NDP pharmacare bill gets its moment in the sun

The Liberal government has promised to deliver universal pharmacare, and the opposition New Democrats are giving them a chance to write a pharmacare program into Canadian law. NDP MP Peter Julian (New Westminster-Burnaby, B.C.) has introduced a private member’s bill into the House of Commons that would create what he calls a legal framework for a national pharmacare system. The bill has been debated twice in the Chamber, most recently on Feb. 17, and will come up for a second reading vote on Feb. 24. MPs who are not in cabinet introduce private members' bills on all manner of subjects in every session of Parliament. Few are given time for debate in the House. Even fewer are voted through by MPs. Those that pass those hurtles are sometimes left to die in the Senate. Mr. Julian’s bill is unlike many other private members' bills because it proposes to do almost precisely what an expert panel struck by the Liberal government has recommended. That may not matter: Liberal MP Darren Fisher (Dartmouth-Cole Harbour, N.S.), the parliamentary secretary for health, and a spokesperson for Health Minister Patty Hajdu (Thunder Bay-Superior North, Ont.) have both suggested that the government is against the bill. The health critics for the Conservatives and the Bloc Québécois have also criticized Mr. Julian’s bill in the House of Commons. Mr. Julian’s bill, C-213, would not establish a single, federally-run pharmacare program. It would set criteria for universal provincial pharmacare programs, and stipulate that the federal government “may” transfer money to the provinces that meet those criteria each year. Recommendations from the final report of the Advisory Council on the Implementation of National Pharmacare. Screen capture The bill does not address how much money would be transferred. Private member’s bills can’t require that the government spend money, and Mr. Julian said he is confident that his bill does not violate that rule. The amount of money to be transferred, and which drugs would be covered, would be left to negotiations between the federal and provincial governments, he said in an interview with The Hill Times. The Parliamentary Budget Officer estimated in 2017 that running a national pharmacare program would cost roughly $20-billion per year. Right now, the provinces—which are responsible for health care under the constitution—pick up most of the tab for prescribed drugs through a patchwork of programs that cover many, but not all of their residents. Private insurers pay a large share of the cost as well, and the general public pays the remaining $3.6-billion per year out of pocket. Liberal MP Darren Fisher, right, pictured with Defence Minister Harjit Sajjan, is the parliamentary secretary to the minister of health. He has argued that Mr. Julian's bill does not take into account the wishes of the provinces. The Hill Times photograph by Andrew Meade Spokespeople for the Liberal government say all of the details of a pharmacare system, including the qualifying criteria, should be left to intergovernmental negotiations. Mr. Fisher said passing the bill would amount to “imposing federal legislation without consultation and without co-operation of our partners at the provincial and territorial level,” and that he would oppose it, during a speech in the House on Feb. 17. In an emailed statement, Cole Davidson, Ms. Hajdu’s spokesperson, wrote that, “we’re committed to working collaboratively with willing jurisdictions to develop a national, universal pharmacare program, but we won’t get there by imposing criteria on provinces and territories.” The government will continue to work towards a pharmacare program with the provinces and territories, he wrote. Mr. Julian argued that those negotiations could be “chaotic” without a legal framework to use as a starting point. If it were passed, Mr. Julian’s Canada Pharmacare Act would require that provincial pharmacare plans be run by a public entity; that they fully cover the costs of all of the included drugs; that they be accessible to everyone in the province; and that they are “portable,” meaning the provinces couldn’t restrict coverage to only those who have resided there for a long period of time, or cut off coverage to people who temporarily leave the province. Those are essentially the same criteria laid out in the Canada Health Act, the basis of Canada’s longstanding federal-provincial health transfers, and the same as the criteria recommended by the Advisory Council on the Implementation of National Pharmacare. That council was struck by the Liberal government in 2018 to advise the government on how to start a national pharmacare system. It was led by Eric Hoskins, a physician and former health minister in Kathleen Wynne’s Ontario Liberal government. The panel recommended in its 2019 report that “the federal government enshrine the principles and national standards of pharmacare in federal legislation, separate and distinct from the Canada Health Act, to demonstrate its ongoing commitment to partnership on national pharmacare and provide for a dedicated funding arrangement.” The panel’s report recommended that the pharmacare legislation include the five criteria, or principles, that Mr. Julian included in his bill. It also recommended that the legislation outline how the federal and provincial governments will share costs and responsibilities for pharmacare, and the path for provinces and territories to opt into the program; Mr. Julian’s bill does not do that in any detail. He said he would leave those details for intergovernmental negotiations. “To respect their own process as a government, should be voting ‘yes’ on Feb. 24,” said Mr. Julian. peter@hilltimes.com @PJMazereeuw Recommendations from the final report of the Advisory Council on the Implementation of National Pharmacare Screen capture from the final report of the Advisory Council on the Implementation of National Pharmacare Text from Bill C-213 Screen capture from LEGISinfo

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NDP pharmacare bill gets its moment in the sun

The bill would do what a Liberal-struck expert panel recommended. The Liberals don’t like it.

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