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Bill C-64 now at third reading in the Senate

Per CBC, the federal pharmacare bill made it through committee study in the Senate this past week and is scheduled for a final vote on October 10. No further amendments were made to the bill, in large part for the political reason that it would then have to return to the House of Commons, which is a shitshow, for further study. The Senate is once again in the position of having to pass legislation it and experts see problems with because the Government left things to the last minute and did a half-assed job besides.

I don’t understand what the Senate’s observation on the bill is meant to accomplish, but the CBC article explains a bit about the Minister expressing ambivalence when he appeared in the Senate:

During a Sept. 18 hearing of the Senate committee, Holland said he was “ambivalent” about how pharmacare would be administered. He later clarified his position by calling for universal, single-payer coverage in a letter to committee chair Sen. Ratna Omidvar on Sept. 27.

“This standard of coverage means that all residents of a participating province or territory will be eligible to receive free access, without co-pay or deductible, to a range of contraception and diabetes medications. Under this program, the cost of these medications will be paid for and administered through the public plan, rather than through a mix of public and private payers,” Holland said in the letter.

Apparently parliamentarians and journalists found this clarification reassuring, perhaps assuming a principle of statutory interpretation that a letter from a Minister has more weight than the text of the actual law. But here is the text of the actual law (s. 6(1)):

The Minister must, if the Minister has entered into an agreement with a province or territory to do so, make payments to the province or territory in order to increase any existing public pharmacare coverage — and to provide universal, single-payer, first-dollar coverage — for specific prescription drugs and related products intended for contraception or the treatment of diabetes.

I don’t understand where the Minister got ambivalence out of that.

Was he unaware of the text of this quite short bill when he, as Minister, went to present and defend it in the Senate, all the while haranguing senators not to amend it because “every word was carefully debated and argued over“?

Or is there legal ambiguity to the terms “universal, single-payer, first-dollar coverage” that his government didn’t bother to address through definitions?

Both explanations seem quite bad from a rule of law perspective.

But, there is already one pharmacare agreement signed!

Something I hadn’t considered in my projections of when Canadians might actually benefit was the possibility of bilateral pharmacare agreements being signed before the legislation came into force.

Presumably the BC-Can pharmacare agreement is signed contingent on Bill C-64 becoming law, since the only other explanation I see is that the Minister already had the authority to enter into these agreements, from some other source. That would certainly call into question why the Liberals didn’t enter agreements earlier and what the non-hype point of this legislation would be.

So let’s assume it’s properly contingent. Akin, perhaps, to regulations that get drafted early so they can be ready once whatever enables them becomes official. Expeditious! Except even if the bill becomes law next week, apparently BC won’t get anything until next fiscal year anyway. So there wasn’t anything earmarked for pharmacare in this year’s budget after all? I don’t think Mark Holland is very good at his job.

A neat thing worth highlighting in this agreement is that, since BC already covers oral contraceptives, again per CBC, the province negotiated “to make something else free at point-of-purchase, free for British Columbia women”: free post-menopause hormone therapy. That’s cool, although “free hormone therapy for anyone who needs it” would have been cooler.