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Senators should pass pharmacare legislation as soon as possible without amendments, says the former chair of an advisory council who put forward a roadmap on the path to universal pharmacare in Canada.

Eric Hoskins, a former Ontario health minister who chaired an advisory council that reported on the implementation of national pharmacare, said a new letter from federal Health Minister Mark Holland makes the government’s intentions clear.

Mr. Holland’s letter, first reported on by The Globe and Mail on Monday, was sent to the chair of the Standing Senate Committee on Social Affairs, Science and Technology last Friday. It appears to be designed to address calls to clarify the legislation and past comments made by the minister.

On Monday, Mr. Holland’s office did not provide further comment on the letter.

In it, Mr. Holland said 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.

Under the program, he said 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.

Mr. Holland also said no one will lose coverage for these classes of medications and the program will be rolled out so all residents will be covered by pharmacare.

Academics who are proponents of universal pharmacare and former federal health minister Jane Philpott have recently raised concerns about a lack of clarity in the legislation.

Matthew Herder, the director of the Dalhousie Health Justice Institute, and his colleagues wrote to the Senate committee on Tuesday to say they believe the legislation needs to be amended to explicitly state pharmacare will be “publicly administered.”

The legislation in its current form is ambiguous about how pharmacare will be implemented, their letter states.

Dr. Hoskins said it is his strong feeling “we should just get down to work and let this government roll out the program as soon as possible.” He does not believe an amendment is necessary because the Liberals have agreed, in no uncertain terms, to the universal, single-payer model.

Dr. Hoskins said he also worries about the political environment in Ottawa and the uncertainty about an election call. “I just worry that that could put the entire piece of legislation at risk,” he said.

NDP MP Don Davies agrees that an amendment to the legislation is not necessary, adding that “we need this legislation passed.”

Mr. Davies served as his party’s health critic and negotiated with the Liberals on pharmacare as part of a supply-and-confidence agreement that existed between the two parties for 2½ years beginning in March, 2022.

The deal saw the Liberals and New Democrats work together on key priorities and it afforded stability for the governing Liberals in a minority government.

At the beginning of September, NDP Leader Jagmeet Singh said his party was walking away from the agreement, which has fuelled election speculation and whether a vote will take place before the next scheduled date of October, 2025.

Mr. Davies, who is now his party’s finance critic, said Mr. Holland’s letter reflects exactly what the agreement was between the NDP and Liberals all along, which is to deliver medications and devices for contraception and diabetes through a public system without co-pays or deductibles.

The minister’s letter clarifies exactly what was intended, what the legislation means and it is what the NDP demanded, Mr. Davies said.

The Council of Canadians, a non-profit organization advocating for publicly funded universal pharmacare, called Mr. Holland’s letter an encouraging and much-needed clarification.

Conservative Ontario MP Adam Chambers, on the other hand, pointed to The Globe’s story and said on X, formerly Twitter, that Mr. Holland has “finally” admitted the bill “will displace private coverage.”

Mr. Davies said the Conservatives, who oppose pharmacare, are mistaken. He said the pharmacare will provide coverage for diabetes and contraceptive medication and devices to everyone who does not have it now and to anyone who currently has coverage through private plans.

“It’ll just be shifted and paid for through the public plan,” he said. “So everybody will have coverage. No one will lose any coverage.”

The chief executive of the Canadian Life and Health Insurance Association, Stephen Frank, issued a statement saying the minister’s letter directly contradicts testimony that he delivered to senators.

Earlier this month, Mr. Holland said “folks will have a choice” between using private insurance and using a single-payer, universal model.

Mr. Frank said the full impact of Bill C-64 remains unknown and Canadians “cannot afford for games to be played with the benefits that they rely on to keep their families healthy.”

With a report from Chris Hannay in Toronto

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