Health Minister Mark Holland speaks during Question Period in the House of Commons on Parliament Hill in Ottawa, on Sept. 24.Blair Gable/Reuters
Health Minister Mark Holland has written a Senate committee studying the pharmacare legislation to confirm that the government intends for the diabetes medications and contraceptives involved to be paid for and administered through a public plan.
Mr. Holland wrote Ratna Omidvar, the chair of the Standing Senate Committee on Social Affairs, Science and Technology, on Friday to say that as a first phase, Ottawa plans to negotiate bilateral agreements with provinces and territories to provide “universal, single-payer, first-dollar coverage” for a range of contraceptive and diabetes medications.
Mr. Holland’s outreach to the chair of the Senate committee appears to be designed to confront concerns that have been raised about the legislation and calls for it to be amended, including by academics and a former health minister.
Last week, The Globe reported that former health minister Jane Philpott, now the dean of health sciences at Queen’s University, is among pharmacare proponents who want clarity on the model being proposed in the government’s legislation. She said a “bad pharmacare bill is not what we’re looking for as Canadians” and stressed the importance of a universal, single-payer, first-dollar system.
Mr. Holland’s office did not provide additional comment or the motivation behind his letter when contacted on Monday.
His letter said “for additional clarity” the standard of coverage would see residents of a participating province or territory be eligible to receive free access, without co-pay or deductible, to a range of contraceptive and diabetes medications.
“Under this program, the cost of these medications will be paid for and administered through the public plan, rather than through a mix of public and private payers,” he wrote.
“No one will lose coverage for these classes of medications. This program will be delivered universally so that all residents will be covered by pharmacare.”
The Liberal government is keen to see pharmacare legislation passed quickly, particularly because of growing speculation an election could happen sooner than the scheduled federal vote in October, 2025.
Bill C-64 is the result of lengthy negotiations between the federal Liberals and the New Democrats as part of their former supply-and-confidence agreement. The deal was in place for 2½ years and saw the parties work together on key priorities, including pharmacare.
The working arrangement afforded the Liberals the support they needed to stay in power in a minority Parliament. NDP Leader Jagmeet Singh, however, opted to walk away from the agreement in early September.
The pharmacare bill was introduced in February. It passed in the House of Commons in June and is now being studied by senators at the committee.
Senator Kim Pate, who is sponsoring the bill in the chamber, said Monday it was “vitally important” that Mr. Holland wrote to the Senate. She said she and other senators heard academics who have worked on pharmacare for decades who flagged what they perceived as a lack of clarity in the bill.
She said it is her hope the minister’s letter makes intentions clear so an amendment to the legislation isn’t needed at this stage of the legislative process and “so that we can see this bill passed as soon as possible.”
“When you have this kind of clear statement from the Minister of what the intent is, I think it would be very difficult for anybody to turn back and say that the intent was something different,” she said.
Earlier this month, Mr. Holland told the Senate committee the legislation was balanced “on a pinhead.” He said every syllable and word had been debated and argued.
Pharmacare proponents, including Matthew Herder, the director of the Dalhousie Health Justice Institute, testified before senators this month about concerns they have about Bill C-64.
When asked about Mr. Holland’s letter, Prof. Herder, a professor in law and medicine, said it is heartening to see the government’s plan is to ensure that any pharmacare agreements set up with provinces and territories will be through a public drug plan, not public and private or a mix.
On the other hand, Prof. Herder said if this was the Minister’s intention, he finds Mr. Holland’s comments before the Senate committee to be “odd.” The Minister indicated he was “ambivalent” about how pharmacare would be administered during testimony, Prof. Herder added.
“It also makes very conspicuous the absence of the wording in the legislation itself,” he said.
Prof. Herder believes adding two words – “publicly administered”– to one section of the bill would be immensely helpful.
He said he and colleagues at the Dalhousie Health Justice Institute are writing to the Senate committee to say relying on Mr. Holland’s letter alone has risks.
If the Liberals and NDP support public administration of pharmacare, an amendment to the legislation could be passed quickly, he added.
“I don’t think we should leave it to chance.”