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View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 11:00 [p.1983]
Mr. Speaker, I was listening carefully to my colleague's speech. He knows I have an interest in this particular file, and I have more of a comment than a question.
When the member talked about single-payer, streamlining and efficiency when referring to national pharmacare, I hope he does not envision it from the same people who ran Phoenix or the F-35 procurement and who run most of the government. The CRA typically fails at delivering the needed services for taxpayers.
I will give a specific example, because the only time the member mentioned rare diseases was when he was quoting from the Hoskins report. I have an example from my riding where the public health care system failed in my province.
Sharon Lim and Joshua Wong are users of the public health care system. There is a drug approved through CADTH, and there are approved drugs in Canada, but this one is not approved for reimbursement through a public insurer, which I think the national pharmacare system would make even worse. In their particular case, they cannot even get access through the special access program to a competing drug. This is a perfect example of a problem that is unique to the public insurance system, which will be made worse.
I heard the member talk about cost effectiveness and value for money, but those are decisions that should be made by patients and their doctors, not by bureaucrats in these towers here in Ottawa. This will affect patients with rare diseases such as cystic fibrosis, Alport syndrome and every single rare disease out there.
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 11:30 [p.1988]
Mr. Speaker, I want to thank the parliamentary secretary for laying out the government's position on this motion.
Many members know I have a lot of problems with the way we currently have our system designed. I am worried that a national pharmacare system will compound all those problems.
The parliamentary secretary did not address the fact that a lot of medications today are a substitute for surgeries and things that would have required a hospital stay in the past. He did mention CADTH and the Canadian drug agency. Therefore, I have a two-part question.
First, will the Canadian drug agency be subject to the Auditor General, to parliamentary oversight and to the Access to Information Act, the way CADTH is not today? CADTH is not subject to any type of parliamentary oversight, which was discussed once at the Standing Committee on Health.
Second, with respect to the $1 billion that has been set aside in future budgets for rare diseases, there are no details on that. I have a lot of patients in my riding with different rare diseases, such as cystic fibrosis. Cambia has been refused twice now, on October 2018 and November 2017, by CADTH, a government agency, and Trikafta is not coming to Canada. The Prime Minister even got the name of the medication wrong yesterday when he called it “trifacta”. When will cystic fibrosis patients get the medications they need? Also, will any of these agencies be subject to parliamentary oversight?
View Matt Jeneroux Profile
CPC (AB)
View Matt Jeneroux Profile
2020-03-12 11:32 [p.1989]
Mr. Speaker, it is an absolute pleasure to split my time with the member for Mégantic—L'Érable, 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 finance minister 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 C-69 and Bill C-48. 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.
View Matt Jeneroux Profile
CPC (AB)
View Matt Jeneroux Profile
2020-03-12 11:41 [p.1990]
Mr. Speaker, ultimately that was the key component of my speech. As I indicated, yes, we do need to keep more money in the pockets of Canadians and keep our taxes low. Implementing a $15-billion pharmacare program is ultimately the antithesis to all of that.
According to The Conference Board of Canada numbers, only 1.8% of Canadians lack or are ineligible for any prescription drug coverage. To make the argument that we are suddenly putting more money back into constituents' pockets simply does not add up if we are going to spend $15 billion of public taxpayer money to do quite frankly the opposite.
View Matt Jeneroux Profile
CPC (AB)
View Matt Jeneroux Profile
2020-03-12 11:43 [p.1991]
Mr. Speaker, the Liberals have been advocating on this for so long. It was in their 1997 election platform, yet no progress has been made. They have been in government a few times between then and now and have not been able to cross the threshold with it.
Ultimately, we all want to make sure that Canadians have access to the drugs they need when they need them. I would refer the member to The Conference Board of Canada report, which indicates that only 1.8% of Canadians, less than 2%, do not have access right now. We want to make sure we are doing everything we can for that 1.8%, but dumping $15 billion into the budget as the solution certainly does not address that 1.8%. It would also impact so many other Canadians through the cost of living regarding, as the member indicated, the price of food and higher taxes we will see with that cost.
The Conservatives say there is a better way. We can all agree that we need to address that 1.8%, but a pharmacare plan is certainly not the way to do it.
View Matt Jeneroux Profile
CPC (AB)
View Matt Jeneroux Profile
2020-03-12 11:46 [p.1991]
Mr. Speaker, I am glad my colleague on the health committee brought up that point. Right now, we are seeing investment in drugs in Canada come to a grinding halt. The changes the government has put in place with the PMPRB, which comes into effect in July, have really had a significant impact on companies' ability to move forward with the drugs they intend to market, which means there is a lack of investment in Canada, research and product investment. That has come to a grinding halt because we are moving forward at a rapid pace.
I had the opportunity just yesterday to ask the health minister at committee whether we could pause this just a bit because patients are coming to our offices to tell us they were not involved in the consultation process. Whether it be for rare disorders, as we heard in some of the earlier debate, or for future drugs, patients really have not been at the table.
The Conservatives are asking the health minister to consider including more of those conversations. We are going to see that a lot of these drugs will not be available in Canada and will go to the United States.
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 12:43 [p.1999]
Madam Speaker, I have been listening to what people have been saying. I have more of a commentary on what the member said and what his colleague said when he introduced the motion this morning.
On November 25, 2019, the minister of finance in Alberta sent a letter to the Minister of Finance federally, indicating that Alberta would not participate in a national pharmacare program. In fact, Alberta would be asking for the same deal that Quebec has. I just want to make that part of the official record here, that it is an official ask from the Alberta government.
In this debate, too few members have talked about access. They have talked about prices and how difficult it is to pay for some of the latest medication and prescription medicine. Access for patients is what patients want to hear about, and too few members have mentioned it. I think the member for Montcalm was the first one to actually make a big deal out of it. For patients with cystic fibrosis and patients with chronic kidney conditions, like my children, national pharmacare is a recipe for disaster.
I look at CADTH. CADTH twice said no to Orkambi. In the patchwork system in the United States, people can get access to Orkambi. They can get access to Trikafta. They can get access to needed medication.
I just want members to be careful. When they say that it would give access to everybody, it would not. This system would not work for rare disease patients.
View Damien Kurek Profile
CPC (AB)
View Damien Kurek Profile
2020-03-12 13:00 [p.2002]
Madam Speaker, I appreciate the member's comments and the story she shared about her dad's cancer is a touching one. I know I have similar stories in my family.
I would like to make a brief comment. She mentioned that pharmacare would result in free things for Canadians. The reality is that that is simply not the case. We see ballooning administration costs and bureaucracies that would keep the actual front-line services from getting the resources that they need.
My question for the member is quite simple. I have a number of small business owners, pharmacists, in my constituency who are very concerned about the current status of being able to access the medications that are prescribed to patients today. They are terrified. I use the word “terrified” because that is the word that was shared with me. These are small-town health care providers and pharmacists on the front line. They are terrified that they will not be able to access the drugs because of bloated government bureaucracy that would be the result of a national pharmacare strategy.
View Damien Kurek Profile
CPC (AB)
View Damien Kurek Profile
2020-03-12 13:32 [p.2006]
Madam Speaker, my question is brief. Has the member spoken with pharmacists in his constituency about their feelings on the struggle that already exists for pharmacists to access the drugs that Canadians need?
View Blake Richards Profile
CPC (AB)
View Blake Richards Profile
2020-03-12 14:02 [p.2011]
Madam Speaker, in the face of challenging times for local businesses in Alberta, the small business community in Airdrie has banded together.
Lindsey Cybulskie and other local business owners in the community joined forces and created a Shop Local Facebook group. The reaction to the group has been incredibly positive. New members joined from across Airdrie and the Facebook group dramatically expanded in size. It provides a platform through which to share positive reviews, spread the word about exciting events and allows residents of Airdrie to explore local business options.
The community came together and the Facebook group has transformed into a movement that supports and empowers local businesses in Airdrie. Shop Local: Airdrie has led events, such as a flash mob lunch date; a selfie challenge that encouraged community members to take a selfie with a business and its owner; and a midnight madness event, where local businesses were open late for Christmas shopping. The Facebook group now has over 11,000 members.
The Shop Local: Airdrie movement has become a unifying force, supporting small businesses and reminding us all of the great strength in our community.
View Gerald Soroka Profile
CPC (AB)
View Gerald Soroka Profile
2020-03-12 14:10 [p.2012]
Mr. Speaker, I was raised on a farm where I learned the value of money and the importance of financial planning.
With every budget the Liberals put out, they continue to add billions of dollars to our national debt. This is not budgeting, this is reckless spending. There are now so many uncertainties in the Canadian economy, with companies like Teck and investors like Warren Buffett unwilling to invest in Canada. Now, combined with the coronavirus, the future of the Canadian economy is looking pretty bleak.
I am sure the Liberals will paint a pretty picture that navigating our turbulent economy will be like gently floating down a stream in an inner tube, and it might even be enjoyable. I wonder what theatrical words the Prime Minister will use to describe why we are heading straight over Niagara Falls.
View Dane Lloyd Profile
CPC (AB)
View Dane Lloyd Profile
2020-03-12 14:13 [p.2013]
Mr. Speaker, I was prepared to rise today to give a statement regarding what I believe to be the Liberal government's failure to stand up for our energy industry, specifically by not supporting Teck Resources' frontier oil sands mine, but today another partisan speech is the last thing that my constituents or Canadians need to hear. There will be plenty of time for holding the Liberal government to account.
Today as we face the pandemic of COVID-19 we learn that the Prime Minister and his wife have entered self-isolation. We learn of new cases every day. I urge Canadians not to give in to fear. We are going to carry on. We are going to survive, and we are going to be stronger than ever.
I want to extend my heartfelt prayers to the Prime Minister and his family and to all Canadians who are suffering. God bless them all.
View Matt Jeneroux Profile
CPC (AB)
View Matt Jeneroux Profile
2020-03-12 14:35 [p.2017]
Mr. Speaker, yesterday the minister said that between 30% to 70% of Canadians could become infected with COVID-19. These numbers are alarming, especially with the growing seniors population and many Canadians with underlying health issues being directly at risk.
Is the minister confident that Canada has a sufficient supply of beds, ventilators, testing kits and general supplies to keep Canadians healthy and safe?
View Matt Jeneroux Profile
CPC (AB)
View Matt Jeneroux Profile
2020-03-12 14:36 [p.2017]
Mr. Speaker, we are starting to see community spread of COVID-19 in British Columbia. The NBA, major league baseball, NHL and others have suspended their seasons. Large events are being cancelled and governments across the world are shutting down to avoid spread.
The minister has said between 30% and 70% of Canadians may become infected. What is the government doing to show leadership and encourage social distancing to prevent further community spread?
View John Barlow Profile
CPC (AB)
View John Barlow Profile
2020-03-12 14:44 [p.2019]
Mr. Speaker, the agriculture minister was not standing up for farmers before and she is not standing up for farmers now, and we know why. It is because she was too busy ensuring that Canada's oil and gas workers remain unemployed by opposing the Teck Frontier mine at cabinet. Her focus should have been reopening lost trade markets, removing the carbon tax from farm fuels, addressing the processing capacity for Ontario ranchers or removing illegal blockades, things that actually would have had an impact on Canadian agriculture.
Instead of advocating for farmers and standing up for Canadian agriculture, why is her top priority attacking Canadian energy workers?
View Blaine Calkins Profile
CPC (AB)
View Blaine Calkins Profile
2020-03-12 14:58 [p.2022]
Mr. Speaker, in December, Jeffrey Kraft was murdered in Lacombe. The two accused are charged with second-degree murder, conspiracy to commit murder and robbery with a firearm, and are now free on bail. One of the accused is also charged with breaching conditions.
Residents in my riding have lost faith in the justice system due to the Liberals' soft on crime approach that puts the interests of offenders ahead of victims and their families.
Was this the hoped-for outcome that the minister had in mind when he and his party rammed through legislation that forces the courts to give bail at the earliest opportunity and with the fewest conditions?
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 15:02 [p.2022]
Mr. Speaker, later this year, Wayne Sands in my riding, will be made unemployed by Transport Canada. Wayne is 79 and was refused the renewal of his marine medical certificate for ocean-going vessels.
Wayne is the captain of the S.S. Moyie, an amusement park ride at Heritage Park for kids and tourists to enjoy 25-minute paddleboat rides. Having the same rules for container ship captains as we do for amusement park rides is a typical “Ottawa knows best” attitude.
Will the transport minister agree with me the situation is ridiculous and immediately approve Wayne's licence?
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 15:46 [p.2029]
Mr. Speaker, throughout the day I have heard members talk about the price of drugs and how difficult it is for some individuals to gain access to them. I have given this example before.
Access is what we should be talking about, especially for patients with rare diseases. The system we have right now allows a quasi-governmental organization like CADTH to approve drugs, leaving provincial public insurers to reimburse the costs. I have constituents in my riding, like Joshua and Sharon Wong, who have a drug that is approved for use in Canada, but is not available for reimbursement by their public insurer.
This situation will get worse with a national pharmacare system. To control the costs of such a system a formulary must be introduced and it must be mandatory to stick to it, taking away the ability of patients and doctors to make decisions that are best for them. I do not believe a national pharmacare system will make it any better. The Canadian Organization for Rare Disorders has cautioned the government on this.
Could the member comment on that?
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 16:16 [p.2034]
Mr. Speaker, the comment the member made about patient families being used by pharmaceutical companies when they are coming to Parliament Hill to advocate for themselves is an absolutely shameful comment to make in the House.
My family is affected by a rare disease. Being in the province of Alberta, my family is allowed to gain access to a specific type of medication that helps my oldest son with the condition he has. However, Quebec has made the decision on its formulary that one is not allowed to do off-label prescribing, which is Quebec's choice to make. The province should be allowed to make that decision, so if I were a resident of Quebec, I would be going to my MNA in that province and advocating for it.
Patient families are coming to Parliament Hill and advocating for access to medication, and the issue is access, not pricing. There are medications approved in Canada for rare disorders for which there is no reimbursement through the public insurer, the government. There are patient families trapped between two governments arguing over the price, when the issue is accessing the medications we need.
I do not have a question. It is a comment. It is shameful to say that patient families with rare diseases coming to Parliament are only doing so because pharmaceutical companies are pushing them to do it.
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 16:45 [p.2038]
Mr. Speaker, I have raised the issue repeatedly about access for rare disease patients. That is what I want to talk about some more. One of the ways the national pharmacare would work is this. The current architecture for drug approvals in Canada goes through CADTH first for a health technology assessment, or HTA. Then pCPA is the negotiating body on behalf of the provinces.
I know there are some Liberal members who have said the Canadian drug agency would basically do this now, but in the current architecture what is going to happen is that a drug will get approval and then not be reimbursed by the public insurers. It is happening and is going to happen in the national pharmacare system. I have examples from my riding and all across Canada of where this happens. In some cases, people are even prohibited from using a special access program, because they are told it is a drug approved in Canada, but it is not publicly reimbursed.
If the NDP thought it was important to introduce this, I would ask the member why there was no mention of rare disease patients in the motion if it is of concern to the national pharmacare system, because the architecture of the current regulatory system really disadvantages rare-disease patients' families.
View Rachael Harder Profile
CPC (AB)
View Rachael Harder Profile
2020-03-12 17:01 [p.2041]
Mr. Speaker, in my riding of Lethbridge we have a university, and out of that place are coming incredible innovation and creativity and scientific advancement. In particular, there is some advancement with regard to medicine. Research is being done around creating software that would read a person's DNA, and then, based on the reading of that DNA, would be able to prescribe a medical compound. Rather than pharmaceuticals being what they already are on the shelf, they would be made directly for an individual based on that individual's DNA. This is absolutely incredible technology. It would forever change the face of medicine and the way that it is done.
This is something that would not be covered by a pharmacare program. In fact, a pharmacare program would stagnate the progress being achieved within the world of medicine, which means that Canadians would be put at an immense disadvantage and many of these diseases and and rare conditions that we talked about earlier would be without a cure for a very long time. It would be a huge detriment to our country.
How would the hon. member respond to that in terms of advocating pharmacare?
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 17:23 [p.2044]
Mr. Speaker, I am pleased to join the debate at this late hour.
For my introduction I have a good Yiddish proverb, which is, “It isn't done as easily as it's said”. It actually sounds way better in Yiddish. However, the proposal in the motion sounds good. It is something I think a lot of people would definitely get behind. If we called it the national grocery store plan to provide food to everybody for free or at a huge discount, of course a lot of people would think it was a great idea.
We have heard about the Hoskins report. The terms in the report that are repeated often include “value for money” and “cost-effectiveness”. A lot of members have talked about the price, but I want to talk about access, access to medication for rare-disease patients.
Currently, this is a highly regulated part of the free market. Pharmaceutical companies, whether they are big, small or medium-sized, compete in a very tightly controlled market, both through the patent system and in the generic markets. It is hyperregulated. In Canada, there are very few buyers.
What government members have talked about doing with a Canadian drug agency is something that the pCPA already does, and it discounts. This is why I disagree with the PBO report. The discount members keep talking about for medication is already assumed in what the pCPA was able to achieve by doing bulk purchasing and negotiating on behalf of all the provinces together.
My problem with the architecture of the current system is that there is very little parliamentary oversight. What a national pharmacare would do is put this system, and members will forgive for the pun, on steroids. In the current system, which would be expanded in a national pharmacare system, drugs will be approved and then governments will quibble over the cost with the manufacturers. I have yet to see a government manufacture a single drug or a single vaccine. This is a problem of access.
I have mentioned my constituents Sharon and Joshua Wong before. Sharon has a very rare form of lung cancer, and she has never smoked in her life. For her particular lung cancer, only 2% of patients have it, and hers is even rarer than that. She has an ROS1-positive type of lung cancer. There is a drug in Canada for it, and thank goodness it is approved, but it is not for reimbursement in my home province of Alberta.
I have talked to Pfizer and to the Government of Alberta, and I have talked directly to the assistant deputy minister responsible for it. I have to say that none of them is willing to budge. My constituent cannot access it, but it is not for lack of being able to pay. The drug is just not available to access because the public insurer and the manufacturer cannot agree on the price to be paid for it. In between all of this is a trapped family and 13-year-old Jonathan may not see his mother live much longer. This is not an issue of price. It is an issue of access to drugs for rare disease patients. This is a system that will be made worse.
On cystic fibrosis, I have had several constituents come to me over the years to talk about the fact that Orkambi has been twice refused by CADTH in Canada. It was refused in October 2018 and November 2017. It was refused because of value for money, the cost-effectiveness. It is right there in the pharmacoeconomic report produced by CADTH, which says that there is no value for money and so it is not going to approve it. However, it is approved in America. This patchwork system of America approved it, and cystic fibrosis patients there have access to Trikafta, Orkambi and Kalydeco.
In my province of Alberta, the health minister, the hon. Tyler Shandro, got Kalydeco approved and reimbursed for patients in Alberta, and for that I thank him. At least some patients with cystic fibrosis will have access to the drug through their public insurer, and it is also available through many private insurers.
This is my problem with national pharmacare. It is not going to solve the problem that my colleagues in the NDP believe that it will, and I respect their work as parliamentarians.
I sat at that committee several times and listened to the discussion about national pharmacare. If members read the presumptions inside the Hoskins report, it says that all provinces would have to participate. Quebec has said that it will not because it has RAMQ, Régie de l'assurance maladie du Quebec. The Government of Alberta, in an official letter written in November of last year to the Minister of Finance, has said that it will not participate in the plan. Alberta has its own plan and can do this itself.
The Conference Board of Canada has said that only between 1.6% and 1.8% of Canadians do not have access to any plans and it is not even an issue of cost. They do not have access, and that is the greatest problem.
We talk about savings for small business. Small business can join a chamber. The chamber network has an excellent insurance benefit drug plan. Small business could go to a CPHR, a certified professional human resources association. I used to be a registrar for one of these associations before becoming a member of Parliament. A small business could go to one of them to find a benefit program that would work for it.
The issue is access and a national pharmacare program would make the issue worse because the regulatory system does not work for patients with rare diseases. I have another example that I want to give the House.
The PMPRB, call it what it is, is a price control board for trademark medication. The entire consultation it has done is a sham. It did not involve patient groups. If members want to check online they just need to Google the Canadian Organization for Rare Disorders, which called the entire consultation process a sham. It excluded families of patients. It cancelled meetings. It did not want to hear from patients all across Canada. It is going to discourage companies, big and small, from coming to Canada to get listed on the formularies across the provinces. That is not helping patients. That is not helping people in my riding. That is not helping my kids. I am not here representing big pharma. I am here representing my constituents and my kids, who have a rare disorder called Alport syndrome. I know lots of people who have Alport syndrome. There are companies doing clinical trials on this.
Another example of why this PMPRB, this price control board, is a sham is the impact it is going to have on families. One-third fewer clinical trials are going on right now in Canada as a result of the announcement on what the Minister of Health is doing on the price control board. There is already a one-third drop and it was at a low point. This is the problem.
I understand that the Liberals will be supporting this motion. In the lead-up to the introduction of national pharmacare, they are paving the way towards a single-payer, single-user universal pharmacare system despite two provinces saying they are out. Other provinces may bow out as well, thus reducing the cost savings in it. The assumptions in the Hoskins report fail under all of those currently evolving decisions being made by other governments, and they leave behind patients with a rare disease.
Money was announced in budget 2019 but there has been nothing with respect to how the money will be spent, whether it will be a pooling of risk, whether it will be a separate insurance system, and how to bring costs down.
I mentioned at the beginning of my remarks that this is a highly regulated part of the market. It is difficult to get a patented medication onto the market. A whole bunch of hurdles have to be cleared along the way, so many companies struggle with it. Companies have to get a product on the market before their patent runs out, otherwise competitors begin to enter the market. The pan-Canadian system, the PCPA system we have right now, even if we look at the list of generic drugs and how we pay for generics, is a percentage of the trademark medication.
Nobody has really talked about what happens when a pharmaceutical company owns both the trademark and the generic drug. If it is just a percentage, why not just raise the price? There is no price transparency. When we buy Tylenol, we can see how much we are going to pay. We can buy Advil if we so choose. The price can be seen clearly. There is no visible price metric that is easily seen by patients, by organizations that are pro consumer or pharmaceutical company or the government.
I want to draw the House's attention to a book called Overcharged: Why Americans Pay Too Much for Health Care, by Charles Silver and David Hyman. The Dean of Harvard Medical School wrote the foreword. The book talks about the importance of price transparency, which does not exist in the current system. It is all inside baseball. The bureaucrats in the towers of Health Canada get to decide things. I am afraid with a national pharmacare system they will get more power to decide what type of medication will be approved.
Earlier today I heard the House leader for the New Democrats talking about New Zealand. New Zealand is absolutely the worst system in the world for someone with a rare disease. The vast majority of patients with a rare disease do not have access to their medication in New Zealand. We should not want to copy a system like that.
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 17:34 [p.2046]
Madam Speaker, this is from a report of a few years ago on the estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. It stated that 117 essential medicines on the model list accounted for 44% of all prescription drug expenditures in 2015. It is a very small group of medications that cost so much. We do not talk about that here. We are talking about everything; one model to fit them all.
The member talks about how much money we will save. The only way to save money on national pharmacare would be on the backs of rare disease patients because they would have to be cut off from that medication in order to save pennies and dollars. They will wind up in an emergency room because they will not have access to the medications they need.
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 17:35 [p.2046]
Madam Speaker, the first order of good government is do no harm. I will go back to my business experience at the Chamber of Commerce. Before we would roll out a new program for our membership, we would first test everything that could possibly go wrong. If something did not work, we did not roll it out across the board to our entire membership base. The same principle should have applied to Phoenix.
Again, this program will not work the way the members expect it to. For example, Spinraza is a medication for SMA sufferers. I have a young constituent, Evan Palmer, who is in a wheelchair. For the longest time, the CADTH recommendation was to not cover him because he was too young and therefore not deserving of it. Every year he would wind up in a PICU bed at the children's hospital. A PICU bed costs about $10,000 a night. Therefore, for 30 days a year, it would cost $300,000. The medication was $150,000.
When I went to the minister of health in Alberta and made the business case for it, he said that I was absolutely right and that this should be done. Thanks to my local MLA Matt Jones, the minister in Alberta ignored the recommendation of CADTH, this regulatory body, and went ahead and negotiated a great deal for constituents like Evan Palmer to get access to the medications they needed. A business case can be made, but do no harm in the first place.
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 17:37 [p.2047]
Madam Speaker, I thank the hon. member for Shefford for the question. I will answer the first part of the question in French, and then I will switch to English to talk about the more technical aspects.
I agree that some countries should be removed from the list of countries that are considered when setting average prices.
I will switch to English, because this is a technical answer.
The PMPRB is also looking at quality-adjusted life year, which basically says, “this is the value of every single year of a life”, to determine whether it should finance that medication.
I am not saying that national pharmacare may not work. I am saying that it would likely fail and make things worse by limiting access to expensive medication at the beginning. These are real people, with real problems and real families, who will have to go overseas to get the medications they need.
View Tom Kmiec Profile
CPC (AB)
View Tom Kmiec Profile
2020-03-12 17:48 [p.2049]
Madam Speaker, the member for Fredericton mentioned that some members do not agree, so I thank her for recognizing that fact. I am pleased that she is here in the House and not her predecessor, whom I disagreed with often in this place.
Despite having disagreements, obviously we can agree that no patient should be left behind. The primary argument I have been making is that rare disease patients will be left behind in a national pharmacare system, because finding value for money and finding cost-effectiveness in the way the Hoskins report talks about requires picking which medications we will cover, and the current regulatory infrastructure and architecture that the federal government has will be simply enhanced.
Would the member agree that we should first fix the regulatory system we have before we try to impose an Ottawa-centric system on every single province across Canada?
View Heather McPherson Profile
NDP (AB)
View Heather McPherson Profile
2020-03-12 17:51 [p.2049]
Madam Speaker, I stand today to speak about my support for this motion.
I want to start with the COVID-19 pandemic. It is a timely reminder that we are all global citizens and are all connected to one another. The health of Canadians is connected to the health of people around the world. Some days we may even take our health and health care system for granted, but not today of course. The global pandemic is a stark reminder that our health is fragile and so is our health care system.
Across the planet, countries that have had the infrastructure and capacity to quickly isolate and treat patients have had the most success at flattening the curve of infection. These countries have been able to save the lives of what will probably end up being thousands if not tens of thousands of people. While Canadians are rightly proud of our national health care system, we lack the critical element that other countries possess: the ability to provide ongoing medical treatment through pharmaceuticals. As I said, we are all connected. My health affects others' health. If I cannot access the medications I need, others may suffer the consequences. Canadians understand that.
I am a new member of Parliament, and one of the members who have never run for office. It was a real privilege to knock on doors in my riding of Edmonton Strathcona to learn from my constituents. I was particularly struck by the intelligence and generosity of opinions expressed by the people of Edmonton, people who clearly understand the growing disparity between the haves and the have-nots in Canada.
Edmonton Strathcona is a very diverse riding, with Canadians from every region of the world and from as wide a range of socio-economic backgrounds and situations as we would see in any major city in this country. When speaking with my constituents on their doorsteps about the NDP's priorities, I was not surprised to hear overwhelming support for our platform from those struggling to make their needs met. However, I was a bit surprised by how often my constituents who were not struggling were concerned about the very same things.
I will never forget one young man, a successful business owner living in a beautiful new infill home. He told me that his number one priority was health care for struggling Canadians. We talked for a long time about the NDP's plan for pharmacare, dental care and mental care, and he told me about his two young daughters and the children at their daycare and school. He was deeply concerned for his daughters' well-being of course, but he emphasized that their well-being was directly linked to that of their friends.
He described to me those he knew, many of them new Canadians who were not able to access the medicine that they needed. They or their children were going without necessary medications because they did not have drug coverage. He then looked me straight in the eye and said, “This is ridiculous. My child's health is in danger because these people can't pay for their drugs. You need to do something about this.” I am here hoping that I can.
Last week, Alberta was facing an economic crisis. Unemployment in Alberta has skyrocketed over the past nine months. Edmonton has the highest unemployment rate in the country. Thousands of Albertans have lost all or some of their employer-provided prescription drug coverage.
To make matters worse, Jason Kenney's United Conservative Party government just cut prescription drug coverage for thousands of seniors and their dependants, cut funding support for medical assistance devices for seniors and cut access to necessary biologics for thousands of others. In total, 46,000 Albertans have lost their health care and medication coverage or have had it drastically altered. Now these Albertans will have to pay out of their own pockets, if they can. If they cannot, they will pay with their health and possibly their lives.
One family affected by Jason Kenney's cruel cuts reached out to me recently. Helen spent 35 years in our community serving as a nurse. She had to retire before age 65 because of a brain injury. Thankfully, her husband Steve, who is over 65, had coverage for her and their son through a provincial seniors drug program. All three members of this family have health issues. When Jason Kenney kicked dependants off the seniors drug program, Helen and her son lost their coverage.
Today, this family is facing an additional $4,000 in drug costs. That is $4,000 per month. Helen and Stan are desperate for answers. Right now, they are looking into selling their home to cover the additional costs, but they do not know if that strategy will work. With unemployment so high in Alberta, housing prices in Edmonton are really declining.
This family is facing the most difficult decision of their lives. They are having to decide between their home and their health. This family and hundreds of thousands of other families across Canada live with these impossible dilemmas because Canada does not have a national universal pharmacare program.
When Jason Kenney cut this family's drug coverage, he saved the Alberta government millions of dollars, $72 million to be precise, and that is a lot of money. If we put that into context, the costs and savings hardly add up. For every tax dollar that Jason Kenney sent to foreign stockholders with his corporate tax cut, he got 1.5¢ in return from people like Helen and Stan. The cruelty is mind-boggling.
If we want to get a sense of how many Helens and Stans there are out there, we can ask a health care worker. Doctors know, and that is why they support universal pharmacare. Nurses know, and that is why they support universal pharmacare. Nearly every health care professional in our country supports universal pharmacare.
As I have mentioned in the House before, I am a cancer survivor. In fact, I have the incredibly good news to share that last week I was declared cancer-free. While I should have celebrated that news, I struggled to do so because I realized that I was lucky to access medication and the care that I needed to stand here as a cancer survivor. That is not the case for people in my province.
I had the opportunity to visit with my pharmacist the other day and discuss this issue with her. She told me that people would be shocked to learn how many people go without medicine because they cannot afford it. They stand in line with their prescriptions in hand and submit them, but when they find out how much their prescriptions cost, they leave. Those are the easy cases for her. Far more difficult for her are the ones who do not just leave, the ones who try to buy one or two pills, the ones who offer to pay for part of the cost now and some of it later, the ones who cry and the ones who beg.
She told me about one woman who, after paying for a prescription of medication her child needed, simply gathered up her child and her purse from her shopping cart and walked away, abandoning her groceries. This did not happen in a low-income area of Edmonton. This happened in the heart of Edmonton Strathcona, in an area full of lovely homes and well-educated residents.
It is not going to get better; it is only going to get worse. Last week, Alberta was facing an economic crisis. That was last week. This week, Albertans are facing economic collapse.
Tommy Douglas, the father of medicare, knew that our health care system was not complete without pharmacare. He recognized more than 40 years ago that health care is not universal if Canadians still have to pay out of pocket for their medications. In 1984, he said:
Let’s not forget that the ultimate goal of Medicare must be to keep people well rather than just patching them up when they get sick. That means clinics. That means making the hospitals available for active treatment cases only, getting chronic patients out into nursing homes, carrying on home nursing programs that are much more effective, making annual checkups and immunization available to everyone. It means expanding and improving Medicare by providing pharmacare and denticare programs. It means promoting physical fitness through sports and other activities.
The lack of pharmacare is a gaping hole in our health care system and Canadians are falling through.
For the past 23 years, the federal Liberals have made pharmacare a priority, or so they have said. It has been a cornerstone of the Liberals' platform in every election of the past two decades. The Prime Minister promised pharmacare in 2015 and 2019, and I suspect the Prime Minister will make the same promise again when the next election is called. How cynical must one be to continue to do this to Canadians? It is time to stop promising pharmacare. It is time to enact pharmacare.
View Earl Dreeshen Profile
CPC (AB)
Madam Speaker, I heard part of what the member had to say about some of the issues and concerns in Alberta. I was involved with the hospital boards back in the Chrétien times, when the amount of money that was transferred to the provinces went from 58% to 25%. I saw the problems we were trying to solve when Ralph Klein tried to look after what was left of the health care system after the devastation that had taken place because of the Liberals. When we were in power, we made sure there was money going into it. As a matter of fact, there was a guarantee of 3% going to the provinces that would be there forever and when the Liberals came in that went below 3%.
The Liberals always talk about how the Conservatives were cutting money and how they were these great folks who were going to save medicare. It is the same sort of thing with the NDP making comments like that about the problems and issues Alberta has. If we decide to take on this pharmacare for all, it is going to hurt everybody who is looking at rare disorders and the concerns we have there. I think the member should recognize the issues that are really out there for Alberta.
View Heather McPherson Profile
NDP (AB)
View Heather McPherson Profile
2020-03-12 18:03 [p.2051]
Madam Speaker, I would like to echo some of the people who have already spoken in the chamber this evening. I have deep concerns about our ability to meet the needs of those with rare diseases. It is something I have met with my constituents on frequently. There are constituents I will be visiting next week when I am back home, and I want to make sure they understand how important this is to me.
That said, it is a little rich to hear from my Conservative colleagues that they are blaming the race to the bottom between the Liberals and the Conservatives on who cut more to health care. Certainly, we saw a cut to the transfer payments under Stephen Harper. What we need to do is not necessarily talk about that, but talk about how we can make our system better. Universal pharmacare is of course the best way to do that.
View Heather McPherson Profile
NDP (AB)
View Heather McPherson Profile
2020-03-12 18:05 [p.2051]
Madam Speaker, part of the motion the NDP has put forward would make sure that conversation takes place. Considering the high support Canadians have expressed for a universal pharmacare program, I am quite confident that it would not be difficult to convince them to encourage their provincial leaders to support such a move.
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