Second reading of Bill C-64, An Act respecting pharmacare

By: The Hon. Wanda Thomas Bernard

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Hon. Wanda Thomas Bernard: Honourable senators, I rise today to speak to Bill C-64, An Act respecting pharmacare.

Pharmacare is the missing piece of medical care in this country. When medicare was introduced between 1957 and 1966 as a nationally funded health insurance program, it was considered the first stage. Almost 70 years later, we are still waiting for the next stage.

What I hope to add to the debate today is a race equity lens. I’d like to give some insight into the importance of voting in favour of this bill as a way to bring more equity to our health care system.

In the social work field, when I was working closely with families living across Nova Scotia, it was always very difficult to see people forced to make the choice between paying for medications or paying for necessities like food and housing. The most challenging situations to witness were those families with children or family members with chronic illnesses who struggled to manage. With the cost of living rapidly rising, those tough decisions are even more of a struggle today.

We heard from our colleague Senator Simons about the significance of ensuring contraceptives are available to women and gender-diverse people as a means of gender equity, so I will not repeat that information. Another gendered perspective to consider, which I witnessed in my social work practice, is the experience of women leaving domestic violence situations. They would often leave and find employment which allowed them independence and sometimes enough to make ends meet. However, as soon as a medical emergency arose for them or their children, they would then be forced to choose between their employment with no benefits or going on income support, which would provide coverage for the prescriptions they needed.

In my own family, as we navigate my husband’s health conditions through the Nova Scotia health care system, I have noticed that each time a new medication is suggested for him, the first question is always this: “Do you have a drug plan?” I quickly realized this is code for: “Which medication can you afford?” I think of the people who may not receive the most ideal medication for their illness, leaving them with subpar treatments, resulting perhaps in other implications for their overall health and well-being.

For most of us in this chamber, if we receive a diagnosis and treatment plan for an illness, we do not have to make the very hard decisions about whether we can afford the cost involved in that treatment plan to restore or manage our health. Honourable colleagues, I am sure you would agree that all Canadians deserve this privilege.

In preparing to speak to this bill, I decided to consult with the Health Association of African Canadians — commonly referred to as HAAC in Nova Scotia — about this bill so they could share their perspective about the essential nature of this legislation for many Black community members. Their response highlights the necessity for an equitable approach to health care for Black Canadians:

HAAC has a mandate to support the improved health of African Canadians across our diversity. This includes having access to affordable prescription drugs and related products. We hope that a universal, single-payer pharmacare plan will mean that African Canadians who are disproportionately affected by chronic disease, including diabetes, will have access to needed prescription drugs and related products regardless of income. HAAC is hopeful that removing affordability barriers to prescription drugs and related products, as outlined in the bill, will move us closer to the equitable health care we envision.

Starting with expansion of coverage for contraceptive and diabetes medication is a very exciting prospect for those of us advocating for equitable health care for marginalized groups, including women, Black Canadians, Indigenous persons and those with disabilities. In fact, describing it as “exciting” is an understatement. It will be life changing for so many marginalized Canadians. I spoke about the need for a national pharmacare program in Canada about 10 years ago at the Canadian Association of Community Health Centers conference entitled “The Second Stage of Medicare.” Many Canadians have been advocating for this for decades. Is it not time, colleagues, for us to act on the promise?

Numbers around health equity and race can be challenging to pinpoint because we do not have a history of collecting race‑based data in Canada. However, according to the Public Health Agency of Canada, the prevalence of diabetes among Black adults is 2.1 times higher than among White adults in Canada. This is why I urge the use of a race equity lens during the committee stage study of this bill, including consulting with witnesses like the Health Association of African Canadians, or HAAC. We must examine who is falling through the cracks when it comes to pharmacare and whether this bill has the ability to catch them.

Honourable colleagues, I hope this critical race perspective prompts you to consider how the health care we take for granted in Canada — the accessible, universal health care we are purportedly all afforded — is not so universal and still leaves people making impossible decisions for their families. As Senator Moodie indicated in her speech on this bill, access to drugs should be considered a human right. I will be voting for a more equitable health care system with the enactment of Bill C-64. I encourage you to join me.

Thank you. Asante.

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