Canadian Chamber Addresses Bill C-64, the Pharmacare Act, Before the Senate Standing Committee on Social Affairs, Science and Technology

On October 2, 2024, our Senior Vice President and General Manager of Quebec, Kathy Megyery, and Director of Policy and Government Relations, Liam MacDonald, appeared before the Senate Standing Committee on Social Affairs, Science and Technology to express our concerns with Bill C-64, the Pharmacare Act. 

The Canadian Chamber supports the goal of achieving universal prescription drug coverage in Canada, but a single-payer, public system is not the right way to get there. 

Only a small minority of Canadians currently lack access to prescription drug coverage. It would be far more pragmatic and fiscally responsible to target a plan at those who need it, as the government did with dental care, instead of completely overhauling a system that is largely well functioning. 

The Minister of Health has stated that Canadians will not lose their existing coverage under the federal plan. However, this is not reflected in the language of the bill. We hope that the bill will be amended to address this critical lack of clarity and ensure that 27 million Canadians with existing workplace drug insurance benefits do not lose their coverage.  

The full remarks and session recording can be accessed below.

Ms. Chair and honorable senators, on behalf of the Canadian Chamber of Commerce, we thank you for this invitation to discuss Bill C-64. Why is this bill important for the Chamber of Commerce and its 220,000 members from businesses of all sectors and sizes across Canada?

It is common for businesses to provide their employees with a benefits package. While these employer-sponsored benefits plans are not mandatory, about 80% of businesses offer a benefits package to attract and retain employees.

Thus, benefits programs, including drug coverage, are not only essential for attracting talent. They also represent a significant investment in the health and productivity of employees. Absenteeism or poor performance due to health issues is a major concern for employers and has a negative impact on the competitiveness of businesses.

With that preamble, allow us to share some comments and concerns.

First, the chamber firmly believes that all Canadians should have equitable access to prescription drug coverage. To best understand what is required to achieve this, let us begin by scoping the problem. The Conference Board of Canada found that 97% of the population is eligible for prescription drug coverage. The number of people not eligible for a public plan and not enrolled in a private plan is under one million people.

Further, 3.8 million Canadians are eligible, but not enrolled in a private or public plan, as a result of lack of awareness of the programs or unaffordable out-of-pocket costs. That is the problem we need to solve in order to ensure that Canadians who are not insured or not properly insured have access to the medications they need with a pragmatic and fiscally responsible solution.

A universal single-payer system is neither.

Let’s look at the cost. For the first phase to cover contraceptives and diabetes medication and devices, the Parliamentary Budget Officer, or PBO, set the cost at $5.7 billion over five years. The PBO assumes that workplace benefit plan coverage would not be impacted by Bill C-64. That is not what the bill states. If that were the case, the cost of Bill C-64 would be offset dramatically, but still rising to almost $1.9 billion over five years. This brings us to the issue of pragmatism. There is no need to completely undo a system that provides a majority of Canadians with the coverage they need and appreciate. A single-payer, universal pharmacare would actually leave most Canadians worse off. Currently, the majority of Canadians are covered through their employers. These Canadians have access to medicines in half the time as those on public plans and to three times more new innovative drugs approved by Health Canada.

In 2023, Ottawa announced the Canadian Dental Care Plan, stating that the plan is not intended to replace existing dental benefits offered through employer-sponsored programs but rather to fill existing gaps in coverage.

The Minister of Health, Mark Holland, has stated that the federal pharmacare program would not jeopardize Canadians’ private coverage, but the bill repeatedly references a national, universal, single-payer system.

This bill should be amended to ensure pharmacare targets those Canadians who do not have the coverage they require, just as the government did with the Canadian Dental Care Plan. Such a targeted model would be more pragmatic, financially sustainable and better respect provincial and territorial jurisdiction.

Thank you.