On Wednesday afternoon, the House of Commons voted down a New Democratic motion to take a first step toward national pharmacare. The vote went 32 for the measure to 295 against.
All 24 New Democrats and all three Greens voted for the motion. Two Liberals supported the bill, Nathan Erskine-Smith, who represents the Toronto riding for which Jack Layton was once the MP, and Wayne Long, a New Brunswick MP.
One Conservative also voted for the bill, Ben Lobb from central Ontario, as did two independents: Jody Wilson-Raybould, the onetime Liberal justice minister who got embroiled in the SNC-Lavalin affair, and Brampton MP Ramesh Sangha, who was booted out of the Liberal caucus in January after he accused fellow Liberals of supporting the Sikh separatist movement.
Peter Julian, the NDP's finance critic, presented the bill, which would have established the conditions for federal financial contributions to provincial drug insurance plans. Those plans would, in turn, guarantee all Canadians access to life-saving medications.
The bill did not have specific dollar amounts in it. It was merely a statement of principles to guide the federal government in consultations with the provinces -- if and when such talks occur.
The purpose of the bill was to advance a process to which the Trudeau government claims it is fully committed, namely, to expand Canada's public and universal health-care system so that it includes prescription drugs. There was no timeline in the measure. The bill would not bind the government in any way.
Had it passed Julian's bill would have been, in essence, a statement of the Canadian Parliament's aspiration for universal drug coverage, nothing more than that.
And yet the governing Liberals voted against it, with two lonely exceptions. Oh, there was a third, sort of. New Brunswick Liberal MP and former health minister Ginette Petitpas-Taylor abstained.
Bloc talked about Quebec's rights; Conservatives touted private plans
The official opposition Conservatives and the Bloc Québécois had their own reasons for opposing the bill.
The Conservatives argued that most Canadians already have some form of prescription drug coverage, making a national pharmacare program unnecessary.
In debate on the bill Alberta MP Michelle Rempel Garner spoke for the Conservatives.
"This bill proposes that the best way to provide coverage to the smaller percentage of Canadians who do not have adequate coverage is to eliminate access to private plans for those who currently have them and replace them with plans provided by a government agency," she said, an idea that she thought many Canadians would oppose.
Rather than replace private drug plans with a public one, Rempel Garner suggested "it would be better to focus on targeting support to those who do not have it, rather than entirely scrapping a system that works for a majority of others."
To that, the Conservative MP added the fear factor.
She asserted that public coverage might not be as extensive as private: "We do not know the level of coverage this proposal would provide and whether it would be a lower standard than what many Canadians already have in their current plans."
The Conservative MP added that "nationalizing access to pharmaceuticals" could have a negative impact "on workers in pharmacies across this country."
"Would their jobs and businesses and ability to provide expert advice to Canadians be affected?" Rempel Garner asked. The answer is likely "No." But Rempel Garner just left the question hanging there.
The Bloc Québécois' Gabriel Ste-Marie pointed out that Quebec currently has its own prescription drug plan, while admitting that the plan is underfunded, and offers inadequate coverage.
He said Quebecers favour a universal plan, but insisted such a plan must be Quebec's own, not a plan subject to federally determined principles.
The Bloc MP quoted a Quebec National Assembly resolution of June 2020, which stated bluntly: "Quebec refuses to adhere to a pan-Canadian pharmacare plan." That measure passed with the support of all parties.
Ste-Marie then chided the New Democrats who, under Jack Layton's leadership, had made a historic offer to recognize Quebec's distinctiveness and its right to determine its own path. Here's how he put it:
"The NDP in 2005 adopted the Sherbrooke Declaration in which it said it recognized asymmetrical federalism and intended to give Quebec the systematic right to opt out, but it seems to have written off Quebec ever since. That is what the drafting of this bill suggests."
Mostly, the Bloc wants the federal government to boost the amount it transfers to the provinces for health care as currently constituted, before considering any new ambitious initiatives. In making this case, Ste-Mare lumped the NDP in with the governing Liberals.
"The provinces came together to call on Ottawa to increase its share of health-care spending from 22 per cent to 35 per cent with no strings attached," he told the House of Commons. "Despite all that, the government chose to dig in its heels against the provinces."
Ste-Marie concluded, as Bloc politicians habitually do, by appealing to a sense of wounded national pride in Quebec:
"The NDP's and the Liberals' obsession with wanting to interfere and decide for Quebec where it should spend its own money is toxic. The NDP and the Liberals should instead agree to the provinces' requests and increase federal health transfers permanently."
Liberals praised the bill and supported idea of pharmacare
The positions the Bloc and the Conservatives took were entirely predictable. Their reasons for voting against the NDP motion were crystal clear. That was not so for the party in power, the Liberal Party.
Listening to Liberal MP Judy Sgro speak to Julian's motion, one could be excused for believing she planned to vote in favour of rather than against it.
The veteran Ontario Liberal MP and former cabinet minister opened her remarks by discussing how the current pandemic has increased the sense of urgency Canadians feel about access to life-saving medicine.
"COVID-19," Sgro said, "has reminded us how important it is that Canadians have access to the medicines that keep them healthy. We need to implement a national pharmacare plan that gets Canadians the drug coverage they need as soon as possible … National pharmacare would make a significant difference in the lives of many people in my riding."
She then talked about other moves the government might take in conjunction with a national plan, such as modernizing drug pricing regulations, to make it workable, affordable, and effective. And she concluded by referring to the people of her own Toronto-area riding:
"The people of Humber River--Black Creek and across Canada want a national pharmacare plan. I am confident that the government will be successful in implementing the initiatives that I have outlined today, and I congratulate my colleague for bringing this issue forward in a private member's bill so that we can continue to keep everybody's feet to the fire."
After saying all that Sgro voted against the NDP motion.
Peter Julian and his fellow New Democrats will keep talking about this issue during the current crisis and during the next election campaign, whenever that comes. For NDPers, the Canadian health-care system, with all of its imperfections, is one of their party's crowning achievements.
It was Tommy Douglas' NDP government in Saskatchewan that got it started more than 60 years ago, and it was the Tommy-Douglas-led NDP that pushed it at the federal level during a series of minority parliaments in the 1960s.
Now the NDP seeks to play the same role with pharmacare.
Back in the 1960s, medical drugs did not play anywhere near the role in health care that they do now. Today, however, Canada has fallen behind most other countries with similar health systems. Those countries might not cover every single doctor's visit, as we do here, but their coverage is almost always broader in scope. In almost all cases, it includes prescription drugs.
Julian emphasized the economic argument for pharmacare
When he spoke to his own measure, Julian countered the Conservatives' arguments in favour of the status quo. Citing facts and figures, he made the economic case for extending health coverage to medical drugs. We can expect to hear more details of that case in the months, and perhaps years, to come.
"The reality is that with this proliferation and patchwork of private and public plans right now, one in five Canadians have no coverage at all," Julian explained.
"At the same time, it increases the overall costs, not just administrative costs but also the costs of acquiring the medication, which is so important to the health and welfare of so many Canadians … [The Parliamentary Budget Office] tells us that Canadians as a whole pay about $5 billion out of pocket [for medications], [and] small and medium-sized businesses across the country pay about $6 billion in drug plans for their employees. This is another reason why the bill is so important."
Julian then addressed the well-known fact that, economically, Canada's universal health care is "a major competitive advantage." Canada's public health-care system gives a $3,000-per-employee competitive advantage to Canadian companies compared to their American counterparts, the NDP finance critic pointed out.
Julian emphasized that we could do the same -- and save taxpayer dollars -- with a similar national pharmacare plan.
"We spend about $13 billion through a variety of this patchwork of provincial plans," Julian told his colleagues, "so putting into place universal pharmacare makes sense financially."
Not a single MP who spoke to Julian's motion disputed a single one of those facts. They simply ignored them.
We know the Conservatives and Bloc MPs had their own political and principled reasons, whether based on accurate facts or not, for opposing the NDP initiative.
Why the Liberals voted "No" remains a mystery.
Karl Nerenberg has been a journalist and filmmaker for more than 25 years. He is rabble's politics reporter.
Image credit: Adam Scotti/PMO
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