member for .
Today we are talking about an NDP motion on something we have been advocating for a very long time. It is for the government to act on bringing a universal comprehensive single-payer pharmacare system to Canadians.
This has been a long-time dream of the NDP. In fact, 53 years ago, Tommy Douglas brought to us medicare. This is what Canadians itemize as one of the single proudest moments in our Canadian history: to ensure that Canadians can see the doctors and get the medical services they need. This is unlike south of the border, where people in the United States literally cannot access the medical attention they need, and people die from that situation. We are the envy of the universe. To complete that dream of Tommy Douglas, it has always the vision of the CCF and the NDP to bring in a comprehensive universal single-payer pharmacare program.
We know that the Liberals have said they support this idea and have said so for a very long time. In fact, to be more precise, for exactly 23 years they have said that they would support it. Now we are in a situation of a minority government, so let us hope, and I hope with all of my heart, that in this Parliament we will implement a universal single-payer comprehensive pharmacare system. That is what our motion is pushing for. That is what we want to see, and I believe that is what Canadians want to see.
In fact, out of the government's own consultative process with its own council came the Hoskins report, with 60 unequivocal recommendations laying out a concise plan for achieving this goal. The report highlights a number of things that warrant attention in this House.
Just so we know, some 7.5 million Canadians do not have adequate prescription coverage. That is to say, some 7.5 million Canadians cannot get the medication they need. Sixteen per cent of the people in Canada went without medication for heart disease, for cholesterol or for hypertension because of cost.
The amount of prescription-drug spending paid out of pocket in Canada in 2016 was $7.6 billion. That is a lot of money coming out of the pockets of everyday Canadians, money that they could otherwise use to support their family if there were a universal pharmacare program. The government talks all the time about how it wants to support middle-class Canadians; implementing universal pharmacare would support every single Canadian, including middle-class Canadians.
The people who are perhaps hardest hit because they cannot access a pharmacare program are women. Fewer women have employer health benefits compared to men. Women are more likely to report noncompliance to their prescription medication because of costs, not because they do not want to comply but because they cannot afford it.
Cost-related noncompliance is a common problem among the indigenous community as well, and people between 18 and 44 years old, people with lower health status and people with lower incomes also often cannot access the medication they need because they cannot afford it.
There is no question in my mind that it is time to act. I know some members will say that we cannot proceed with this because the provinces and territories say they do not want to. One of the issues that provinces and territories have tabled and put on the record is that they need the government to ensure that the health transfer payments are kept up. If the Liberals actually wanted to do something about this and ensure that negotiations go well with provinces and territories, they would ensure that the health transfer payments are actually provided.
Instead of adopting the Harper Conservatives' cuts to the health transfer payments, the government could say, “No, we are not going to take that path. We are not going to go down the path of the Harper Conservatives. In fact, we will fully fulfill our requirements and responsibility for health care transfer payments.” When we do that, I fully expect that the provinces and territories will come to the table and earnestly negotiate with the Canadian government to put in place a universal comprehensive single-payer pharmacare program.
I will share a story with members.
During the campaign, like everyone else in the House, I went door knocking. One constituent's story has shaken me to this day. He is a senior who just recently retired. He worked hard all his life and paid his taxes and all of those things. As he aged, he became ill. He has a number of complicated health conditions, and his medication costs him about $1,000 a month. That is a lot of money for a senior on a fixed income.
He told me that he had some savings and he could pay for this medication for a few months, but of course his savings will run out, and then what will he do? I think he told me that his savings would run out by this summer. He was very worried about what would happen when that occurred, because he would not be able to get the life-saving medication that he needs. He said to me, “You have to go and fight for a universal pharmacare program, not just for me but for my friends and other people like me.”
I took his words to heart, and here we are in this debate. I ask the government to support this motion before us and then get on with it and actually fully realize this motion and put it into reality. No more excuses. No more delays. No more “I can't do this and I can't do that.” No more saying that we support it and then decades later we are still talking about it. I do not want to come back to the House to have to debate this once again. I want to see this program in place, and Canadians want to see it as well.
This program will save lives. We know that. More importantly, or perhaps of equal importance for those people who talk about money, this program will save money as well. How often do we get to do this? We can have our cake and eat it too. This is the kind of program that we are talking about. We are in a minority government situation, and it can become reality. How about we fulfill that dream? How about we end the notion that Canada is the only country in the world that has a universal medicare program without pharmacare? How about we put that to bed once and for all, forever, by implementing universal pharmacare?
The government says that it wants to act, but I do not want to hear just words anymore; I want to see this action in the budget. In the upcoming 2020 budget, I want to see the government allocate resources to get this done.
The Hoskins report, which I read page by page last night to get the full scope of its recommendations, has 60 recommendations. It outlines very clearly, step by step, how we can get this done and where the savings are, so the government cannot have the excuse of not having a blueprint. The government had this work done to counsel its work, and Dr. Hoskins and the team went out there and did this work, laying out in detail, step by step, how this could be done, so no more excuses.
The constituent I met during the campaign is in desperate need for the government to act. People in our community are in desperate need for the government to act. For members of Parliament, especially on the Liberal side, this is our moment to make that difference, to realize the legacy that Tommy Douglas has left us to fully implement universal medicare and pharmacare.
:
Madam Speaker, since we have just 10 minutes before the start of question period and since I will not be able to come back after that, I will limit my remarks to five minutes so my colleagues can ask questions. I think this is an extremely important conversation. I will stop talking five minutes before question period so my colleagues can ask questions.
[English]
We are facing a pandemic around the world. When we look at how our universal medicare is working, we see an illustrative example of why we are calling on Parliament today to ratify the idea of a universal, public pharmacare program. There is a clear difference between Canadian-style medicare, where we have managed to keep the risk of COVID-19 low, and public health officials across the country working hard to maintain that level, and other jurisdictions, for example the United States, where the medical system is neither universal nor publicly administered. As a result of that, it is much more costly than in the Canadian context.
In British Columbia, the B.C. NDP government, John Horgan and public health officials have been working hard to contain the virus. When we compare the infection rates of COVID-19 there to those in Washington state, right across the border, two hours from my home and from my constituency, we are seeing brush fires erupting in the area of Seattle. In Lynnwood, for example, we are progressively seeing schools closing, churches closing and not celebrating mass or communion. A series of senior centres have had to close as well. The difference is quite clear.
That is part of why, in Canada, it is so essential that we have access to the health care system at all times, without having to worry about having to pay or whether our families have the capacity to pay. It is the same principle with pharmacare. This is why this debate is so vital today.
As parliamentarians, we have had Liberal governments promising to deliver pharmacare for almost a quarter century. The choice needs to be made for a Canadian-style, universal, publicly administered pharmacare program as called for in the Hoskins report, as called for unanimously by the Standing Committee on Health, and as called for by the Standing Committee on Finance. In the report we tabled just two weeks ago, the Standing Committee on Finance called for a public, universal and national pharmacare program.
The difference between that and some kind of piecemeal, for-profit pharmacare program is quite clear. We know with piecemeal, for-profit pharmacare many people are left out, and the costs are much more expensive. The reality, as detailed by the Parliamentary Budget Officer, is that Canadians as a whole would save $4 billion if we moved to universal, publicly administered pharmacare. Businesses would save about $6 billion. Provinces would save, because of the federal government's contribution.
Canadians who are struggling to pay for medication prescribed to them by their doctor would benefit enormously from pharmacare. It would protect our whole country in the event of these kinds of pandemics that can occur.
I am going to tell two stories before I sit down to allow questions.
The first is about Jim. Jim sits outside the House of Commons in -30°C weather, in blizzards and in the blazing sun because he needs to beg to pay for his medication. He gets about $800 a month on social assistance, which is enough to pay for his room and his food. He cannot work because of his disability, and because of his need for that medication to keep him alive, he needs an additional $500 per month. It breaks my heart to see him every day. I make contributions, of course, and I think a number of other members of Parliament do, but in a country as wealthy as Canada, situations like Jim's should not exist. People should not have to beg in order to pay for their medication.
Another story is of a family that lives just a couple of blocks from my home in Burnaby, B.C., just off Cumberland Street. That family is paying $1,000 a month for heart medication that keeps the father of the family alive. They are having to make the tough choice, because of the escalating rents we are seeing, of whether to keep paying for the heart medication or to pay their rent. Canadian families should not have to make that choice.
That is why we need national, universal and publicly administered pharmacare, not piecemeal, not for-profit, not much more expensive, but the kind of universal program Tommy Douglas always advocated and that the NDP and our leader are proposing today.