Pharmacare bill stalled in Senate as lawmakers leave for summer break [video]

Parliament has wrapped up for the summer without the passage of a long-awaited national pharmacare bill.

Supporters say Bill C-64 is a first step towards universal, single-payer coverage of all necessary medications, a longstanding demand from the labour movement and public health care advocates.

The legislation would start by making diabetes medication and birth control available to anyone with a health card. 

For Moncton resident Marty Bourgeois, coverage can’t come soon enough. Bourgeois, 40, was diagnosed with type 2 diabetes after collapsing in his apartment in 2022. Like many people, he has rationed insulin. 

“I haven’t been able to keep up with my upkeep because of reduced financial means,” he said. 

Bourgeois, who works at a low-wage and labour-intensive job, pays $88 per month in premiums for his enrollment in the New Brunswick Drug Plan, which partially covers the cost of his medication, but not equipment such as syringes.

With his premiums factored in, Bourgeois estimates that he pays about $250 to $275 a month for the life-saving treatments he needs. Costs can reach upwards of $350 if faulty equipment needs to be replaced. “It’s not convenient,” he said in an interview. 

He’s not alone. Patients often ration their medication and make hard choices between rent, groceries, and prescription drugs. 

In Canada, the only country with universal health care but no universal drug coverage outside of hospitals, low-income people tend to lack private insurance and are more likely to forgo medications because of cost. 

The problem might be especially acute in New Brunswick, which has one of the highest rates of diabetes in Canada, according to data from the Canadian Chronic Disease Surveillance System.

The provincial government has defended its limited coverage, pointing to recent improvements introduced last year. Those reforms were modest, lifting an age cap on coverage for specific devices that inject insulin into the skin and monitor glucose levels. Nova Scotia soon followed suit with a similar policy change. 

Those changes earned the Higgs government praise from the industry-funded patient advocacy group Diabetes Canada. 

But it’s all part of a patchwork of coverage that public health care advocates hope to replace with a universal, single-payer scheme. 

Province coy about pharmacare

The proposed universal system will require buy-in from provincial governments. Alberta and Quebec have already said they will opt out, while B.C. has endorsed the plan.

So far, Higgs’ government officials have been tight-lipped about their position. 

On Thursday, a spokesperson for the Department of Health said in an email that New Brunswick is “waiting on the federal government to initiate discussions with us about details of the pharmacare legislation.” 

It could shape up to be an issue during the upcoming provincial election, slated for October. 

Support for universal pharmacare has been part of the Green Party platform since at least 2018. Tantramar-Memramcook MLA Megan Mitton called financial barriers to life-saving medications “completely unacceptable.”

The Liberal Party has offered qualified support for the federal government’s plan. 

“We’re generally supportive of this move,” said Moncton Centre MLA Robert McKee, the Liberal health critic. “But we’d like to understand as well the financial implications for the province and on Medicare.”

He said the feds are probably seeking assurances that provincial governments won’t reduce existing coverage. He added that the Higgs government’s “strained” relationship with the Trudeau government may hinder talks. 

The Parliamentary Budget Officer has estimated that a single-payer universal drug plan would cost $11.2 billion in its first year of implementation.

But the system would also reduce economy-wide spending on medicine by $1.4 billion, because bulk purchasing results in better price negotiations. 

Stalled in Senate

Research from the Council of Canadians shows that a network of industry-funded think tanks, lobbyists, and commentators have been working to “derail and delay” a single-payer system. 

“They’re creating an echo chamber of industry friendly messages to try to sway or confuse, or basically slow down the progress towards a public pharmacare system,” said Nikolas Barry-Shaw, a campaigner with the Council of Canadians. 

Even with those barriers, the bill made it through second reading in the Senate last week, after passing the House of Commons earlier in the month. 

Now, the bill is heading to a Senate committee for further study, but no date has been set for the meeting. The NDP has reportedly floated the idea of summer hearings, but that seems unlikely. 

“While the Senate can be unpredictable, it is likely the bill won’t be studied until the fall,” a spokesperson for the Senate said in an email. 

Health care and labour groups held a press conference in Ottawa last week, urging Senators to pass the bill immediately and without amendments before the end of the session. But the bill didn’t make it to Royal Assent last week, as the Red Chamber adjourned until September 17. 

Meanwhile, federal Minister of Health Mark Holland said he hopes to see the program running in every province and territory by April 2025.

The NB Media Co-op reached out to all nine Senators currently representing New Brunswick for their take on C-64. By deadline, four of them had provided comments, which are summarized here: 

• Senator René Cormier is “thoroughly committed to examining the bill and its implications when Parliament resumes,” and aims to ensure it will benefit Canadians and specifically New Brunswickers, according to a spokesperson. 
• Senator Nancy Hartling is “generally supportive of C-64, particularly its provisions around medication for diabetes,” according to a spokesperson. The bill “is a step towards obtaining equal access to medications that are critical to life for so many people” but questions remain, “such as what devices and supplies might also be made available in addition to the listed medications, which is why it is important for the bill to receive fulsome study at committee.” 
• Senator Krista Ross supports “the concept that nobody should lack access in Canada to the medicine they need,” according to a statement attributed to the Senator. “In concept, Bill C-64 is working towards this goal.  Equitable access to healthcare is critical for our national well-being.” Ross added that “New Brunswickers, and all Canadians, are better served when we ensure proper scrutiny of legislation.”
• Senator Joan Kingston expressed support for national pharmacare in a brief phone interview, noting her career in health care as a registered nurse, nurse manager, president of the Nurses Association of New Brunswick, and UNB Faculty of Nursing educator. She also outlined the benefits of universal pharmacare in a series of social media posts. “Many Canadians with chronic health conditions end up in hospital because they can’t afford the medications that could keep them well,” she said. 
• Senators John McNairn, Rose-May Poirier, Jim Quinn, David Adams Richards and Pierrette Ringuette didn’t provide a comment by deadline. 

Robert MacKay contributed to this report. 

David Gordon Koch is a journalist with the NB Media Co-op. This reporting has been made possible in part by the Government of Canada, administered by the Canadian Association of Community Television Stations and Users (CACTUS). Full disclosure: The coordinating editor of the NB Media Co-op, Tracy Glynn, is National Director Operations and Projects for the Canadian Health Coalition, a group that campaigns for pharmacare.