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

By: The Hon. Andrew Cardozo

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Hon. Andrew Cardozo: Honourable senators, it is a rare pleasure to rise in this important chamber to speak about this very important bill: Bill C-64, or the pharmacare act. I have raised this matter several times in this chamber before the bill was introduced, so it is welcome to be here today.

Colleagues, I am the Progressive Senate Group critic of this bill, so I have 45 minutes to speak, and the Speaker has assured me that we will stay as long as it takes for me to complete my speech; I’m just kidding. I do believe that all speeches should be capped at 15 minutes. If you can’t say it in that amount of time, it is probably not worth it. But that is another issue for another time.

Much has been said about this bill. I want to take a few minutes to place this in the historical context of what we are doing. While we are here, I want to speak to two important developments in 1960 and two more in 1961, which I want to identify because they are relevant today. They involve all three national political parties.

First, in 1960, the Saskatchewan NDP led by Tommy Douglas proposed medicare in the 1960 electoral platform. Second, the Liberal Party of Canada had their “Thinkers” Conference that year under the leadership of Lester B. Pearson, known as the Kingston Conference. That was when the Liberal Party first identified medicare as a national objective, and it became a part of their platform in 1962 and 1963.

Then, in 1961, the government of Tommy Douglas implemented the Saskatchewan Medical Care Insurance Act that was supported by voters in the province, although controversial among some and strongly opposed by the medical profession.

Second, also that year, Progressive Conservative Prime Minister John Diefenbaker established the Royal Commission on Health Services, headed by Emmett Hall — who was also a Conservative — which reported in 1964. In that report, Hall said, “The only thing more expensive than good health care is no health care.”

The federal medicare act was passed by a minority Liberal government and supported by the NDP. The federal NDP of that time was led by the aforementioned Tommy Douglas, whose pioneering program in Saskatchewan inspired the national medicare program.

Interestingly, it is the same situation today. A Liberal minority government supported by the NDP has now brought forward the pharmacare bill.

I want to mention that, in 1966, while the Liberal Party was obviously committed to medicare, the funding of it was yet to be confirmed. The story is that the Minister of Finance was Mitchell Sharp, and, days before the budget of that year, he was considering pulling back from announcing the funds that would make medicare a reality because he felt the government could not afford it. A revolt broke out in the Liberal caucus, and, at the last minute, Sharp put the medicare bill back into the budget.

I say that because, today, much as we might think medicare is a core Canadian value that has been with us forever, it almost did not happen at that time. Who knows what would have happened if it didn’t happen then? I draw the parallel to the national child care program brought in by the government of Paul Martin in 2005-06. And then because it was not confirmed by Parliament in full, it was cancelled by the subsequent government and did not happen until almost 20 years later.

What we do this week in this chamber matters. This is a good chapter of Canadian history that is taking place here.

On the bill today, as the Hoskins report made clear in 2019, Canada is the only country in the world with universal health care that does not provide universal prescription drug coverage. It is about time we stop being the exception and join the mainstream.

The 1964 Hall Commission report that led the medicare reforms actually recommended pharmacare — that the federal government should develop a national formulary, centralize drug purchasing and engage in bulk buying, with prescription costs that should be kept at $1, which in today’s money would be about $10. Emmett Hall’s recommendations on this aspect were not implemented then, and here we are 60 years later, but it is better late than never. I am glad that the recommendations set out by that royal commission are now seeing the light of day.

The roots of pharmacare can be traced to all three parties over six decades.

The next major development was the passage of the Canada Health Act, introduced by Monique Bégin, who was the Minister of National Health and Welfare in the government of Pierre Trudeau. It has five principles: Portability, accessibility, universality, comprehensiveness and public administration. Looking back at that significant development, my only regret is that it did not include pharmacare.

To come to Bill C-64, so far, this bill will cover two types of medication. They are very important medications, and this coverage will help a great many Canadians, but I would like to have seen this bill be more ambitious. What we have now is, I think, considered a good and strong start. What we are doing is opening the door to comprehensive drug coverage for Canadians.

I want to take a moment to compliment Minister of Health Mark Holland, a Liberal, and the NDP health critic Don Davies for the bill we have in front of us. It takes parliamentarians with vision and ambition to work across party lines to make things happen, and they did just that.

It has truly been a long road. It is worth remembering that medicare was built brick by brick. Not all provinces signed on immediately. Some had pre-existing systems and they made demands for compensated opt-outs, but in the end, they did join. It took six years to get all provinces on board, but they did come. I want to add that opting out with compensation remains an option in this bill, in my view, whether for Quebec or other provinces.

Colleagues, I support Bill C-64. I support finishing the work of John Diefenbaker, Emmett Hall, Lester B. Pearson, Tommy Douglas and Monique Bégin on the work they have done over these several decades. Thank you.

Some Hon. Senators: Hear, hear.

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