Countdown to a pharmaplan

Feb 28, 2024

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By Kyle Duggan

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In today's edition:

→ You can switch to counting in hours until Ottawa reveals its pharmacare plan. ERIC HOSKINS chimes in on provinces already bristling over it.

→ Health policy experts tell us what to watch for when the legislation drops.

→ Senators want to know: Is the DST going to become a “C-18 2.0?”

DRIVING THE DAY

PHARMACARE BILL APPROACHETH — It will be the second landmark legislation the federal Liberals reveal this week where the devil is entirely in the details.

This one could fundamentally alter the relationship the Liberals have with the NDP. And maybe it will even change how the NDP gets along with some of its sister provincial parties.

The Liberal government is poised to unveil pharmacare legislation worked out with the NDP by end of the week, although there’s still mystery surrounding the exact timing.

All eyes are on the Friday deadline set by the NDP, and according to Health Minister MARK HOLLAND, “if you work backwards from March 1st, there's not a lot of geography.”

“We're going to meet the timeline,” he told reporters Tuesday.

— Tight on messaging: One thing was made clear Tuesday about pharmacare. It’s not what the federal Liberals wanted to spend their day talking about. Tricky, since everyone else is lining up at the mics.

— Score so far: First, the NDP ruined some weekends when NDP Leader JAGMEET SINGH scooped the government on news of a deal last week and dished on diabetes and birth control being covered.

Then Alberta Health Minister ADRIANA LAGRANGE got out ahead of the government Monday, stating preference for a per-capita share of the program funds and raising ire.

Peppered with questions, Holland told reporters “some people are jumping the gun” and reacting prematurely since the government hasn’t unveiled the details yet.

“Everybody just needs to take a pause,” he said, noting he had “emphasized” during the negotiations that leaks like these only create confusion.

That said, he hasn’t “met a province where they don't want to take action on improving access to drugs and reducing prices.”

Finance Minister CHRYSTIA FREELAND sidestepped a reporter’s question on whether the program will affect the budget numbers this year or next.

“We have some great announcements that we’ve made this morning. None of them are about pharmacare,” she replied.

— Voice of optimism: Former Ontario health minister ERIC HOSKINS, who led a federal advisory council on pharmacare that pitched a single-payer public model in 2019, has provided advice over the past several months to those involved in the negotiating and hammering out the legislation.

“It's pretty monumental,” he tells Playbook. “In terms of prescription medicines, it's the biggest advancement in the direction of improving access to prescription medicines since Medicare itself.”

Hoskins was among the first to call for extending the January deadline set by the Liberals and NDP, after seeing the “tremendous amount of effort expended by both sides.”

Hoskins was careful not to spill any beans, but said he’s not worried about thundering from two provinces — Quebec and Alberta — seeking to opt out already.

“I think there'll be momentum, particularly as the first provinces and territories enroll or reach agreement with the federal government.”

His report had suggested it be a voluntary, opt-in program.

“We reflected on how Medicare evolved in Canada when it was first passed and began to be implemented. I think Saskatchewan was the first province. There were a few at the beginning, but it took five or six years before all provinces and territories actually signed on to Medicare. It didn't happen overnight.”

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HALLWAY CONVERSATION

9 THINGS TO WATCH — Playbook asked three experts what they’ll be watching when the pharmacare legislation is revealed:

— The key question: UBC health policy professor STEVE MORGAN, who has spent the past three decades studying the issue, said there's a “glimmer of optimism” it will be a public program rather than something like Quebec’s system or Medicare Part D in the U.S.

“There's reasons to be both optimistic and pessimistic and that's why, really, we have to wait.”

He’s watching for:

→ Whether Ottawa tries to lowball on funding and asks provinces to pay a portion of the programs that qualify early on — which could mean they won’t join — or if it offers to pay the entirety of the first stage of the formulary. “That kind of financial carrot would permit any but the most recalcitrant of premiers from opposing that program because essentially it's free drugs for their residents, and potentially hundreds of millions of dollars per province.”

— The 4-D political chess: PATRICK FAFARD, public and international affairs professor at University of Ottawa, said he expects provincial-federal fireworks, but that’s predictable drama.

“Anyone who says that the government of Canada does not have the constitutional authority to do this is making an almost purely political point.”

He’s watching:

→ Will it be widely accepted or something everyone loves to hate based on fiscal constraints and limited coverage? “It's one of those things where you get caught in the middle and you get shot at from all sides,” he said. “It depends on what they announce.”

“What we risk getting is a compromise built on top of a series of concessions, the product of some partisan games, filtered through a communication strategy, and compressed and constrained by the Department of Finance.”

→ Where does the public thinking on pharmacare sit after the pandemic changed the world and health-care systems? One poll has suggested it’s not a top priority.

— Looking down the road: KATHERINE BOOTHE, an associate professor of political science at McMaster University, pointed to a few things that might not all be immediately clear.

She’s watching:

→ What kind of barriers people might face accessing medicine — “quite important because that has a big impact on whether people who are eligible are actually able to benefit.”

→ Whether coverage for contraceptives and diabetes medications will be first dollar or insurance of last resort.

→ Details behind the choice of direction for the formulary.

→ Public confidence in the federal government's ability to roll it out.

2024 WATCH

A voter fills out her ballot for the Michigan primary election in Grosse Pointe Farms on Feb. 27, 2024.

A voter fills out her ballot for the Michigan primary election in Grosse Pointe Farms on Feb. 27, 2024. | Paul Sancya/AP

ABOUT LAST NIGHT — Some notes from Tuesday evening:

— JOE BIDEN won the Michigan Democratic primary decisively — but not by enough to calm Democratic angst.

— DONALD TRUMP marched to victory in Michigan Republican primary, though with a familiar note of caution.

Where the leaders are

— Prime Minister JUSTIN TRUDEAU will attend the Liberal caucus meeting at 10 a.m. At 2 p.m., he’ll attend QP.

— Bloc Québécois Leader YVES-FRANÇOIS BLANCHET holds an 11:30 a.m. media briefing in Wellington Building on the Bloc’s budget expectations.

— NDP Leader JAGMEET SINGH attends the NDP caucus meeting at 9:30 a.m.

— Green Party Leader ELIZABETH MAY will hold her weekly caucus meeting at 11 a.m.

A message from Universities Canada:

DULY NOTED

9 a.m. The Parliamentary Budget Officer will release a new report: “Planned Capital Spending under Canada’s Defence Policy: 2024 Update.”

ALSO FOR YOUR RADAR

Canada's Deputy Prime Minister Chrystia Freeland, left, and Canadian Defence Minister Bill Blair talk to the media during a joint exercise in which Polish and Canadian troops provide training to soldiers from Ukraine near Jezewo, central Poland, on Sunday, Feb. 25, 2024. (AP Photo/Czarek Sokolowski)

Deputy Prime Minister Chrystia Freeland and Defense Minister Bill Blair in Poland on Sunday. | AP

NOTED ON THE HILL — The assets of the Russian Central Bank are a Canadian preoccupation, Deputy Prime Minister CHRYSTIA FREELAND said Tuesday. “We have been centrally involved in the work being done to take the next step and confiscate those assets,” she said during a press briefing. “I have been working closely with [U.S. Treasury] Secretary Yellen. She and I agree 100 percent.”

— Related reading from POLITICO: The West tried to crush Russia’s economy. Why hasn’t it worked?

— This week, the Canadian government plans to issue its second green bond “subject to market conditions.” Freeland says with the issuance Canada will become the first country to include nuclear expenditures in a green bond. Canada issued its first C$5 million, 7.5-year green bond in March 2022. International buyers accounted for 45 percent of investors, according to Finance Canada.

— Elsewhere on the Hill: Conservatives voted in favor of a Liberal government bill banning replacement workers.

— Meanwhile in the Senate: Senators flagged fears that Canada’s pursuit of a digital services tax could lead U.S. tech giants to reduce services to Canadians.

The Biden administration says the tax discriminates against U.S. companies. Ottawa insists it targets big Canadian and foreign companies that collect and sell user data.

Tuesday at the Senate national finance committee, finance department officials fielded questions about the potential impacts of the DST.

“Are we heading to a C-18 2.0?” asked Sen. CLÉMENT GIGNAC, referencing Facebook’s decision to ban news content for Canadian users in retaliation to the Online News Act. Gignac asked if Netflix might stop providing services if asked to pay the DST retroactively.

JAMES GREENE, a senior Finance Canada tax policy branch official, said companies could respond by passing costs to consumers. “Market competition, obviously, will play some limits on their ability to do that,” he said.

MEDIA ROOM

— The "Curse of Politics" opens with the latest polling from Abacus Data. “I honest to god don’t see a way back,” host DAVID HERLE said of Liberal prospects. “I don’t.”

— The Canadian Press headline this morning on the latest Leger tracking poll: "Support for Conservatives, PIERRE POILIEVRE is growing."

— AMANDA STEPHENSON of CP reports that the company building the Trans Mountain pipeline expansion now estimates costs will come in 10 per cent higher than its May 2023 estimate of C$30.9 billion.

— ELIZABETH THOMPSON of CBC News notes that the government is running out of time to name a new ethics commissioner.

— “Measles is just the canary in the coal mine,” ANDRÉ PICARD writes in the Globe. “When it comes roaring back — and at this rate, it almost seems inevitable — we will see a resurgence of other conditions like whooping cough, chickenpox, mumps and other old-world diseases we have controlled effectively with vaccination.”

— PETER DONOLO, LOUISE BLAIS and JEREMY KINSMAN have launched the "Red Passport Podcast."

— ERICA IFILL of The Hill Times writes of the Online Harms Act: "Guess what? I don’t hate it."

— Finally, this morning: MAX TANI of Semafor chronicles the transformation of a forty-something Californian blogger into a conservative influencer on the rise, a curiosity tale for these times.

PROZONE

Our latest policy newsletter for Pro subscribers from ZI-ANN LUM and SUE ALLAN: Canada’s next tech battle.

In other news for Pro readers:

— WTO head puts pressure on reaching an MC13 deal.

— Colorado asks the FDA again to approve its Canadian drug import plan.

— Tech giants refuse to work with Britain’s top secret military censorship board.

— EU nature law survives conservative backlash.

— Energy industry groups petition DOE to reverse LNG freeze.

Playbookers

Birthdays: HADRIEN TRUDEAU is 10 today! Alberta NDP MLA ROD LOYOLA hits the big 5-0. HBD also to Liberal MP FRANCESCO SORBARA, CARSON JEREMA of the National Post, Sen. DAVID WELLS and retired senator LARRY CAMPBELL.

Birthdays, gatherings, social notices for this community: Send them our way.

Spotted: Canada’s Ambassador to Russia SARAH TAYLOR commemorating the ninth anniversary of the death of opposition politician BORIS NEMTSOV … Canada’s Ambassador to the EU AILISH CAMPBELL meeting with Greece’s EU rep IOANNIS VRAILAS.

Sen. SCOTT TANNAS, welcoming MANUELLE OUDAR to the Senate with five pieces of advice. ... Sen. WANDA THOMAS BERNARD, recognizing Lincoln Alexander Day, “albeit a little late.”

Agriculture Minister LAWRENCE MACAULAY using a lob ball from MP KODY BLOIS to pay tribute to Atlantic lobster. “I always promote Canadian products overseas,” he told the House.

Movers and shakers: U.S. President JOE BIDEN’s campaign has elevated ALANA MOUNCE to serve as its political director. ROOHI RUSTUM will serve as national organizing director and MEREDITH HORTON will be the national director for voter protection and access. Details here. … DONALD TRUMP’s daughter-in-law LARA TRUMP officially kicked off her campaign to be Republican National Committee co-chair on Tuesday.

Media mentions: Today is the final day for journalists who wish to sign up for the latest round of CAJ mentorships.

Farewells: MP SHELBY KRAMP-NEUMAN paid tribute to her dad in the House on Tuesday. “My dad loved this place,” she said of the former MP and MPP. “With an infectious optimism and innate ability to lift others up, DARYL KRAMP raised the bar for everyone around him.”

Send Playbookers tips to ottawaplaybook@politico.com .

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Projects like CubeSat NB are driving innovation in Canada. Investing in Canadian research is crucial to supporting them. Learn more now.

ON THE HILL

— It’s caucus day on the Hill.

4:15 p.m. The Senate banking committee will continue its look at Bill C-34.

4:15 p.m. The president of the Canada-Ukraine Chamber of Commerce will be at the Senate foreign affairs and international trade committee to take questions on the Canada-Ukraine free-trade agreement.

4:15 p.m. The Senate social affairs committee will meet to take Sen. LUCIE MONCION’s Bill S-252 through clause-by-clause consideration.

4:30 p.m. The House government operations and estimates committee will continue its study of ArriveCAN.

4:30 p.m. Rogers Communications wireless president PHIL HARTLING and Telus chief financial officer DOUG FRENCH will be at the House industry committee’s study on the accessibility and affordability of wireless and broadband services in Canada.

4:30 p.m. Minister MARC MILLER will be at the House standing committee on immigration to brief MPs on updates to international student policy.

4:30 p.m. The House veterans affairs committee will continue its study on veterans’ transition to civilian life.

4:30 p.m. Correctional Investigator IVAN ZINGER will be at the House Indigenous and northern affairs committee where MPs are studying his office’s 50th annual report.

6:45 p.m. Victoria Mayor MARYANN ALTO will beam into the Senate national finance committee where senators are studying Sen. KIM PATE’s Senate public bill that seeks to develop a national framework for a guaranteed basic income.

6:45 p.m. Crown-Indigenous Relations and Northern Affairs Canada Deputy Minister VALERIE GIDEON will be at the Senate Indigenous peoples committee where senators are studying the implementation of the United Nations Declaration on the Rights of Indigenous Peoples Act.

6:45 p.m. The Senate transport and communications committee will meet to continue its study on the impacts of climate change on critical infrastructure.

Behind closed doors: The Senate ethics committee will meet to discuss a case of privilege.

TRIVIA

Canada’s Parliamentary Caucus is in Washington this week to meet the influential Congressional Black Caucus.

Canada’s Parliamentary Black Caucus traveled to Washington to meet the influential Congressional Black Caucus. | Courtesy Sen. Rosemary Moodie

Tuesday’s answer: The Congressional Black Caucus took selfies with a Canadian ten spot after its first meeting with Canada’s Parliamentary Black Caucus.

Speaker GREG FERGUS wrote to Playbook: “The CBC members took a picture with a ‘Desmond,’ Canada's 10-dollar bill that features the image of the late VIOLA DESMOND, an African-Nova Scotian business woman. … I lent our American friends this banknote as they continue their long-standing efforts to put HARRIET TUBMAN on a U.S. banknote.”

Props to ROBERT MCDOUGALL.

Wednesday’s question: What city in Canada was first to proclaim Black History Month?

Answers to ottawaplaybook@politico.com

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