Singh calls out Trudeau over pharmacare commitment as Commons begins debate on new bill

NDP Leader Jagmeet Singh is throwing down the gauntlet and challenging Prime Minister Justin Trudeau to back up his promise to implement a national pharmacare plan.

"Do they actually mean what they say? They've promised this for years, they promised it in the last campaign, they talked about it in the throne speech," Singh told a press conference Wednesday called to discuss his party's Canada Pharmacare Act.

"So are the Liberals just talk? Because here's an opportunity to back it up."

During the 2019 election campaign, New Democrats promised to bring forward legislation to establish a national pharmacare plan at their first available opportunity.

That opportunity presented itself when House leader Peter Julian's name was drawn early in the lottery that determines which of the dozens of private members' bills and motions introduced in the Commons each session actually get time allocated for debate and potential passage.

The first hour of debate on Julian's Canada Pharmacare Act is scheduled for late this afternoon.

Other opposition parties seem unenthusiastic about the bill because it infringes on provincial jurisdiction over health care.

"We are very concerned with this issue," said Conservative House leader Gerard Deltell on his way into his caucus meeting Wednesday morning. "I live in Quebec, I know what I'm talking about."

Bloc Québécois Leader Yves-François Blanchet told CBC News that Quebec already has its own provincial drug plan, so this bill will not have his party's support.

"If Canada wants to give itself such a program, they are entitled to," he said. "But there is one condition: Quebec does not have to be subjected to any jurisdiction of the federal government in such a matter."

If this "centralized" pharmacare program proceeds, he said, Quebec's share of the money "should be given, without any conditions, to the government of Quebec which already [administers] a very good program."

Without unanimous consent — which this bill seems to lack — private members' bills often move slowly through the stages of debate and committee review in the House and the Senate because government bills are prioritized. If an election is called for this spring, for example, the NDP bill could die on the order paper.

A framework, not a directive

Singh said his party's legislation is not an attempt to force the provinces to opt into a national universal pharmacare plan but instead provides a framework for the provinces to negotiate with the federal government on implementing such a program. 

But it's the conditions the provinces must meet for them to receive federal pharmacare funding that Conservatives and the Bloc are most likely to oppose. 

In order to receive a cash contribution from Ottawa, each provincial or territorial government needs to show that it is delivering a drug plan that is publicly administered, comprehensive, universal, portable and accessible.

Julian said that while a patchwork of provincial drug plans currently exists, they are not truly universal.

If you need medication in this country you should use your health card, not your credit card.- NDP Leader Jagmeet Singh

"The parliamentary budget officer has indicated Canadian provinces and territories already pay billions of dollars for [plans that] are partial, and often full of holes," he told CBC News.

Health Minister Patty Hajdu said that it is a goal of her government to "ensure that we have a national pharmacare plan so that every Canadian can access drugs no matter what their circumstances."

Hajdu said she has not ruled out voting for the bill herself and is looking forward to debating it — but she added that any pharmacare plan would have to be built on a respectful relationship between the provinces and the federal government.

"One aspect of their particular bill compels provinces and territories," she said. "I personally feel, especially through the experience of being a minister of health through a pandemic, that we need to work with provinces and territories. So I'll be listening very closely to the debate to understand what their vision is in working with provinces and territories."

Negotiating with provinces

Setting up a more credible national scheme without further delay could be a win-win, Julian said.

"This is simply a no-brainer in terms of the cost effectiveness," Julian said, describing the potential savings outlined in recent studies of the feasibility of federal pharmacare. "Canadians as a whole save $4 billion dollars. Businesses save money, individuals save money.

"What's been missing is the federal government stepping up and saying, 'Here are the conditions. Let's negotiate a financial framework.'"

Should the legislation pass, Julian said, it would compel the federal government to sit down with the provinces — one by one, if necessary — and start making pharmacare a reality for the 7.5 million Canadians he said have no public or private drug coverage at all.

Pandemic has made situation worse: Singh

If anything has proven the need for pharmacare, he said, it's the lived experiences of Canadians during the COVID-19 pandemic who have faced both economic and physical stress.

"Let's put in place a situation where everybody can have the medication their doctor prescribes," he said. 

Doing so would fulfil what Tommy Douglas always intended the medicare system to include fifty years ago, Julian said. His bill mirrors the strategy used then to put Canada's universal health care system in place, step by step.

During the last Parliament, the Liberal government appointed former Ontario health minister Eric Hoskins to chair an advisory panel on national pharmacare.

Hoskins met with the provinces and territories and laid out a plan for implementing a system before the election was called.

The 2019 budget funded some early steps to set up such a system, including a national drug formulary — a common list of drugs to be covered by the scheme — allowing for coordinated bulk drug purchases across all of Canada's jurisdictions.

Bulk purchasing — which premiers have already worked to set up through the Council of the Federation — will reduce the cost of a future national pharmacare program. 

The federal government has been trying to work collaboratively with pharmaceutical companies to drive prices down further for specific medications.

Singh said that the pandemic has made access to medication harder for Canadians who have lost their jobs and benefits. 

"If you need medication in this country you should use your health card, not your credit card," he said.

"This bill that we are putting forward is more important than ever. We cannot continue to force people to make the impossible choice between buying medication or fundamental costs and expenses like heating their home."