Health Minister Mark Holland rises during Question Period, in Ottawa, on Sept. 16. Holland recently urged senators at a committee to move quickly to see the passage of bill C-64, saying it was 'balanced on a pinhead.'Adrian Wyld/The Canadian Press
Advocates of universal pharmacare say they worry the government’s legislation needs to be clarified but is being rushed through the legislative process for political reasons.
The pharmacare bill, C-64, was tabled in the House of Commons in February. The bill is the result of protracted negotiations between the New Democrats and Liberals as part of their now defunct supply-and-confidence agreement.
The deal, which was in place for 2½ years, saw the parties work together on key priorities, including pharmacare.
The working arrangement afforded the governing Liberals the support they needed to stay in power in a minority Parliament. Speculation has mounted since NDP Leader Jagmeet Singh recently announced his party was walking away from the agreement that an election could take place earlier than October, 2025.
Jane Philpott, a physician who served as health minister under Prime Minister Justin Trudeau and is now the dean of health sciences at Queen’s University, said what is “risky” right now is both the Liberals and the NDP are motivated to be able to say to Canadians that they were able to get a pharmacare bill passed.
“But a bad pharmacare bill is not what we’re looking for as Canadians,” she said. “We need the right kind of model for pharmacare.”
Pharmacare legislation passed in the House of Commons in June and is now being considered by the Senate. Dr. Philpott said it is her hope the Senate will exercise its authority and “make the necessary amendments so that we won’t have this fragmented, insufficient bill passed.”
“Then we have to hope that the both the Liberals and the NDP will support those amendments and get it right the first time,” she said.
Health Minister Mark Holland recently urged senators at a committee to move quickly to see its passage, saying it was “balanced on a pinhead.”
The bill says if there’s an agreement in place, the federal health minister can make payments to a province or territory to bolster any existing public pharmacare coverage and to provide “universal single-payer” coverage for specific prescription drugs and related products intended for contraception and diabetes treatment.
Mr. Holland has pointed to a memorandum of understanding, announced this month with the NDP government of B.C., and hopes it will answer questions about how the program could work.
It would see the province’s existing contraceptive coverage expanded to include hormone replacement therapy to treat menopausal symptoms. Both governments have said they intend to enter into formal negotiations if Bill C-64 receives royal assent, but B.C. is currently in the midst of a provincial election campaign.
Pharmacare proponents, such as Steve Morgan, a professor at the University of British Columbia’s School of Population and Public Health, testified before a Senate committee this month and outlined concerns about Bill C-64.
Prof. Morgan said his view is Bill C-64 was “written under duress” as the Liberals and NDP “attempted to salvage” their supply-and-confidence agreement.
“The result is a bill that is dangerously ambiguous,” he testified. For example, he said the bill “does not even attempt” to define terms such as universal and single-payer.
While speaking to reporters outside the chamber of the House of Commons on Thursday, Mr. Holland said the government is approaching pharmacare in stages. There is not “universal consensus on where we go,” he added.
Mr. Holland said there is a model for single-payer, universal delivery of two classes of drugs – contraceptives and diabetes medication – that will be publicly delivered.
When the pharmacare bill was tabled, the NDP was asked how it could frame the bill as a win for universal, single-payer pharmacare when there is only coverage for the two drug classes.
NDP MP Don Davies, who was his party’s health critic at the time, said diabetes and contraceptive medications would be delivered through a single-payer model. He also said within a year of the passage of the bill that an essential-medicines list would be established as the next slate of drugs that would be considered for an expanded program.
The bill says the federal minister must, no later than 30 days after the bill receives royal assent, establish a committee of experts to make recommendations on options for the operation and financing of “national, universal, single-payer pharmacare.”
The federal Conservatives do not support the government’s pharmacare legislation.
With a report from Stephanie Levitz